How some police departments are rethinking 911 call responses

Sign up for the On Point newsletter here.  

Calling 911 can sometimes have tragic consequences for people in mental health crisis.

They can be arrested or even killed.

Some organizations – and police departments – are trying to change that by working with behavioral health professionals.

Today, On Point: Rethinking policing and mental health.

Brian Peete, director of the Riley County Police Department in Manhattan, Kansas. Board Member of Crisis Intervention Team International, a program for law enforcement and mental health professionals aimed at better serving people with mental health challenges.

Stephanie Van Jacobs, program manager at WellPower, Denver’s community mental health center, which provides clinicians for the Support Team Assisted Response (or STAR) program. Licensed clinical social worker and addiction counselor.

Part I

DEBORAH BECKER: I’m Deborah Becker in for Meghna Chakrabarti. And this is On Point.

911 OPERATOR: 911, what's the address of your emergency?

BECKER: Every year in the U.S. there are an estimated 240 million calls to 911. About 20% of those calls involve someone experiencing a mental health crisis. When police respond to those calls, the outcome can be tragic. Advocates say police are trained to react to potential dangers — quickly and aggressively. And they are not equipped to handle many mental health crises that are often not a threat to public safety.

Research from the Treatment Advocacy Center says that those with mental illness are 16 times more likely to be killed in police encounters than other people approached by law enforcement.

In May of 2020, a 911 caller in Minneapolis asked for help with a man who had passed a counterfeit $20 bill in a store. According to the 911 transcripts, the caller said the man — George Floyd — was sitting in a car where he appeared to be drunk and quote “not in control of himself.” Police responded forcefully when Floyd resisted getting in the cruiser and kept a knee on his neck for almost 9 minutes.

FLOYD: I can’t breathe. I can’t breathe, man. Mama, I love you. Teresa, I love you.

OFFICER: (INAUDIBLE)

FLOYD: Tell my kids I love them.

BECKER: Minneapolis firefighter Genevieve Hansen called 911 that day as well – but to report the officers. This was part of her call that was played during the trial of one of the officers convicted of killing Floyd:

HANSEN: (SIREN) Hello. I am on the block of 38th and Chicago and I literally watched police officers not take a pulse and not do anything to save a man. And I am a first responder myself. And I literally have it on video camera.

BECKER: In response to Floyd’s killing, Countless police departments across the country have taken steps to change how they respond to incidents like this. Some have increased mental health training for officers. Others have hired social workers. In some communities, clinicians are patrolling the streets with officers which is known as "co-response."

MORABITO: The needle has moved on this that it's an expectation now for what a police department will do. And not just something extra or window dressing. It is a real part of police operations.

BECKER: Melissa Morabito is a professor in the School of Criminology at the University of Massachusetts, Lowell and an advisor to the Boston Police Department. She says police are handling an increasing number of calls involving complex mental health issues and they understand they need to improve and that clinicians can help.

Some communities have removed law enforcement from some emergency calls entirely. They've created agencies to handle emergency call centers where behavioral health workers – and not officers – deal with mental health related calls and situations that are deemed not threatening. Also, a national 988 suicide and crisis hotline was established last year as another place for those in mental health crisis to seek help.

We’re going to spend this hour talking about changing the way we respond to emergencies: how it's going, how we got here, and some of the questions raised when merging public safety and public health.

One question is: who determines if a 911 call might become dangerous and require police?

This question is raised in a lawsuit over a 2021 fatal police shooting in Newton, Massachusetts. Officers — along with a police department mental health clinician --answered a call about a man with a knife who was behaving erratically. That man, 28-year-old Michael Conlon had a history of mental health issues and was receiving treatment.

When officers responded, Michael ran into his apartment building. Officers followed and began talking with him in a third-floor hallway, urging him to drop the knife. State police responded as well and while they were waiting for professional law enforcement negotiators, Conlon did drop the knife nearby and asked to talk with his father. The officers tried to use a bean bag gun to prevent Michael from retrieving the knife.

