El Paso police changing approach to mental health crises
With two full years in operation, the El Paso Police Department’s Crisis Intervention Team has helped divert hundreds of El Pasoans dealing with a mental health crisis away from jail, but officials say gaps in the program remain.
Crisis intervention teams are designed to improve police officers’ ability to safely intervene, link individuals to mental health services and divert them from the criminal justice system when appropriate.
City Rep. Alexsandra Annello, who fought to get funding for the program in 2017, said its operation over the last two years shows there is a need for expansion.
“To really have a completely 100% successful response to mental health or people in mental health crises in this community, we are going to have to expand this program,” Annello said.
The Police Department is facing multiple lawsuits filed from 2014 through 2018 stemming from the use of deadly force against people in mental health crises. Three men were killed and one survived multiple gunshot wounds. Each of the lawsuits allege the El Paso Police Department, under the leadership of Police Chief Greg Allen, has poorly trained officers on how to respond to mental health cases.
Prior to the program launch at the beginning of 2019, El Paso was the only large Texas city without an established CIT. Dallas, San Antonio, Austin and Houston have long-established teams and programs.
Annello said when the city first approved funding for the program, they knew it wouldn’t provide 24-hour service for the community, but it would be a starting point.
“The goal was to see how effective (the program would be). Well, it’s working. I think that the hours of operation that they are doing, and the capacity that the program runs, it’s been doing well,” Annello said.
Rene Hurtado, Emergence Health Network’s chief of staff, who has been working with the El Paso Police Department from the program’s inception, said there are currently 14 teams that pair a police officer with a licensed mental health clinician from EHN.
Hurtado said the officers and clinicians respond together to calls involving mental illness, with an emphasis on de-escalating tense situations. He said many factors determine when a CIT team is deployed.
“It’s built on a delicate balance of the team availability and looking at the entire system of the city and what’s going on at that particular moment in time as to who’s going to get a CIT team deployed and who is not,” Hurtado said.
He said there is a misconception that people in distress can call 911 and specifically request a CIT response.
“That is not how the system works and that’s based on national protocol. PD dispatch looks at availability (and) determines which cases out in the city warrant the deployment of a CIT team,” Hurtado said.
Mental health training for other officers
Hurtado said police officers who are not on the teams have also received training for how to respond to calls for individuals in a mental health crisis.
“Even though you may not get a CIT team, we believe you’re going to get an officer who has been trained to a higher level than had been,” Hurtado said.
Dionne Mack, deputy city manager of public safety, said the Police Department also is committed to increasing the training for officers not in the CIT program.
“One of the things that we see as being important for us is utilizing our ability to really expand that base of knowledge throughout the department,” Mack said.
Training for police officers in 2021 will include additional mental health training such as 40 hours of crisis intervention team training for up to 70 officers offered quarterly, and eight hours of de-escalation training for 70 officers offered quarterly, Mack said.
The 14 teams cover each of the Police Department’s five regional command areas.
“We need more than 14 teams to provide 24-hour coverage of two teams out at a time,” Hurtado said, adding two additional teams would help bridge the gap.
Annello and Hurtado said the program needs more funding to add the additional teams.
Mack said the city has been able to supplement the grant funding provided by EHN over the last few years the program has been in place, but said it is not certain whether they will be able to expand the program in the next fiscal year.
“I think every year we’re sort of holding our breath a little bit in terms of whether the funds will come through,” Mack said, adding the economic impact of the COVID-19 pandemic has left uncertainty of additional grant funds from the state level. “We’re just waiting to hear that information.”
The City Council in 2017 approved $315,000 to begin training the police officers who would participate.
Annello said the city provided initial funding for the first two years of the program and is set to take over full funding in fiscal year 2022.
According to city budget documents, funding the program for a full fiscal year would cost $2.5 million. In the 2019 fiscal year the city allocated $969,206; about $1.9 million in 2020 and $2 million in 2021.
EHN has provided funding from Texas state allocations under Senate Bill 292 for mental health grant programs over the last three years. In 2019, EHN provided about $1.4 million in 2019, $2.8 million in 2020 and $1.4 million in 2021.
