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LA Makes (Slow) Progress On Getting Police Out Of The Mental Health Business

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Psychiatric Technician Connie Villareal inside a county "therapeutic transport" van. (Courtesy L.A. Dept. of Mental Health)
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The mass movement for police reform that exploded in the wake of the killing of George Floyd also led to a renewed push to re-think our reliance on law enforcement to handle thousands of mental health crisis calls every year.

The numbers make the case: People with untreated serious mental illness are 16 times more likely to be killed during an encounter with the cops than other civilians, according to the Treatment Advocacy Center. And 25% of people shot at by the LAPD from 2015-19 were perceived to have a mental illness.

Since last summer, we've seen a flurry of initiatives in the city and county of Los Angeles aimed at alternatives to crisis response. But several months in, where do they stand?

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BABY STEPS IN THE CITY OF LA TOWARDS UNARMED RESPONSE

In October, the L.A. City Council approved a motion that called for the city to develop an unarmed model of crisis response that would divert non-violent calls for mental health and substance use situations away from law enforcement. Here's what's happened since:

  • This week city staff told the council that they plan to model the effort on the CAHOOTS program in Eugene, Oregon. Run out of a mental health clinic, CAHOOTS deploys teams made up of a medic and a crisis worker -- no police. (The LAPD's Mental Evaluation Unit deploys teams comprised of a police officer and a social worker; more on that below.) The program says out of roughly 24,000 calls in 2019, the team had to ask for police backup less than 1% of the time.
  • We still don't know what the L.A. program's scope will be. It's unclear whether the city will try to go big or just launch a small pilot program. There are concerns from both council members and advocates that a model from small and less diverse Eugene (with a population of about 170,000, compared with L.A.'s four million) will face difficulties here. Whatever approach the city decides on, the program is slated to start this fall or winter.

THE CITY MOVES TO MORE QUICKLY DEPLOY ITS COP-SOCIAL WORKER TEAMS

For years, the LAPD's Mental Evaluation Unit (MEU) has sent out two-person teams of mental health clinicians and officers to try to defuse mental health crisis situations and get people help instead of arresting them. Last year the department had 17 of these teams. Now the department has launched a pilot program that's aimed at getting those teams into the field more quickly:

  • Until now, a patrol officer would have to call in these teams as secondary responders. Under the pilot, they'll go out at the same time. But questions remain: how will dispatchers decide which calls are appropriate to handle in this way? Another issue: There aren't enough teams to respond to all the calls the MEU gets. In 2019 they got about 20,000 calls but could only respond to about 8,000 of them.

THE CITY AND COUNTY TEAM UP ON THERAPEUTIC TRANSPORT VANS

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Last year, city and county officials announced a joint pilot program to better utilize the County Department of Mental Health's fleet of five "therapeutic transport" vans:

  • Staffed with mental health experts and equipped with TV monitors that allow the patient to connect with a psychiatrist remotely, the vans will be based at five city fire stations. County mental health specialists will also deploy to the stations and be integrated into the 911 system, although officials didn't have details on which calls will be directed to them. The pilot was expected to launch in January, but it hasn't begun yet; the city still needs to approve a memorandum of agreement.

THE CITY AND COUNTY ARE DIVERTING SOME 911 CALLS TO CRISIS COUNSELORS

  • Another LAPD pilot program transfers non-violent 911 mental health calls to crisis counselors at Didi Hirsch Mental Health Services, which runs the National Suicide Prevention Hotline. Didi Hirsch estimates it could handle some 28,000 calls a year.
  • Last month, the L.A. County Sheriff's Department established a direct line to the Department of Mental Health so some 911 calls could be diverted to Mental Health's Help Line.
  • This week, county supervisors approved a measure that calls for exploring how the Department of Mental Health and Didi Hirsch might transfer calls between the two.