But that bean bag gun misfired – and Michael picked up the knife again. That’s when officers shot him seven times. His father, Robert Conlon is asking why the mental health clinician who was with police had to wait outside in a cruiser and was not asked to help:

CONLON: The social worker knew Michael's address that had been there – knew about it a year earlier, was outside in the car. The police felt like it was too dangerous for her to go in. If there is a mental illness call – and police knew he was obviously having something going on, severe. Why wouldn't you have a mental health representative there?

BECKER: An inquest into the shooting determined that the police were not criminally responsible, because Conlon didn’t drop the knife. Shootings like his are not all that uncommon. Nationally, statistics show that one in five fatal police shootings involve someone with a mental health issue.

Now these types of situations are difficult for sure and move quickly. Many officers say it's their job to protect public safety and they should be the ones in charge of responding — even if they're working with a clinician.

Larry Napolitano is a police sergeant in Shrewsbury, Massachusetts. He's just completed a new program where officers and clinicians are trained to respond to emergencies together. Napolitano says police are needed on calls to protect public safety, but he does say working with a social worker can help.

NAPOLITANO: And when we're dealing with mental health calls, there are some situations unfortunately where people are totally out of control. And you have to contain a situation to make sure that no one gets hurt. And that's ultimately what you want. You want no one to get hurt. So I think the combination of the two provides the perfect dichotomy to be able to handle an ever-changing situation.

And then there’s Cassie McGrath, a mental health clinician who works with police in Framingham, Massachusetts. She was also part of the training program with Napolitano. We spoke with her while she was out on patrol with some officers. And she says she can help officers defuse tense situations and help people get treatment or services. In most cases, McGrath says she wouldn't feel safe responding without an officer.

McGRATH: You know, as a clinician, I'm putting myself in situations where my safety is in the hands of the officers that I'm riding along with. I'm relying on them to make sure that I'm safe to, you know, read cues on scenes that I wouldn't necessarily pick up on, that they're part — like part of their training. And they, on the same side of that, are expecting me to know where I need to be on scene and understanding my role in that way.

BECKER: Yet some mental health providers say police should not be involved at all in most behavioral health calls. Rebekah Gewirtz, head of the Massachusetts chapter of the National Association of Social Workers. She cites data from civilian-only alternative response teams showing that those alternatives can lower costs and reduce the number of tragic outcomes.

GEWIRTZ: Too much of our attention is focused on this co-response model. I think we should be thinking about how we can promote, support and fund alternative response where people who are in a mental health crisis get a mental health response.

BECKER: Among the communities that have created an alternative mental health response team is Amherst, Massachusetts. Its program is called Community Responders for Equity, Safety and Service or CRESS. It started last year with trained civilians taking emergency calls to a separate phone line. It will begin taking diverted 911 calls this fall. Earl Miller runs CRESS and says all communities should have alternative first responders and he says co-response has some limitations.

MILLER: A clinician who comes out of a car with a cop is always second. They are always not – they're not going to be the lead decision maker. And co-response, you know, I think while it appears really good on paper, I think there’s a lot of reason to believe that it doesn't look that different than traditional policing.

So far Miller says about 75% of the calls to his group have been mental health related. And he believes that the creation of groups like his represents a shift in policing.

MILLER: Practically, we represent a kind of different level of deployment that’s able to keep low level calls from becoming higher level calls down the road. And then, I think, you know, politically, we're an example made of a promise made and a promise kept. And ultimately that in 2023 there is action that happened after the death of George Floyd.

BECKER: The Justice Department recently released a scathing investigation of the Minneapolis police department that began after George Floyd was killed. It said the city discriminated against people with behavioral health disabilities and sent police to mental health calls when they weren't needed and where their response was — quote — "often harmful."

The investigation is considered a call to policy makers to do more to address police harassment and violence. Speaking in Minneapolis after the report was released, U.S. Attorney General Merrick Garland said the DOJ observed the practices that made what happened to George Floyd possible — and Floyd's killing had an irrevocable impact on the country.

Today we’re talking about rethinking mental health and policing. And joining us now is Brian Peete, director of the Riley County Police Department in Manhattan, Kansas. Brian's also a board member of Crisis Intervention Team International. And that’s a program for law enforcement, mental health professionals and civilians with lived experience aimed who work with communities on responding to people with mental health challenges. Brian, welcome to On Point.

