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Who Ya Gonna Call?

How to make sure your next mental-health crisis doesn't become a death sentence.

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On Sept. 4, 2020, Utah became another not-so-shining example of American policing gone wrong. Thirteen-year-old Linden Cameron was shot 11 times by a Salt Lake City Police officer after the boy's mother, Golda Barton, called for help to get her son to a hospital due to his severe separation anxiety brought on by her returning to work. In an attempt to describe her son's state of mind, Barton allegedly told police her son might have a gun, but maybe not a real one.

With that knowledge, police chased and shot Cameron; he miraculously survived but suffered serious injuries to his bladder, intestine and left arm (which a recent lawsuit filed by Cameron's family states could result in permanent paralysis). A court filing against the Salt Lake City Police Department notes several bullets remain lodged in Cameron's body nearly three months after the shooting. Body camera footage of the shooting shows Linden Cameron on the ground bleeding profusely, saying, "Tell my mother I love her."

Police brutality recently has become, sadly, a hot-button issue. The Washington Post reports police shooting deaths of over 1,000 civilians nationwide at the hands of police in 2020 (The Salt Lake Tribune counted 30 police shootings in Utah in 2020, with 17 fatalities), violence that's sparked riots and protests, heated discussions at all levels of government and the passage of new laws and regulation to rein in excessive force and over-policing.

Police reform is a multifaceted issue with many areas of concern, especially as it relates to racial bias by police. Linden Cameron, however, is white; race was not a factor in his shooting. His mental health was. A teen who, according to his mother, has Asperger's syndrome, Cameron's shooting by police raises questions about how police interact with those in the throes of a mental illness crisis.

In a handout on the SLCPD website, local autism advocate Montell McDowell says that people with autism are seven times more likely to have interactions with law enforcement. Police response to vulnerable populations needs to remain a focal point of police reform. Thankfully, Utah police and policy makers are beginning to take note.

What's a Parent to Do?
The SLCPD (and other area police) currently maintain an Autism Safety Registry that allows parents and caretakers of individuals with autism to provide police with vital information, such as: if the individual is verbal or non-verbal, things that trigger a behavioral episode as well as soothing objects, words or actions. This information is then stored in a database that dispatchers can access and communicate to first responders when they answer calls.

The trouble is that in the wake of Linden Cameron's shooting, the SLCPD disclosed only five families have entered information into the registry (see sidebar for details). Further, the registry needs to be updated annually or the information on file becomes inactive. It's potentially a life-saving database that—until very recently—few members of the community even know existed. The department is encouraging those with an autistic family member to enter their information.

In mid-October 2020, the SLCPD announced it would be the first police department in the nation to partner with KultureCity, a national nonprofit, in a sensory inclusive training that helps police better serve neurodivergent Utahns with autism, dementia and stroke.

Officers who are "Certified Sensory Inclusive" can better respond to those overstimulated to the point of excruciating emotional and sometimes physical pain brought on by common sensory occurrences such as lights, crowds and smells.

COURTESY CPE
  • Courtesy CPE

A Smaller Footprint
Despite the program's promise, Chris Burbank, who, for nine years, was chief of the Salt Lake City Police Department and now serves as vice president of law enforcement strategy for the Center for Policing Equity, argues that additional training, while helpful, is not enough to prevent future calamities like Liden Cameron's shooting. Burbank said the officers who responded to Golda Barton's 911 call were faced with "an impossible, no-win situation."

In his view, "They shouldn't have even been there. There was no reason to go to that house," Burbank says. "They should have let it be." Burbank commends the female officer on scene who can be heard on the bodycam footage suggesting not to approach because they were dealing with a psych issue.

A strong proponent of reducing the police footprint, Burbank stresses that a lessened footprint doesn't mean cutting funding from departments so that crime runs rampant. Rather, he says, it's using existing law enforcement resources more wisely and efficiently.

Two ways to refocus police resources are to minimize what Burbank calls "silly policing," such as unnecessary traffic stops that can needlessly escalate into aggressive confrontations. He also thinks that social workers and other first responders with specialized training should respond to calls like Golda Barton's. Burbank says that if police resources are concentrated and redirected to investigate serious crimes such as homicides, society becomes safer, and police become much more effective.

Four years ago, the SLCPD pioneered its Crisis Intervention Team (CIT) that added several licensed clinical social workers to accompany officers on calls that involve mental-health incidents that could potentially be de-escalated by a mental-health professional.

SLCPD Sgt. Keith Horrocks wants people to feel safe around the police. "Police officers tend to be a jack of all trades," he says, "and we're happy to deal with a bunch of different situations. But it is helpful to have a mental-health professional to give help with containing certain situations."

Budgetary constraints remain a factor when it comes to utilizing SLCPD's social workers, who are on the clock only from 7 a.m.-4 p.m., Monday-Friday. Needless to say, mental-health crises that require the intervention of a trained professional don't always happen during business hours. Linden Cameron, for example, was shot on a Friday night, several hours after the SLCPD social workers had gone home for the weekend.

