The Clark County Sheriff’s Office recently began partnering with mental health providers from Sea Mar Community Health Centers to respond more effectively to people in crisis, who may otherwise go to jail or the emergency department. The Columbian reported on the new co-responders program which was modeled on a similar partnership launched in October 2020 between Sea Mar and the Vancouver Police Department.
The program typically involves mental health specialists from Sea Mar being notified by Vancouver police or a 911 dispatcher of a person experiencing a mental health crisis who may be a danger to themselves or others. The Sea Mar team will then meet up with the police officer responding to the call and help by de-escalating the crisis or providing support services to the person in need. Joining us to talk about the co-responders program and the impact it’s having are Blaise Geddry, a lieutenant in the Vancouver Police Department, and Laura Nichols, a mental health therapist and the program manager of behavioral health services at Sea Mar Community Health Centers.
Note: The following transcript was created by a computer and edited by a volunteer.
Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. About four years ago, mental health care providers started going out on calls with the Vancouver Police Department to help people who are in the middle of mental health crises. Now, that program has expanded. The Clark County Sheriff’s Office recently started its own partnership with the nonprofit Sea Mar. We want to know how this program has been working in Vancouver, so we’ve invited Blaise Geddry, a lieutenant with the Vancouver Police Department and Laura Nichols, program manager for Behavioral Health Services at Sea Mar Community Health Centers. They both join me now. It’s great to have both of you in the studio.
Blaise Geddry: Thank you.
Laura Nichols: Thanks for having us.
Miller: So, Blaise Geddry first. Why did the Vancouver Police Department seek out this collaboration?
Geddry: So the conversation started probably a year or two before the actual program got moving and it was really about addressing issues that were best served with mental health in mind. So not a police-centric focus, but a mental health focus and how best to do it...
Miller: Is it saying it too strongly to say that police, you didn’t want to be going out on these calls? You were the ones you were sort of stuck with these, but this is not what even police thought policing was for?
Geddry: Yeah, I think that’s a fair statement. And it had been going in different parts of the country. There are different co-responders and police collaboration with mental health groups in different parts of the country. So as we were watching that, it made sense for us to start navigating towards that.
Miller: What would happen in the past? I mean, what options did you have when there was a behavioral health crisis of some kind – somebody having a bad reaction to drugs or some kind of untreated mental health crisis – and before this co-responder program is up and running, what would happen?
Geddry: Consistently, we’ve always had two options for law enforcement, right? If you’ve committed a crime, you go to jail, otherwise we would take you to the hospital. There were sometimes other options available, like we could take you to detox facilities. But those were not always consistent and not always available, the rooms or the beds would fill up. And so that was it, and we would fill up the emergency room with people who had not committed crimes, but couldn’t be left on their own.
Miller: Laura Nichols, why did Sea Mar say yes, we’d like to be involved in this collaboration, we will ride along with you or show up when you call us?
Nichols: Well, we saw the need in the community. We saw that officers were doing their best, but there are so many resources in the county and officers respond to so many different kinds of calls. There’s just no way for them to stay up to date on all of the services that are available. And we also want to serve folks who are underserved and who might need to see someone that cares about them when they don’t feel like there is anyone that cares about them. And so that’s something that Sea Mar wanted to do and we were happy to do it.
Miller: You didn’t invent this idea, so what existing models did you look at and consider as you were shaping the program that you wanted for Vancouver? Lieutenant Geddry, first; I mean, what did you consider?
Geddry: So kind of the flagship model that was out there was where a mental health professional would be in the vehicle with a police officer, and so you would either have a specially trained police officer or just a patrol officer and their job was to go to calls that were predominantly mental health centric.
Miller: And sitting next to them in the cruiser is somebody who’s not a police officer
but who has specific behavioral health training?
Geddry: Correct.
Miller: OK, so you think of that as the gold standard?
Geddry: No, I just think of that as an option, I think that’s a way to do it.
Miller: And was that possible for Vancouver? That’s not the direction that you ended up going in, but did you like that idea?
Geddry: The idea was fine. The practicality of it didn’t shake out for Vancouver, largely because of our staffing. We couldn’t dedicate a number of officers to only respond to mental health calls. We just didn’t have that luxury.
Miller: Laura, would you have wanted that model? And with the folks who work at Sea Mar, would they have wanted that?
Nichols: Oh, yeah, it’s definitely one of the models we looked at. And there’s value to that, to have a mental health therapist in the car with an officer really changes the culture and the collaboration there.
Miller: Changes the culture of policing?