BRIAN PEETE: Thank you so very much. I appreciate being here.

BECKER: So you're a police officer, well-versed on emergency response training, but the statistics, really, about the number of calls involving folks in a mental health crisis are limited at best. And so I wonder, in your experience, what are you seeing in terms of the number of calls your department in Kansas receives that involve mental health and which ones are mental health crisis?

PEETE: I think there's a very high percentage of calls to law enforcement across the country that involve a mental health aspect to it. To me, we're getting slow, I think, collectively as a country and gathering and collecting this data and using this data.

But there's a model that's already out there that talks about this and that works towards this. So yes, this is a significant problem and it requires movement on all sides for this. So what would you say though, in terms of percentage for you? Is it 5%, 10%? What is it?

PEETE: I'd say for us it's probably closer to 30%.

BECKER: 30%. And you've worked in other departments, Chicago, Vermont. Do you also think that most police departments are taking steps to try to improve their response to folks in mental health crisis?

PEETE: Yes, without a doubt. I also think that one of the things that law enforcement is also advocating for is for more resources to be put into non-law enforcement responses to this.

BECKER: Okay. I'm going to ask you to hold on for just a moment, because we're going to take a break. We're discussing mental health and policing with Brian Peete. He's the director of the Riley County Police Department in Manhattan, Kansas. When we come back, we'll learn about an alternative response program in Denver, Colorado.

That's changing how the community is handling some 911 calls. We'll be back in a moment. I'm Deborah Becker and this is On Point.

Part II

BECKER: This is On Point. I'm Deborah Becker, and today we're talking about the intersection of policing and mental health and whether there's a better way for communities to handle 911 calls so they can try to avoid harm, and in some cases, tragedy. We're joined by Brian Peete. He directs the Riley County Police Department in Kansas.

He's also on the board of Crisis Intervention Team International. And I'm wondering, Brian, can you explain for us exactly what can a clinician do on the ground, specifically, to handle a situation and perhaps diffuse a tense situation to improve outcomes?

PEETE: There's a lot to that.

And ultimately, I say it depends. It depends on the individual. It depends on the training of a clinician. It depends on the capabilities of the clinician and a lot of external factors that are quite often beyond the control of a lot of folks that are responding to the incident. Keeping in mind that if someone calls 911 for a mental health emergency, most of the time, it may not be a situation in which a support group was able to deescalate the situation. And now it's grown to an issue of, that law enforcement may have had to been called in the first place.

But also there's a certain element of education that has to come from the public about other resources to call other than 911. But looking at the original question, it's just, I think it just, it depends on the situation entirely.

BECKER: But what would you say is the best thing that works for officers when they have a co response model like you do in Kansas?

PEETE: It would be as many people that are there that can reach the individual who's in crisis. There may be sometimes that the folks who are in crisis may have a strong relationship with a co-responder. They may have a strong relationship with an officer. So I think, from my perspective the better amount of folks that can be there to help this person and that can gain trust is the best possible outcome.

In our introduction to this program, we heard from a man whose son was fatally shot by police in Massachusetts, and the clinician who was working with the police department was waiting outside in the car because it was deemed unsafe for that clinician to help the officers, because there was a weapon involved.

But some of these situations, aren't these the situations where you really need a mental health clinician? And how do you draw the line there in terms of knowing when a clinician should be called in and when a clinician should be told to wait in the cruiser?

PEETE: I couldn't, I don't know the specifics of that situation.

I think it's a travesty all the way around. But I am aware of other situations in other departments where law enforcement have gone to scenes where weapons were involved and the clinicians were out of the vehicle, were interacting with the person in crisis. It's something that it differs everywhere you go. And this is why I think that organizations need training, and they need partnerships and communications with the folks that they're working with, co-responders, with stakeholders, to identify how they're going to make these responses.

BECKER: Now, Crisis Intervention team training has been around really since the '80s.

How do you know it works?

