Win Big with a Co-Responder Program to Manage Mental Health Crisis Calls

Co-responder programs team mental health and substance abuse professionals with law enforcement officers. Together, these teams manage the community’s responsibility for mental or behavioral health crisis calls.

While co-responder models are gaining popularity across the country due to their efficient and practical success, some communities still struggle with how much this program could help them. 

What can a Co-Responder Program do for your jail crowding, law enforcement, and mental health crisis call management?

Co-responders bring training and expertise to emergency calls that law enforcement officers and emergency medical responders do not have. We have had medical professionals responding to appropriate emergency calls for many years.

Yet, despite the evidence that mental health is just as physically tied to the individuals as physical health, there seems to be hesitance in many areas to have mental health professionals respond to appropriate emergency calls the same way physical medical professionals respond. 

Instead of recognizing that mental health requires the same level of expertise in emergency response as physical health and creating policies and programs to address this, many individuals with significant mental health problems are assessed by police officers. Law enforcement may then need to bring the individual to an already crowded and overwhelmed jail due to typically lower-level offenses they have committed simply because they lack a better option. 

If not placed in jail, they could be placed in a law enforcement mental health hold, tying up officers in prolonged paperwork and duties to transport to hospitals that may or may not admit the patient. Then, once discharged, the officers may have to transport individuals back to their community. This drawn-out process can take up multiple hours of an officer’s shift depending on how far the closest available inpatient hospital is. 

Establishing a co-responder program allows mental health workers to be primarily responsible for these calls and for facilitating services that they are much more aware of and connected to. In addition, this established practice saves on jail usage and the officers valuable time as they can quickly return to duty and focus on problems in the community that require their expertise and specialized training. 

Reports on the efficacy of these programs in the state of Colorado show that having an active co-responder program resulted in more jail diversion to more appropriate placements and a smaller percentage of law enforcement mental health holds being utilized

In Albuquerque, NM, the Co-responder program showed that in two years of existence, the team response to calls led to 40% of calls having no needed action, 33% of calls ending in a voluntary transport for mental health services, and only 3% required law enforcement action. This is a huge save for the jail, law enforcement officers, and the community. Making the most of a co-responder program saves everyone in the community. 

In New York City, calls were analyzed, and it was noted that “Of the more than 170,000 mental health crisis calls to 911 last year, an estimated one call every three minutes, the majority of concerns were people who just needed help. There was no indication of violence at all,” reported first lady Chirlane McCray. In these situations, it makes no sense to tie up law enforcement officers’ time with something mental health specialists or co-responder teams could handle more effectively and efficiently. 

Every law enforcement officer in the country can probably attest to the feelings of overwhelming amounts of felt responsibility and duties they experience regularly. This level of stress leads to exhaustion and impairments in both decision-making skills and the ability to protect themselves and others when duty calls for that.

Separating the calls that require their specialized training and the calls that need others to respond to them would take a significant burden off.

Our law enforcement professionals deserve to have the ability to take care of their own physical and mental health to be their best in both their careers and personal lives. Co- responder programs are helping with that in every area they have been established.

When already established co-responder programs can expand to cover more hours and areas, this facilitates law enforcement’s return to more typical duties on a higher level. For example, in communities with an Office of Behavioral Health-funded co-responder program, officers reported they could return to patrol duties more aligned with their training and expertise, rising from 26.4% to 38.4%.

What can a Co-Responder Program do for your community and help manage mental health crisis calls?

A co-responder program can benefit the community at large in many ways as well. 

When communities adopt a co-responder model, other patrol teams can focus on much-needed police work in the community.

When there aren’t enough officers to ensure investigations can be completed efficiently and effectively, offenders hurting the community are left on the streets, continuing to commit crimes and emboldened by the fact that they haven’t been caught. 

Another program style similar to co-responding, Denver, Colorado, uses the  Support Team Assisted Response (STAR) program. In this team, healthcare workers are dispatched to incidents involving issues with mental health, poverty, homelessness, or substance abuse.

STAR providers only respond to incidents in which there is no evidence of criminal activity, disturbance, weapons, threats, violence, injuries, or “serious” medical needs, as those may fall under the expertise of law enforcement or medical professionals. By freeing law enforcement from responding to these mental health crisis calls, they are more available to respond to calls where they are most needed. 

According to the Denver police chief, in a CBS News report, he believes the program “saves lives.” 

During the program’s first six months, from June 1 to November 30, 2020, these professionals responded to 748 calls, including trespassing, welfare checks, narcotics calls, and mental health crisis calls. In all of these calls, not one required law enforcement to be pulled from regular duty or for any arrests to occur.

This allowed law enforcement to continue patrolling the streets and responding to their own calls, making for a much safer community.  

Law enforcement officers provide an invaluable service to their communities. Still, no service can be as beneficial as possible if they are stretched thin and offer many different types of services. Co-responder programs help ameliorate this struggle by allowing other patrol teams to focus where they are most needed.