WIKICOMMONS
  • Wikicommons

The Reform Quorum
Horrocks said that the SLCPD is painfully aware of the shortfall in mental-health support for the community and hopes to acquire enough funding to support a team of licensed clinical social workers to work with officers 24/7. "Every officer receives crisis intervention training at the academy, but that certainly doesn't make them a clinical social worker," he says. "We can't really put a value on the support our social workers offer."

Regarding police reform, Salt Lake City Mayor Erin Mendenhall and the Salt Lake City Council both hope to fund an expansion of mental-health care by hiring more providers to partner with police. Demilitarization of police, a review of chokeholds and restraints, a stronger civilian review board and a blanket expansion of mental health-care services are all part of recent police-reform discussions.

"When I served on the Salt Lake City Council," Mendenhall said, "I was proud to support the launch of the SLCPD's co-responder program, where social workers accompany police officers on calls. Our program is a model for other departments across the country, as they look to build out teams like this in their own cities, and I would absolutely support the expansion of this team."

But, Mendenhall hastens to add, is not always safe for social workers to approach certain individuals without police. "I won't sacrifice the safety of any of our employees," she stresses, noting the current dispatch system does not properly serve individuals with mental illness and hidden disabilities. By having police partner with mental health-care providers, SLCPD can get people the treatment or response they need when they are in crisis, she says.

The Salt Lake City Council is currently experimenting with the city's first ever zero-based budgeting exercise for the police department, meaning the budget will be rebuilt from the ground up, based upon a financial audit conducted by an outside agency. This will allow members of the council and community members to scrutinize historical spending patterns and decide what needs to change. Reconstructing the budget is a time-intensive process that may take up to a year to complete, and community feedback on the police budget is welcomed.

Feeling Judged Doesn't Help
One social worker with 13 years' experience working with various populations says that working with police in mental-health crisis situations is a mixed bag. She has requested anonymity for this article, so we'll call her Audrey.

Some of the officers she has worked with are empathetic, respectful and trained to interact with those having a mental-health crisis having taken Crisis Intervention Training or completed a higher level of education. All the same, she has witnessed heated clashes between police and mentally ill individuals.

One case that comes to mind was when a bipolar woman at an inpatient treatment facility required supervision while her medications were being adjusted. The patient defied her case manager's instructions and left the facility instead of attending a group therapy session. After the case manager requested assistance from the police, an officer responded but had an abrasive manner the bipolar woman found offensive. She slapped the officer and then was handled roughly while being handcuffed.

The bipolar woman became catatonic after the altercation with the police officer and required a higher level of care. She sustained an injury to her arm and was charged with a misdemeanor for assaulting a police officer. The financial, legal and emotional stress of the incident compounded her already severe bipolar issues. The misdemeanor charge was ultimately dropped, but Audrey believes that the entire ugly scenario could have been avoided if the case manager and officer had employed proper de-escalation techniques.

A local musician who we'll call Jimmy had a psychotic break while staying at his parents' house for the weekend. Jimmy experienced a 48-hour period of which he has no recollection at all. "My mom found me outside during the dead of winter, burning a blanket in my underwear because I thought the blanket was possessed by evil spirits," Jimmy said. "It made perfect sense at the time."

Jimmy said his mom knew that he needed help and desperately wanted to call an ambulance but was afraid police would show up and harm or even kill her son.

Audrey feels that Jimmy's mom may have been right to be wary of police intervention. "In my experience, most clients that I have served have expressed or exhibited fear of the police," she said. Many of her clients have had some negative experiences with law enforcement.

"Sometimes a person being restrained may not understand what is happening to them, and that is scary," she said. Furthermore, if the first responder is not trained in de-escalation, it could increase the likelihood of force being needed and used to subdue the patient.

"This is often what the person remembers, and it degrades their trust in the police," Audrey says. "Sometimes, a person is judged by the police negatively, and this may affect how the police react. The feeling of judgment does not just wash away. It is part of the stigma for many with severe and persistent mental illness."

UNI to the Rescue
One lesser-known and lesser-utilized resource that Utah residents can call upon to offer support to an individual experiencing a behavioral or mental health crisis is the University Neuropsychiatric Institute's Mobile Crisis Outreach Team (MCOT). MCOT offers licensed clinical social workers and peer specialists who have firsthand experience with a mental-health crisis. MCOT teams are available to help individuals in crisis at no cost 24/7. Arriving in plain clothes and unmarked cars to protect the privacy of the people they serve, MCOT teams put individuals in crisis wary of law enforcement and other authority figures at ease. The average response time is 19-21 minutes.

But note: MCOT cannot be reached by dialing 911 and instead has its own crisis hotline—locally 801-587-3000 and statewide 800-273-8255 for the National Suicide Prevention Lifeline. You can also text START to 741-741. In fact, UNI features a few different mental health hotlines: UNI's "warm line" offers non-emergency emotional support from a peer specialist. SAFEUT crisis chat and tip line is dedicated to lessening violence in schools by catering to struggling youth, and those who work with them.

The services of MCOT will be included in the FCC's new three-digit 988 suicide prevention number, slated to go into effect in 2022. For any vulnerable individual at high risk of COVID-19 complications, MCOT offers virtual consultations. All in-person consults are conducted with masks and other personal protection equipment.