PEETE: I know it works because it saves lives every day. And it started, it's the same unfortunate, it's the same script, different cast. And in 1988 there was a mother who had called law enforcement and unfortunately her son was killed in a mental health response.

And that's where CIT was formed, that law enforcement realized that it needs to train officers. In mental health, in what a crisis looks like and how to deescalate it. Because responding to a criminal act is entirely different than responding to someone who's in mental health crisis.

And it's important that law enforcement recognizes the difference between the two and acts accordingly, but also that we have resources within our communities. That law enforcement is not the only option, and because we've defunded social services across the country, 911 is the catchall. And every law enforcement agency that I'm aware of wishes that there were other resources and other places.

And again, like coming up to 988, which was implemented last year, and we're hoping that that's a source that when people see someone in mental health crisis that they think of 988. Before they think of 911.

BECKER: 988 being the national suicide and crisis hotline that folks are supposed to call.

But I'm wondering, can you gimme a specific example of how training changes the way an officer handles a mental health call? What do you do differently, or what does that training tell you to do differently? Give me, is there a specific example you could give me?

PEETE: Sure. I can give you a very basic example. So in law enforcement across the country, one of the things that law that's taught in the academy is you want to make sure that the hands, that you can see the hands of the individuals that you're dealing with, because that's where the threat could possibly come from, if there's a threat to you or to anyone else during that interaction.

So if I came to a call for service and there was an individual smoking a cigarette, I would ask that person, "Please put the cigarette out because I want to have this interaction with you. I don't want you to use that cigarette against me or anyone else." But often in a lot of cases there are folks with mental health issues, that nicotine is a calming factor.

So if I'm aware that it's a situation, that it's a mental health related call and that person is smoking a cigarette, why would I pull them away from something that's giving them comfort and stability in a highly stressful situation. And so that's just one of the many small examples, is meeting people, recognizing what the issue is and meeting people where they are and not escalating it to the point that you have to use force.

BECKER: And yet we hear increasing reports of the use of force and obviously some high profile, horrific situations. And so where's the disconnect?

PEETE: I think it depends on, again, entirely on the situation. I would encourage folks that CIT is more than training. CIT is a program. CIT relationships, strong relationships, there are lives that hang in a balance of all stakeholders, of law enforcement, mental health service providers, people with lived experiences, their support groups, their families. We have to come together and we have to know and trust one another. So when these crisis situations happen, we know how to respond.

But most importantly, when you come together and you have a strong CIT program, you can see signs that a person's crisis may be escalating. That these things, they're not automatic onset. Sometimes, majority of the time, they're gradual things. And that if you have a partnership, and you know that someone in your community is starting to elevate towards that level of crisis, everyone can get together and intervene before it becomes an issue when law enforcement has to be called.

BECKER: I've heard a criticism of CIT or Crisis Intervention Team training, and that is that everybody implements it differently. So there's not really a standard way of really utilizing this training in some departments, and in some cases it might just be perfunctory.

They may just be saying, "Yep, did the training, 40 hours. Okay, I'm done. I'm trained." And that's just not enough, especially in terms of what police departments are dealing with, as you mentioned, because of the lack of social services in this country and increasing complex mental health needs.

So what do you do about that? About making more uniform approaches, standards to ensure that training is actually something worthwhile.

PEETE: That is a very good question. And so when we look at CIT International, so there are a lot of folks. CIT is a lot like Kleenex, say, "Hey, hand me a box of Kleenex." Kleenex or Xerox, these are the names, that's what you think of when you say it. So when some folks may go out there and say, "Hey, this is CIT." But it's not CIT International. And CIT International advocates for a program, a collective program, and a set of standards. We have accreditation program much like Calea for law enforcement.

And in those things, it talked about, you have a 40-hour training, but in the 40-hour training, you build partnerships. You don't take officers as a checkbox and just say, "Okay, every officer's going to be trained in CIT, and there you go." Because you have to have the right person, with the right frame of mind, with the right level of patience to deal with mental health costs for service.

We have a standard, that standard's been in existence since the late '80s, and it's something that we wish people would fully subscribe to, rather than just saying, taking bits and pieces of it and then saying that they have a CIT program, which in those cases, we have negative outcomes like this.

