Wednesday, September 11, 2019

Austin funds alternatives to police for mental-health first response

The Austin City Council yesterday approved $1.75 million in its next budget to create a new system for responding to 911 calls involving potential suicides and other mental-health-related scenarios, thanks to a measure promoted by Just Liberty and the Austin Justice Coalition.

The money would pay for 6.5 new positions to put mental-health clinicians on the front lines of 911 calls related to mental health crises along with seven new Community Health Paramedics at EMS.

As a result, according to a "policy direction" memo accompanying the funding, "The Council expects more calls to be appropriately directed to EMS and fewer to APD based on a better clinical triage in the 911 center." In some cases, that will mean mental health clinicians communicating with folks by video-call; in others, clinicians will will show up in person. And instead of uniformed police doing followup visits to the homes of the mentally ill to check on their medical progress (yes, that is what Austin has been doing,) trained Community Health Paramedics will do followup visits to help people address their needs.

In 2018, according to a report from the Meadows Foundation, Austin PD responded to 11,124 mental-health-related calls, most of which should now get clinicians and/or EMS personnel responding instead. This will reduce unnecessary incarceration, involuntary hospitalization and use-of-force incidents - a huge boon to the thousands of sick people involved. Giving a health care call a health response will also free up police officer time.

Austin's reform has been a long time coming. An audit released last year found Austin police shoot people on mental health calls more than in other large US cities. (Indeed, Austin's most recent high profile police shooting involved someone in mental health crisis.) And letters written by the now-disbanded Civilian Oversight Panel revealed its frustration at harmful police policies with respect to mental-health calls.

After two, full years of discussion and debate, advocates came to the city council this budget cycle with a well-developed proposal, passionate testimony from people harmed by the city's 911 system, and support from a wide range of groups. That convinced the Mayor to promise earlier this summer that needed funding would be included in the budget. Yesterday, the Council voted to include all the requested funds.

Protocols have yet to be developed, much less implemented, so it's too early to say for sure, but advocates and the City Council believe this measure should result in police responding to thousands fewer calls. When Dallas initiated reforms to its system for responding to mental health calls, the city saw, in first seven months, teams "addressed 709 mental health calls with only 21 cases (3%) ending in an arrest." If Austin can achieve such rates in a citywide program, that would amount to a sea change.

The city council included a list of performance measures and reporting requirements along with the funding, so we should have data coming out beginning next year to tell us whether we are meeting a health care emergency with a health care response.


Anonymous said...

Maybe I'm not reading this correctly. What I got out of it was 6.5 positions will cost $1.75M. That's a nice salary for 6.5 people.....or maybe I'm just misinterpreting this.

Anonymous said...

Plus 7 EMT's

Gritsforbreakfast said...

Right, 13.5 positions overall. I believe there is also some non-salary expense in there as well.


Scott! the threats to liberty are advancing. Our EMS in Montgomery COunty now has a Tactical Unit.

Anonymous said...

If the 6.5 workers will address even a small portion of the 11,124 mental-health-related calls, even the kind of cherry picked, low danger calls one would expect them to like Dallas' crew did, they will be well worth the cost. I hope they expand the program rapidly when initial successes come in, after all, that few in numbers spread out over 3 shifts and 7 days is not going to lack for business.

Anonymous said...

EMS personnel, in general, are not peace officers. The right to perform emergency mental health detentions is reserved for peace officers. This statute became necessary as part of the 1993 reforms in the wake of massive private psychiatric hospital fraud. One of the most egregious examples was Sector One security in San Antonio.

At that time, the local mental health system allowed these non-peace officers to fill out official looking emergency detention forms and then detain people. Two private security guards showed up at the home of Jeramy Harrell, in an official looking car, uniforms and handcuffs. Jeramy was detained and held for days based on a warrantless detention order from a psychiatrist he'd never met.

Many of these types of detentions are currently going to private, for-profit, psychiatric hospitals, and will be billed for services they often didn't want. Once in the hospital, they will be held for days before seeing a judge.