Hurtado said accessibility to additional state funding will depend on any actions taken by the Legislature during this session as it relates to continued funding of SB 292 and any other possible funding opportunities.
How the program is measured
Hurtado said EHN has been tracking metrics to evaluate the success of the program.
Documents obtained by El Paso Matters through the Texas Public Information Act show EHN and the Police Department track different metrics.
EHN tracks metrics such as the number of CIT encounters that result in avoidance of incarceration and emergency services, the number of behavioral health related calls resulting in CIT response and the number of individuals who are linked to behavioral health services by an EHN CIT caseworker, as a result of a CIT encounter, among others.
The EHN data for its 2020 fiscal year report shows an average of 258 individuals served by the program per month.
CIT encounters that resulted in avoidance of incarceration and emergency services in 2020 totaled 2,816; the number of behavioral health related calls resulting in CIT responses totaled 3,651; and the number of individuals who were linked to behavioral health services by an EHN CIT caseworker after a CIT encounter totaled 205, according to the data.
Hurtado said a third-party study commissioned by EHN is currently being conducted by the Meadows Mental Health Policy Institute that will evaluate the full program, including metrics associated with officer attitude and confidence levels regarding interactions with persons with mental illness.
Documents obtained by El Paso Matters from the city were heavily redacted, but did contain certain details about what the Police Department tracks.
El Paso Police Department generates weekly CIT reports that contain data that includes information on regional command areas that responded to calls, emergency detention orders that were executed, instances of use of force, which facilities individuals in crisis were taken to and summaries of incidents of note.
The Police Department’s CIT procedures manual states that officers can execute an emergency detention order when officers have reason to believe a person poses a substantial risk of harm to themselves or others, regardless of age.
“Officers may take that person into custody for the purpose of obtaining an evaluation of the person’s mental health and the potential need for involuntary hospitalization. Individuals shall not be taken into custody merely for displaying signs of a mental illness,” according to the manual.
The police data shows that by the end of December 2020, 1,422 emergency detention orders had been executed. The reports show that in 2019, 1,321 EDOs were executed.
Examples of intervention
The summary of incidents shows that police officers and CIT teams face a variety of situations when dispatched, some of which result in life-saving encounters.
A March 2020 entry describes a CIT response to a suicide in progress where a man was standing on a third story roof. According to the report, the man was threatening to jump off the ledge. It took 45 minutes to de-escalate the situation and for the man to voluntarily step down from the ledge and be taken to El Paso Behavioral Health.
In another March incident, a CIT responded to a domestic disturbance call where a man was found holding a utility knife to his neck. Documents show the team was able to de-escalate the situation in 20 minutes with the offer of cigarettes after the man “voices the need for a smoke.”
The summary states the man was transported to Del Sol Medical Center under an emergency detention order and the officer “being a man of his word purchases a pack of cigarettes and takes them back to (the man) at the hospital after he was left under the ED.”
In May 2019, a CIT was dispatched to a suicide call, but the team could not locate the man. The report shows they called him multiple times, but the man hung up more than once after making suicidal outcries. The team noted that it sounded as if there was a lot of traffic in the background so they checked Transmountain for the vehicle.
The team found it and noticed there was a hose running from the exhaust pipe to the window. According to the summary, they were able to extract the man from the vehicle and have him transported to a hospital for care and placed under an emergency detention order.
Other instances in the weekly reports document use of force incidents. While some of the use of force descriptions in the reports were redacted, others identified the circumstances that unfolded.
In May 2019, a “takedown” occurred with a “subject resisting arrest after being taken into the hospital on an ED. Subject was attempting to destroy narcotic evidence,” according to the summary.
In June 2019, a CIT officer responding to a call of a person walking erratically in traffic “grabbed hold of the subject and a struggle ensued.” The subject was taken down to the ground and handcuffed and taken to the hospital after he had initially refused to step away from traffic, according to the summary.
Reach out for help
Emergence Health Network COVID-19 Mental Health Support Hotline (915) 779-1800
National Suicide Prevention Lifeline (800) 273-8255
Cover photo: Members of the El Paso Police Crisis Intervention Team provide support to El Paso resident. (Photo courtesy of the city of El Paso)