Mobile crisis teams for mental health crises have been in practice for several decades. However, when it is brought up in public policy to include this practice in more areas of the nation, there is pushback.
Many people suggest that police are the best to respond because of their ability to manage many situations and their expertise in public safety. However, these mobile response teams have successfully safely managed mental health crises with minimal police intervention. For example, CAHOOTS, a mobile response team in Eugene, Oregon, only had about one call out of 60 calls per day on average, where police had to assist them with a call.
Mobile crisis teams are not put in place with hopes of replacing police. Instead, they are designed to support the police and the community. These programs respond to calls that involve individuals in a mental health crisis but are not necessarily a danger to the community.
Having mental health professionals respond to these calls is best practice because police are not always adequately trained to respond to mental health crises in the way that mental health professionals are. CIT International published a paper expressing that police are not needed on most mental health crisis calls.
Other models include co-responder teams. Even with co-responder models in which mental health professionals ride in a car alongside a police officer, the police officer is typically not necessary on most of the calls they respond to. However, many would argue that having police on the scene for safety is advantageous for mental health professionals. Ultimately it likely depends on the needs of the community.
What is a mobile crisis response team?
Police are dispatched to hundreds of calls and are expected to complete calls promptly and diffuse situations. In addition, mobile crisis response teams have been put into place to respond to calls requiring specialist knowledge in mental health.
Police officers receive much training but often are unaware of how to navigate mental health crises best. Mobile response teams have these skills and knowledge because they may include a mental health professional, EMT or paramedic, and even a nurse.
Additionally, mental health crises often require treatment, whereas incarceration would further cause problems for them. Unless alternative destinations are available for police officers, they usually only have two choices: jail or the hospital. But most hospitals are not equipped for mental health care. As a result, mental health professionals can better assess if these clients need hospitalization or if the crisis can be solved on the scene.
What are the benefits of a mobile crisis response team?
- The community builds trust in the mobile response team. In addition, community members feel less intimidated by the mobile response team because of the lack of power differential compared to police officers. While police officers need to have that power differential in certain situations, it often is ineffective in managing a mental health crisis.
- Decreased load on the police officers. In 2019, the mobile crisis team in Eugene, Oregon, known as COHOOTS, took a load of 18,583 calls off of police officers. This amounts to more than 60 calls per day. This allows for police officers to respond to more crimes and public safety issues.
- It helps police officers gain knowledge about the community. Increased involvement of mobile crisis teams in the community allows for increased safety and helps the police officers gain knowledge about when someone might be in crisis. The more the mobile crisis teams respond, the more documentation police have to help inform them about a call they may receive. These two teams must communicate together to make this system work. Accomplishing this is task is easy with software like Julota.
How can you stay safe when responding?
When responding to crisis calls in the field, it is imperative to keep safety at the forefront of your mind. This includes the safety of yourself and the safety of the community and the individual in crisis.
When individuals are in crisis, they have difficulty using reason because they are running on adrenaline. Because of this, their decision-making skills are altered at the moment. Unfortunately, sometimes this means that they make decisions that negatively impact the safety of themselves or others.
When arriving on the scene, park on the road if possible so that you can quickly leave the premises if needed. Scan the scene to ensure it is safe – take note of any suspicious behaviour and contact the police if you feel unsafe. Although mobile crisis programs have rarely had to call the police for backup, it is rarely necessary.
Having accurate and up-to-date information on an individual can prove to be invaluable. Such information as is the individual currently in treatment, are on medication, what triggers do they have, topics to avoid with them, have been in contact with law enforcement previously. All of this information can be shared with proper consent and compliance on the Julota platform.
De-escalation Techniques
The Crisis Prevention Institute (CPI) offers training on de-escalation techniques when a crisis presents itself. These techniques focus on stabilizing a crisis situation with verbal and non-verbal techniques to avoid physical restraint as much as possible.
CPI emphasizes the importance of keeping in check with yourself in times of a crisis. The first place to check in is your nonverbal response. Next, you want to make sure that you are standing at a reasonable distance from the individual in crisis so that they have enough personal space to process the situation and feel safe.
It’s also essential to maintain body language that is neutral but also keeps you safe. For example, make sure to maintain neutral facial expressions and tone of voice. In addition, keep your body open toward the person to show that you’re there for them and maintain a strong physical stance if it does escalate.
When interacting with individuals, ensure that they feel heard and validated. This helps them to get their feelings and needs out and prevent them from further escalating. You can do this by focusing on the emotions they’re experiencing.
For example, if they are experiencing delusions, it will only escalate the situation to challenge their misconceptions. Validating that these delusions are scary or frustrating for them will likely yield a more positive response. Ensure that responses to emotions and needs are said with empathy in your voice and a nonjudgmental tone.
The ultimate goal is to get to some solution to meet the individual’s needs. For some individuals, this may be hospitalizations, and others may have just needed to talk it out.
As you figure out the solution, ensure that you are being flexible and giving the individual time to process. Their brain takes longer to process logic in times of crisis. Allow them to use silence to think about what they want and make a decision.
Trauma-Informed Care
Trauma-informed care (TIC) is an approach used mindfully by many behavioural health providers to not re-traumatize individuals who have experienced trauma. Since it is impossible to know if someone has been through trauma when first meeting with them, it is recommended by TIC that you approach someone in a way that acknowledges that they are likely to have been through trauma in their life. TIC operates on five fundamental principles:
- Safety: Make the individual feel physically and emotionally safe. It would help if you appeared inviting and kind. This can be achieved through effective non-verbal communication described in the above section.
- Choice: Make it clear that the individual has a choice and clearly state what those choices are.
- Collaboration: Approach the client in a way that shows that you two are on the same level. A power differential shouldn’t be evident because this can be triggering for those who have experienced trauma. If they try to challenge you and create a power differential, ignore this effort and continue to focus on the crisis at hand.
- Trustworthiness: Make an effort to make the client feel comfortable and safe and maintain their privacy to build their trust in you.
- Empowerment: Validate and affirm the client’s feelings, wants, and needs. Make them feel heard and seen by listening and giving them the chance to talk through their crisis.
The Importance of Communication Between Providers: How Julota Can Help
While it’s very much a debate whether police officers need to be present during mental health crisis calls, it is still crucial that they communicate with the mental health responders.
When they’re in communication and work together, these service providers can better help those in need. Frequently, community providers are all separate and communicate internally.
They rarely share information externally with each other. Julota helps fill this gap by offering software that effectively and efficiently connects local service providers into a well-coordinated network. It allows necessary service providers, such as EMS, behavioural health, law enforcement, social services, and healthcare, to share information that can help each other when responding to people in crisis and who need help.
For example, suppose police officers respond to a call in which an individual needs mental health services. In that case, they can use Julota software to know right away if the person is already enrolled in mental health services. They can also tell which healthcare facilities are available to evaluate the individual if additional assistance is necessary.
Schedule a demo today to learn more about how Julota can help your community.