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It's Not Just the Money

At one point with Project EDGE, I was asked to develop and present a TED-style talk on the EDGE program. I wanted to run my ideas past the boots-on-the-ground EDGE staff; I felt that it was critical to get the ground truth across in this talk. We went around the circle a few times, and there was a lot of brilliant observation.

But there was one point that the team agreed was the main takeaway: our streets are less tense.

It’s true that law enforcement and mental health collaboration programs (the term “co-responder programs” is emerging) save communities money. We see a reduction in high utilizer usage of emergency services (especially when a program is wise enough to implement a strong peer support presence in their program); there is a reduction in incarceration; time invested up front reduces subsequent calls for service. All of this translates to cost savings for emergency services.

But leadership and policy makers can have a harder time seeing the on-the-street changes: better job satisfaction for officers; changes in how respondents in crisis are approached; changes in how the community views police.

As supervisor of Project EDGE, I was invited to a Leadership Academy for one of our partner communities. Local police had some time to present to the Academy. They chose to use some of their time to share how their co-responder program works.

They staged an enactment: one of the officers was a professional actor on the side, and played a psychotic person (very effectively, I might add). Another played the responding officer. A third played the reporting party, who had just been assaulted by the psychotic character.

The responding cop spoke to the group: “Okay, here’s how this used to go.” He approached the perpetrator, demanded that she keep her hands in sight at all times, was firm, controlling, and in command. The perpetrator escalated and ended up on the ground, cuffed. She went to jail.

Then he addressed the group again: “Here’s how we do this now that we’ve worked with mental health on-scene.” He approached the woman casually, and asked her name, where she was from. While making strange hand gestures, she responded that she was communicating with Vishnu, and Vishnu had told her that man over there was trying to destroy the world. The officer stepped aside, and used his radio: “243, is mental health in service?”

I expected a mental health worker walk up and interact differently. I thought the officer would standby and observe. But they threw a curve ball, and dispatch responded: “243, fifteen minutes out.” Oh-ho! This cop is stuck for fifteen minutes alone with a psychotic person!

The officer sat down on the curb, stretched, offered up his name, asked hers. She told him she was Cheryl. He gestured for her to have a seat if she liked. She sat next to him. He asked when the last time she had anything to eat was. She said it was a long time. He didn’t have food, but offered her a water bottle. They chatted casually about Vishnu until mental health arrived.

The officer introduced them. The clinician chatted with Cheryl for a bit, and then moved, with the officer, out of earshot: “I have everything I need to write a hold.” “Let’s do it,” the officer said. This time, Cheryl was kindly and compassionately transported to the hospital.

The point: the officers in this local police agency are so proud of how they interact differently, that they wanted to show city leadership.

Co-responder programs save money, sure. When a psychotic respondent like Cheryl is booked into to a jail, it can be very difficult, if not impossible, to move them to a psych facility. Care must be provided in the jail. Even if we ignore how misaligned that is, most jails don’t have the resources for that kind of care. And even if they do, it’s often a social injustice; this respondent may not have been responsible for her behavior.

But the message that the EDGE staff were trying to send outward through my TED-style talk is what happened in that moment, right there on the street: the respondent was not traumatized; the officer was not uptight, and felt better about the interaction and the outcome. The next time this respondent encounters an officer, maybe she won't be as alarmed, and she may be less likely to escalate. And the officer has more confidence in his ability to help mentally ill respondents stay calm, and isn't as stressed about potential escalating behavior. The street slowly takes a breath...

It's not just the money. Co-responder programs change our quality of life.

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