Mental health calls, some deadly, a growing challenge for Austin cops
Austin American-Statesman - 7/6/2018
July 06--At first, Austin police officer Randy Hunt thought the woman he saw in the parking lots under Interstate 35 near Seventh Street downtown was trying to break into cars.
But as he approached her that morning of June 12, he realized she was wearing essentially a see-though dress torn enough to expose part of her breast and much of the rest of her body.
"It turns out she was fixated on her reflection in the car windows," Hunt said. "She had schizophrenia."
Hunt said that in his opinion, she was a victim waiting to happen, either of a rape, or some of type of crime.
"She was having very strong delusions and hallucinations," Hunt said.
Hunt got on the phone to find mental health care providers that could take her in, but he also needed another officer to place her in handcuffs.
As the woman was cuffed, she screamed and cried, shouting "I refuse" over and over again, and saying she was sorry.
Several passers-by stopped as the woman wailed, drivers rolled down their windows and gawked. Though jarring, Hunt said the detention was necessary to protect the woman.
Hunt's response during the mental health call comes from specialized training, which is more the exception than the rule. Police, community leaders and mental health advocates agree that most patrol officers aren't always the best suited to treat the nation's mentally ill, despite often being the first ones responding to those in crisis.
Austin police are responding to an increasing number of mental health calls that send people to treatment units or jail, detaining or jailing people more than 5,000 times last year alone.
The department's partnership with Integral Care is supposed to bring mental health professionals into these cases as fast as possible, and get the subjects into treatment instead of tossing them into jail. But it's not happening often enough, or fast enough, and some are calling for more funding that would make mental health professionals the first responders in these cases more often.
Even more troubling is that while police academy training and continuing education has included crisis response and de-escalation, encounters between officers and citizens with mental health issues still turn deadly.
In Austin, for instance, a third of the 24 people killed in Austin police shootings from 2010 through 2016 had confirmed mental health conditions, according to department records obtained by the American-Statesman.
Among the eight people who died, seven were armed, two of whom were later found to be holding BB guns, and one took his own life after being shot by an officer.
Austin police tallied another 20 shootings in which the person an officer shot did not die. Mental health information on those individuals was not releasable, nor were detailed records for shootings in 2017 and 2018, many of which are still under investigation, police said.
Though complete numbers were not available for the past two years, police have fatally shot people with mental health conditions in that time.
In March, 46-year-old Victor Ancira was shot and killed by officers when he lunged at them while holding a pickax, police said.
"Any situation like this, where a person may possibly be armed with a gun, a knife, a baseball bat, you name it, these situations are incredibly quickly evolving and very dynamic, so things happen in the blink of an eye," said Lt. Brian Jones, who heads the Austin Police Department's crisis intervention team that focuses on mental health-related calls.
Chas Moore, a founder of the social advocacy group Austin Justice Coalition, said he thinks the number of people with mental health conditions shot by Austin police is higher than reported, and points to a stigma about mental health issues as a possible source of under-reporting.
"But even with eight shot and killed by APD, I think that's way too many," Moore said.
Both Moore and coalition member Kathy Mitchell said ending clashes between police and those with mental health issues requires a structural and funding change that takes police out of the driver's seat in situations involving mental health crises.
Climbing numbers of crisis calls
The Statesman found that 90,109 mental health calls were logged from 2010 through April 2018, the most recent date for figures available, and found that the annual number of calls involving emotionally distressed people has trended upward in Austin since 2010.
Austin police recognize they often are not the ideal response to mental health crises, but when a person acts out violently or in ways that can frighten the public, officers increasingly have found themselves in those roles.
"If you look at our stats over the last five to 10 years, the number of calls that we respond to that are mental health-related grow each and every year," he said.
Out of nearly 8,000 mental health calls in 2010, about 26 percent -- or 2,073 calls -- were emergency detentions in which police took a person who posed a threat to themselves or others to either jail or a mental health facility, according to Austin police records.
That number steadily climbed over the next six years, reaching a peak of 5,564 calls -- or 45 percent of all calls -- in 2016, then dropping slightly to 5,356 (43 percent) in 2017.
As deadly as armed encounters between police and potentially mentally ill civilians can be, the data show they are rare.
For instance, only 201 firearms were seized in fewer than 1 percent of the 26,898 emergency detentions since 2013.
Shifting focus of response
Mitchell of Austin Justice Coalition said mental health is, at heart, a health issue, not a criminal one. So health care-centered first responders, such as Austin-Travis County EMS, should be the agency of choice, she said.
She pointed to a new program in Dallas that sends a team of health care and social workers out to mental health calls as primary responders, with a police officer in support.
"The police presence is not the lead presence. They are not the ones actually doing the first response," she said.
John Snook, executive director of the Treatment Advocacy Center, a mental health advocacy organization based in Arlington, Va., pointed to other programs in Tucson, Ariz., and Houston as models for mental health response.