Nichols: Yeah. Even all of our staff, we do ride-alongs with officers, even when we’re not… It’s just an added kind of training that we do and having a long chunk of time to sit with an officer and see what they do and talk with them and understand their ideas of policing or trauma informed care, or even what trauma means. We have those conversations in the car with them and can chat with them. It’s definitely a model that we were looking at. It’s not something for our purposes that we wanted to do, because one of the main goals was to be able to clear up a unit to be able to go to another emergent call that wasn’t behavioral health. If we had the unit just set aside for behavioral health, they wouldn’t be able to clear off that call and go to something else. The officer would have to stay on scene with us.
So we chose this other model, where we meet the officers on scene, they call us directly and we meet them on scene. Officers will often stay with us on scene, but they can also leave if there’s something else pressing that they need to attend to and we can handle the call on scene.
Miller: Did any members of your team have reservations about working directly with law enforcement? There are other models that are maybe the other extreme from having somebody in a car, the two cultures together in a police cruiser, which is like in CAHOOTS [Crisis Assistance Helping Out On The Streets], where there’s no police officer at all. It’s just members of the CAHOOTS team, in Lane County, in Eugene, responding without a police officer. What did you hear from your staff when you were in the initial conversations?
Nichols: So we do have another unit that responds without law enforcement necessarily. That was the first program that we started and that’s what our staff knew originally. And so when we were adding in this new model with law enforcement, there was some anxiety just working with another entity. Any kinds of ideas that staff might have about what it means to be a police officer or being fearful of not being accepted by officers, maybe, or not being respected by officers. But Blaise did a great job inviting us in to present to officers and teach them about what we do and have them meet our staff. So we had a relationship there before we were even going out onto scenes with folks.
Miller: Blaise Geddry, what do you remember hearing from your officers when you were in those early stages? I mean, what kinds of questions or concerns did they bring to you?
Geddry: I think there was concern from a lot of officers. So police officers do a really good job dealing with people in crisis. And I think some of their initial hesitation is that there was some level of belief that they couldn’t do as good of a job.
Miller: Oh, that by virtue [of], because you were saying we’re going to have this new program, we’re going to bring in these mental health professionals, some officers saw that as a kind of, if not rebuke, evidence that that leadership didn’t have faith in their ability to handle these situations?
Geddry: Yeah, there was a little bit of that, it may not have been quite that strong of a sense. But our culture and law enforcement, we go to emerging calls, in crisis daily, multiple times a day, and it’s what we do. And so once the explanation was like… the idea is that if the underlying cause of whatever you’re there for is really mental health related, even if there’s a low level crime and if the person that we’re dealing with would best be served by getting mental health help, then the co-responders can come in and then we get to go and maybe go and address the actual criminal acts going on in the community more.
Miller: What’s an example of a low level criminal act where in the end it’s not really a priority? I mean, what would an example of that be?
Geddry: It could be anything from malicious mischief, somebody causing some property damage, which is not uncommon for somebody going through some type of mental health crisis. They’ll break windows or they’ll take trash and go throw trash everywhere.
Miller: So technically, there could be criminal charges, but does that make the most sense for that situation?
Geddry: Correct.
Miller: Laura, my understanding is that you’re not just one of the managers for this program and this partnership, but you also go out on calls.
Nichols: Yeah, I do go out on calls.
Miller: What’s an example of a call that stands out to you now, that you think illustrates how this program can work?
Nichols: Oh, yeah. Well, I was just thinking about Blaise, how he was describing how officers attend to crises all of the time. That’s what they do. And that’s not what a lot of mental health therapists go to school thinking they’re going to do, right? They don’t think about that. They think about private practice or sitting in an office, which is not at all what we do.
Miller: You seek out the people who seek out crisis help.
Nichols: Correct. Exactly. And so people are open to that. But one of the calls that I think demonstrates the combination of the skills that Vancouver Police has and that our therapists have – I went on a call, it was in the summertime, and it was for a woman who was having a psychotic episode and had barricaded herself in her home, and she had also ingested a lot of cleaning solutions because she was trying to resolve some delusions that she was having basically by doing that. She thought that was a good thing for her to do. It was an attempt at a solution. And her mother, who lived in the home, had called the police because she had barricaded herself in and she couldn’t get back in the home. She was concerned about her adult daughter’s safety. And so we arrived on scene and it was myself and a peer counselor, and I hadn’t been planning to go out into the field that day, but I was up and so I went out there…
Miller: You arrived on scene because police officers arrived first and then they called you.
Nichols: They called us.
Miller: Because this was a case that fit the partnership, the project model. OK, so you arrived on scene with a partner.
Nichols: Yep, 100%. We arrived on scene with them. They were in their full tactical gear, and it’s just not a scene that most therapists think about going into. And I honestly didn’t know what it was going to look like when we went inside. But the officers did a great job. They had the mother open the door for us, and they had to push their way in, and the officers kind of guided me to come along behind them and they found the individual hiding in her closet and she was very fearful of the officers and she had a small weapon. But, she was just very fearful. And so the officer positioned me – knowing with his skills – in the doorway, so that I could speak with her. He kept himself out of sight but nearby so that he could keep me safe as well.
