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In Tucson, special unit handles mental health calls

Editor’s note: Today is the second of a three-part series comparing how Tucson and Albuquerque tackle mental health issues and police response.

With all of the coverage of police shootings and evictions of homeless tent-dwellers, it might be surprising to learn that Albuquerque police often handle confrontations with mentally ill people without incident.

But they acknowledge they could be much more effective with better communitywide systems, more officers specifically assigned to handle mental health calls and better laws.

APD Lt. Glenn St. Onge, right, works with other officers and community members at a tent city of homeless that had sprung up on an empty lot in Albuquerque. (Jim Thompson/Albuquerque Journal)

APD Lt. Glenn St. Onge, right, works with other officers and community members at a tent city of homeless that had sprung up on an empty lot in Albuquerque. (Jim Thompson/Albuquerque Journal)

Lt. Glenn St. Onge of the Albuquerque Police Department’s crisis intervention section says that, as of last month, 90 percent of APD’s field officers had been trained in crisis intervention, and soon 100 percent will be. There were 170 calls for crisis intervention last month, only a few required any use of force, and the force was of the Taser or “empty-hand takedown” variety.

St. Onge says APD had the nation’s first dedicated crisis intervention unit, but it has only two detectives, and one is about to take maternity leave. So, on most calls, it is line officers who respond to the calls – unlike the specialized mental health officers who take those calls in Tucson.

The Justice Department, which entered into an agreement with the city outlining wide-ranging reforms, wants APD to employ 12 detectives for its mental health unit. The agreement was the result of a DOJ investigation sparked by numerous officer-involved shootings, many of them involving mentally ill suspects.

“There is so much I could do with 12 detectives, but that would be robbing Peter to pay Paul,” St. Onge said. “Where are those officers going to come from?”

APD Officers from different units were involved in the standoff with James Boyd, a mentally ill homeless man. The standoff ended in Boyd’s death. (From video obtained by the Albuquerque Journal)

APD Officers from different units were involved in the standoff with James Boyd, a mentally ill homeless man. The standoff ended in Boyd’s death. (From video obtained by the Albuquerque Journal)

Still, there is no way to ignore the two most glaring examples of APD police shootings involving mentally ill men: Christopher Torres, who suffered from schizophrenia and was fatally shot in his own backyard in 2012 by officers serving a warrant, and James boyd, a mentally ill homeless man shot and killed last year after SWAT was called out because he wouldn’t leave his illegal camp in the Sandia foothills.

Both garnered national attention, and Mayor Richard Berry called the Boyd shooting, captured on police video, a “game changer.”

Tucson’s program

St. Onge was part of a local delegation organized by the Greater Albuquerque Chamber of Commerce that visited Tucson last January. Tucson has built a nationally respected system of mental health treatment and crisis management. The chamber asked law enforcement and health care experts, along with community and government leaders, to see what might be tried in Bernalillo County. St. Onge returned impressed with the Tucson Police Department’s approach to dealing with mental health crises and envious of Tucson’s resources.

Tucson has a crisis response center that gives police officers one place to take mentally ill people they encounter. There, adequate care can be obtained and follow-up care organized. Officers can be back in service within eight minutes of arriving at the center on average, compared to the hours they once had to spend taking people to emergency rooms or booking them into jail.

The Tucson Police Department has specially trained officers whose only job is to serve court orders on mentally ill residents, respond to mental health crises and monitor mental patients who may become dangerous.

St. Onge is trying to organize a similar unit for APD. He hopes a crisis response center can be built here.

Arizona has also enacted two laws that St. Onge said would help Albuquerque police. One would allow police to arrest a mentally ill person in possession of a firearm if he is barred under current federal law from having a gun. As of this moment, all local police can do is call federal agents and ask them to make the arrest.

The other is known as an assisted out-patient treatment law. It’s a variation of what is known as Kendra’s Law. A measure introduced in the recently concluded state legislative session by Senate President Pro Tem Mary Kay Papen, D-Las Cruces, would have authorized courts to order certain mentally ill people to accept out-patient treatment. Opponents say such laws can be abused and can violate a patient’s civil rights.

A version of Papen’s bill passed both legislative chambers, but the different versions could not be reconciled before the session ended.

