Problematic Behavior Or Activity
In 2010 the Marion County Sheriff’s Office and the Marion County Health Department started a Crisis Outreach Response Team to follow up with people who had experienced a mental health crisis that involved police contact. It became clear that hundreds of these types of calls occurred throughout the county in the first year. By the third year, the team reviewed more than 2,000 police reports from all arresting agencies in the county. The need for mobile teams became clear—teams that could take these crisis calls directly from dispatch, de-escalate a crisis, take people to the most appropriate facility or refer them to an appropriate service, and avoid taking them to jail.
Previously, many individuals experiencing a mental health crisis were taken to jail or issued citations in the field. This resulted in placing a few thousand individuals in the criminal justice system every year—and not resolving the original crisis. Marion County has excellent mental health services in its jail and through its transitional services, but stabilizing people in the community where they live typically results in the best outcomes. This ultimately means fewer jail bookings, so that, ideally, incarceration is used only when it is needed.
The county has two Mobile Crisis Response Teams, in partnership with the Marion County Health Department and the Salem Police Department. The teams consist of one mental health professional riding in the car with a deputy or officer. They take crisis calls from two dispatch centers throughout Marion County as they arise. Their mission is to respond to the call, assist the primary agency, de-escalate the situation, and determine the best course of action. The mental health professionals are able to conduct a brief assessment in the field; this helps determine whether someone needs immediate care or if team members can defuse the situation and refer the person to services. Marion County is fortunate to have a Psychiatric Crisis Center that is open 24 hours a day. The center is operated by the health department and serves as the hub for many referral services used by the teams and countywide. If the situation is severe enough, the teams can take clients to the hospital and held under Police Officer Custody.
Based On Research
The county developed its mobile crisis response teams based on three jail surveys that showed a growing number of inmates reporting mental illness, as well as increasing numbers of inmates sent to the Oregon State Hospital for evaluations. This process takes up valuable bed space and prolongs the rest of the court process.
The Mobile Crisis Response Teams received funding from Oregon Health Authority for two teams. This covers one Marion County deputy, one Salem PD officer and two mental health professionals from Marion County Health Department. The annual cost for two teams is approximately $397,000 for personnel and equipment.
The Crisis Outreach Response Teams received 2,764 police reports from arresting agencies in Marion County that had a mental health component.
The teams responded to 524 crisis calls. Of these calls, only two were use-of-force incidents and none involved injuries to staff or clients. Eighteen of the 524 calls resulted in individuals going to jail, mostly due to warrants. That’s only 3.4 percent, a rate smaller than in past years. Three calls resulted in a Director’s Custody, 35 resulted in a medical transport, and 217 required no action in the field but resulted in referrals to services in the community.
Critical Success Factors
The collaboration between the sheriff’s office and the health department—and access to its resources—contributed to the teams’ success. The program is also supported by the Marion County Sheriff, Police Chiefs, District Attorney, Commissioners and the Oregon Health Authority.
We’ve learned that, based on the annual number of crisis calls that occur each year, we need to expand our services. We are negotiating the launch of a third team with Woodburn Police Department. This team will also consist of an officer and mental health professional in the car and will focus on the north county area and backing up the other two teams. We’ve also learned that the cases that made it to court require more focus, so we now have a half-time Deputy District Attorney to help resolve them.
For jurisdictions looking to add a team like this, we would encourage them to develop partnerships with their local health organizations, as well as other key players in the criminal justice system.