Local and national activist groups are calling on San Antonio officials to reject a plan to send a police officer, along with a mental health clinician and a paramedic, to respond to 911 calls involving mental health.

A new, local police reform organization called Accountability, Compassion and Transparency for San Antonio (ACT 4 SA) and more than a dozen groups want guns and badges taken out of the first-response equation, according to an open letter sent to city leadership on Tuesday.

“Including law enforcement as a core component of a crisis response team will only continue to result in situations involving arrest, excessive force, and/or unnecessary fatalities,” states the letter, co-signed by Texas Organizing Project, MOVE Texas, Texas Criminal Justice Coalition, Black Voters Matter Fund, and other groups. “Instead, individuals in crisis … deserve to have an option that will ensure the experience necessary to de-escalate the situation, properly assess and treat the individual on-site, and connect that individual to services and treatment options in the community.”

The multidisciplinary teams, which were proposed in the city’s 2022 budget, include officers in order to ensure the safety of the patient, community, and the other team members, according to BJ Wagner, the Meadows Mental Health Policy Institute’s senior fellow of justice system policy. An analysis by the institute informed the city’s proposed program. The teams are part of a comprehensive shift in how the city responds to — and prevents — crime, and the new approach must be approved by City Council.

Meanwhile, the San Antonio Clubhouse, which operates a community center for people with mental health conditions, recommends a compromise between the “never police” and “always police” philosophies.

‘A smarter way’ vs. safety

Ananda Tomas, founder and executive director of ACT 4 SA, wants to see San Antonio adopt teams that look like those in Eugene, Oregon, or Denver, which first deploy unarmed clinicians and paramedics to mental health calls. If law enforcement is needed, officers are called to assist.

“It’s just a smarter way to go about it,” Tomas said, noting that people experiencing a mental health crisis can be triggered by the presence of a uniform or a gun.

The letter sent by Tomas’ group recommends establishing a clear and narrowly defined set of circumstances that warrant the presence of law enforcement. “If that presence is necessary, ensure that law enforcement officers serve in a secondary role.”

In 2019, only 311 out of the 24,000 mental health calls that the Eugene team, known as CAHOOTS, responded to required police backup, according to a policy study.

San Antonio should follow the CAHOOTS model “rather than throwing police at every single issue,” Councilman Jalen McKee-Rodriguez (D2) said via text. “If there is a model that works, that saves resources and time, and allows us to really help serve people with compassion and care, then I am all for it!”

Councilwoman Teri Castillo (D5) is also supportive of removing police from the team.

“The CAHOOTs model has demonstrated de-escalation and safety measures that do not require law enforcement in every case by relying on a trauma-informed approach,” Castillo said via email. “As a city, we should replicate policies that work.”

The idea will likely face significant opposition.

“There are plenty of mental health calls that probably don’t require police intervention,” said Councilman Manny Pelaez (D8). “But the nature of 911 calls makes it impossible for dispatchers to know if the person in crisis is a threat to themselves or others. 

“I can’t, in good conscience, support sending a social worker on a 911 call with little more than a clipboard to protect herself from someone with a knife or a gun. To do so would be an abrogation of our duty to maximize public safety.”

The city’s proposed program would resemble those used by Bexar County and Dallas, where police officers in plain clothes are deployed as part of the response team. The officers on these teams are specially trained in mental health issues. Once the initial contact is made following a 911 call, the resident is then connected to resources — such as therapy, prescriptions, housing, and peer support — they need to get or stay healthy.

“[There] are cases where there is no need to send an untrained officer to handle the complex needs of someone experiencing a mental health crisis,” McKee-Rodriguez said.

The city will launch its pilot mental health response team in the Central Substation that covers downtown and stretches into the near East and North sides. Specifics about how the team will operate — such as whether the officers will be in uniform and how much additional training they will receive — haven’t been finalized.

“The officer’s role in this model is to secure the scene so that the clinician and the paramedic can provide treatment in a safe setting,” said Deputy City Manager María Villagómez, noting protocol changes could be made as needed.

The $4.8 million proposed for the program includes $4 million for the San Antonio Metropolitan Health District to add 34 positions and funds to partner with other agencies. Most of that ($3.1 million) will be used for the city’s response to domestic violence while $1.7 will be directed to mental health.

Mental health will be the team’s primary responsibility, Villagómez has said, but its members likely will be involved in calls related to domestic violence, substance abuse, and homelessness.

The rest of the funds will be used for SAPD overtime to staff the two new shifts ($311,000) and to the fire department for EMT staff ($537,719). The city’s public safety budget, including police and fire, is $860 million, roughly two-thirds of the city’s proposed $1.36 billion general fund budget.

Once the program is approved, developing and deploying the teams will take several months, with a launch in March or April 2022.

A potential compromise

About 43% of mental health calls in San Antonio from January 2018 to October 2020 were classified as lower-level or routine calls, according to an analysis performed by the University of Texas at San Antonio. That’s 22.5 calls per day.

These calls have the same priority level as so-called nuisance calls regarding fireworks, loud music, or barking dogs — the same calls that the city is planning to divert police away from.

The SA Clubhouse, which participated in a national training program for alternative emergency responses, recommends substituting law enforcement with a mental health specialist, such as a licensed individual who also has a mental health condition.

For higher-priority and higher-risk calls, the SA Clubhouse recommends augmenting the police-paramedic-clinician team with one of these specialists.

Other cities have demonstrated success, noted Eric Estrada, executive director of the SA Clubhouse. “Why can’t it work here as well?”

Bexar County Sheriff Javier Salazar offered two possible obstacles to such an approach during a press conference last month: people with guns and military veterans.

Many veterans suffer from mental illnesses such as post-traumatic stress disorder, he noted. “It’s not their fault … We owe it to them to take care of them.”

But that hints at the root of the stigma associated with mental health.

“People confound and conflate the idea of mental illness with violence,” Estrada said. The idea that “somebody who has a mental illness is inherently dangerous … is wrong.”

Estrada is not opposed to the city’s proposal to include law enforcement, but he hopes the program will evolve as the city and its police department learn that sending cops to low-risk calls is a waste of resources.

“The median cost of a peer [specialist] is half of the median cost of a police officer, and you’re talking about somebody who inherently is going to be more compassionate,” he said.

Councilman Mario Bravo (D1) said he would be open to a blended approach that deploys police when needed.

“I want the response to fit the situation,” Bravo said. “If somebody calls and says: ‘Hey, my son is having a breakdown, and he’s got mental health issues, and he’s outside the house waving a gun.’ Then, yeah, that’s a co-responder situation. … I don’t want a mental health professional going there all by themselves unprotected.”

On the other hand, reducing uniformed police response can save time and money, he said, noting that he will be advocating for increased funding for more mental health clinicians in next year’s budget. “I would like to see us be able to implement some level of mental health professional [response] for certain situations without police.”

Correction: This article has been updated to accurately state the proposed general fund budget: $1.36 billion.

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