KALAMAZOO, MI — Police responding to a domestic dispute between mother and daughter find a distraught teenager who is cutting herself.
A disruptive man in a parking lot appears to be experiencing psychotic delusions.
A frantic 911 call comes from a woman worried her husband is suicidal or from someone whose family member has overdosed on drugs.
In Kalamazoo County — as in across the country — police calls frequently involve individuals in the throes of a behavioral-health crisis.
“I would say between 25% to 30% of our calls have a mental-health component to it,” said Deputy Chief John Blue of Portage Public Safety.
Indeed, Kalamazoo County Sheriff Ron Fuller estimates that 60% of his jail inmates have mental health issues, “and that’s on a good day.”
In 2021, Kalamazoo County’s 911 central dispatch received almost 19,000 calls in which a behavioral-health issue was flagged, county officials estimate. That’s an average of 51 calls a day.
County police agencies have been working for years to improve their response to such calls, particularly in the wake of the Black Lives Matter protests two years ago.
But now, bolstered by a $500,000 federal grant, the county’s police chiefs are joining forces with the local mental-health experts to take reforms to the next level. Instead of a piecemeal approach, police department by department, they’re devising a countywide collaboration to strengthen the relationship between law enforcement and the mental-health system.
“We are not counselors,” Kalamazoo County Sheriff Rick Fuller said. “We are police officers trained to uphold the law. And we are called to be mental-health counselors in greater amounts of calls than we would ever prefer.
“Our ultimate goal is that the day comes when many of the calls that come to law enforcement can be released quicker and the mental-health system can take over because it’s not a law-enforcement function,” Fuller said. “Way too many times now, law enforcement is the only answer. We’ve had serious cases where we’ve had to engage someone physically, take them to jail, and the caller is saying, ‘This is not what I wanted,’ and neither did we.”
The new project has four “pillars,” said Lindsey O’Neil, program supervisor for Integrated Services of Kalamazoo, the county’s community mental-health agency. O’Neil is working with the county’s 10 police chiefs to oversee project planning this year, with implementation in 2023.
The first pillar is creating “a countywide call response model that has (mental health) clinicians available to respond in real time to crisis situations,” O’Neil said. “How that will look will depend on the model this group chooses to adopt.”
The second piece is opening a 24-hour mental-health crisis intervention center to provide first-responders a place to bring people needing immediate attention, as an alternative to hospital emergency departments. The new facility will be located at 440 W. Kalamazoo Ave. and is expected to open next year
RELATED: Behavioral health urgent care planned for downtown Kalamazoo
The third piece is creation of a countywide group that will meet regularly to focus “on our high-risk, high-needs individuals who are high utilizers of EMS and have a frequent recidivism rate,” O’Neil said. “We’ll try to create a holistic plan where we can wrap services around those individuals and families to reduce the frequency of calls and frequency of crisis situations.”
The fourth and final piece, she said, is creating a countywide coding system for local police departments to facilitate better data collection on calls involving behavioral health.
Such a coding system would allow officials and the public to know how many such calls are received, and how many result in an arrest or a hospitalization or a diversion to other programs, O’Neill said.
It’s an ambitious project but it bodes well that the collaboration is being driven by law enforcement, said Jeff Patton, head of Integrated Services of Kalamazoo.
Local police chiefs “approached us and said, ‘We’re ready. We want to take this next step. Our communities are saying we need it,’ ” Patton said. “They’re the ones spearheading it, and saying this is what we want to do, and they’re putting their money where their mouth is, I’ll say that.”
The Memphis Model
Kalamazoo County is using the “Memphis model” as a template for the project.
That model was developed after a 1987 Memphis police shooting in which a mentally ill man was shot dead by police. In the backlash following the death, the city worked with the National Alliance on Mental Illness and civic leaders to develop new strategies for handling people experiencing a mental-health crisis.
From this emerged specialized training to educate police about mental-health symptoms and conditions, and how to effectively respond to calls involving behavioral-health issues.
