If Milwaukee really wants to improve this time around, it would do well to study some of the best practices found in Houston. Since developing their mental health unit — now a full division — Houston police have dramatically reduced the number of people with mental illness who are detained against their will. They've helped get more than homeless people with severe mental illness off the streets in the past three years. Houston is the first police department in the nation to devote an entire division to mental health.
The department has five programs aimed at helping people in psychiatric crisis avoid arrest — including a homeless outreach team, a team dedicated to identifying chronic consumers and a team of 10 officers who are paired with mental health counselors to go out on calls for help.
Houston's Chronic Consumer Stabilization Unit is especially instructive for Milwaukee as it focuses on ways to reduce emergency care. When launching that program in , Houston police reviewed all reports involving people with mental illness.
They found that more than people in mental health crises had repeated interactions with police officers since , the year the department began compiling the data. They then narrowed that list down to those who had been taken in on emergency detentions four or more times — a total of 57 "chronic consumers.
Two caseworkers were assigned to the Some could not be found; others were in jail, prison or hospitals. They located 30 people and got them help. In the six months before the pilot program began, those 30 people had been named in offense reports and emergency psychiatric detention orders. After intense intervention by the two case managers, the same 30 individuals were reported to have been involuntarily committed by officers 39 times in the following six months — a decrease of They were involved in 65 police offense reports — a Police estimate they saved patrol manpower hours and investigative hours on those 30 people alone.
That doesn't count the cost in time, money and resources of emergency room care, hospitalizations, lawyers and court costs.
go site One man had been hospitalized 17 times in a six-month span before the program. He had 23 contacts with police and was incarcerated five times. In the first six months he was in the program, he was hospitalized twice, had two police contacts and was not incarcerated. Houston's population of 2.
Houston's decision to focus on mental illness began in earnest in after two people with schizophrenia were shot and killed by police two months apart. In the first case, a year-old woman had gone to a neighborhood police station with a knife, demanding to be shot. She was killed when she lunged at an officer. Two months later, police killed a year-old man who had been refused admission at the public psychiatric hospital after doctors determined he did not meet the standard of being an imminent danger to himself or others.
Police Chief Charles McClelland ordered all officers to undergo training to identify signs and symptoms of mental illness. The first step: Find out if the person police have been called about has a mental health history. Wick and his partner, Jaime Giraldo, keep a bulletin board with the pictures of people they meet on streets and under bridges. In two years, these two police officers have found homes for people who were sick, homeless and not getting better. Patrick Plourde spends big chunks of his day not combing the alleys of Houston but diving through data on his computer screen.
He developed a program that allows police to see if a person has a psychiatric history and previous contacts with police. He and his staff investigate firearms sales to make sure people who have been committed do not buy guns; they check credentials of group homes and adult protective service workers. Plourde stood last week in front of a screen of charts he had assembled to train officers how to find people who suffer from mental illness so they can better respond to their needs. Officers in 10 crisis intervention response teams are paired with psychological counselors with master's degrees.
They respond together to calls involving people with mental illness. Last Tuesday, a reporter and photographer were allowed to go with Plourde as he responded to the scene of a man in crisis. Glancing at his computer screen, Plourde could see that the man, 26, had been diagnosed with bipolar disorder.
He had been hospitalized in March at the county's bed psychiatric hospital. The man's mother told police that he had stopped taking his medication and was extremely agitated. He would not let her leave that morning as she was trying to get to work.
"Houston Solution" is a song written by Paul Overstreet and Don Schlitz, and recorded by American country music artist Ronnie Milsap. It was released in April . Houston Solution Lyrics: I've got some friends down in Houston / Who know me quite well / They'll be more than happy to put me up for a spell / I can hang out or .
An officer and counselor persuaded the man to go with them to the county's psychiatric emergency room, known as the Neuropsychiatric Crisis Center. Before the department began focusing on improving its mental health procedures, such trips were rarely voluntary and typically took between four and five hours, as police filled out cumbersome paperwork, Plourde said.
Police did not have working relationships with hospital intake workers. The form police officers fill out requesting that a patient be detained has been streamlined from seven pages to one. Police in Houston's Mental Health Division share office space with the Mental Health Mental Retardation Authority of Harris County, a quasi-private mental health agency that contracts to provide services. Last summer three Milwaukee police officers went to Houston to learn more effective ways for police and mental health counselors to collaborate. Dubis heads Milwaukee's homeless outreach team, a part-time assignment for officers who have other duties.
She drafted a proposal when she got back last summer for Milwaukee police to develop its own mental health unit after seeing the success of Houston's. Last year, Milwaukee County law enforcement officers brought patients to the county's psychiatric emergency room against their will more than 7, times.
Add in people who go voluntarily and more than 13, patients a year are treated for psychiatric emergencies. A Journal Sentinel investigation found one man who was detained 10 times in one month. One woman was admitted times in six years.
She estimates the department handles about 5, cases a year, with sheriff's deputies and others handling the rest. Yerkes said that any task force seeking to reduce emergency psychiatric crises in the Milwaukee area should include law enforcement members.
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On June 1, Chad Stiles became the first Milwaukee police officer to join the county's mobile crisis team. He has been paired with a psychologist and social worker to go out to the scene of a person in a psychiatric emergency. In Houston, all new officers are required to take a hour course on Crisis Intervention Training — a curriculum developed by a Memphis police officer that is now widely practiced worldwide. Often that means officers without training or counselor partners are the only ones available when a call comes in.
Last July, dispatchers did not alert officers that John Kriewaldt, 30, had mental illness and mental retardation when they sent two officers to a group home where he was staying overnight. No officers with mental illness training were available to take the call. Kriewaldt, who had poor communication skills and could speak only in short sentences, struggled with police, who misunderstood him and thought he lived at the group home.
Kriewaldt was begging to be taken home to his mother. He banged his head repeatedly in the back of the police car, was wrestled to the ground and eventually stopped breathing. Paramedics restored his breathing and heartbeat, but he died two days later. An autopsy found that he was suffering from pneumonia, which the county medical examiner said probably led to the angry outburst that had led to the police call. No one knows the differences between Milwaukee and Houston's emergency mental health care systems better than Daryl Knox.
Knox is medical director for the psychiatric emergency program for Mental Health Mental Retardation Agency of Harris County, the agency that provides public mental health services.
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