TUCSON POLICE DEPARTMENT
LESSONS IN BEHAVIORAL HEALTH COLLABORATION
Arizona Problem Solving Courts
Conference
Prescott, Arizona
April 28, 2015
TUCSON POLICE DEPARTMENT
Captain Paul Sayre
Sergeant Jason Winsky
27 years law enforcement experience
10 years law enforcement experience
Oversee TPD’s Central Investigations
Division
Supervises the Mental Health
Investigation and Support Team (MHIST)
Helped develop MHIST team, currently
oversee MHIST Unit
Prior SWAT Commander
LAW ENFORCEMENT LINK TO BEHAVIORAL
HEALTH SYSTEM
Kate Lawson
Criminal Justice Manager
 Team assists individuals in crisis and/or with
mental health disorders, wherever they are in
the criminal justice system: court, jail, prison,
probation, etc – including law enforcement
12 years experience in intersection
of criminal justice and mental health
BIG PICTURE
TOPICS COVERED IN TODAY’S PRESENTATION
Concept: How can law enforcement, within it’s scope and mandate of
community protection, work with individuals in crisis or with a mental
health disorder to improve public safety?
Catalyst for Change: Legal Issues Impacting Law Enforcement Interactions with
Individuals with Behavioral Health Concerns
…Resulted in: Mental Health Investigative Support Team (MHIST) – Tucson Police
Department
…And how it Fits into the larger continuum of Crisis and Behavioral Health Systems
 Crisis Intervention Team (CIT) Training vs. Mental Health First Aid (MHFA) Training
COURT RULINGS
Regarding Law Enforcement and
“Emotionally Disturbed Persons”
EMOTIONALLY DISTURBED PERSON (EDP)
EDP
Court’s language
Terminology for anyone who
has a mental illness or is in
some other way
inhibited/incapacitated by
crisis
GLENN V. WASHINGTON COUNTY (2011)
Hillsboro, Washington County – 2006
18 year old Lukus Glenn, a popular high
school athlete, was intoxicated and
distraught over a recent break-up
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Returned home at 0300
Angry, intent on riding his motorcycle
Parents would not let him leave the house
He began damaging property, including doorway
that led out to the garage
Prior to this event, Glenn had no history of
violence or criminal activity
GLENN V. WASHINGTON COUNTY
Glenn held a 3 inch pocketknife to his
neck and threatened to kill himself
Mom called 911believing that “the
police would have the expertise and
experience to deal with an emotionally
distraught teenager.”
Call was dispatched as an armed
domestic violence incident.
GLENN V. WASHINGTON COUNTY
Based on dispatch of “armed DV situation” Deputy goes directly to the house without
conferring with other officers on scene or en route
Deputy finds family sitting with Glenn, who still has knife at his neck
Mother tells dispatcher “Don’t let him shoot him… They’re going to shoot him.”
Second deputy arrives and begins shouting at Glenn, like first deputy, “Drop the knife
or you’re going to die!”
 Second deputy also presented as “frantic and excited” and “only pursuing a course of screaming
commands at Luke”.
GLENN V. WASHINGTON COUNTY
Family implored deputies to calm down
Deputies ordered family to go back
inside the house
Sergeant radioed deputies to say
“Remember your tactical breathing”
Ordered a officer from neighboring
department to “beanbag him”
 Lucas defensively retreats from direction of
beanbag fire
GLENN V. WASHINGTON COUNTY
Deputies had independently determined
if Glenn moved towards the house they
would use deadly force
 Glenn (taking cover from bean bags) ran from
garage towards only exit—the house
 Because he was headed toward house, where
the other family members had been told to go,
officers used deadly force
Deadly force occurred less than four
minutes after the first deputy
arrived on scene
Seconds before he was fired
upon, Glenn said “Why are you
yelling?” and “Please tell them
to stop screaming at me!”
GLENN V. WASHINGTON COUNTY
Glenn bled out and died on the family
porch within minutes.
In 2007, Washington County Sheriff Rob
Gordon released their results of their
shooting board and determined
 No policies had been violated and
 “WCSO deputies involved in this incident
performed as trained, followed established
policies, and acted in a professional manner.”
GLENN V. WASHINGTON COUNTY
Court’s decision….
“…we have made it clear that the desire to
quickly resolve a potentially dangerous
situation is not the type of governmental
interest…that justifies the use of force that
may cause serious injury (Deorle).”
