1. MHST Sgt. Terry Staten Pima County Sheriff’s Department October 2013 Mental Health Investigative Support Team

2. What Are We Doing Different Now The Sheriff’s Department 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 catalysts for taking a fresh look Mental Health Support Team (MHST)

3. Overview Background/History – Started December, 2012 The Process Before MHST Significant Events Philosophy Shift Development and Approach of MHST Where We Are Now

4. The Old Way Civil Division Deputies – Serving Mental Health Orders Evaluation orders Treatment orders – Service rate about 30% Patrol Deputies – Service rate even lower

5. SIGNIFICANT EVENTS October 28, 2002 – Three nursing professors killed at the University of Arizona Medical school – Multi-agency response to an active shooter

6. SIGNIFICANT EVENTS Shooter – Robert Flores Previous contacts – Mental health – Law enforcement

7. SIGNIFICANT EVENTS Dep. Timothy Graham, PCSO End of Watch - August 10, 2005 Responded to a convenience store where Aaron Swyers with history of mental health issues was in crisis

8. SIGNIFICANT EVENTS Tucson Police Officer Erik Hite End of Watch – June 2, 2008 Responded to “officers need assistance” call Deputy wounded

9. SIGNIFICANT EVENTS Shooter – David Delich Previous contacts – Mental health – Law enforcement

10. SIGNIFICANT EVENTS January 8, 2011 – Mass shooting at grocery store parking lot event – 6 killed, 19 wounded, including Congresswoman Gabrielle Giffords

11. SIGNIFICANT EVENTS Shooter – Jared Loughner Previous contacts – Mental health – Law enforcement

12. Philosophy Shift 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

13. Philosophy Shift Goals – Improve officer safety – Improve community safety Identify and intervene sooner when possible – Improve efficiency & save taxpayer dollars – Reduce liability to the department Fewer “hands on” situations – BREAK THE CYCLE

14. Philosophy Shift To help meet goals – Need changes in the legal system Courts’ expectation to treat individuals with mental illness differently – Changes in community resources Active Crisis Intervention Training (CIT) program collaboration Collaboration with mental health system Collaboration with other law enforcement agencies

15. The Old Approach Patrol deputies 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

16. The Costs Repeated responses to same mental health related calls Frequent consumers of services Frustration with the system People fall through the cracks in the system

17. The Costs-continued Man hours spent by departments on mental health issues are a drain on resources 1 repeat consumer 2080 hours in a year 1 new officer

18. Where We Fail Many people suffering from mental health issues fall between the cracks of the system They always become the burden of law enforcement Law Enforcement Behavior al Health Courts MHST

19. Development of MHST Personnel – 7 full-time personnel 3 uniform deputies 2 detectives 1 sergeant 1 civilian support specialist – Developing into a regional resource

20. The New Approach 100 % service rate on mental health orders 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

21. How It Works MHST is responsible for the service of all mental health related court orders All field calls where the core issue is a mental health crisis AND a threat to public safety is identified are tagged for follow up by MSHT detectives

22. Triaging The Calls 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

23. Triaging The Calls 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

24. The MHST Investigation Criminal Investigation Mental Health Investigation Initial Call Long term care, medication Presentation to evaluating provider Presentation to Prosecutors Start of the mental health investigation Start of criminal investigation Adjudication or mental health diversion

25. Prioritizing Solutions Medical- Medical issues that are critical must be addressed first Criminal – Criminal charges will take priority over an immediate mental health solution Mental Health – Mental health solutions will generally be the third priority and can be begin along with both the medical and criminal processes

26. MHST Focus MHST

27. Partnership with Providers MHST will focus on those cases with a criminal nexus – Allowing for a law enforcement action & ownership – No HIPAA issues for law enforcement MHST will not focus on danger to self cases – No role for law enforcement beyond immediate care and referral

28. SUCCESSES John – History of mental illness – History of assaulting dad and destroying his house – History of not staying on his medication program – Now staying on his program – Dad now helping his son stay on the program – No new law enforcement interactions

29. SUCCESSES Brandon – Texted girl friend and threatened to shoot up school and “do it better than Columbine” – Arrested and evaluation ordered – Failed to continue counseling and violated restraining order – Determined counselor was not a right fit – Brandon back in counseling with new counselor

30. Questions