What does a Co-Responder Program do for Individuals in need of care?

A statewide report on the efficacy of co-responder programs showed that between July and September of 2020: 3,473 individuals in need of mental health care were served by the programs, and about 25% of mental health crisis calls were tied to recognized high-needs individuals who called multiple times for assistance. In addition, co-responders provided needed services such as an assessment for needs, referrals for services, and connections to the available resources in 93% of calls. 

Those who need mental health services are 16 times more likely to be killed by police than the general population, according to Dr. Jack Rozel, president of the American Association for Emergency Psychiatry. Dr. Rozel said, “If I have a heart attack or a diabetic emergency and my wife calls 911, the odds are overwhelmingly likely that I will end up on my way to the emergency department. If I am suicidal and I call 911 for help, there’s a good chance the police will respond,”   

This also applies to psychosis; if a community member calls in a report on someone who is seemingly psychotic, the police respond. Law enforcement officers do not receive the years of training that mental health professionals do in how to handle crisis situations with individuals who are suicidal or paranoid, and hallucinating. It requires an entirely different skill set than law enforcement officers need to respond to someone without these concerns that are causing a disturbance in the community. 

Co-responder teams have more connections to local resources and residential options for individuals experiencing a mental health crisis. However, in many states, resources are severely limited due to funding, and individuals in need of assistance may not know how to access them or even that they exist.

Co-responder teams bridge the gap between emergency services and community services for individuals in need. 

Expecting one type of person to respond perfectly and appropriately to a gang shootout and then to an individual experiencing a psychotic attack or suicidal planning is illogical. Just as an EMT should take the lead in a heart attack, a mental health clinician should take the lead in a mental health crisis. Likewise, Law enforcement should take the lead when an individual is endangering others’ lives or in instances where the law is being broken, and people’s lives are in danger.

When individuals who need substance abuse help are linked to inpatient or outpatient resources to manage their illness instead of being placed in jail, they are much more likely to recover. 

When individuals with mental health concerns are linked with community or outpatient resources that can help them receive needed medications, counseling, and support groups, they are more likely to stay in treatment and maintain progress. Conversely, suppose they are placed in jail. In that case, they may regress because they may or may not be able to receive proper medications in jail. Moreover, they are unlikely to receive any other type of support regularly and are likely to be exposed to some form of trauma likely to exacerbate their condition. 

How do I track who needs help when there are privacy concerns to consider?

One of the biggest struggles in any community trying to implement a co-responder program is managing the individual legal obligations to privacy required by each professional area. For example, mental and emergency health professionals are bound by HIPPA not to discuss anything treatment-related with anyone not directly authorized by the individual.

In most situations, clinicians cannot even acknowledge that the individual is receiving health services. Violating HIPPA for these professionals can result in significant fines and, in extreme cases, jail time. 

Additionally, police and substance abuse professionals have their own sets of privacy laws that must be followed or are also subject to censure. This emphasis on privacy is significant for protecting individuals’ right to privacy.

Still, it can get in the way of other public service entities knowing how to serve an individual best. For example, law enforcement may not know that the person they are responding to has a history of PTSD and may inadvertently trigger a severe episode resulting in dangerous and potentially tragic outcomes. 

However, to facilitate the best results, communication between all areas that interact with individuals in need must occur on some level. Communication and documentation systems must be shared to ensure that the right resources are given in as many situations as possible.

One system that is built to connect community systems while still following privacy guidelines for all parties involved is Julota. Julota is completely HIPAA-/mental health (42 CFR part 2)-/Criminal Justice Information System-compliant. Additionally, Julota can interface with any law enforcement CAD system ensuring all systems involved have access to what they need.

How do I show that the results are worth the cost?

According to the report on the state of the co-responder program in Colorado, “Future evaluation activities should assess opportunities to link co-responder program data to community mental health center enrollment data, as well as private and self-pay data, to understand how many people were connected to behavioral health services, who remained in services, and what services they received after being contacted by a co-responder program,” 

Anyone involved with federally or state-funded programs understands that data drives the funding. To maintain or grow a budget for a program, you have to track whom you serve, what you do, and what the results are.

This can seem quite daunting for something as complex as community emergency programs. However, community interoperability software can help you keep track of your data and keep you organized. Additionally, you will now have the reporting to present the benefits of your community co-responder program. 

If you need a way as a community to keep track of this data to show the benefits of a co-responder program, then you also need Julota. Julota is a cloud-based information/data program dedicated to helping communities implement more efficient programs and prove how many resources are saved with community data about individuals benefitting from different programs. 

Julota can help your community win big by keeping track of individuals served or in need of service and providing data to help you determine how much a co-responder program is saving your law enforcement program, individuals in need, and your community as a whole. 

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