A Successful Partnership of Two Community Systems; The Houston Police Department (HPD) and Mental Health and Mental Retardation Authority of Harris County (MHMRA)

A Successful Partnership of Two Community Systems; The Houston Police Department (HPD)

and Mental Health and Mental Retardation Authority of Harris County (MHMRA)

Crisis Intervention Response Team (CIRT)

Mission Statement

To provide a more professional and

humane response to individuals in

serious mental health crises.

Houston/Harris County Facts

4 million people in County

Approximately 700 square miles

2.2 million people within the City of Houston

Estimated 540,000 have mental illness, 147,000 have Serious and Persistent Mental Illness

Over 20,000 times a year an HPD Officer is dispatched to a call involving a mentally ill person

Texas is 49th per capita in funding for the mentally ill

Historical Collaborations

1986: Harris County Psychiatric Center opened (HCPC) 1991: Partnership between MHMRA and HPD began to

streamline the procedures in obtaining a mental health warrant

1999: HPD CIT piloted 1999: Psychiatric Emergency Services program opened Between 1999-2004 the County approved funding for all

the major components of a comprehensive psychiatric emergency program

Law Enforcement to PES

On average, the PES treats 3,700 involuntary consumers brought in by law enforcement

On average, 30-35% of total admissions to the unit are brought by law enforcement.

Approximately 65% were treated and did not require inpatient hospitalization

Law enforcement takes another 5% from the PES to jail after a brief psychiatric evaluation.

Factors for the creation of CIRT

Needs identified from the relationship between HPD/MCOT/PES

Increase in police calls involving individuals with mental illness resulting in: Fatal shootings Mentally ill persons being jailed for petty crimes that result from

their mental illness (e.g., criminal trespass, public intoxication)

Increase in demand for limited supply of mental health services

Crisis Redesign Initiatives

A planning committee with more than 100 participants from over 40 public, private, criminal justice, and advocacy organizations

Identified major components of an ideal Crisis Response System for Harris County

Proposed 19 possible projects, of which 9 projects were ultimately approved.

CIRT was one of the 9 approved projects. MHMRA & HARRIS COUNTY COMMISSIONER’S COURT

FUNDS: $500,000 on CIRT $9,000,000 on the NPC $6,000,000 on MCOT

RESPONSE TEAM

CRISIS INTERVENTION

CRISIS INTERVENTION RESPONSE TEAM

Collaboration between MHMRA of Harris County and Houston Police Department

Partners a Crisis Intervention Team (CIT) trained officer with a licensed mental health clinician from MHMRA.

CIRT evolved from a successful, mutually beneficial relationship between MHMRA Crisis Programs and the Houston Police Department’s Mental Health Unit

The CIRT program augments HPD’s Crisis Intervention Team (CIT) program

CIRT Implementation

Pilot Program: May 2008 Full Implementation: (3 Units) December 2008

Team Expansion: (+2 Units) April 2009

Team Expansion: (+2 Units) February 2010

Current total 7 Units

CIRT Staff Qualifications/Requirements

Police Officers must have the 40 hour CIT training certification.

Police Officers must have a minimum of three years experience working as a Police Officer

Master’s Level Clinicians are licensed by the state and must have a minimum of five years mental health crisis service experience

Both clinicians and police officers receive ongoing specialized training

CIRT Program Responsibilities

Responds in a watermarked police vehicle to the more serious CIT calls where they:

Conduct on-scene mental health assessments Assess for suicide/lethality risk Access & provide MHMRA mental health treatment history Link and coordinate with appropriate community resources Facilitate engagement in ongoing mental health services Provide crisis intervention and resolution on-scene

CIRT Program Responsibilities, cont.

Prisoner assessments at the city jails Transportation of involuntary consumers from

local MHMRA clinics to emergency psychiatric facilities

Respond to all SWAT calls as a resource for the on-scene commander

Provide overnight mental health assessments for walk-ins to county psychiatric hospital

Responsibilities of CIRT Clinicians

Conduct mental health evaluations and assessments of consumers

Assist in determining a clinically appropriate disposition for consumer

Provide on-scene trauma support for survivors Provide community resources to families and

consumers

Responsibilities of CIRT Officers

Handle all prisoner control/safety issues

Provide safety for the clinician, consumer and community

Address issues involving criminal charges

File Emergency Detention Orders

Assist in determining the appropriate disposition supporting consumers’ needs and safety

CIRT StatisticsMar ’09-Mar’10

Activity TOTAL

CALLS FROM HPD DISPATCH 4,005

SELF INITIATEDINVESTIGATIONS

1,135

SWAT CALLS 31

E.D.O. 1,154

ARRESTS 67

COMPLETED REFERRALS 139

REFERRAL FOLLOW UPS 263

Successes

Improved public safety Improved relationship between the community, Houston police

department and MHMRA Improved public perception of police interactions with individuals

with mental illness and their families Individuals with mental illness are directed into appropriate

mental health treatment Increase in consumers being diverted from jail into appropriate

mental health services Expedited admission process to mental health unit in jail when

incarceration is necessary

Local Challenges

Jurisdiction limited to Houston City limits Budget restraints that restrict the number of CIRT units

available in the City of Houston Shortage of inpatient psychiatric beds Overwhelmed clinics Lack of safe, adequate housing options Inability to oversee linkage of services for those

patients non-adherent to treatment

Awards and Media Recognition

Houston Press Fox 26 News Houston Chronicle National Public Radio Al Jazeera English Chief of Police Unit Citation-HPD National Behavioral Health/CIT Awards:2008

CIT Officer of The Year Behavioral Health Employee of The Year

Houston Police Department Awards Ceremony:2009 CIRT Lieutenant -Mid Manager of the Year CIRT Officer- CIT Officer of the Year

Houston Police Department Awards Ceremony:2010 CIRT Officer- CIT Officer of the Year

Where do we go from here?

Expanded the number of CIRT units – currently only 7 for a population of over 2.2 million

Expand the collaboration to include the Harris County Sherriff’s Department to extend CIRT coverage throughout Harris County

Continue to educate the community Continue to learn from experiences and refine service

delivery in daily operations as well as improve community relations and perceptions

Where do we go from here? (cont.)

Chronic Consumer Stabilization Initiative Mental Health Courts Continue to seek more comprehensive

collaborations between service providers (e.g., V.A./State Hospitals)

Questions?

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STIGMA

SUICIDE

“Suicide by Cop”HOPELESSNESS

FEAR MISCONCEPTIONS

CIRT DECREASES

HOMICIDES

POLICE ENCOUNTERS

DOMESTIC VIOLENCEUNNECESSARY JAILINGS

Contact Information

Mental Health Unit Investigator/Officer – CCSI, CIRT– Rebecca Skillern, LPC-S– [email protected]

Mental Health Unit - Police Officer – CIRT– Eric Chimney, Sr. Police Officer/CIRT Officer– [email protected]

Mental Health Mental Retardation Authority of Harris County– Michael Erickson, LPC– [email protected]