By Sandra Storey / Special to the Gazette
Talk about falling through the cracks. Talk about holes in safety nets. Between 1955 and 1994, state mental institutions were closed in Massachusetts and around the country with few reliable care resources available in the communities.
Now it is sometimes said that troubled people have to “hit bottom” before they can get the help they need.
Unfortunately for everyone, that has meant the job of dealing with people in crisis from mental illness, substance abuse and/or homelessness often falls to law enforcement by default.
Thousands of calls to the Boston Police Department (BPD)—at least 9,600 in 2019, according to researchers—specifically involved an emotionally disturbed person.
“We can’t arrest our way out of every problem,” BPD Sgt. Peter Messina said in an interview last week. “Mental illness is at the crux of a lot of calls.”
Messina is a BPD deputy superintendent and head of the Street Outreach Unit. As such, the he is the “lead collaborator” who synchronizes the myriad parties involved in the BEST Co-Responder Program, including community groups and non-profit partners.
In the BEST Co-Responder Program, Master’s level clinicians and their supervisors work in partnership with Boston police. Co-responders are paired with officers at district stations where they work the same shifts. They can then deal together with calls that involve a “behavioral health” component.
The Co-Responder Program “combines law and social work that results in deescalating crisis situations,” Messina said. “Sometimes it’s good if a problem is dealt with by a hospital, not a court.”
Co-responders have frequent opportunities to work with people in their districts and often work closely with the Community Service Office in their station, according to BMC Communications Director David Kibbe.
Much needed expansion of the Co-Responder Program is on the way now, after additional funding was announced by the City of Boston in September. BEST (Boston Emergency Services Team), based at Boston Medical Center (BMC) since 2003, received reallocated City funds to greatly expand its Co-Responder Program in partnership with BPD.
BMC will be adding up to four new positions this spring and continue to build toward a total of 15 new clinical and supervisory positions through this summer and early fall, Kibbe said in an email earlier this month in response to a question.
“Expansion was required,” Messina said. “The city and the communities need it.”
Currently, there are two full-time and one part-time clinician and one Certified Peer Specialist working in the Co-Responder Program, which began in 2011.
District 13, JP’s station on Washington Street, has one part-time co-responder now. JP also hosts one of two meetings in the city where the police and service providers/stakeholders from the community come together to discuss issues of mutual concern and determine which services or agencies would be best to offer, according to Kibbe.
Kibbe gave some hypothetical examples of calls where cooperation between an officer and a social worker can be very helpful: a parent or guardian contacts police because they want a verbal altercation with a child de-escalated; a person or community contacts the police because someone is acting strangely, such as walking in traffic; an individual is struggling with anxiety due to the pandemic; a parent calls about a depressed child who has been searching the internet for information about suicide; a person with a history of mental illness has not been taking their medications, and it is affecting their behavior.
BMC’s goal is to hire clinicians who reflect the diversity of the city “linguistically and culturally,” Kibbe said. Monthly trainings cover a variety of topics, including cultural competence.
Funding for the additional co-responder positions comes from the BPD budget. In late June, the Boston City Council passed the 2021 budget proposal of Mayor Marty Walsh.
In his resubmitted proposal, Walsh reallocated $12 million in BPD overtime spending—20 percent of the department’s overtime budget—to other programs, including the Co-Responder Program. He shifted the funds in response to calls by racial justice advocates to put some policing resources into services for troubled people.
One of the current co-responder positions and a peer specialist position are funded through a Department of Mental Health grant to the BPD. BMC employs and supervises the Co-Responder clinicians and the Certified Peer Specialist.
BEST’s Co-Responder Program has become a national model, according to Messina. Most cities have similar numbers of calls with a behavioral health component where a co-responder would be helpful. Rather than just being “reactive” to events, having co-responders allows intervention to occur before a situation becomes critical, Messina said.
He also credited Boston’s “outside the box” community policing component which involves communicating with groups and individuals in the neighborhoods regularly.
Families are now reaching out before incidents occur, he said. And police training now includes information about dealing with calls that have a behavioral health component.
In addition to overseeing BEST’s Co-responder Program, BMC is the lead agency for what’s called the Emergency Services Program (ESP) in Suffolk County.
According to Kibbe, BEST’s ESP mobile team has a similar role to co-responders. ESP is different in that mobile clinicians can be accessed directly by members of the community in case a mental illness-related issue arises.
People who call 1-800-981-HELP, available 24/7, always speak to a live Master’s level clinician, Kibbe said. Among other things, the clinicians can go to the scene, arrange to see someone in person or set up a telehealth evaluation. They can consult with a police officer and even call one in, if needed.
It’s helpful if a person who dials 911 tells the operator clearly if they have mental health or substance abuse or homeless concern regarding the situation, Kibbe said. That will alert first responders as well as officers who may have a co-responder on their shift so the clinician can provide assistance on the scene or by phone.
It’s important for people in the JP community to realize we have a role, too, in educating ourselves and our neighbors about how to access, create, evaluate and preserve humane policing programs and practices.