While San Antonio prepares to deploy a new, mental health-focused team to respond to certain 911 calls next month, another program — also aimed at reducing the number of emergency detentions for people experiencing mental health issues — will enter its third year of operation this summer.

City Council unanimously approved on Thursday the nearly $383,000 annual budget for the Program for Intensive Care Coordination (PICC), which aims to connect residents to outpatient services rather than waiting until a mental health crisis forces law enforcement to involuntarily take them to a local hospital.

“This is the kind of collaboration that our citizens have called for; an overall care plan that aims to prevent more crisis,” Councilwoman Melissa Cabello Havrda (D6) said before the council’s vote.

The program, funded by Southwest Texas Regional Advisory Council, is comprised of two police officers and a supervisor who are specially trained in mental health issues. The PICC team — a police officer, paramedic and mental health clinician from the Center for Health Care Services — makes contact with a rolling list of the top 100 or so people who have been detained by police against their will at least six times. The team visits these folks to preemptively find out if they need any help.

For example, if the person is out of medication, the team can make sure they get more. If they need a clinical visit, the team will provide the transportation, SAPD Assistant Chief Karen Falks, who oversees the department’s mental health programs, told the San Antonio Report. “They identify what that person needs and they connect that person to that service — whatever it is.”

Some people remain on the list for years, others get help and are removed and others drop off but then end up back on the list, she said. “But we’re still gonna pursue [them] … we’ll meet them where they are.”

PICC began as a six-month pilot program in July 2019. Before it was established, the San Antonio Police Department issued roughly 14,000 emergency detentions — that means officers took people experiencing mental health crises to hospitals against their will — in 2018. That number jumped by about 900 in 2019, then dropped back down to about 14,000 in 2020.

Last year, however, emergency detentions decreased by more than 30% to just over 9,500, according to the city. Falks attributes that decrease to the PICC. Since the program launched, the PICC team has contacted 328 patients more than 1,200 times.

Before PICC, the city found that a cohort of about 50 patients was detained nearly nine times and voluntarily went to an emergency room nearly eight times on average over the course of a year. Once in the program, those patients were detained 1.2 times and averaged about two emergency room visits.

“We’re going to continue to help this very vulnerable population because they need help,” Falks said. “That’s why we’re trying all these programs.”

The PICC team has the same elements as the pilot emergency responder team, SA Core, which also features a police officer, paramedic and mental health clinician. That team will respond to certain mental health-related 911 calls. While the PICC team is proactive, SA Core will be reactive.

The SA Core team emerged as part of the city’s police services review in 2020 in response to protests in the wake of the police killing of George Floyd.

The teams may often have an overlapping constituent base, but the SA Core team will find more patients who haven’t connected with any mental health care yet, Falks said. “Now we’re going to reach a whole other part of the community that needs to be connected with services.”

Iris Dimmick

Senior Reporter Iris Dimmick covers public policy pertaining to social issues, ranging from affordable housing and economic disparity to policing reform and workforce development. Contact her at iris@sareport.org