Kalamazoo County law enforcement agencies having been conducting these Crisis Intervention Team trainings since 2008, most recently this spring when 42 officers from Kalamazoo, Portage, Kalamazoo Township, Vicksburg, Kalamazoo County Sheriff’s Office and the Michigan State Police participated in the 40-hour program.
The program gets high praise from local police agencies.
“In Kalamazoo County, we’ve built a culture of problem-solving based on CIT,” said Capt. Rafael Diaz of the Kalamazoo Department of Public Safety “It’s not as though it’s a new program and people are uncertain as to the efficacy and whether it has good results. I will tell you almost that within hours of taking the class, someone will have an experience where they can use those skills on the street.”
But a U.S. Department of Justice guide on CIT and the Memphis model underscores that police training is only part of the program.
“The hardest lesson we’ve learned is about the temptation of training,” the guide says. “Law enforcement and jails continue to be the de facto system for responding to mental health crisis situations and housing people with mental illness. Law enforcement agencies are under immense pressure to address this systemic challenge. We hear daily from agencies eager to learn about CIT training, hoping it will be a solution to their problems. Training is an important step, but the goal of CIT is not to train officers to be kinder and gentler as they take people to jail.
“The goal of CIT is to keep people safe and that is not possible if jail is the only destination during a mental health crisis,” the guide says. “A CIT program should help people get connected to treatment and services and offer hope for recovery… Training-only approaches do not improve safety and reflect a misunderstanding of the CIT model. The CIT model is not just about policing; it is about community responses to mental health crises.”
For Kalamazoo County, the challenge now is getting to that next level. The four pillars of Kalamazoo County’s new project are all elements from the Memphis model.
Among Kalamazoo County’s 10 police departments, the Portage Department of Public Safety has done the most with CIT training — almost all of their officers have gone through the CIT program, compared to about 90 of Kalamazoo Public Safety’s 240 officers.
Portage also requires its officers to flag calls with a behavioral-health component. A list of those calls are turned over every week to Integrated Services of Kalamazoo, which reviews them to see which are the best candidates for follow-up. On Wednesdays, an ISK social worker goes out with a Portage police officer to knock on doors and steer individuals and families to appropriate services.
To be sure, some police calls require immediate intervention, such as taking someone to a hospital emergency department, Blue said.
The calls referred for ISK follow up are “more the things that can slip under the radar, where we could be responding on a barking dog complaint, and we find a senior citizen who is suffering from Alzheimer’s dementia has never been to a doctor and there’s hoarding in the house,” he said. “The clinician takes the lead on the follow up, but we’re the ones who initiated it.”
But Portage’s experience also underscores the roadblocks that exist, Blue acknowledged. People may refuse mental-health counseling or other services. They may accept the offer for help, but then fail to follow through. They may lack insurance to pay for counseling or other services. The statewide shortage of in-patient psychiatric beds remains an ongoing issue. Medical confidentiality laws mean that law enforcement may not know what happens once clinicians take over.
The new collaboration will not be a silver bullet, officials acknowledge, but it should improve the ability of law-enforcement officers to connect people with mental-health services and make those efforts more consistent countywide.
“As we start to pull the data and look at what’s happening in the community, I hope we can really pinpoint those high-risk, high-need areas, and figure out who needs what and where,” O’Neil said.
Like Patton, O’Neil said she is impressed by the eagerness of police chiefs to get a plan in place.
“There’s a lot of moving pieces to this and they have put all hands on deck,” she said. “They have said, ‘Whatever you need, whoever you need to make this happen, we’ll make it happen.’”
This story is part of the Mental Wellness Project, a solutions-oriented journalism initiative covering mental health issues in southwest Michigan, created by the Southwest Michigan Journalism Collaborative. SWMJC is a group of 12 regional organizations dedicated to strengthening local journalism. For more info visit swmichjournalism.com.
More on MLive:
Saying these words could help someone who is contemplating suicide
How to be happier: 13 ways to improve your mental health
A holistic approach is key to student mental health and retention
9 tips for picking the right mental-health therapist for you