BECKER: In doing reporting on policing and mental health I've watched some police trainings. Certainly, in volatile and mental health situations and there has to be, right, a focus on when to use force, and sometimes you do have to use force. Sometimes you are going to, as an officer, you are going to use a firearm, and those decisions are made in a matter of seconds.

That's a very different goal and level of training than what a mental health clinician, obviously, does. So I'm wondering how you take those two very different goals and put them together in a crisis situation and make sure they work together effectively. I know that's a big question. But I really want to hear your thoughts on accommodating both of those things in a co-response model to make sure that you are responding effectively to the community.

PEETE: I think the goal of anyone who responds is not to use force and having force as a last option. But, and that might be the difference that you have, individuals who are law enforcement may think that's what the outcome is supposed to be. I need to get, take control of the situation before I move on to the next call for service.

And then you may have a mental health clinician that may say, "This is what the response is. I need to sit down. I need to have time to speak with this person to help deescalate and law enforcement may be concentrating on time to get to the next call." That's why having that relationship before this call comes out is extraordinarily important. And one of the other things that I do have education and training within mental health counseling.

BECKER: And one of the things that's shocking to me is there's no certified national level of training that I'm aware of for mental health responders that talks about safety within these situations as well as de-escalation, outright. Going through college, getting my master's degrees and everything, we talk about theory, we talk about counseling practices. But I think collectively there are a lot of gaps within the system of response that require a very in-depth research and partnership if we're going to get it right. And this requires investments and advocacy from our elected officials.

What's the biggest gap that you think really, Brian, to make this more effective? What's the biggest gap?

PEETE: Law, or I'm sorry, mental health service providers, that they're not being paid what they should be paid, that they don't have the resources they need. In a lot of cases, when we deescalate someone to the point that they need services.

Follow up in a lot of communities could be as much as two to three months out. So there aren't enough folks who are doing the work. There aren't enough resources for folks, there aren't things like sobering centers or respite centers there. What we've done as a society, years ago, when we got rid of state institutions and hospitals, everything's out on the street and every community has to fend for themselves.

And now law enforcement is the default for when someone is in crisis. But we also have to look at, when we invest in mental health service, then family members support groups, a person's support network. They also need to understand or need information on what could happen in crisis.

How do you escalate your loved or deescalate your loved one? How may, some of the things you're doing in saying escalate them to the point that they may be in crisis? So there's a lot of education that goes all around. But I think in answering your question, we have to invest in a non-law enforcement response.

BECKER: So all these alternative response teams, you would say are very helpful in some communities to divert some of the lower-level calls and get people into services. Absolutely, but there's a danger in an us versus them. In a lot of communities, unfortunately, with George Floyd, we've seen an uptick in organizations who do not want to engage in everyone else and all the other stakeholders that are involved.

Law enforcement needs to be at the table just as much as NAMI, advocacy groups or groups who are doing the work. Because again, it is important you have that relationship and trust before the crisis happens, rather than after it happens.

BECKER: Okay. I wanna bring another voice into this conversation.

Seems like segue time here. Stephanie Van Jacobs is a program manager at WellPower, that's Denver, Colorado's Community Mental Health Center, and it provides clinicians for what's known as the STAR Program, Support Team Assisted Response. Stephanie is a licensed clinical social worker and addiction counselor.

Stephanie, welcome to On Point.

STEPHANIE VAN JACOBS: Hello. Thank you for having me.

BECKER: So I'm wondering, based on what you've heard us talking about with Brian here, what do you think regarding alternative response and how it can work with police officers similar to what you're doing in Denver right now?

VAN JACOBS: Yeah. So in order to start talking about the alternative response, I do have to acknowledge our co-responder program that launched in 2016, which is the mental health clinician that pairs with Denver Police and responding to provide the support in real time. That program has been tremendously successful, and over the years conversation started of how do we develop an alternative response?

And Denver launched its STAR pilot program in 2020, and the concept of the STAR program is that it's an alternative response. So it is a WellPower mental health clinician and a Denver Health Paramedic or EMT that are responding in the community, 100% of the time to these low level, low risk calls that officers don't need to be at.