MCOT can perform a wellness check for individuals experiencing a panic attack or a psychotic break—or simply lend an ear to those feeling overwhelmed by the unique and cascading stresses of a pandemic year like we've just experienced (i.e., job losses, financial challenges, COVID-19, shifting family dynamics or other changes in routine.) "A crisis means something different to every person. You don't have to be in a life-or-death situation to use MCOT's services," says David Eldredge, UNI's director of Community Crisis Services.

While MCOT Crisis Service business director Rachel Lucynski says that the vast majority of MCOT calls do not require police assistance, the SLCPD does call upon MCOT professionals to accompany first responders on calls that clearly involve a mental-health crisis. MCOT social workers and peer specialists undergo extensive crisis de-escalation training and are sensitive to the needs of individuals of all ages, races, genders and sensory needs.

"If the pandemic has a silver lining, it is that it is helping to take the stigma out of seeking mental-health treatment," Lucynski says. "We're so used to seeing everyone's highlight reels on social media. Twenty-twenty is a year when so many people are struggling with job loss, financial strain, family stresses. We're all realizing that it's OK to struggle and seek help."

With no advertising budget, MCOT relies on community organizations and word of mouth to educate the public about their services. Eldredge says that one of MCOT's primary goals is to resolve mental-health episodes in a safe and comfortable setting so that individuals experiencing a crisis potentially can be spared the financial and emotional expense of rolling into an emergency room or spending time in an in-patient facility.

As a mental-health response team, MCOT is perhaps the closest thing that Salt Lake City has to compare with the community-based public-safety response team in Eugene, Oregon, known as CAHOOTS (Crisis Assistance Helping out on the Streets). Founded in 1989, CAHOOTS is dispatched via Eugene's 911 system and features two-person teams staffed by a medic and social worker who respond to calls involving homelessness, substance abuse, suicide attempts and mental-health episodes. Clad in hoodies, CAHOOTS' teams arrive in a white van with a dove painted on the side. The CAHOOTS budget is $2.1 million compared to Eugene's annual police budget of $90 million.

DREAMSTIME
  • Dreamstime

A Crisis With a Silver Lining
Chris Burbank wisely states that no police reform measure can solve every issue. But incidents like the shooting of 13-year-old Linden Cameron—who may never walk normally again and may have permanent bladder and intestinal issues—demonstrate there is an urgent need to improve how police interact with vulnerable populations, and if they should be interacting with them at all.

In the recently filed lawsuit by Linden Cameron's family against the SLCPD, Cameron's family claims police should have known that as an autistic boy, Cameron was in the throes of a mental-health episode. They claim his mother, Golda Barton, let them know about his state of mind when on the phone with dispatch. She also described Cameron's fear of the police and that there was a good chance that he could get scared and run.

Yet, even with specialized training, police first responders may not have the skills and sensitivity to protect the most vulnerable among us. Do we ask them to do too much? And do organizations like MCOT deserve a larger mission and budget? During this period of tremendous upheaval, when so many police practices and budgets are under increased scrutiny—these questions must be asked.

"We are facing a mental health crisis in this country—with a void of resources for those in crisis," Salt Lake City Police Chief Mike Brown said in a statement following Cameron's shooting. "Make no mistake. This is a crisis." Had Linden Cameron's shooting not made national headlines, had there not been a lawsuit demanding change, mental-health training might not have become a lynchpin of police reform. Perhaps the next neurodivergent individual undergoing a mental health crisis will be met by an unarmed social worker skilled in de-escalation rather than an officer who's trained to shoot to kill when threatened.


Autism registries:
Each Utah law enforcement agency maintains its own Records Management System. Until a central database is complete, register your loved one in each agency

Salt Lake City Police Department:
801-799-3111, click on Autism Safety Registry at slcpd.com/resources/online-report

Unified Police Department:
updsl.org/page_services_autismRoster.php

Central Dispatch
801-840-4000 (Bluffdale, Draper, Midvale, Murray, Sandy, South Jordan, South Salt Lake, Cottonwood Heights, West Jordan, West Valley)

During a Crisis
• Stay calm—you are an advocate!
• Before contacting police, try MCOT through UNI first at 801-587-3000 (Mobile Crisis Outreach Team—Salt Lake County only).
• Request a CIT officer (specially trained to deal with disabled individuals)
• Make an Emergency Checklist available to responders.
• If officer wants to interview individual, always have caregiver present. Use camera phone to document.

Courtesy of SLCPD

Bills to watch in the 2021 Legislature
Democratic Salt Lake City Rep. Angela Romero's HB 162 requires a peace officer's annual training to include training on mental health and other crisis intervention responses, arrest control and de-escalation training. It also provides that each law enforcement agency or department set standards for training to be approved by the director or designee; and it requires annual reporting of training hours.

SB53, sponsored by Sen. Daniel Thatcher, R-West Valley City, would allow EMTs and firefighters to be trained to respond to mental health calls. This would allow agencies statewide to form trained EMT teams that specialize in mental health emergencies.