HoustonPoliceDepartmentMental H P li D M l HealthUnit Health Unit

HoustonsMentalHealthCrisisResponse
TheHPDMentalHealthUnitislocatedinthe HarrisCountyNeuroPsychiatric Center CrisisInterventionTeam(CIT)startedin1999as resultofcollaborationwithmentalhealth result of collaboration with mental health community Houstonhas1,670CrisisInterventionTrained (CIT)officerswhorespondtoincidentsinvolving thementallyill the mentally ill

HoustonsMentalHealthCrisisResponse
Everyyear,HoustonPolicerespondtoover25,000 incidentsinvolvingpersonsinamentalhealthcrisis incidents involving persons in a mental health crisis In2008,HPDcommittedover3,200personsina , , p mentalhealthcrisis Onaverage,every2.5hours,HPDofficersdetaina personinamentalhealthcrisisandfilean EmergencyDetentionOrder Emergency Detention Order

INCREASEDCALLS

Lawenforcementhasbecomethefront linementalhealthresponse li t l h lth

Si l largest mental health facility in the U.S. is the Los Single l l h l h f ili i h U S i h L Angeles County Jail with over 3,000 prisoners a day on p y psychiatric medication Harris County Jail averages 2,400 prisoners a day on psychiatric medication As of 9/1/2009 all 10 state mental health hospitals had 9/1/2009, a combine patient count of 2,328

ApproximatelyhalfofourSWATcallsinvolveaperson inamentalhealthcrisis.Thistrendisoccurring nationwide

Nationally,itisestimatedthat10%ofallpolice calls involve a person in a mental health crisis callsinvolveapersoninamentalhealthcrisis

CollaborationisKey
ResponsestrategiesareexamplesofSmart, proactive,collaborativecommunitypolicing proactive collaborative community policing Identifyadifficultissueandengage stakeholdersaspartners NAMI,MHMRA,MHAhavebeenpartnerswith HPDforover10years

Aneffectivementalhealthresponseis morethanjusttraining th j t t i i
Thefollowingarethreeexamplesofneedfor specializedpoliceresponsestrategies:

January8,2007
OmarEsparza Omar Esparza 21yearoldwithrecent symptomsofmentalillness 3weekspriortoshooting,began actingirrational,notbathingor changingclothes Haddelusionsofdemonsflying throughthewindows Wasonwaitinglisttobeseenby MHMRA After2hourstandoff,charged officerswithhammerandfatally wounded.

May6,2007
Marnell Villareal 42yearoldwithhistoryof shizophrenia Historyoftrespassingat1200 Travis Madeclaimsoflaserbeamsbeing shotthroughherhead,food beingpoisoned Numeroushospitalizationsfor mentalillness Entered1200Traviswithknife, stabbingherselfinheadwhile screamingforofficerstokillher

July21,2007
StephenGuillory Stephen Guillory 39yearoldmalewithlengthy historyofschizophrenia DetainedandcommittedbyHPD3 timesinprioryear JustreleasedfromHCPC1week Just released from HCPC 1 week priortofatalencounterwithpolice Quittakingmedication,deteriorated Mothercalled911afterbeing turnedawaybyHCPC Chargedofficerswithpipeandtold g pp themShootme

CrisisInterventionResponseTeam

CrisisInterventionResponseTeam(CIRT)
PairsaCITofficerwithalicensedmentalhealthclinician a sa o ce a ce sed e a ea c c a fromMHMRA RespondtothemostseriousCITcalls Sevenfulltimeunitsprovide24/7coverage RespondtoallSWATcalls

CrisisInterventionResponseTeam(CIRT)
Conductproactiveandfollowupinvestigations o duc p o ac e a d o o up es ga o s Proactivelyengagethehomelesspopulation y g g p p TheonlyprogramofitstypeinTexasandoneofafew nationally(LAPD,SanDiego,Vancouver)

CHRONICCONSUMER CHRONIC CONSUMER STABILIZATIONINITIATIVE

AMULTIAGENCYCOLLABORATION

WHATISCCSI?
TheChronicConsumerStabilizationInitiative(CCSI)isa collaborativeeffortbetweentheHoustonPoliceDepartment, TheMentalHealthMentalRetardationAuthorityofHarris County(MHMRA)andTheCityofHoustonHealthandHuman Services CCS as des g ed to p oact e y de t y, e gage, a d p o de CCSIwasdesignedtoproactively identify,engage,andprovide servicestoindividualswhohavebeendiagnosedwithserious andpersistentmentalillnessand whohavehadfrequent encounterswiththeHoustonPoliceDepartment encounters with the Houston Police Department