And so we are really working in parallel with traditional response and co-response. Having the right response as opposed to them or STAR.

BECKER: Basically, what you're doing is these calls are diverted from the outset to STAR and you'll handle these sorts of lower-level calls. And so the operator really is in charge of deciding does this go to a police officer or does this go to someone from STAR?

VAN JACOBS: Yeah, absolutely. So we do a lot of work with 911 dispatch and asking those questions when individual or community members call in to see if STAR is the appropriate response.

BECKER: And do you know, at this point you started in 2020, so you're relatively new. How many calls would you say you are taking on average? How many things are you responding to?

VAN JACOBS: Yeah. So since our start in 2020, we are roughly around 12,000 calls that we have responded to, and that number continues to increase with our expansions.

BECKER: And what does that represent in terms of total 911 calls? Do you know?

VAN JACOBS: So any call that STAR is responding to that is tracked.

So when an individual or a community member calls in and STAR responds out to meet that person where they're at, that is what I'm referring to.

BECKER: Yeah. I'm just wondering what does that represent in terms of total police department calls? Are you 1% of the calls to the police or do you know?

VAN JACOBS: I don't have that specific number.

BECKER: Okay. Okay. Stephanie Van Jacobs, I want you to hold on for a minute. We have to take a quick break. We're discussing policing and mental health and how some communities are reinventing their response to people having a mental health crisis. We'll have more when we come back.

Part III

BECKER: What do you think, or how would you describe the main difference in STAR's response to an emergency call versus a police response?

VAN JACOBS: So the main difference is that STAR is non-emergent. And STAR is responding within the community to these low-risk, low-level calls. And so they're able to meet individuals where they're at. They can spend time really building that rapport and coming up with solutions or connections to resources with individuals in the community.

BECKER: And would you say that many of these calls right now, many police departments around the country are likely having officers handle this, which is often a lot of time for an officer and that's how situations can drastically change and people are not getting the services they need?

How would you describe it?

VAN JACOBS: Yeah, absolutely. I think officers are very busy and need to focus on those high-risk calls, and so having an alternative response allows us to reach community members and take that time to really provide those connections. And historically, officers don't always have time to do that.

They need to move on to the next one to make sure they're completing their day.

BECKER: Brian Peete, I'm wondering in Riley County, in your police department in Kansas, do you have an alternative response? Do you agree with this type of way of dealing with some of these lower-level calls?

PEETE: Absolutely. Yeah we do have an alternative response. We do have a licensed clinical social worker on staff with us. So we are able to go to those different calls for service. So yeah, I agree with it 100%.

BECKER: So you think that communities really need to have this whole comprehensive, police, alternative response and co-response to be able to handle what we're seeing in mental health and also to be able to handle what's happening because of really fewer mental health services. Brian?

PEETE: Yeah. I'm going to get in a little bit of trouble here. Yeah. This is one, this is a Band-Aid. What we're all doing is a Band-Aid and in light of George Floyd, I think we missed, I think our leaders missed an opportunity to invest in systems that we don't have to talk about a crisis response the way we're doing right now.

So I think that investment, yes, we are here. We need to have training, we need to have alternative responses, but more importantly, I think we need to have services for people because after we get done deescalating the situation, there's no place for people to go to get treatment. And we need that investment.

BECKER: All right. Brian Peete, director of the Riley County Police Department in Manhattan, Kansas. Thanks so much for joining us On Point today.

PEETE: Thank you.

BECKER: Stephanie Van Jacobs. I'm wondering what do you think about what Brian says? Is this a Band-Aid and is really the main issue here a lack of services across the country and this is a much bigger problem than how we respond in 911?

VAN JACOBS: I think that this is acknowledging what is happening in our society and this is getting us to reach more individuals in the community to provide that real time support. And I think that's a really wonderful start. And as far as resources, I think as populations grow, there is always going to be a need for more resources and accessibility to individuals and community members.

Here in Denver, we're lucky to have numerous different resources and we will continue to need more, to be able to support those individuals in long-term connections.

