By Emalee Gillis, NAMI Spokane Blog Editor.
According to Sergeant Jason Hartman of the Spokane Police Department, the idea of deploying mental health professionals with emergency personnel is taking off around the country. He explained that Spokane is ahead of that trend. Back in 2019, Spokane began a program called the Behavioral Health Unit or BHU. The BHU works throughout Spokane County and consists of teams in which a mental health professional is paired with a specially trained police officer to respond to calls that have a behavioral health component to them.
Carrie Christiansen, the Mental Health Coordinator employed by the Spokane Police Department, added that the officers assigned to the BHU choose to do this work and are dedicated and passionate about the population they serve.
When a BHU team responds to a call, safety is always the first priority. Once the scene is safe, the responders will assess the situation and determine what action is necessary. According to Ms. Christiansen, much of the time, the situation can be taken care of with a referral to an appropriate mental health provider. In fact, of the 4,912 individuals who were served by the BHU in 2022, 79 percent of those contacts had an outcome other than jail or hospital. Only 67 individuals or only 1.4 percent of contacts resulted in an arrest.
One of the strengths of the BHU is that the responders are trained in crisis intervention and motivational interviewing. They understand the appropriate verbal techniques to communicate with a person in crisis. Using effective communication approaches, the team can hopefully talk to the person, find out their needs, and determine what they can do to help.
Another of the strengths of the BHU is the team takes more time with calls than is typical for a standard Spokane Police call. Even before the BHU team arrives, the team searches their database to determine if they had served that individual earlier. If they have, there are notes in the file including things like the diagnosis, triggers, and approaches that have worked in the past. The goal of the BHU team is to reduce the overall number of calls for service, so the focus isn’t just on the current crisis, but on how a crisis can be prevented in the future.
As part of the BHU’s focus on prevention, team members look for patterns. If a subject is doing well, then suddenly there are more contacts regarding that person, the BHU team will intervene and work on coming up with a prevention strategy. The BHU tries to intervene early, before the situation is a ten out of ten.
Multiple contacts with a single person is part of the work of the BHU. For example, one woman they worked with had over 100 contacts with the police department. The BHU was part of the effort to stabilize that person. She eventually found housing and a job and is one of the many success stories that the BHU can point to from their work. Another young man generated 60 emergency calls within a couple of months. The BHU worked with the young man to come up with an effective game plan. BHU successes like these can free up a great deal of resources that can be spent on other emergencies in the area.
Partnering with community organizations is critical to the BHU’s work. The BHU works with Frontier Behavioral Health, Pioneer Human Services, local group homes, homeless shelters, CHAS, Compassionate Addiction Treatment, Spokane Treatment and Recovery Services, inpatient treatment facilities, hospitals, the mental health providers at the local jail, and others. The referrals go both ways. Sometimes a shelter will request services from the BHU if someone at the shelter is becoming violent or unable to care for themselves and other times the BHU will forward a request for assistance to one of their many partners.
According to Ms. Christiansen, there is almost always a co-disorder in the calls the BHU responds to. In many cases, drugs are involved. Other times the team is dealing with developmental delays or autism.
Sergeant Hartman stressed that when there is a threat to safety at a group home or in the community, the police are the only ones that are prepared to respond to that call. Mental health providers are not equipped to handle violence. Sergeant Hartman explained that some of the national conversations about excluding police completely from situations involving behavioral health issues have been naïve. He said that mental health counselors are not trained or prepared to physically control someone who is violent or who needs to go to a medical facility against their will.
In 2022, Spokane’s BHU responded to 415 suicide calls. The team is trained to recognize the difference between suicidal ideation and suicidal intentions. In dealing with suicides, the approach differs depending on the situation. If a person has a leg over a bridge, the goal will be to get them safely off the bridge and to a hospital. If a person calls and says they have a gun to their head, the team will not break down the door and force a confrontation which would put both the officers and the client at risk. They will offer help in other ways.
One of the biggest challenges the BHU faces is that police and fire resources are overwhelmed with people dealing with mental health and drug issues. Emergency calls for mental health went up during the pandemic and haven’t come back down. In fact, the contacts with individuals that the BHU made in 2022 represented a 20 percent increase from 2021.
Another major challenge is the lack of involuntary beds for drug use. There are none of these types of beds in Spokane, so people have to be sent elsewhere in the state. Also, the maximum someone can be held involuntarily for drug use is 14 days which isn’t enough time to stabilize the person.
Another challenge is the shortage of mental health professionals. The BHU has employed as many as four mental health professionals, but currently only has two on staff. The BHU is in the process of hiring more mental health professionals to add to their team.
The BHU is not available 24 hours a day. To make a referral to the BHU, residents of Spokane County can call 988 if they are in crisis or 911 if the situation is escalating and safety is at risk.
Jason Hartman is a Sergeant with the Spokane Police Department. He is currently the supervisor of the Behavioral Health Unit. He has served the police department for over thirty years.
Carrie Christiansen is the Mental Health Coordinator employed by the Spokane Police Department. She has a Master’s in nursing and has worked in psychiatric settings for more than 20 years. She is also a reserve police officer.
Emalee Gillis is a writer and blog editor. She is the author of the memoir Adventures on the Path to Living Well with a Mental Illness and has a related TEDx Talk.