Snook said Tucson police have a dedicated team of officers that work directly with treatment professionals who usually defuse most situations involving people in a mental health crisis, and almost always bring people to treatment facilities rather than jail.
In Houston, considered a model for connecting people with services through outreach teams, police have employed a Crisis Call Diversion Program that is designed to put mental health counselors alongside call takers and dispatchers to talk through issues and de-escalate calls.
Austin police works with Integral Care, which provides mental health services in Travis County, and other agencies to form the Homeless Outreach Street Team. The group of officers, behavioral health specialists, medics and social workers try to connect the mentally ill in the homeless community with services. Mental Health experts from Integral Care also work closely with police in training.
Laura Wilson-Slocum, practice administrator for the agency's Crisis Services and Justice Initiatives, said training focuses on suicide risk assessment, crisis intervention, community resources, mood, psychotic, anxiety and personality disorders, along with verbal de-escalation skills.
Integral Care also runs a 24/7 Crisis Helpline independent of the police department, and can dispatch their own response teams throughout the community without tapping law enforcement.
"When someone is experiencing a mental health crisis, the best action, the vast majority of the time, is to be seen by a mental health expert," Wilson-Slocum said.
Police also have integrated Integral Care's response team into their own dispatch system, so experts can get to the scene of a mental health call quickly.
When that happens, Wilson-Slocum said experts try to relieve law enforcement within 10 to 15 minutes of arriving and take control of the situation, freeing up police and EMS personnel to focus on criminal and public safety calls.
Health advocates like Snook say calls involving people suffering from mental health issues are among the most worrisome for police.
Often, officers know the person they are dealing with is not a criminal, but too often have to use force to defend themselves or others. All too often, he said, people who find themselves in these situations are very sick, and out in the community without access to the care they need.
Snook said the priority should be enhancing and strengthening the mental health service infrastructure that is supposed to prevent people from experiencing a crisis requiring police in the first place.
Austin Police Chief Brian Manley, who addressed mental health calls during a community forum on May 17, said getting more mental health professionals engaged with individuals in crisis is a priority for the department. But more money isn't available to expand programs or initiatives that Austin police already have in place.
"Law enforcement is so frequently called into situations to which we may not be the best trained or the best equipped to handle. We're just simply the only ones available at that time," Manley said.
Cadets get 40 hours of mental health training in the academy. Some officers, though, can get more training to become certified mental health officers, but police dispatch the nearest officer available during most violent incidents. So having a mental health officer immediately on hand when a crisis develops is not guaranteed.
Hope for more health services
Snook said the research conducted by his center found that people with a mental illness are 16 times more likely to be killed in an encounter with law enforcement than the general public.
"On one hand, we want to ensure that officers have every tool in the toolbox to defuse these situations," Snook said. "We always advocate for crisis intervention training, and making sure law enforcement has diversion tactics to prevent these situations."
Snook, however, said he also cautions against the knee-jerk reaction to tragic encounters of just calling for officers to be better trained.
"Too often, there is nothing the training would have done differently," he said. "You can't train your way out of this crisis."
The key, Snook said, is to keep people from getting to that level of crisis in the first place, and, to whatever extent possible, respond with health care, rather than law enforcement.
Programs like Austin's Homeless Outreach Street Team are part of the solution, but there's still a long way to go.
"That one of the big pieces here," Snook said. "In addition to that, we need a more robust mental health system."
Snook said his center has partnered with U.S. Sen. John Cornyn, R-Texas, to start programs that combine outreach teams with court orders requiring people to stay connected with treatment to keep people close to medical care they need, rather than law enforcement.
Locally, Integral Care offers a Mental Health First Aid course to members of the community at no cost. The one-day training program gives people basic tools to help identify people who are showing signs of mental illness or substance abuse, or are in a mental health crisis.
The consensus among police, mental health experts and community members is that any mental health response needs to be shifted away from police -- but how that would happen and how it would be paid for remain the biggest questions.
Manley said he thinks a system in which a civilian mental health professional could respond to calls, as long as they aren't violent and require an officer, could be a model program to address the mental health crisis.
"Because all too often we see where they just have a tragic outcome," Manley said.
Mitchell said city leaders need look no further than the Austin police budget to find money for a pilot program that could address mental health calls.
"We don't buy into the idea that there's no money. We do understand that nobody wants their money taken away," she said. "I believe that we are at a moment right now where the city needs to decide to say no to some money that police officers have asked for in order to start that conversation."
Officer Hunt said the woman he encountered on June 12 was taken to the Dell Seton Medical Center for treatment. He said he hopes that she gets the continued care she needs to remain healthy. But at the end of the day, he said he thinks he will run into her again.
"Normal feelings (I might have) would be exasperated and frustrated that there's not more that we can do, there's not more that can be done," he said. "And I'm not talking about just police, the system itself."
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