On a Monday afternoon in Far East El Paso County, Sheriff Deputy Alba Calzada hears a call on the scanner in her patrol unit: a woman in East Montana is having a mental health crisis.
One of El Paso County Sheriff’s Office first crisis intervention team members, Calzada is familiar with the caller – she’s responded to several calls from the woman in the past and has gotten to know her. Calzada alerts headquarters that she will respond this time, too.
Even before driving down the unpaved desert road to the caller’s home, Calzada knew the woman requested a CIT unit and she began assessing her mental health background. The older woman lives by herself; the rest of her family no longer lives in El Paso, which has contributed to her mental health struggles.
The call, like others the sheriff’s crisis intervention teams respond to, can be unpredictable. But the Sheriff’s Office is better equipped to respond to calls involving people in a mental health crisis with the recent expansion of its crisis intervention program that first launched in April 2021.
What started as three teams has grown to 10, with the most recent cohort completing training and going on calls in early November, said Sheriff’s Commander Ryan Urrutia, who developed the program. Now there are 10 deputies, 10 clinicians and two sergeants who can ride with the clinical supervisor, he said. Between them and the lieutenant overseeing the program, the Sheriff’s Office is able to move up to 12 teams if necessary.
“It really came to what we wanted it to,” Urrutia said. “At this point with the 10, we’re very robust.”
About 1,000 people were fatally shot by police in the United States in 2018 – 25% of them had mental illness, according to a 2019 study by the Journal of the American Academy of Psychiatry and the Law.
The mission behind the crisis intervention teams is to improve law enforcement officers’ ability to safely intervene, help those people connect to mental health services, and when circumstances allow, divert them from the criminal justice system.
The county has received about $4.3 million from a variety of sources, including the Office of the Attorney General Justice Assistance Grant Program and the American Rescue Plan Act, to launch the program. In the current fiscal year, the program will also receive about $4 million in grant funding.
The Sheriff’s Office partners with Emergence Health Network, the largest mental health service provider in the area, to pair a deputy with a clinician to respond together to calls involving people with mental illness, with an emphasis on de-escalating tense situations.
Urrutia said the additional teams help to make sure there is coverage for all outlying unincorporated areas of the county such as Horizon, Anthony and San Elizario. Prior to expanding, the teams didn’t favor one area over another, rather they tried to respond to as many mental health calls as possible, he said.
Meeting the need
For Calzada, who started her career in law enforcement with the Sheriff’s Office in 2012, serving on the crisis intervention team aligns with her longtime interest in mental health. She noticed the need for mental health services while she worked in the El Paso County Detention Facility during her first two years on the job.
Calzada said there were instances where she noticed some people in the jail that may have been having a psychological episode or hallucination that got in trouble for a charge like criminal mischief that could have benefited from a CIT response.
“So I saw it from back then and when CIT started, it felt really different just being able to actually say, ‘hey, let me help you,’” she said.
During her response to the woman in Montana Vista, Calzada calmly talked with the caller on her front porch for about a half hour. Calzada asked key questions about how she was feeling and whether she was thinking of harming herself. She also asked whether she had eaten that day or had been drinking enough water.
El Paso Matters does not identify people in a mental health crisis.
For Calzada, those small details can make a big difference in how receptive an individual is for the help they are trying to provide.
“I just always go back to everyone’s human needs when I deal with people,” she said.
The Sheriff’s Office has responded to at least 1,043 calls from people suspected of having a mental health crisis since the program launched.
Urrutia said one of the benefits of CIT has been an overall reduction in use-of-force incidents throughout the department.
He credits that with multiple strategies the department has implemented including shift briefings with the crisis intervention teams and patrol officers. Those briefings allow the CIT teams to give patrol officers tools to use when they encounter an individual that may be having a mental health crisis. He said all deputies have also undergone state-required mental health peace officer training.
“We’re giving them extra tools to deploy and or call us at CIT to come in and help de-escalate, without having to use force, without having to put themselves in that situation, or one of our citizens in that situation,” Urrutia said.
Lt. Jerome Washington, who oversees the program, said that since the CIT units started, they have been able to complete 448 emergency detention orders without having to use force to execute them. The orders are used to detain people for their own safety when they are experiencing a crisis related to mental health that is putting their health, safety and life in danger or the health, safety and life of others in danger.
Washington said this crisis can be shown as a result of mental health issues such as depression, anxiety, schizophrenia or any life situation that is overwhelming for the person such as loss of employment or the death of a loved one. The crisis can also be induced as a result of self-medication and the use of illegal narcotics, he said.
The emergency detention orders can be in place for up to 48 hours.
