Baltimore County beefs up non-police resources to respond to mental health emergencies

Baltimore County announced this week an expansion of emergency behavioral health services to support residents experiencing crises.

The county announced a 50-percent expansion during peak hours of its mobile crisis teams, which are made up of health professionals and specially trained police officers to respond to emergency calls.

The county will also create a 9-1-1 Call Center Clinician Program, in collaboration with the Baltimore County Department of Health and Human Services. Mental health clinicians will screen calls from residents and divert mental health or substance abuse related calls to appropriate behavioral health support.

“Our goal is to provide innovative services that are both patient-focused and patient-friendly,” said Dr. Gregory Wm. Branch, Baltimore County’s Health Officer, in a news release.

The expansion comes as pandemic-related stress continues to grow, and as local governments across the country are re-thinking the appropriate response to calls for assistance. Many believe that police should not be first-responders to someone undergoing a mental health crisis.

According to a database of fatal shootings by police officers maintained by The Washington Post since 2015, nearly a quarter of all people killed by police officers in the United States have had a known mental illness.

In Maryland, nearly 40 percent of the 109 people killed by police between 2010 and 2014 presented in a way that suggested a mental health or substance abuse issue, according to a study released by the ACLU of Maryland in 2015.

Last July, the shooting of a man undergoing a behavioral health crisis in Baltimore raised questions regarding the effectiveness of the city’s crisis response system.

There was no indication that police dispatchers responding to the July 1 incident attempted to connect officers with behavioral health resources before the officers responded to the situation. The police department’s own crisis team was off-duty at the time.

While officers attempted to calm the situation before shooting the man, Ricky Walker Jr., no one with mental health training was involved.

As the COVID-19 pandemic enters its second year, the economic stresses, barriers to social interaction, and collective grief continue to have a marked effect on people’s mental health.

In December, more than 42 percent of people surveyed by the US Census Bureau reported symptoms of anxiety or depression, an increase from 11 percent the previous year.

The growth in behavioral and mental health issues has highlighted the need for police departments to reevaluate their crisis response systems.

The Baltimore County Police Department currently employs the mobile crisis team model, in which a licensed mental health clinician and specially-trained police officer respond to behavioral health related calls.

“Teaming licensed mental health clinicians with specially-trained police officers supports that public-health-focused approach to behavioral health issues,” said Branch, the health department head.

The widely-used model for responding to mental health and substance abuse crisis calls, crisis intervention teams (CITs), was pioneered by the Memphis Police Department in 1987. The model, known as the “Memphis Model,” spread to almost 3,000 law enforcement agencies in the country.

While the CIT model is intended to keep both officers and residents safe and send fewer people to jail, many have called its effectiveness into question. They argue that the program is not correctly applied and integrated into police departments.

Some advocates of police reform are pushing for the complete removal of police in responding to mental and substance abuse issue related incidents. In this model, a non-law enforcement crisis response team manages the incident with no police involvement unless absolutely necessary.

At present, this model is rare.

One of the few cities to implement this system is Eugene, Oregon. An organization called White Bird Clinic developed the program, CAHOOTS (Crisis Assistance Helping Out On The Streets), three decades ago.

The CAHOOTS model involves a two-person team, consisting of a medic and a crisis worker with substantial mental health training, responding to a crisis situation.

So far, the system has proven effective in de-escalating crisis situations and limiting police involvement. Last year, police backup was requested only 150 times out of roughly 24,000 CAHOOTS calls.

Programs like CAHOOTS have been in the spotlight over the past year, as the topic of police reform became a national debate following the killing of George Floyd last year. Questions regarding police accountability remain top of mind at the trial of Derek Chauvin is currently underway.

The recent expansion of Baltimore’s crisis response system indicates a potential shift in the county’s approach to policing.

“Behavioral health issues present challenges to law enforcement that we cannot successfully mitigate alone,” Baltimore County Police Chief Melissa Hyatt said in a statement.

“It takes collaboration with our valuable partners to divert individuals to the proper resources. Under this new initiative, we will have the opportunity to get more resources to the individuals who need them most,” she said.