developments of the endorsement 2700 communities across the country.
San Antonio's program is based on the Memphis Model that originated in
Memphis, TN and is now in some 2700 communities across the US. You can
find a wealth of information, an interactive map, and articles on the
Memphis Model Crisis Intervention Team (CIT) at:
http://cit.memphis.edu/ *Kaiser Health News* includes an article: "San Antonio Police Have
Radical Approach To Mental Illness: Treat It" by Jenny Gold.
Here are some excerpts:
[begin excerpts]
It's almost 4 p.m., and Officers Ernest Stevens and Ned Bandoske have
been driving around town in their black unmarked SUV since early this
morning.
The officers are part of San Antonio's mental health squad - a
six-person unit that answers the frequent emergency calls where mental
illness may be an issue.
The officers spot a call for help on their laptop from a group home
across town.
"A male individual put a blanket on fire this morning, he's arguing with
them, and is a danger to himself and others, he's off his medications,"
Stevens reads from the blotter.
A few minutes later, the SUV pulls up in front of the group home in a
run-down part of the city.
A thin 24-year-old sits on a wooden bench in a concrete lot out back,
wearing a black hoodie.
<snip>
"You're Mason?" asks Bandoske. "What happened to your blanket?"
Eight years ago, a person like Mason would have been heading to the
emergency room or jail next.
But the jail in Bexar County, Texas, where San Antonio is located, was
so overcrowded - largely with people with serious mental illnesses -
that the state was getting ready to levy fines.
To deal with the problem, San Antonio and Bexar County have completely
overhauled their mental health system into a program considered a model
for the rest of the nation.
Today, the jails are under capacity, and the city has saved $50 million
over the past five years.
The effort has focused on an idea called "smart justice" - basically,
diverting people with serious mental illness out of jail and into
treatment instead.
It is possible because all the players in the system that deal with
mental illness -- the police, the county jail, mental health department,
criminal courts, hospitals and homeless programs - pooled their
resources to take better care of people with mental illness.
<snip>
Across the country, jails hold 10 times as many people with serious
mental illnesses as state hospitals, according to a recent report from
The Treatment Advocacy Center, a national nonprofit that lobbies for
treatment options for people with mental illness.
<snip>
"We had absolutely no training 20 years ago in the police academy on how
to deal with mental health disturbances," recalls Stevens.
Back then, Bandoske adds, police responded to mental health emergencies
the way they would to any other call: They used the tough guy command
voice they're taught to handle criminals.
"Police are notorious for the A personality type. They walk into a
situation. They gain control of it. It's their call now. They're in
charge,"
he says.
And more often than not, the officers ended up taking people like Mason
with serious mental to jail.
"They would be arresting them for just minor misdemeanor offenses such
as trespassing or criminal mischief or just disturtype
calls,"
says Stevens.
The other option was to take the person to a hospital emergency room.
But in San Antonio, the police were waiting an average of 12 to 14 hours
in the hospital until the person could to be triaged; that often made
jail seem like a much more appealing option.
"You can book somebody in the jail in 20, 30, 45 minutes tops,
especially if you have a partner to help share the paperwork load, and
then you're back out on the streets," says Bandoske.
The police were arresting the same people over and over again; many not
only had a serious mental illness but were also addicted to drugs or
alcohol and were often homeless.
And whether they went to the jail or the ER, it was expensive for
everyone -- the jails, the hospitals and the police department that had
to pay for overtime while cops waited at the hospital.
And it meant that fewer police were available to work the streets.
San Antonio's response was to require all officers to take a 40-hour
course called Crisis Intervention Training,- to learn how to handle
mental health crises, like the one with Mason.
The course includes visits from families of people with mental illness,
who come in to tell their stories.
And while some officers, like Bandoske and Stevens, specialize in mental
health, all learn de-escalation techniques and how best to interact with
someone in a state of psychosis.
The effort to train police to handle mental health emergencies is
gaining steam across the country.
Fifteen percent of police departments nationwide offer the program.
But even with strong programs, there's only so much that training alone
can do; there's still the problem of where to take patients like Mason,
other than jail or an emergency department.
San Antonio tackled that problem, too.
"I'll be honest with you. When it first came out, I was very skeptical.
I thought, well this is ridiculous. If somebody's breaking the law, if
they're public intoxication, they should go to jail," says Bandoske.
People who commit a felony still go to jail, regair mental
status.
And those who need extensive medical care are still taken to the
hospital.
But for patients like Mason, San Antonio built another option: the
Restoration Center - a totally separate facility with a 16-bed psych
unit, a medical clinic and a "sobering room" where police can drop off
people who are intoxicated.
The Restoration Center was built with cops in mind to allow them to drop
off their charges as quickly as possible.
There's a work station for paperwork, free coffee and a nurse available
to provide medical clearance for people who are arrested, even those
without a mental illness, to save the police a trip to the ER whenever
possible.
The center is saving the police department at least $600,000 a year in
overtime pay.
[end excerpts]