I went to a call last week where 3 mental health pros tried to break up a domestic between two clients living in separate apartments in a 4 plex. Girl client got mad and chased them around the parking lot with butcher knives in each fist.
They called me in a panic.
All it did was add more victims/case reports to my load.
One of them was shocked that I wouldn’t evict the female. I had to explain the Constitution to this expert.
Pesky due process and all.
Regards.
It won't matter. There's no long term solution for most of these folks. Until the long term is addressed, repeated short term interventions are going to have very limited success. I wish them the best and truly hope it helps, but I suspect it's not going to pan out like they think.
Sorta around sometimes for some of your shitty mod needs.
The department I retired from had a program since the late 80s that used field psych workers called Community Service Officers.
It was fairly successful, mainly because it wasn't rooted in the current "police are murdering racists" meme of today.
WE would call them after we got the situation under control. Then they would interview the officers and the 78 (crazy person") and would start the appropriate diversion into
rehab, in-patient treatment etc.
This way, the CSOs would gain a good working knowledge of our frequent flyers and how to handle them as well as gaining very valuable street experience. They hung out in our precincts
and had a good working knowledge of our procedures and policies.
They were paid what our sergeants were paid on entry. A few coppers transitioned into this program.
They worked their butts off and most officers respected and relied on them to help handle the volume of calls for this.
Whenever we had to take a 78 into custody, that officer was gone for the shift usually. We had to guard them at the hospital until the psych doc would either
admit them or cut them loose, at which point they'd be arrested.
Rookies got 40 hours training in the academy, and in-service every so often as well as lots and lots of hands on.
The CSO style program is probably about all that can be realistically maintained and paid for, year after year. Most of the current notions being floated are
just silly liberal hot air. Dealing with 78s can be as scary as it gets, or as heartbreaking. It's always an annoying drain of manpower dealing with the marginal
ones, who self medicate with street drugs and alcohol.
I hope they don't get good people hurt in their pursuit of social justice...but they will.
Originally Posted by rd62
Thread drift warning:
The thing that disturbs me about the fire service is that we are still manning FD's like Mother O'Malley's cow kicked over the lantern yesterday.
Fire and construction codes, as well as codes for rental housing have monumentally reduced actual fire calls. But fire departments remain the sacred cows of emergency services. The Kelly Day concept is an antiquated scheduling system that costs cities manpower money and ensures most firefighters are well-rested and in-shape for their side jobs as tile or carpet layers (in this area anyway).
Please note that I have said nothing derogatory about firefighters, I've seen a couple unhesitatingly enter structures to do searches for occupants under pretty sketchy circumstances, etc. I was a volunteer for an RFD, largely because I was an EMT, and, quite frankly, going into a burning house was not in my top 20 of experiences I needed to have. I'm a little claustrophobic and I made it through the smoke house search and rescue scenarios by repeating to myself 'it's just a drill' as I crawled the walls.
And, I have absolutely no problems with the fire service adopting the EMS role that they have. In 2007, I did the slide down a metal roof I was putting on, landing feet, hands, butt, head on the concrete 12 feet down. I was told the fireguys were the first ones there and got me taken care of until the ambulance arrived - we live eight blocks from a fire station, several miles from the ambulance.
I just wish LE was given the same consideration for staffing and training. Think of the highly trained police departments we'd have if police worked a Kelly Day system.
Back on subject: I hope these teams work out, I'm sure there will be a learning curve involved before final guidelines covering when to dispatch armed officers (hopefully in conjunction with the CIT's that many agencies already field) and the unarmed response.
If LE could dump these calls, patrol officers might be able to actually do preliminary investigations instead of just taking reports and maybe regain some community contact.
As previously noted, the fire department runs EMS ( including transport) in a lot of areas.
I'm not sure what the paramedic's role on these teams is. I can't pink slip people. There are procedures in place for people who are not 'with it' enough to refuse care, but if there's no medical issue, that doesn't really apply. Going back to @Gadfly 's example, stripping and 'finger painting' yourself isn't a medical condition, and unless you're doing it outside in the winter isn't really a danger to yourself.
Our local mental health crisis center will not accept a patient brought by EMS, with the reasoning that if they required EMS transport then there's a medical issue that needs cleared by an ER.
