a successful partnership of two community systems; the houston police department (hpd) and mental...
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A Successful Partnership of Two Community Systems; The Houston Police Department (HPD)
and Mental Health and Mental Retardation Authority of Harris County (MHMRA)
Crisis Intervention Response Team (CIRT)
Mission Statement
To provide a more professional and
humane response to individuals in
serious mental health crises.
Houston/Harris County Facts
4 million people in County
Approximately 700 square miles
2.2 million people within the City of Houston
Estimated 540,000 have mental illness, 147,000 have Serious and Persistent Mental Illness
Over 20,000 times a year an HPD Officer is dispatched to a call involving a mentally ill person
Texas is 49th per capita in funding for the mentally ill
Historical Collaborations
1986: Harris County Psychiatric Center opened (HCPC) 1991: Partnership between MHMRA and HPD began to
streamline the procedures in obtaining a mental health warrant
1999: HPD CIT piloted 1999: Psychiatric Emergency Services program opened Between 1999-2004 the County approved funding for all
the major components of a comprehensive psychiatric emergency program
Law Enforcement to PES
On average, the PES treats 3,700 involuntary consumers brought in by law enforcement
On average, 30-35% of total admissions to the unit are brought by law enforcement.
Approximately 65% were treated and did not require inpatient hospitalization
Law enforcement takes another 5% from the PES to jail after a brief psychiatric evaluation.
Factors for the creation of CIRT
Needs identified from the relationship between HPD/MCOT/PES
Increase in police calls involving individuals with mental illness resulting in: Fatal shootings Mentally ill persons being jailed for petty crimes that result from
their mental illness (e.g., criminal trespass, public intoxication)
Increase in demand for limited supply of mental health services
Crisis Redesign Initiatives
A planning committee with more than 100 participants from over 40 public, private, criminal justice, and advocacy organizations
Identified major components of an ideal Crisis Response System for Harris County
Proposed 19 possible projects, of which 9 projects were ultimately approved.
CIRT was one of the 9 approved projects. MHMRA & HARRIS COUNTY COMMISSIONER’S COURT
FUNDS: $500,000 on CIRT $9,000,000 on the NPC $6,000,000 on MCOT
RESPONSE TEAM
CRISIS INTERVENTION
CRISIS INTERVENTION RESPONSE TEAM
Collaboration between MHMRA of Harris County and Houston Police Department
Partners a Crisis Intervention Team (CIT) trained officer with a licensed mental health clinician from MHMRA.
CIRT evolved from a successful, mutually beneficial relationship between MHMRA Crisis Programs and the Houston Police Department’s Mental Health Unit
The CIRT program augments HPD’s Crisis Intervention Team (CIT) program
CIRT Implementation
Pilot Program: May 2008 Full Implementation: (3 Units) December 2008
Team Expansion: (+2 Units) April 2009
Team Expansion: (+2 Units) February 2010
Current total 7 Units
CIRT Staff Qualifications/Requirements
Police Officers must have the 40 hour CIT training certification.
Police Officers must have a minimum of three years experience working as a Police Officer
Master’s Level Clinicians are licensed by the state and must have a minimum of five years mental health crisis service experience
Both clinicians and police officers receive ongoing specialized training
CIRT Program Responsibilities
Responds in a watermarked police vehicle to the more serious CIT calls where they:
Conduct on-scene mental health assessments Assess for suicide/lethality risk Access & provide MHMRA mental health treatment history Link and coordinate with appropriate community resources Facilitate engagement in ongoing mental health services Provide crisis intervention and resolution on-scene
CIRT Program Responsibilities, cont.
Prisoner assessments at the city jails Transportation of involuntary consumers from
local MHMRA clinics to emergency psychiatric facilities
Respond to all SWAT calls as a resource for the on-scene commander
Provide overnight mental health assessments for walk-ins to county psychiatric hospital
Responsibilities of CIRT Clinicians
Conduct mental health evaluations and assessments of consumers
Assist in determining a clinically appropriate disposition for consumer
Provide on-scene trauma support for survivors Provide community resources to families and
consumers
Responsibilities of CIRT Officers
Handle all prisoner control/safety issues
Provide safety for the clinician, consumer and community
Address issues involving criminal charges
File Emergency Detention Orders
Assist in determining the appropriate disposition supporting consumers’ needs and safety
CIRT StatisticsMar ’09-Mar’10
Activity TOTAL
CALLS FROM HPD DISPATCH 4,005
SELF INITIATEDINVESTIGATIONS
1,135
SWAT CALLS 31
E.D.O. 1,154
ARRESTS 67
COMPLETED REFERRALS 139
REFERRAL FOLLOW UPS 263
Successes
Improved public safety Improved relationship between the community, Houston police
department and MHMRA Improved public perception of police interactions with individuals
with mental illness and their families Individuals with mental illness are directed into appropriate
mental health treatment Increase in consumers being diverted from jail into appropriate
mental health services Expedited admission process to mental health unit in jail when
incarceration is necessary
Local Challenges
Jurisdiction limited to Houston City limits Budget restraints that restrict the number of CIRT units
available in the City of Houston Shortage of inpatient psychiatric beds Overwhelmed clinics Lack of safe, adequate housing options Inability to oversee linkage of services for those
patients non-adherent to treatment
Awards and Media Recognition
Houston Press Fox 26 News Houston Chronicle National Public Radio Al Jazeera English Chief of Police Unit Citation-HPD National Behavioral Health/CIT Awards:2008
CIT Officer of The Year Behavioral Health Employee of The Year
Houston Police Department Awards Ceremony:2009 CIRT Lieutenant -Mid Manager of the Year CIRT Officer- CIT Officer of the Year
Houston Police Department Awards Ceremony:2010 CIRT Officer- CIT Officer of the Year
Where do we go from here?
Expanded the number of CIRT units – currently only 7 for a population of over 2.2 million
Expand the collaboration to include the Harris County Sherriff’s Department to extend CIRT coverage throughout Harris County
Continue to educate the community Continue to learn from experiences and refine service
delivery in daily operations as well as improve community relations and perceptions
Where do we go from here? (cont.)
Chronic Consumer Stabilization Initiative Mental Health Courts Continue to seek more comprehensive
collaborations between service providers (e.g., V.A./State Hospitals)
Questions?
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STIGMA
SUICIDE
“Suicide by Cop”HOPELESSNESS
FEAR MISCONCEPTIONS
CIRT DECREASES
HOMICIDES
POLICE ENCOUNTERS
DOMESTIC VIOLENCEUNNECESSARY JAILINGS
Contact Information
Mental Health Unit Investigator/Officer – CCSI, CIRT– Rebecca Skillern, LPC-S– Rebecca.Skillern@cityofhouston.net
Mental Health Unit - Police Officer – CIRT– Eric Chimney, Sr. Police Officer/CIRT Officer– Eric.Chimney@cityofhouston.net
Mental Health Mental Retardation Authority of Harris County– Michael Erickson, LPC– Michael.Erickson@mhmraharris.org
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