“We also recognized in Deorle, that when
dealing with EDP’s who is creating a
disturbance or resisting arrest, as opposed to
a dangerous criminal, officers typically use
less forceful tactics.” (notice the change in
language)
GLENN V. WASHINGTON COUNTY
Ruling, continued:
“The facts in this case, viewed in the light
most favorable to the plaintiff, bear this
out: Lukus did not respond positively to
the officers’ forceful tactics, and just
before officers fired the beanbag gun,
Lukus pled, “Tell them to stop screaming
at me’” and “why are you yelling?”
The Court now expects
a differentiated
response from law
enforcement.
Or…
“No excuse now – train
your officers”
LESSONS LEARNED FROM GLENN
The Family hired a Subject Matter Expert, a former Bellevue, Washington Chief of
Police. His professional opinion forms the basis for what should be our response to
these situations with EDPs:
1. Slow it down,
2. Do not increase the subject’s level of anxiety or
excitement,
3. Attempt to develop a rapport,
4. Time is on the side of the police
SHEEHAN AND HAYES
9th Circuit Opinions
Duty to Care-Now Extends to Actions PRIOR to critical incident
ADA Application-If Upheld, Will Change American Policing Forever
SO – ON ONE HAND WE
HAVE NEW EXPECTATIONS
ON USE OF FORCE…
BUT – ON THE OTHER HAND, GROWING PUBLIC SAFETY
CONCERNS…
CREATION OF THE MENTAL HEALTH
INVESTIGATIVE SUPPORT TEAM
MHIST
TYPICALLY POLICE HAVE TO BALANCE THE TWO...
Public
Safety
Community
Service
…MHIST SEEKS TO FIND SOLUTIONS FOR BOTH
Community
Safety
Accountability
Treatment
Recovery
CREATION
Pima County Sheriff’s
Department – 2013
Tucson Police Department –
2013
Teams:
 Sergeant
 Detective(s)
 Patrol Officers (Transport)
WHY
Law enforcement recognized the need to
take a different approach to mental
health issues related to law enforcement
The wave of mass shootings and the
increased mental health related calls
served as a catalyst for taking a fresh
look
PURPOSE
Public Safety
Community Service
Risk Management
But also…
It’s the right thing to do.
FUNCTION
Mental Health Court Order Transports
 “Title 36” in Arizona
 Specialized training to avoid going hands-on
 Locate/transport before order expires
Investigations
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Circumstance code
Patterns of behavior
Problem-solving with mental health treatment
Title 36 petitions
MHIST = CIT PHILOSOPHY IN ACTION
Has to be a better way to
approach problem
Need to
 Decrease risk to officers/deputies
 Decrease risk to community
 Decrease waste of taxpayer dollars
 BREAK THE CYCLE
MHIST AREA OF INTERVENTION
Law
Enforcement
Many people suffering from mental health
issues fall between the cracks of the system
They always become the burden of law
enforcement
MHIST
Justice
System
(Courts)
Behavioral
Health
OUT WITH THE OLD…
Old Way
New Way
Patrol Officers Serving COE Orders
100 % service rate on mental health
orders
 Court Ordered Evaluations orders served
before expiring = 30%
Patrol officers would look for the
quickest, easiest solution to a situation
with a mental health nexus
 Often resulting in arrest and incarceration
 As a result, the Pima County Jail is now the
largest behavioral health facility in southern
Arizona
 The problems continue
Mental health facilities and providers
communicating with law enforcement
One central location for patrol to go to
for answers to problems
Law enforcement talking to law
enforcement
CALL TRIAGE
Calls where there is not a threat to public safety (danger to self) are handled
as they always have been-referred to the appropriate mental health provider
 Voluntary committal
 Involuntary committal
 Referral to various providers
Calls for service where there is a criminal component, and the
person is a threat to others (public safety)
 Routed to the MHST Unit for follow up
 A full criminal/mental health investigation is conducted where appropriate
 A unique 2-pronged process is initiated
MHST INVESTIGATION
SUCCESSES
“Jose”
 Jose is a Marine veteran and a student
at Pima Community college
 Jose perceived he was assaulted in the
school library (unfounded)
 He began making threats towards PCC
personnel
 Outcome
 Kept out of jail
 Compliant with treatment
SUCCESSES
“Maria”
Young woman in her 20s, lives at home with her
parents
Tucson City Court – Mental Health Court Diversion
(misdemeanor charges)
Repeatedly calls 911 requesting transport to the
Crisis Response Center
 Find that she is bored and wants out of the house
TPD participate in Adult Recovery Team (ART)
meeting, along with treatment provider
Develop crisis plan that includes TPD differentiated
response
WITH A CIT TRAINING PROGRAM +
A MENTAL ILLNESS/CRISIS RESPONSE PROTOCOL
A Best Case Scenario
But If the Outcome Is Bad Anyway…
Officer is able to de-escalate the situation
Officer should be able to say:
Person is taken to crisis center and/or
referred to community treatment
“I am knowledgeable of and considered use
of de-escalation techniques and community
resources.
