By Allison Schatz
Medill Reports

At a recent City Council meeting to review the annual Chicago Police Department budget, a proposed co-responder pilot program designed to change how the city responds to behavioral health-related 911 calls brought criticism from community members and aldermen alike.

The program, viewed by many as a more humane and logical first response to what is fundamentally a health crisis, would use $1.4 million of the nearly $1.7 billion CPD budget to trial and study the model in action.

“The police cannot be the first and only responders on every call for help from our residents,” Mayor Lori Lightfoot said during a speech on Chicago’s proposed budget. “In 2021, we will launch a pilot program, born of real research from subject experts that looks at a co-responder model and starts the process of building the infrastructure for alternative means of response.”

A new co-responder program, outlined by the Chicago Department of Health, will be piloted in 2021. The program offers a tripartite model for crisis response, with a team of officer, clinician and paramedic, to respond to a call. The plan will be used in two districts this year, and the outcomes will be measured against a number of variables, including violent outcomes, health care cost savings and fewer repeat callers to 911.

The question of how police respond to calls that involve individuals afflicted by mental health and in active crisis has been a subject of conversation this past year, after multiple reports of deaths involving mentally ill Americans. Last month, 27-year-old Walter Wallace, bipolar and armed only with a knife, was shot and killed by two police officers in Philadelphia. The officers, called to the scene by the mother of Wallace, were notified in advance that Wallace had a knife, was in a manic state, and suffered from bipolar disorder. According to Shaka Johnson, the attorney for the Wallace family, the officers did not have proper mental health training, nor did they have tasers that they could have used in place of their guns.

First responders are often dispatched based on the prioritization of calls, as well as incentivization to show up fast and first. Despite explicit calls for behavioral health support, armed officers untrained in de-escalation tactics are often dispatched instead of paramedics, and many times without all of the pertinent details. These sorts of shortfalls often lead to violent and even deadly conflict.

Twenty-two percent of those killed at the hands of police have a diagnosable mental health issue, and the chance of being killed in a police encounter if you have an untreated mental illness increases 16-fold, according to a study released by The Treatment Advocacy Center.

John Snook, executive director and co-author of the The Treatment Advocacy Center study noted the collateral damage often resulting in armed police responses to crisis calls.

“By dismantling the mental illness treatment system, we have turned a mental health crisis from a medical issue into a police matter,” he said. “This is patently unfair, illogical and is proving harmful both to the individual in desperate need of care and the officer who is forced to respond.”

Chicago 911 dispatchers receive more than 150 mental health-related calls a day, and how many co-responder teams would ultimately be needed under the new plan is yet unknown. Currently, when Chicago residents call 911 for a behavioral health-related matter, the police officer responding may have only received nine hours of academy training for mental health intervention. It was only after public outrage of the deaths of Chicagoans like Laquan Mconald, a mentally ill 17-year-old armed with a knife, who was shot and killed in 2014 by CPD officer Jason Van Dyke, that a conversation around lack of preparedness took root.

This past year, CPD made additional training available to officers in a 40-hour-program sponsored by the National Alliance on Mental Illness (NAMI). Officers who take the program are certified as crisis intervention team specialists. To date, roughly 25% of CPD officers have undergone such training. But in the wake of the ongoing deaths of individuals like Chicagoan Daniel Prude, who was killed by police in Rochester, New York, earlier this fall, the demand for reform became louder.

Proposed Chicago co-responder model

At the Oct. 30 budget meeting for the police department, CPD Crisis Intervention Cmdr. Antoinett Ursitti outlined three steps to Chicago’s proposed approach, designed to minimize risk to those in crisis and alleviate pressure to police.

First, the department would embed a mental health professional in the 911 call center to assist in assessing and dispatching personnel. Ursitti noted that many mental health-related calls to 911 do not actually require in-person resources to be dispatched and could be managed effectively by a mental health professional over the phone.

Second, for those calls actually requiring in-person assistance, a team consisting of a crisis intervention-certified officer, an EMT and a professional crisis counselor would be dispatched to the scene.

The third and final step of the new pilot program concerns itself with follow-up care for those hospitalized and released for behavioral health-related conditions. This step is critical to reducing the number of future calls to 911 each month, law enforcement experts say, because a continuity of care is established that supports those at-risk after their initial crisis and reduces the need for subsequent crisis calls.

