Local police departments are increasingly implementing “co-response” protocols for calls involving mental health crises, where a licensed social worker serves on department staff and responds to calls alongside police officers.

This dual-response approach enables departments to effectively address situations where law enforcement and severe mental illness intersect, using a nuanced approach that is tailored to the situation at hand.

“Collaborative co-response strategies can help de-escalate situations in real time, as well as lead to thorough follow-up and better outcomes over the long-term,” said attorney John Scheft, head of Law Enforcement Dimensions LLC.

Scheft and Christina Valeri, a mental health clinician with the Arlington Police Department, co-led a MIIA-sponsored training session on Dec. 13, “Police Response to Emotionally Disturbed People,” which was attended by more than 50 law enforcement officers from around the state.

During the training, Scheft outlined initial call response considerations, documentation and processes for mental health commitment, and strategies for supervisors and commanders. Valeri provided a mental health overview, including types of disorders that officers may encounter, common mental-health-related medications, and de-escalation strategies.

An estimated 20% or more of police calls involve a mental health, substance abuse, or quality of life concern. A recent nationwide survey of more than 2,400 senior law enforcement officials conducted by the Naval Postgraduate School and Michael Biasotti, formerly of the New York State Association of Chiefs of Police, found that more than 80% of law enforcement respondents said they have seen an increase in mental health-related calls during their career, and 63% said the amount of time spent on these calls has increased. More than half reported that challenges with making appropriate referrals for treatment account for the increased time.

In Massachusetts, Valeri estimates that more than 50 local police departments are already implementing co-response strategies, and that most police calls she’s responded to have included some level of mental health distress. Common concerns encountered by local police and clinicians include hoarding, unhealthy living conditions, elder abuse, substance abuse, and child services issues. Having a mental health clinician present during calls can help build trust — with both the clinician and the co-responding officers — as well as keep people out of the correctional system when mental health treatment is likely to be more effective, Valeri noted.

Scheft said co-response is one of the top innovations in policing over the last decade.

“It can be very difficult to predict when a mental health situation will turn violent,” he said, “and having an experienced mental health professional on calls provides a less threatening approach that can help de-escalate.”

Police reform laws in Massachusetts now mandate that officers must de-escalate prior to any use of force, so having clinical resources on scene is vital, Scheft noted.

Many people, lacking other options, call 911 when a mental health crisis overwhelms their family, and some of these volatile situations may result in injury or death by the time police intervene. In addition to helping de-escalate these active situations, “co-response at its best provides follow-up care referrals that prevent the need for a future police response,” Scheft said.

An effective clinician embedded with a police agency can provide follow up: staying in contact with family members, ensuring medication adherence, and arranging ongoing mental health care.

Law enforcement liability insurance claims related to personal injury are among the highest in cost, but it’s important to look at the bigger picture, noted MIIA Executive Vice President Stan Corcoran.

“We can save lives and recognize that someone is going through a crisis and perhaps isn’t necessarily a threat to others but is to themselves,” he said. “It makes sense for us to have an approach in place that is good from both a police perspective and a community perspective.”

Training materials for the session with Scheft and Valeri are available at emiia.org.

 

MIIA Offers Maternal Mental Health Resources

 

Perinatal depression is the most common complication of childbearing, with about 15% of women experiencing significant depression following childbirth and 10% during pregnancy, according to Postpartum Support International.

To help connect municipal employees with the resources needed to help themselves or a loved one facing maternal mental health challenges, MIIA’s Health Benefits Trust will soon launch a six-part informational video series available to anyone, regardless of health plan status, at emiia.org and in the MIIAWinners wellness portal.

Michelle Visser, a licensed psychotherapist and certified early intervention specialist with extensive experience in perinatal and parental mental health, worked with MIIA to develop the program and lead the video training. The series of 10- to 15-minute videos will include an overview description of perinatal mood and anxiety disorders, screening and discussion tools, risk factors, tips for self-advocating in the doctor’s office, and treatment and support options.

In addition to reducing stigma around maternal mental health, Visser said a goal of the program is to ensure that people have factual information, as opposed to what might be covered by the media. It’s important to know that perinatal depression can occur over a broad spectrum, from mild to more serious cases, she said.

“Women don’t often think of mental health as part of the pregnancy experience, and symptoms can be surprising,” Visser said. “My hope is that people might access these videos and have the information that they need to help themselves or a loved one.”

For additional resources on maternal mental health, visit postpartum.net or visit the Blue Cross Blue Shield of Massachusetts website’s “MyBlue” section under health and wellness.

For immediate assistance, call the Postpartum Depression Crises Hotline (1-800-PPD-MOMS), the National Maternal Mental Health Hotline (1-833-9-HELP4MOMS), or the national suicide and crisis lifeline at 988.

Maternal mental health informational flyers (for posting in worksite common areas) are available from both MIIA and Blue Cross Blue Shield of Massachusetts.