After the Webinar: Crisis Intervention Models in Small and Rural Agencies. Q&A with the Presenters

Webinar presenters Melissa Reuland, Rob Davis, and Jennifer Zeunik answered a number of your questions after their presentation, Crisis Intervention Models in Small and Rural Agencies. Here are just a few of their responses.

 

Audience Question: Can you talk a little bit more about what the lieutenant ended up experiencing and what interventions was he able to implement? 

Melissa Reuland: Yes. Again, thank you for that question. Working with the rap, and it’s multi-layered, as you saw. And what the lieutenant ended up working out was, you mentioned to the recovery coaches sort of a little bit as an aside, but the recovery coaches ended up being very critical to what the department is trying to connect people to. And these are folks who are hired by the public health department, they’re paid professional-level salaries. They are people with lived experience, substance use addiction, mental health concerns, and some of them have had interactions with the criminal justice system. And these coaches, what lieutenant does is go and talk with the person and say, “Hey, this seems to be something you might want to talk to somebody about.” And something like 80% of the cases that the person agrees to speak with one of the recovery coaches. And then the Recovery coach, you know, starts putting together that relationship, begins meeting the person, talking with them by phone has been the case during COVID, and then they keep in touch with the person over time. And develop that relationship, and provide that peer support to keep, you know, to help the person access treatment, when and where that person might be able to do.

 

Audience Question: Are your survey instrument and the results publicly available anywhere? 

Rob Davis: We’re hoping. As I said, it was done with funding from Arnold Ventures, and we are working with ————- now to try to work through some comments I had on the final report. I expected it will be through that within the next couple of weeks. And we’d be happy to send copies out if people would get in touch with me

 

Audience Question: When collaboratively discussing those with repeat clients, does each agency require a release? 

Melissa Reuland: I am not sure that I know the answer to that question. Actually, Rob, are you familiar enough with the data from the case studies?

Rob Davis: No, I don’t think we’ve found anything like that in case studies.

Melissa Reuland: Yeah, I don’t think a written release is used in winter, or if it is I wasn’t I didn’t hear about it, but it is certainly verbal consent to be contacted.

 

Audience Question: Did you run into any agencies that have the ability to make online referrals to mental health providers directly from their patrol vehicles, not as a crisis response, but as a referral medium? Douglas goes on to explain we have a system like that in the Rural Adirondack Mountains in New York. Is this something you see elsewhere? 

Rob Davis: No, we did not. I love the idea. I think that’s a fantastic idea. And it’s something that agencies could explore. But we did not run across anyone in the survey in the 380, or so responses that we got.

 

Audience Question: Were the agencies that you did the case studies with a mix of sheriff’s departments and police departments who are primarily police? 

Rob Davis: We had one sheriff’s department and seven police departments.

 

Audience Question: What is the definition for regional versus in-house CIT? 

Melissa Reuland: Sure. So, an in-house CIT program would be one where the agency itself was training its officers. The agency itself was managing collaborative relationships with its behavioral health and other partners. And a regional program is where, five to six on average, agencies come together and form a larger collaborative, right. And through that collaborative, arrangements are made. Perhaps we can imagine, let’s say there’s a countywide behavioral health provider, and agencies within that county to come together to work with the behavioral health provider on maybe fielding a team, for example. And then talking about the different kinds of access each of the agencies could have to either a team that is going out into the field, or some sort of resource that’s available by phone.

 

Audience Question: Do evaluators require callers to be homicidal or suicidal with a plan in order to be admitted? Even if law enforcement completes a petition, they’re not being honored. Do you know, is this policy common within other agencies?

Melissa Reuland: So, the question that you’re raising Olivia is complicated. Because the laws that govern what kind of role law enforcement officers have in determining that someone meets the criteria for emergency custody are different in every state. And so, in some states, oddly, police officers are the only people that can make the determination that someone meets the criteria and can be admitted to the hospital. In other more thoughtful states, those determinations can be made in addition by behavioral health, mental health professionals. So, sometimes, we definitely do hear that when law enforcement officers bring someone to the hospital to be evaluated, there is doubt about their ability to make those assessments, however, and that they’re not wrong. I think sometimes law enforcement officers are really out of their element when they’re asked to make these assessments. So, it is I think in everyone’s best interest if that kind of determination is made by the mental health or behavioral health professional in consultation with what the law enforcement officer saw in the field. And what can happen is when someone gets to the hospital, their behavior can change pretty dramatically from the way it was when the officers saw in the field, which further complicates things. I hope I answered your question.

 

Audience Question: Is there a resource or a website you can recommend, that provides statistical information about law enforcement interactions with people in crisis? 

Melissa Reuland: If only there was. I just finished a lit review that was exactly what I wanted was a resource like that. I can say that, and, I think, you know, Jen Zeunik might be able to reflect on this, that the council of state governments, the team there that’s working, you know, it works pretty comprehensively and understanding the national landscape generally is still available to respond to that.

Jen Zeunik: Yeah, I’m here. And I kind of agree with you, Melissa with regard to, I wish. And I do think what’s happening is that there are the JAMHCP as well as organizations that have received grant funding from BJA have begun to sort of assess the types of models that are being developed across the nation. But with regard to the statistics of how many crisis calls or mental health calls are being taken, I don’t know of reputable national sources. Some agencies do have their calls for service data available. I think the challenge there is sort of comparing apples to apples. Agencies code their mental health calls differently, and as everybody who’s working in law enforcement knows, oftentimes, a call comes in, it’s coded one way, it doesn’t end up being what it’s originally coded for. And it’s changed as the officer responds. So, there are some challenges with kind of making a statistical determination. And I think it’s different from agency to agency, I don’t know a national scope. I do know there was an article, I believe in the New York Times that Cynthia Lum.

Melissa Reuland: I was going to reference that too. Cynthia Lum’s article and then the Times was Ben Horowitz and Jeff Asher.

Jen Zeunik: Yeah. So, they have some, I know Cynthia Lum had, and Melissa help me out on this one, she had statistics on mental health calls from a number of agencies. It wasn’t a national survey a representative sample. But I know that there were, you know, she looked at several agencies, and I don’t know about the other one you referenced, Melissa.

Melissa Reuland: So, if you want to, you could probably Google Jeff Asher and New York Times to get that piece by Jeff. And then Cynthia Lum wrote a piece, and she did a lot of really deep exploration into nine agencies. And she found that the percentage of calls that they could determine based on ag data were related to behavioral health to which an officer was dispatched is 1.3%. Which everybody on the call is going, wait, that sounds awfully low. So, obviously, all the caveats that Jen mentioned are absolutely true. And so, I know there’s a study that’s going to be coming out soon so keep your eye. You know. Do a Google Scholar search or like alert thing, like, for, you know, mental health crisis calls, or police or something, and things will be coming up. I also do want to mention that I am working also on a project called Transform 911 and we do maintain a map of different initiatives across the country. And we do have some literature that we’re that I’m referencing is on our hub. So that’s Transform911.org

 

Audience Question: Do you have any examples or sample MOUs between agency and emergency rooms regarding drop-off procedures? 

Rob Davis: This is Rob. No. We didn’t collect that on the research project, and I don’t know if you haven’t.

Melissa Reuland: I actually do, believe it or not, if whoever said that question will reach out to me, it’s from a large agency. So, it will definitely need to be adapted to fit, obviously, any, the jurisdiction and the agency that’s smaller and maybe doesn’t have as many officers, but I do have, I do have an example that I can make sure, the agency is okay with me sharing, and I’m happy to share it.

 

Click Here to Watch a Recording of Crisis Intervention Models in Small and Rural Agencies.

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