When your father is going into a diabetic coma, you call the ambulance. When your mother, who also suffers from a chronic illness, goes into psychiatric crisis, you call the police. Both are health issues. Both have very different trajectories. Dad will be taken away on a stretcher, while Mom may be led away in handcuffs. Dad the diabetic may be admitted into a hospital, while Mom most likely will end up in jail. The disparate treatment does not end there — at every level of care, much like in society at large, people with mental illnesses are treated as both separate and unequal.
The American Civil Liberties Union put out a video (www.overcrime.org) this week that describes how the United States spends $9 billion on jailing over 356,000 people suffering from mental illnesses. This lack of humanity has to stop, and the best way to halt it is at the first response, before someone gets sucked into the criminal justice system simply for being ill. We need mental health professionals to respond, but even with those in place, the reality is that police are often first on the scene.
Across the country, police departments have changed the way they address people in psychiatric crisis. Based on the highly successful Memphis Model, they have put Crisis Intervention Teams in place. These teams consist of highly trained police officers that have both the desire and capacity to address individuals in crisis.
This has led to vastly increased safety for officers and civilians alike. Training plays a small but important part in the success, but it goes far beyond that.
Police departments are regulated by many policies and procedures that determine how they respond — generally speaking they give commands, and if suspects are unresponsive, they use escalating force to garner control. For someone in psychiatric crisis who is unable to respond to commands, these tactics often escalate crises, and sometimes lead to injury.
In a recent analysis done by KQED News, more than half of those killed by San Francisco police are mentally ill. Ironically it is not just the loved ones of the deceased who suffer; police officers involved in these shootings often suffer greatly as well, leading to suicides, post-traumatic stress and depression among officers.
San Francisco has been incredibly slow on the uptake. While CIT started in Memphis in 1988, it wasn't until 2011 that San Francisco adopted it, after an earlier attempt lacked departmental support. Since 2011 it has been an uphill battle.
It took three years to get the emergency dispatch orders in place. Training was very slow to start, and not enough was done to elevate officers who volunteered for the training. Chief Greg Suhr has consistently rejected the team idea, and relegated it to training alone.
The evaluation loop that has been critical for every successful team, where incidents are reviewed and changes recommended, has not happened.
SFPD brass was not taking it seriously, until it came under Cmdr. Richard Correia, who embraced the team approach, put the training in place, secured the administrative support, started to collect data, and was working with a university.
Even partially implemented, the CIT was seeing a decreased use of force in incidents involving people in psychiatric crisis.
Sadly, he is now ready for retirement, and the program has been removed from under him. The program is at risk of being buried, with no commander to champion it, a chief who has not fully embraced the concept, and in fact has often referred to the program as Crisis Intervention Training — instead of team.
Police departments like any organization are prone to inertia. Sometimes changing the way we approach things is hard, because it challenges the way things have been done in the past.
This program has been studied comprehensively and has proven to work — saving police and civilian lives. Suhr has done a lot of things right — including asking his officers to slow down when crises occur.
We would ask him here to speed things up — find a commander to champion this issue and take us to the finish line. San Francisco deserves a fully implemented Crisis Intervention Team.
Jennifer Friedenbach is executive director of Coalition on Homelessness, San Francisco.