Washington said the teams were able to divert 739 clients from possible criminal charges and unnecessary incarceration. Of those, 667 people were also diverted from unnecessary hospitalization in emergency rooms by diverting them to outpatient services and or mental health facilities.
Some of those partners for emergency detention orders and voluntary inpatient treatment include El Paso Behavioral Health Center, Rio Vista Behavioral Health Center, El Paso Psychiatric Center and Peak Behavioral Health Center.
Training beyond Sheriff’s Office
Officers that join the CIT program undergo an intensive two weeks of classroom training and third week of role-playing at the headquarters located in Far East El Paso off Montana Avenue.
The recent group included officers from other area law enforcement agencies including an officer from the Canutillo Independent School District.
Rene Hurtado, Emergence Health Network’s chief of staff, said Emergence trains all of the local law enforcement CIT programs.
“In just a very few short years, it has become this region-wide initiative, to where we have the cities and county coming on board and devoting resources and entering into these agreements,” Hurtado said. “We’re now providing a level of service that was really unheard of just five years ago.”
During the role-playing exercises deputies and clinicians work through various approaches on how they would communicate with an individual or situation in the field and get feedback from trainers on how those approaches were appropriate, or could use improvement.
Sgt. Salvador Vergara, an original member of the Sheriff’s Office unit and the first supervisor of the program, said the training helps the deputies and mental health clinicians gain confidence to be out in the field. Vergara said once the training is over the deputies and clinicians work 8-hour shifts together.
They do not assign a specific clinician to a deputy or a specific deputy to a clinician because they need everyone to be comfortable with everyone, he said.
“We are always rotating them because we want them to be confident and comfortable working with each other,” Vergara said.
When they are dispatched to a CIT call, the responding team is able to immediately get information about whether the person has been seen before. They also try to make contact with the person before arriving at the scene to ensure the individual is aware they are coming.
Andres Arvizu, Emergence CIT program director, said they partner with the El Paso Police Department that launched its program in 2019, the Sheriff’s Office and have recently partnered with the Socorro Police Department and officers from the El Paso Independent School District and Canutillo school district.
“Whether you’re living in Vinton or you’re living in El Paso, you’re still going to receive the same level of service,” Arizu said.
Arvizu said part of the program is also a follow-up after seven days to see how the client is doing and ensure they are connected to ongoing services.
The Sheriff’s Office and the El Paso Police Department teams do not cross into each other’s jurisdictions, although there is coordination between agencies if someone crosses from one jurisdiction to another.
Similar programs across the state
In Houston, the Harris County Sheriff’s Department has had a crisis intervention team program since 2011 that serves the population of about 5 million.
Sgt. Jose “Rico” Gomez said they initially launched as a pilot program partnering with the Harris Center for Mental Health and IDD, the local mental health authority in the region. The collaboration was quickly expanded, he said.
In Harris County, the Sheriff’s Office also partners with the Houston Police Department and multiple smaller municipalities for coverage that allows the agencies to cross jurisdictions.
“If other agencies or entities within Harris County needed a crisis intervention response team, we can cross boundaries, or they can cross boundaries as well,” he said.
Between the sheriff’s program and Houston PD there are about 22 teams, he said. The law enforcement officer is also paired with a clinician who works the same shifts and responds to calls as necessary anywhere needed within the county.
In 2018, the department also implemented a tele-health program that equips deputies with an iPad in case a crisis intervention team is not close enough to respond, he said. The tool allows the deputy to call a clinician to do a mental health assessment out in the field without having to wait, he said.
“It’s been part of the training and we have seen deputies be able to de-escalate (situations) further,” Gomez said.
In San Antonio, the Bexar County Sheriff’s Department uses the Specialized Multidisciplinary Alternate Response Team, or SMART, approach to addressing people in a mental health crisis that launched in October 2020.
SMART is a multi-agency effort organized and coordinated by the Office of Criminal Justice, said Tom Peine, Bexar County public information officer.
The program is a co-responder approach with teams that are made up of two deputies, an emergency medical responder and a mental health clinician, he said.
It differs from crisis intervention teams that pair a clinician with a deputy that ride together and respond to 911 calls.
“The law enforcement deputies with the Bexar County Sheriff’s Office are out there to make sure that the scene is safe and provide for the safety of the EMT and the clinician,” Peine said. “Then the evaluation is done by the EMT and the mental health clinician, and they make a decision on the best course of action for that person.”
He said a key part of the program is also following up with the people they serve to make sure that the client is aware of the mental health resources and utilizing them and, if necessary, conduct follow-up visits.
“The idea is always to take the edge off, take into account that this is a situation that is different – while it can still be dangerous – it’s very different from any other scenario that you would typically encounter,” he said.
The teams currently focus on serving non-violent people who are experiencing a mental health crisis and need access to treatment, according to the program’s fact page.