A national problem

Every police department in the nation is looking for better ways to deal with mental health crises, said Tucson Police Capt. Paul Sayre, who runs that department’s mental health investigative support team. Courts all over the country are faulting police departments for failing to differentiate between “garden variety criminals and those in crisis from mental illness” when it comes to using force, Sayre said. They are ruling in favor of mentally ill plaintiffs in use-of-force and wrongful-death lawsuits brought against police departments. Local governments are getting tired of paying settlements.

More to the point, Sayre said, traditional police tactics simply don’t work when dealing with the mentally ill population.

SAYRE: 90% of crisis calls resolved over the phone

SAYRE: 90% of crisis calls resolved over the phone

Mostly officers deal with people suffering from depression, he said. “Their base line is when they get up in the morning, they are suicidal. The only thing that changes is acuity.” A uniformed police officer who shows up in a police car raises anyone’s anxiety, but seriously depressed people “can’t react in the same way” as a healthier person. “They are not able to calm themselves down or put a rational component to it,” Sayre said. “The condition gets worse, and they escalate to doing something illogical.”

Making matters worse, he said, is that traditional police practices increase the tension. Police are trained to take control of situations, by asking politely first, then by demanding compliance. “It’s part of command presence,” and it is done to assure the officer’s safety, Sayre said. The paramilitary SWAT units, which Sayre once commanded, “want to go go go,” he said. “They want to get tactical.” Tensions increase, and an encounter that could have been defused with enough time and proper training explodes instead.

Taking your time

One time, Sayre said, a man armed with a knife barricaded himself all alone in a Tuscon convenience store. Instead of summoning a SWAT unit, negotiators were called. No one was in danger, so there was no need to rush things, Sayre said. “Once the public is safe, time is on our side.” Five hours later, the man walked out of the store without the knife.

“Nobody got hurt, there were no lawsuits, no injuries, none of our officers was hurt,” Sayre said. “It’s not as glitzy as what SWAT folks do, but when you can get someone to peaceably surrender, you save taxpayers money and you keep officers’ careers intact.”

St. Onge is also a big believer in taking your time. Police are learning to dis-engage instead of engage with some of the people they encounter, he said. An officer who is directed to pick up a mentally ill resident, perhaps because a court ordered an evaluation, might find the resident doesn’t want to come out of his house. St. Onge said that instead of asserting their command presence, officers might be better off leaving for a few hours and trying again later.

Albuquerque police are called out on entirely too many calls involving mental health issues, St. Onge said, probably because the area doesn’t have enough mental health treatment options. Officers are often asked by family or neighbors to check on someone’s well-being. A home visit by a case worker or by a peer – someone who is herself in treatment for a mental problem – might be a better idea.

A police visit could just escalate the anxiety level. A wellness check on a 98-year-old man with dementia shouldn’t be a police matter, St. Onge said. It should be treated as a health care need, and medical staff should be dispatched.

Crisis center

Tucson’s crisis response center houses a network of trained phone operators who can provide help and direct calls to people and agencies best equipped to help, Sayre said. Last year, the network transferred 1,700 callers with mental health difficulties to a case worker, a clinician or another mental health professional. Sayre said 90 percent of the calls were resolved over the phone, which keeps more police officers in service to handle crimes and emergencies.

St. Onge is trying to develop a similar system in Albuquerque, by training 911 dispatchers and agencies like Agora that operate crisis lines. Instead of automatically dispatching a police officer, 911 operators could involve crisis management agencies that are already at work.

Both police officers caution that the public should not expect miracles.

“The public thinks crisis intervention teams are a cure-all,” St. Onge said. “That we can talk anyone down, de-escalate any situation. Sometimes, we can’t. If a situation escalates into deadly force, officers revert back to their training. There is always a time to talk, but you don’t want to compromise your safety.”

Recently in Tucson, the family of a mentally ill man called police. The man had stopped taking his medications and his behavior had become frightening. Police stopped him in traffic and began the long, quiet process of engaging him, developing some rapport and earning his trust.

“The officers were doing a great job, trying to talk him out of the car and into some help,” Sayre said. Then, the man stepped out of the car and pointed a gun at police.

“It was suicide by cop,” Sayre said. “Sometimes, the outcome doesn’t change, no matter what you do.”

Next Sunday: Part three of the series.