The Manager's report back on the feasibility of an alternative Public Safety Crisis Response System

As a department, it is recognized that far more individuals would be better served through a “Social Justice” approach rather than a “Criminal Justice” approach. The resulting paradigm shift led to: Increased documentation of calls for service involving mental health and homelessness issues, as well as increased documenting of both involuntary and voluntary psychiatric admissions. Doing so has permitted for a better understanding of service needs among these vulnerable populations.

The Department also increased its mandatory training for all officers to receive 40 hours of Crisis Intervention Training (CIT).

Enhanced partnerships and coordination with area service agencies supporting these vulnerable populations; including but not limited to: (A) other City departments, such as Health and Human Service Programs and Public Health, (B) area healthcare systems such as the entire CHA network and the largest area hospitals, and (C) other community stakeholders such as clergy, courts, businesses, and various advocates for homelessness and for those suffering from mental health and substance use issues. 2

In 2018, CPD formed the Family and Social Justice Section (FSJS), in order to bring all services designed to protect vulnerable populations (homeless, juveniles, elders, and those suffering from mental health and substance use issues) under one umbrella. The FSJS is overseen by a Deputy Superintendent and is comprised of three (3) units: The Social Justice Unit, Family Justice Unit and Clinical Support Unit (staffed with a Child Psychologist, Licensed Clinical Social workers, and Domestic Violence Advocates).

The desired outcomes of the FSJS are to reduce the incarceration of vulnerable populations, reduce the need for emergency service utilization (e.g., frequent ER trips) and improve access to outpatient and community-based supports and services.

The FSJS is home to the City’s renowned Safety Net Collaborative; a partnership between the Police, Human Service Programs, School, and Public Health Departments, which has been empirically recognized for its successes in reducing juvenile arrests and recidivism, while also increasing access to behavioral health services.

The work that the City of Cambridge has done toward implementing these protective strategies is in accordance with best practices and heavily influenced by guidance from authorities such as The Council of State Governments Justice Center and the U.S. Justice Department’s Bureau of Justice Assistance (BJA), which for more than 30 years has emphasized the need for a co-responder model and pioneered Police- Mental Health Collaboration Programs (PMHC). The BJA has produced a useful PMHC toolkit.

PMHC emphasizes five types of programs; however, according to the BJA “There is no one ‘right’ type. Agencies need to first assess their community’s needs and resources to determine which type of PMHC is most appropriate…the five approaches are not mutually exclusive…”. The five types of programs are: Crisis Intervention Teams: After completing a 40-hour training course, CIT officers are dispatched to mental health calls or utilized to assist non-CIT qualified officers.

CIT officers rely upon their expertise to work with mental health providers and reach an appropriate [socially just] disposition (currently used by CPD). Co-Responder Teams: Specially trained officers and mental health crisis workers respond together to mental health calls for service. By drawing upon the combined expertise of the officer and mental health professional, the team is able to link people with mental illnesses to appropriate services or provide other effective and efficient responses.

The most common approach is for the officer and crisis worker to ride together in the same vehicle for an entire shift, while in other agencies the crisis worker meets officers at the scene, and they handle the call together. Co- responder teams can respond throughout the entire jurisdiction, or they work in areas with the greatest number of mental health calls.

Mobile Crisis Teams: Utilizes a group of mental health professionals who are available to respond to calls for service at the request of law enforcement officers. The mobile crisis team’s goal is to divert individuals from unnecessary jail bookings and/or emergency rooms. These crisis workers are skilled at helping to stabilize encounters and assume responsibility for securing mental health services for persons, including those in crisis who may need further evaluation and treatment.

Mobile crisis teams are not necessarily dedicated to assisting only law enforcement officers but respond to requests directly from community members or their families and friends. Case Management Teams: A proactive team approach in which behavioral health professionals and officers provide outreach and follow-up to repeat callers and high utilizers of emergency services.

Officers do not treat or diagnose the individuals, but work with behavioral health professionals to develop specific solutions to reduce repeat interactions. This approach strives to keep people connected to mental health services and community resources, abide by treatment plans, and meet other responsibilities such as work, school and training. Case management is used in agencies in conjunction with other police-mental health collaboration strategies. (currently used by CPD) 3

Tailored Approach: A tailored approach is one in which an agency intentionally selects various response options from multiple PMHC programs to build a comprehensive and robust program. This allows the agency to adhere to a consistent policing philosophy while being responsive to community needs. Other factors agencies consider when choosing this approach can include the size of the jurisdiction and the number of officers on a given shift.

When using the tailored approach, a law enforcement agency begins with the expectation that every patrol officer must be able to respond effectively to mental health calls. Agencies enhance their patrol force with officers or detectives whose primary responsibilities are to liaise with stakeholders to coordinate criminal justice and mental health resources. (currently used by CPD).

Discussion: In making recommendations for non-police responses it is crucial to begin with the understanding that it is sometimes difficult and at other times impossible to begin with a non-police response even when a non- police response is most desirable. This will be true for a variety of reasons, including but not limited to: Vulnerable populations are at increased risk of being reported for potential criminal offenses and behaviors.