Our crisis teams locally are PO/deputy and a mental health professional. They seem to be working well, if for no other reason than there's only a few and they get to know all of the regulars pretty quickly.
To @jlw 's point, I don't think substituting a uniformed medic for a uniformed police officer gets you much. I think the uniform is enough to cause a reaction. And on our crisis teams the mental health professionals are wearing external vests...
All of that said, I really hope this works, or that we find something that does. I'm frustrated, and my cop buddies are frustrated, because we keep getting called for this stuff, and we can't fix it. We all got into this business to help people, and I'm really, really tired of telling mom, wife, kids, or caregiver that there's really noting I can do, and even if I could, the patient will be out of wherever in a day or 2 and right back to doing what you called us for.
'Nobody ever called the fire department because they did something intelligent'
I think there's a lot of misconceptions about locked units. Ive had 2 knives pulled on me and multiple sharp improvised weapons. At 4am in a locked unit how many people do you all think are working in there?
Do you all know what is the typical response to a weapon in a locked unit?
Yes pts are searched. By people who make minimum wage.
Im no longer working in places like that but my current clients can be nearly as difficult to deal with. I recently had a 270lb 6 foot 4 pissed off client with schizoaffective disorder screaming at me threatening to kill people and press charges on the facility for being racist.
You need to know what your dealing with and a plan. I was able to read him pretty well and had him pretty calm by the time the cops showed up.
I was pretty nervous honestly. I was alone in a dark room in a facility im not allowed to restrain in. I cleared everyone out to de escalate him. It worked this time.
To those who think you cant reason with people with schizo diagnosed people shows how little you really know. Ive been doing it for years and would rather deal with them. You just need to know how to talk to them. Even when they're eating shit. Sometimes reasoning doesn't work though.
I hope the program works but I doubt it.
Totally agree with you that a uniformed EMS presence can evoke the same response that a uniformed LEO presence can evoke....that's my experience having been EMS, at least. Differentiating the two requires rational, and crisis patients are by definition not functioning rationally.
Where I worked, we had a similar program to what others have described here....a crisis call would first initiate a police response for scene safety, and a team from the crisis center would also be dispatched. If they wanted the patient admitted, we as EMS could then take them directly to the crisis center (co-located in the same hospital as the trauma center) instead of having to filter them through the ED where they would usually get a referral from a doc if not admitted-from-the-field by the crisis staff.
I think the bigger problem more than anything is the revolving door that you nailed. You get admitted on a 72 hour hold, here's some drugs that make you feel better and your problems are now absolved, and you get a boot out of the door. When the mental health industry wakes up and realizes that people go off their meds and putting them on the street under such conditions isn't working, then we'd have a lot less of these issues....
Imagine if every time you went to the hospital for a heart attack they gave you some aspirin and sent you on your way....we'd be in fits about it, for obvious reasons.
"Are you ready? Okay. Let's roll."- Last words of Todd Beamer
It wasn't mental health professionals who shut down asylums. It was the media, politicians, and the public.
My father in law fought this battle when on city council in a fairly large CA city. Times were tough financially, but the firefighters and their overtime/contracts are absolutely sacred cows. The Dems hated the cops then, but sorta hid it. Not now.
#RESIST
A small step in changing the default 911 response:
https://www.npr.org/sections/health-...th-emergencies
President Trump has signed into law a bipartisan bill to create a three-digit number for mental health emergencies. The Federal Communications Commission had already picked 988 as the number for this hotline and aims to have it up and running by July 2022. The new law paves the way to make that a reality.
"A national three-digit number will make it far easier for millions of Americans to reach out for help and get immediate connection to care when they're experiencing a mental health or suicidal crisis," says Kimberly Williams, president and CEO of Vibrant Emotional Health, the organization that runs the National Suicide Prevention Lifeline. "Most importantly, 988 will help save lives."
The new law helps solve this problem, say Gebbia and Williams, because it provides funding and resources to boost the capacity of local crisis centers to handle call volumes, which are expected to go up once 988 is up and running in 2022.
Right now, many people end up relying on 911 for these emergencies. And the cases are handled by the police and hospital emergency departments.
"But often, the person can be helped just by a conversation," he adds. "We don't have to dispatch police."
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