Financial Savings
I still could not have handled
the situation any other way.”
 “Breaking the Cycle” – avoid future interactions
 Positive Community Policing
 Officer time
 Jail Days
 Criminal Case Proceedings
Avoid going “hands on”
 Improved liability
 Improved safety
PREPARING ALL OFFICERS FOR SOME
PREPARING SOME OFFICERS FOR ALL
Ensuring behavioral health and
crisis training needs are met for
public safety
AUDIENCE POLL
How familiar are you with CIT?
Do you have a CIT program in your
community?
 Who facilitates?
 How long is the training?
How familiar are you with Mental Health
First Aid (MHFA) training?
CONTINUUM OF
MENTAL HEALTH TRAINING
CIT & MHFA
PHILOSOPHY
All Officers receive basic mental health training (Example: MHFA)
De-Escalation
& Crisis
Intervention
Mental
Health Basics
& Community
Resources
Some officers receive intermediate (Example: CIT)
Voluntary
Participation
Aptitude for
the Population
Specialized Units – Advanced Training
SWAT Negotiators
MHIST Teams
COMPARING MHFA & CIT –
TRAINING FOR EVERY STAGE
CIT
MHFA
“Advanced” Training
Introductory
Officers with 18+ months patrol
Appropriate for academy and new
officers
 Relies on experience on the street to provide
context
Voluntary
 Can be made mandatory training for all
officers and employees
 No history of discipline related to excessive
force within last three years
Certified instructors through National
Council required
40 hours
8 hours
CORE ELEMENTS
Voluntary
 Not “charm school”
 No history of excessive force within
3 years
Some patrol experience
 18 months+ recommended
 No academy/post-academy
 MHFA
Fidelity to Memphis Model
IS OBJECTIVE OF CIT TO
ALWAYS USE DEESCALATION?
No, purpose of CIT is to give experienced
officers:
TOOLS FOR
THE TOOL BOX
Objective:
 Provide skills to be able to de-escalate individuals
and situations, when appropriate
 Does not override tactical training
 Officer and citizen safety is always paramount
MENTAL HEALTH FIRST AID (MHFA)
Established in 2001 in Australia
Like CPR, designed to be quick response
for emergent situations
 “First responder”
8 hours
 Includes certification
Specialized modules
 Law Enforcement
 Veterans
 Spanish
RESULTS SUMMARY
Law Enforcement Training
Specialized LE Teams (MHST)
A responsive Crisis System
 Facility
 24/7/365 phone line
 MAC teams
Communication between Law
Enforcement, Criminal Justice System &
Mental Health Treatment
Support & Buy-In from Consumers &
Advocates (NAMI)
WORKING AT AN INTERSECTION –
NOT A PARALLEL
Behavioral Health working with
Law Enforcement to Achieve
Better Outcomes for Clients
WHOSE GOAL – TREATMENT, OR POLICE?
Productive Citizen
Engaged in Treatment
CHANGING OPINIONS
- CHANGING LIVES
“If a mentally ill person has done something
wrong, they should go to jail”
“When a mentally ill person is arrested, it
represents a failure of the mental health system.”
“I’m not going to help the police catch my client.”
GOALS OF BEHAVIORAL HEALTH TREATMENT NOT
AT ODDS WITH JUSTICE SYSTEM
“Accountability is therapeutic”
-Kate Lawson
Involvement with the justice system can
be the point of intervention for client
 With the right interventions, and the right
collaborations with the justice system, justice
contact can become the support system needs to
obtain recovery
Goals of the CJ Team
1. Improve client’s lives
2. Save taxpayer dollars
3. Improve public safety
Court
• Treatment provider – send med sheet and case management notes to jail
• Jail – bridge medications, identify SMI, housing
• CPSA – Assign to Mental Health Court or Docket
• Mental Health Courts – Diversion Eligible? Coordinated Probation?
• Treatment – monitoring treatment compliance, additional support
Remedy • CPSA – MHC coordination, treatment advocacy, Court liaison
• Community Re-Integration (Coordinated Jail and Prison Releases)
• Other Supports: NAMI, Family reunification, other support systems
Recovery • Continued coordination with Probation or Parole
HOPE
Sequential Intercept Model
Arrest
• Coordination with Law Enforcement, MHIST
• CPSA Criminal Justice team: Contact at Initial Appearance, Notify Provider & Jail
Healthcare, Identification & notification to treatment providers, release planning,
communication with court
QUESTIONS – DISCUSSION – DANCE OFF?
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