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 MentalHealthTaskForceformedinSeptember 2007 Taskforcecomprisedoflawenforcement, communityleaders,andmentalhealthadvocates community leaders and mental health advocates Goal was to closely examine recent deadly Goalwastocloselyexaminerecentdeadly encountersandidentifypossiblesolutions Metthreetimesoverasixweekperiod

TASKFORCERECOMMENDATIONS TASK FORCE RECOMMENDATIONS:

1 Id tif 30 1.Identify30mostchronicallymentallyillwith t h i ll t ll ill ith highestnumberofpolicecontacts 2.Assignthese30individualstotwomental healthcaseworkersforintensivesupervision 3.Addmentalhealthscreeningto911dispatch protocol

 The Chronic Consumer Stabilization Initiative began as a six TheChronicConsumerStabilizationInitiativebeganasasix monthPilotProgram:February15,2009throughAugust15, 2009 TwoCaseManagerswerehired&trainedbyMHMRAand fundedbytheCityofHoustonHealth&HumanServices Staffwereresponsibleforengagingandinteractingwiththirty (30)ofthemostchronicandproblematicconsumers identifiedbytheHoustonPoliceDepartment sMentalHealth identified by the Houston Police Departments Mental Health Unit;prioritywasbasedonthenumberofinteractionswith policeofficerswithinthelastcalendaryear

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PROGRAMGOALS
ReducethenumberofinteractionswiththeHouston PoliceDepartment Identifyunmetneedsandbarriersinthecommunity Linkandcoordinateclientswithneededmental healthtreatmentandpsychosocialservices health treatment and psychosocial services Providesupportandeducationtotheindividualand theirfamilymembers

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ELIGIBILITYCRITERIA
Three(3)ormoreadmissionstotheNeuropsychiatricCenter (NPC)byHoustonPoliceDepartment(HPD).NPCisa psychiatricemergencyroom E ExcessiveandhighfrequencyofphonecallsmadetoHPDby i d hi h f f h ll d t HPD b clientsorothers,ontheirbehalf HighfrequencyofcontactwithHPD Highutilizers ofCityofHoustonservices h l f f

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STAFFING
DirectCareStaff:

OneMasterlevelcasemanagerwith approximately30yearsofCaseManagement approximately 30 years of Case Management experience Onebilingual(Spanishspeaking)casemanager withapproximately8yearsofCase Managementexperience
HPDMentalHealthUnitLiaisonOfficer AdministrativeoversightprovidedbyAssistantDeputyfor Administrative oversight provided by Assistant Deputy for CPEPservices&theLieutenantfortheHPDMental HealthUnit

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SERVICESPROVIDED
CrisisInterventionandRelapsePrevention Screeningandassessment Case management & psychosocial supports Casemanagement&psychosocialsupports Referrals for primary health care substance abuse Referralsforprimaryhealthcare,substanceabuse treatment,jobtraining,educationalservices,and relevanthousingservices Familyeducationandsupport

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PILOTSUCCESSES
Decreasedtheoverallnumberofinteractions betweenCCSIclientsandtheHoustonPolice Departmentby70% DecreasedadmissionstoNeuroPsychiatric Centerby21% AdmissionstoHarrisCountyPsychiatricCenter y y (HCPC)decreasedby51%

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CCSIRESULTS

After the six-month pilot of intense engagement and interaction between the two case managers and the listed consumers, there was a 70% DECREASE in overall events reported by the police department This represents a significant reduction department. of police contacts. Calls-for-service decreased by 67.3%, emergency detention orders (EDO) decreased by 76.4%, and offense reports also decreased by 67.3%.

FINANCIALIMPACTRESULTINGFROMREDUCED HOSPITALIZATIONS
ClientsenrolledintheCCSIprogramachievedanoveralldecreaseinadmissionstothe NeuroPsychiatric CenterandattheHarrisCountyPsychiatricCenter(HCPC).Thisdecreasein admissionsresultedinacostsavingsof$176,550duringthesixmonthpilot.

WHATWORKED???
Divertedcallsfrom911byprovidingcase managercellphonenumberstoclients Strongadvocacyroleofcasemanagers NoStatefundingrestrictions HoustonPoliceDepartmentinvolvementand support S SupportfromtheDistrictAttorneysOffice tf th Di t i t Att Offi Consistencyanddependabilityofcase managers Networking(communicationamongproviders)
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CURRENTSTATUSANDNEXTSTEPS
CityCouncilextendedfundingthrough2011 FormationofanAdvisoryCouncilcomprisedof representatives(whohavedecisionmakingauthority) fromcommunityagencies from community agencies Expandtheprogrambyaddingadditionalclinicalstaff pa d t e p og a by add g add t o a c ca sta andpairintoteamstoworkwithclients DedicateafulltimepoliceofficerpositiontotheCCSI program

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QUESTIONS ?? QUESTIONS??

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CONTACTS

WWW.HOUSTONCIT.ORG