BECKER: As you explained earlier in the program, you said you're going to non-emergent sort of lower-level calls. That's what your clinicians do with this program.

But I wonder if you are only doing that, yes, you are certainly helping some, what may be overburdened police departments, but does it really address some of the problems resulting from aggressive policing? How do you make a dent in that?

VAN JACOBS: I think there's just a lot of collaboration that takes place here within our programs of how we send the right response, not a one size fits all response.

And so we'll continue those conversations and continue to better these programs to address issues such as that.

BECKER: So what would you say is the main challenge for your program? One of the main challenges I think now is just becoming that alternative response. So providing education and getting the word out that there is this alternative response, and that we're here to operate parallel to traditional response.

BECKER: Can you explain how a clinician might handle an emergency call differently? What, give me a visual on the ground of what de-escalation looks like.

VAN JACOBS: Yeah, absolutely. So our mental health clinicians have on our STAR program, since they are non-emergent, they have the time to really build those connections.

And so that can look like traditional deescalation. That can look like traditional therapeutic approaches, and that could also mean providing a water bottle, and a snack and just sitting down and listening to the individual and really meeting them where they're at, so that we can have those connections moving forward.

So we really work to listen to the individuals. And then go from there.

BECKER: And get them, so is the approach then getting services for that person and that's really the big difference?

VAN JACOBS: think the approach is really meeting them where they're at. And if that result is getting them connected to long-term services, then absolutely.

But that could mean numerous different things of what that individual needs in that moment.

BECKER: Now there's been some data published and studies done about your program. Can you tell us, it looks at this point, it's been fairly positive. Actually, a report in a reduction in crime levels, which I thought that was really surprising.

Is that just because, there were fewer arrests when police aren't responding? Or A, tell us about the data and tell us about that data point in particular and why you think it came out the way it did.

VAN JACOBS: Yeah. So STAR has been incredibly positive and has grown from our co-responder program.

We have a really trusting, functioning relationship with Denver Police and so we were able to acclimate this STAR program to into the city. And so we have responded to over 12,000 calls. I don't have an exact answer of whether that would lower crime rates or not. And what I can say is that when we're reaching more individuals and providing more support, individuals are receiving those long-term connections.

BECKER: But there was a study done by Stanford University, right? That showed reports of less serious crimes in neighborhoods where STAR was working. Were down 34% in compared with other neighborhoods where STAR was not available. In terms of lower crime and lower costs are these some of the positives that we're seeing so far from this program?

What do you tell other communities that might be thinking about a STAR program? How do you present this data?

VAN JACOBS: Yeah, absolutely. So STAR is in the community100% t of the time. And in each of our units we stock the units with inventory that we can provide in real time. So that could be anything from clothing items to hygienic products, to Narcan to fentanyl testing strips.

And so that alone is building those relationships. Within our communities that can have very positive outcomes.

BECKER: And positive outcomes, meaning that people are not arrested and it's less expensive than using a police officer.

VAN JACOBS: Yeah, absolutely. And coming up with alternative solutions, connections. We've helped veterans get connected back with the VA.

We have supported community members in getting driver's license or IDs or setting up a primary care appointment. So anything on the spectrum where individuals just need that connection or that guidance of where to go, STAR is able to do that, real time in the community meeting that person where they're at.

BECKER: Do you think it would be helpful if STAR could expand the number of calls that it takes and expand and perhaps be available at calls that were a little bit higher level?

VAN JACOBS: I absolutely think that STAR will continue to expand, and I do look forward to that. I think expanding STAR and having it become just this norm, traditional, not traditional, excuse me, alternative response alongside other responses, I look forward to that.

And I think STAR really operates parallel to co-response and there is a lot of collaboration there with Denver Police and our co-responders and STAR, and we're able to have the co-responders on those more high-risk calls and STAR to be on the other side with the low risk. So I think we'll continue that collaboration and those expansions moving forward.

