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The latest death of a Black man at the hands of law enforcement in Bexar County turned County commissioners’ attention to the need for more mental health resources.
Bexar County commissioners voted Thursday to allocate $1.5 million of the County’s 2020-2021 fiscal year budget to fund a pilot program that would train 911 call-takers on mental health response and hire licensed mental health professionals to respond to emergency calls.
The pilot program was created as a direct response to the Aug. 25 death of Damian Lamar Daniels, a Black Bexar County resident killed by a sheriff’s deputy after he and his family made multiple calls asking for mental health aid. That same week, Bexar County Judge Nelson Wolff instructed County staff to recommend changes to mental health policy in the County.
Gilbert Gonzales, the director of the Department of Behavioral and Mental Health, praised the collaboration between different County departments and outside agencies, including the Southwest Texas Regional Advisory Council (STRAC). STRAC, a network of hospitals and first responders who maintain the regional trauma and emergency health care system for San Antonio and nearby counties, will help the Office of Criminal Justice implement a “co-responder” model for mental health calls that would typically be answered by the Bexar County Sheriff’s Office.
The co-responder model has been used in places such as Colorado to shift how mental health issues are addressed. Instead of sending a police officer to respond, mental health specialists can “co-respond” and offer their expertise when needed. These specialists would come from outside of law enforcement agencies. The sheriff’s office has mental health-trained deputies, but they are not licensed mental health specialists, Gonzales said.
All sheriff’s deputies receive 40 hours of “crisis intervention training,” but that is no match for the thousands of hours licensed mental health professionals put into their training, said Mike Lozito, director of the County’s Office of Criminal Justice.
“The better resources we have, the better outcomes we have,” Lozito said.
The program also plans to train all of the county’s 911 call-takers on how to triage mental health calls, Lozito said. Not every mental health-related call may require a licensed professional to respond, but there needs to be some kind of change, he said. Right now, people who answer 911 calls essentially have three places to direct the caller: the fire department, emergency medical services, and police. This pilot program aims to provide a fourth option where either the call-taker helps address mental health issues or dispatches the proper response to the caller. Currently, Law enforcement fields many of the mental health calls.
“It’s not fair to the police officer to have to make all those decisions on there,” Lozito said.
The pilot program will start in three or four weeks by putting two people on mental health response duty: one paramedic, provided by Acadian Ambulance Service, and one licensed mental health professional, provided by the Center for Health Care Services, STRAC Executive Director Eric Epley said. After a month or two, Epley expects to ramp up the number of people working in the program.
“We’re moving people from existing positions to get started quickly,” Epley said.
As the program begins, there will be one mental health professional and one paramedic on duty for a “power shift” each day between 1 p.m. to 9 p.m, Epley said.
“That will expand to full coverage later as we get into the expanded coverage,” he said.
Though some public commenters advocated for taking the responsibility of mental health response out of the sheriff’s office entirely, Epley stressed that the new program would complement the expertise law enforcement officers offer.
“I think mental health units in law enforcement are essential. … Even a specialized team like we’re talking about right now can’t go to every call,” he said. “The more capability and training for law enforcement, that’s always good. And at the end of the day, a more well-rounded officer is better for all of us.”
The $1.5 million allocated for the mental health response program will go toward hiring staff, training, and operational costs. Officials will determine how best to measure success as they get the program started, Lozito said.
“That’s what we have to learn,” he said. “The pilot is to address that because there’s no book out there for best practice models.”
Commissioner Tommy Calvert cautioned the court from thinking they had finished their work on mental health issues in the county. Wolff assured him and the others that the program was still a work-in-progress.
“This here is an initial start on how to respond to emergencies and mental health crises,” Wolff said.
“It’s so important that we handle this [well] … people are losing their lives in response to mental health issues. Confrontation breaks out and a shooting occurs and then someone is killed. Hopefully we make this work.”
Gonzales said commissioners’ approval of the program Thursday marked “one of the most important days for mental health, ever.”
“It signifies a complete acceptance and awareness of what we need to do,” he said. “You have an evolution of progress that has happened. We’ve gone from having police not being trained [in mental health response] at all, then having them trained, then those police being accompanied by mental health professionals. But now you’ve got an awareness of what we’re doing and what it will take to provide individuals with recovery and resiliency.
“What we want to do continuously is to increase early identification [of mental health issues], to increase the access to care, and to close the gaps to continuity of care with the least restrictive and most effective approach. Today, we can begin that.”