I was able to build rapport with this individual and help her understand that I wanted to help keep her safe as well, and that I was concerned about her safety and her delusions and things that were going on for her that made her feel unsafe. And eventually, she agreed to go to the hospital voluntarily, and the officers were able to kind of back out of the home and she was able to get in the ambulance on her own and go to the hospital.
Miller: It’s probably impossible to know, Lieutenant Geddry, how that might have gone if you didn’t have this partnership. But it’s possible to imagine that a police officer in tactical gear, that just somebody in a crisis, seeing that would get even more escalated, more in a bad mental state. I mean, is that part of the thinking here, that even just seeing somebody who’s not from law enforcement, that alone could help diffuse the situation?
Geddry: So I think you hit it right there. It’s options. So sometimes simply it’s the uniform and that can create a barrier for whatever reasons, right? It’s simply the uniform. Most of the time, officers are really good at working around that and they do a great job. But when we’re not able to, then what other options do we have? Well, having the co-responders who are not in uniform, who are not trained police officers [and] speak differently and can interact in kind of a different way, can sometimes get to the resolution that we’re all trying to, which is to help this person.
Miller: Laura Nichols, the program that we’re talking about operates, I think this timing is right, from 8 a.m. to midnight. What happens if a mental health crisis call comes in at three in the morning?
Nichols: Yeah, that’s a great question. This program is a direct line for Vancouver Police during those hours. We also have 24/7 crisis response services available to the community and to first responders and law enforcement and professionals 24/7. And that is the line that they would call if it was at 3 a.m. and they needed additional assistance. And so that’s something that they can still access after hours and we would still respond to.
Miller: Blaise Geddry, the case that Laura just described, it seemed like that was a real success story. A person in crisis was able to, without hurting herself or others, go to a hospital. Are there times when the two different approaches, the trained mental health care workers and police officers, where they actually have a disagreement about the best way to proceed in the middle of a call?
Geddry: Yeah, they do. Yeah, they’ll disagree. And usually they’re able to figure out a way forward. At the end of the day, it’s a police call. And if the police officers on scene make a determination that this person either needs to go to jail or they are going to put them in the hospital, we have the authority to do that. And we leverage, if we leave this person alone, are they going to be an immediate danger to themselves? Are they going to be a danger to the public? And so it’s this ongoing evaluation. It’s reasonable to believe, and it happens on occasion, that a police officer and the mental health professional will come to different conclusions. And that’s OK. That’s totally fine.
Miller: Laura, when that happens, are there patterns that you’ve seen? I mean, that there are ways in which those disagreements, even if they are rare, are likely to fall into?
Nichols: Yeah, definitely. And I think it has to do with the different training that our agencies have and sometimes different policies as well, or different standards, but a lot of it’s kind of looking at risk assessment and what a mental health therapist or professional might think is high risk versus what a law enforcement agency might think is high risk. And it’s not that one is right or wrong. It’s that they have different lenses looking at it and so we have to kind of navigate that. And it is a VPD call and so we will defer at the end to Vancouver Police.
However, Blaise and I, we do a great job talking about calls where we have those disagreements after the fact, so that we can debrief those and see, what was the disagreement there? Is it something that’s going to keep coming up? Did it go the way it needed to go or did it need to go a different way for the future? We’ve done that so many times that a lot of those disagreements have decreased a lot.
Miller: Lieutenant Geddry, Vancouver police officers, the ones who have spent significant time alongside the mental health care experts that are a part of the Sea Mar team, do you think that has affected the way they do their everyday policing when they’re not with core responders?
Geddry: It’s a great question. I don’t know. The program, as we’ve tried to implement it, is really based on relationships. So if an officer sees that a mental health professional uses certain phrases or tries a certain technique, we’ll absolutely do it. And we’re like, well, it worked for them and it’s not unusual to have an officer go well, the worst it could do is not work. And so, yeah, absolutely, it’s just educating both halves and it’s really improving how we do our jobs and increasing the options out there.
Miller: Laura Nichols, we just have about a minute left. But how do you assess whether or not this program is working? What are the metrics?
Nichols: It’s a great question. We gather a lot of data. But mainly we’re looking at, who are we serving? And are we diverting folks from going to jail or from being hospitalized? Those are the main metrics that we’re looking at. We do do some follow-up services with folks after the initial crisis and that helps us to see if they’re getting connected with services and if they’re being repeat customers of the crisis system or not. And so that’s what we’re looking at as well.
Miller: Laura Nichols is a program manager for Behavioral Health Services at Sea Mar Community Health Centers. Blaise Geddry is a lieutenant with the Vancouver Police Department. Thanks very much to both of you.
Geddry: Thank you very much.
Nichols: Thank you.
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