DEPARTMENT: Police Department
DEPARTMENT HEAD: William P. McManus, Chief of Police
COUNCIL DISTRICTS IMPACTED: Citywide
SUBJECT: Mental Health Unit/IMPACT Program Update
SUMMARY:
Over the last several years, the San Antonio Police Department has implemented nationally-recognized mental health programs and training to provide officers with the expertise and resources to effectively address mental health and drug addiction issues which are often underlying factors that influence homelessness and criminal activity. The Mental Health Unit and the Integrated Mobile Partners Action Care Team (IMPACT) Program, working in coordination with area advocacy organizations and health providers, facilitate service delivery to address the psychiatric and medical needs of individuals through referrals to various service providers.
BACKGROUND INFORMATION:
Mental Health Detail
The SAPD Mental Health Detail (MHD) is comprised of ten officers and one supervisor that are trained to assist individuals with mental illness that are in crisis. The Mental Health Detail develops partnerships with mental health consumers, their family members and other mental health agencies and organizations to better serve the mental health consumer in crisis and responds directly to referrals and requests for assistance from external agencies and various departments.
Officers assigned to the Detail receive training from the Center for Health Care Services to identify and recognize individuals with mental illness. The ability of officers to recognize signs of mental illness has proven to be successful as evidenced by the significant decline in the number of use of force reports and the number of emergency detentions and diversions from jail to treatment facilities as outlined in the table below:
|
|
2016 |
2017 |
|
Mental Health Calls |
1,153 |
1,825 |
|
Emergency Detentions |
505 |
758 |
|
Emergency Detention in Lieu of Arrest |
21 |
38 |
|
Use of Force |
4 |
2 |
In addition, the MHD works closely with area mental health providers such as, NIX, San Antonio Behavioral Health, Laurel Ridge, Methodist, Baptist and STRAC to route individuals placed under emergency detention to a behavioral health facility rather than an emergency room.
The San Antonio Police Department as a whole handles approximately 12,000 emergency detentions a year. In light of this fact, the MHD provides instruction to cadets through Crisis Intervention Training (CIT) which is offered as a forty hour course as part of the Training Academy curriculum which focuses on teaching officers how to effectively respond to an individual with a mental illness that is in crisis. Among the topics discussed as part of the course are: introduction to mental illness, active listening skills, personality disorders, psychosis and de-escalation techniques.
The CIT course is also offered to all SAPD officers, San Antonio Fire Department personnel, school resource officers and civilians that come in regular contact with individuals with mental illness.
HOPE Team
The Homeless Outreach Positive Encounters (HOPE) Team is comprised of two bike patrol officers that have extensive experience with the homeless population in the downtown area. HOPE utilizes non-traditional law enforcement methods to assist individuals and families that are displaced, unsheltered and homeless within the community by identifying specific needs, guiding individuals to appropriate services and assisting with the challenges typically associated with homelessness.
Ultimately, the goal of the HOPE Team goal is to reach out to the homeless community through positive role modeling to build a stable rapport and guide individuals to services that result in an enhanced quality of life. One of the primary methods to achieve this goal is ID Recovery due to the fact that a valid form of identification necessary to access virtually all government services and programs.
The HOPE Team has developed an identification verification service, in partnership with the State of Texas Department of Vital Records, the Department of Public Safety and the local Social Security Administration Office, that allows the Department to provide a document that certifies an individual’s identity and provides a current color picture that meets governmental identification requirements for the listed agencies.
In 2017, the HOPE Team made 1,406 contacts. Of those contacts, 490 individuals were assisted with ID Recovery resulting in a total of 160 birth certificates and 250 Texas identification cards being issued.
IMPACT Program
IMPACT is a collaborative effort comprised of members of the SAPD Mental Health Detail and the San Antonio Fire Department EMS Mobile Integrated Healthcare Team with the following objectives:
• Improve Downtown public safety and quality of life
• Accurately identify the immediate medical need(s) of the individual
• Create streamlined treatment process
• Introduce case management to achieve long-term success
The listed objectives are achieved through the IMPACT Program’s multidisciplinary approach to address the psychiatric and medical needs of individuals by utilizing security, emergency detention and arrest authority as well as medical expertise and resources to preserve the health and well-being of the individual. In addition, multiple agencies offer a variety of resources to include: housing/social assistance and case management follow-up to promote long-term success. The ability of the IMPACT Program to effectively address the needs of the homeless has been enhanced through partnerships with groups such as the San Antonio Food Bank, Haven for Hope, Behavioral Health Hospitals and the South Alamo Regional Alliance for the Homeless that are able to provide specialized assistance to referrals.
Since its inception in January 2016, the focus of the program has been to offer services to assist the chronically homeless who are defined as individuals that have been homeless for over a year or have a disability that has resulted in four homeless episodes in a three year period. The IMPACT Program also contributes significantly to the overall efforts of the Downtown Initiative. The tables below provide statistics on Downtown Initiative health referrals made since October 1, 2015 through February 16, 2018:
|
Number of Contacts |
3,030 |
|
Referrals |
1,673 |
|
Refused Service(s) |
819 |
|
Emergency Detention |
282 |
|
Detoxification |
256 |
Of the 3,030 contacts made to date, a total of 819 individuals encountered by staff did not demonstrate signs of serious mental illness to be deemed a threat to themselves or others and were not otherwise engaged in criminal activity and were free to refuse assistance. 538 contacts were either under the influence of drugs or alcohol and were transported directly to a detoxification facility or were placed in emergency detention due to their actions and mental/physical condition.
To date, the following agencies have received the most referrals and combined account for approximately 86% of all referrals made:
|
Agency |
Referrals |
|
Haven for Hope |
777 |
|
SAPD ID Recovery |
587 |
|
DPS ID Recovery |
30 |
|
NIX Hospital |
24 |
|
Salvation Army |
15 |
The Emergency Medical Treatment & Active Labor Act (EMTALA) regulates the duties and responsibilities for processing individuals in need of medical treatment. EMTALA prohibits officers from transporting individuals to multiple facilities. Once the individual is transported to a medical facility, hospital staff must obtain an Order of Protective Custody and arrange for transportation, via private ambulance, to an appropriate agency. In the event an individual is not transported to another facility, EMTALA requires that the hospital provide treatment.