BECKER: I asked this question to Brian Peete earlier in the program and we were talking about a lawsuit in Newton, Massachusetts where the family is suing over a fatal police shooting of a man who was having a mental health crisis. And the family asks why the clinician who was part of the co-response team who responded to their son, why it was that the clinician waited in a police cruiser and did not go to the scene to try to deescalate. And why there was a reluctance on the part of officers to allow the clinician to be involved. And the officers say, "The man in question had a knife, and this could have been a dangerous situation."

So I wonder, what is your thinking about potentially dangerous situations and where you draw the line or where STAR responders may have to draw the line?

VAN JACOBS: Yeah, so we have a lot of conversations with community partners within the team of safety and when is it appropriate for STAR to respond.

And so when a weapon or imminent risk is involved, we definitely send that more to our co-responders with officers. And STAR is there to provide support for individuals in a way where we can have those conversations and we can have our STAR clinicians and EMTs and paramedics respond on scene. And we want to make sure that everyone goes home safely.

That includes the individuals within the community. That means our mental health clinicians, and our EMTs and paramedics. So it will be a continued conversation of how do we ensure safety, and how do we meet individuals where they're at in the community in a moment of crises.

BECKER: Do you have an anecdote that you often think of about STAR that really explains what it is to people?

A very specific way of handling a call?

VAN JACOBS: I would say that it is a mobile alternative response that is able to just meet individuals within the community, listening to their needs to try to move forward.

BECKER: What do you think it represents in terms of changing policing and the response to mental health?

Are you an example of how communities across the country really are grappling with this and trying to come up with something new and why is that? How would you say? If you're looking at a big picture.

VAN JACOBS: Yeah, I think big picture, this is just the start of addressing or acknowledging how we respond to individuals within the community.

How do we come up with a response that is more fitting for specific individuals or specific calls? And so I look forward to the future. I think Denver, we're really thankful here. It's been a game changer of having mental health clinicians work with traditional response to make sure that we're sending that right response, that can become more effective than just sending an all size or a one size fits all response.

BECKER: And why do you think it's been a game changer? What are you seeing on the ground that you think it's become a game changer?

VAN JACOBS: Yeah, I think providing the support for those community members and individuals has been a game changer.

And I think allowing the collaboration with officers and social workers has been a significant game changer. And I say that it has been a fact that we are able to address individuals, if it's a co-responder with an officer, they're able to collaborate on scene. The social worker is able to provide support in maybe a different manner than an officer is, and vice versa.

And then having an alternative response alongside or parallel to that. We're able to have those mental health clinicians and EMTs and paramedics responding within the community and also having that collaboration.

BECKER: Some police officers I've spoken with are really reluctant to give up the response and they say it could be a real compromise to public safety.

There's a real liability there for departments, for communities and a risk to the clinicians. And some clinicians agree with that and say, "I would not want to respond to calls. Even calls that are determined low or deemed low level. I don't want to do that without a police officer." And I wonder, I asked this question to Brian.

Are there very different goals and trainings involved in officers and mental health clinicians, and how do you balance both of those when you're dealing with high stakes emergencies?

VAN JACOBS: Yeah, I think there's absolutely different trainings. And I think the goal in a larger sense is the same, is that we want to come to a solution with individuals.

We want to make sure that everyone is safe and we want to make sure that we're reaching individuals within the community. Although social workers and police officers do come from two different trainings or two different backgrounds, the collaboration and the goal can absolutely be the same, and they can collaborate and work together to have a larger impact on the community as a whole.

BECKER: What would your advice be in the last minute we have here, Stephanie? What would your advice be to other communities that are looking to implement STAR-like programs?

VAN JACOBS: Yeah, I would say a piece of advice is to look to your community, listen to the needs of your community and to have those conversations or collaborations with other community partners.

The idea of these alternative responses are to really meet the larger needs of our community members and provide that positive or significant support. And so with that, we have to have conversations in building and working relationships with other departments or agencies and community partners.

BECKER: So have a lot of dialogue and start small, would you say, or how, what would you say?

VAN JACOBS: Yeah, absolutely. When the pilot program started in 2020 here in Denver, it was one unit with one WellPower mental health clinician and one Denver Health EMT, and paramedic. And we have steadily increased over the last two years to having eight units, 16 mental health clinicians, and 16 Denver Health paramedics.