Law enforcement weighs in

Law enforcement experts say they are frustrated with the current system itself, whereby 911 call centers dispatch armed officers to what are fundamentally health crisis calls . Officers on a beat who respond to 911 calls, oftentimes for mental health-related concerns, see the same individuals for the same issues. They say this revolving door is a burden to the officers and is a financial strain on the system itself. They also argue if left untreated, some mental illnesses cause behavioral escalation, which increases the likelihood of a future violent outcome when police are called.

“Making assessments at every level is critical,” said Philip Andrew, a former FBI agent and law enforcement consultant. When untrained, armed officers show up to a call with a dysregulated individual, “they’re bringing the guns to the gunfight.” Once the response has happened, it’s what comes next that is so critical.

“What do we do with what we have learned about this person’s condition? And that’s where a lot of these systems fail. When you have had three calls to the same house in three months, we know we need a significant intervention with this family. So, what might happen next? We need to leverage community resources. What happens next to provide for the care of the person they are interacting with, that is critical.”

So, while a co-responder model reduces the statistical likelihood of a violent outcome, it does not address the larger problem of lack of long-term care for many of these individuals, he said.

“We send out our first responder crew that might solve the problem in the moment, but I guarantee you, they’re going to get called back, and it’s going to get worse the next time. But systematically we are not addressing this. There is no tier two, there’s no second string, there’s no sustained relationship in place for those affected,” Andrew explains.

Several of Chicago’s aldermen have come out in strong support of this new model of response. In particular, the 18-member Progressive Reform Caucus of the Chicago City Council stands behind a new model of crisis response.

“I think what we are talking about now, in terms of a co-responder [model,] doesn’t do enough,” 33rd Ward Ald. Rossana Rodriguez Sanchez said to the City Council members. “I think it’s an emergency to get police out of the mental health response.”

Many of the Progressive Reform Caucus members said they dislike the dependence the proposed model has on armed officers co-responding to crisis calls, citing a documented link to violent and even deadly outcomes when an armed officer is on scene. This past September, Lindon Cameron, a 13-year-old autistic boy from Salt Lake City, was shot and killed by armed first responders after his mother called 911 when her son was in distress. Cameron’s mother notified officers that her son was unarmed, had a history of mental illness, and was only a child.

Treatment teams, not armed officers

There are alternative co-responder models in the U.S. that do not use armed officers as part of the initial response. Eugene, Oregon, is once such city, and uses the Crisis Assistance Helping Out On The Streets (CAHOOTS) model. This model is a mobile crisis response program that works in partnership with local law enforcement and deploys an EMT with a trained crisis intervention specialist.

Established in 1989, CAHOOTS has been highly successful with its alternative model to mental health-related 911 calls. Never meant to replace policing, White Bird Clinic, who runs the program, states “CAHOOTS team members are not law enforcement officers and do not carry weapons,” according to a statement by the organization.

In Eugene last year, which has a population of 156,000, a total of 105,000 calls were initiated to public safety. Out of those, CAHOOTS was called in to assist in 24,000 calls. Of those, police backup was needed 150 times.

The CAHOOTS model is designed to alleviate the burden to law enforcement by taking over calls for welfare checks, public assistance calls, and mental health-related calls. This model saved the city of Eugene $8.5 million in 2019.

“Why is it that police became the default response for all of these situations?” said Timothy Black is the director of consulting at Whitebird Clinic, which runs the program. “For a lot of different reasons, morality has been the lens through which we commonly view addiction and mental health. When you. Have a cross-section of the nation that’s in a position of power, and they are viewing all of these struggles through that morality lens, it helps reinforce that perception that it’s all just about pulling yourself up by the bootstraps.”

Change is coming

Even as cities like Eugene and Bend deploy crisis response teams without armed officers, believing that mental health is best managed by health care professionals, Mayor Lightfoot feels differently. Her administration and CPD insist that for Chicago, armed officers need to be a part of the solution for now.

“Those calls that end up being dispatched, even with triaging on the front end, might include something that the officer needs to be present, where there might be some physicality that the mental health professional is not equipped to deal with,” CPD Superintendent David Brown said at the meeting.

Whatever model Chicago deploys long-term, urban policy expert Rebecca Neusteter and Amy Spellman at University of Chicago Urban Lab praise Chicago for their self-critical appraisal of the problem and the need for change.

“We have been working with the city for several years, thinking about and analyzing emergency crisis response via 911, particularly with individuals who have been experiencing mental health and substance abuse disorders,” Neusteter said. “Chicago has been at the forefront of trying to examine their 911 data in a way that most jurisdictions in the country have not done.”

Allison Schatz is a Social Justice & Investigative Reporter who covers mental health at Medill. You can follow her on Twitter at @AllisonSchatz8.