How Meadows Is Diversifying Crisis Response in Texas

Meadows Mental Health Policy Institute is helping other municipalities launch teams that can respond to mental health crises and divert individuals experiencing episodes from jail. The mental health policy nonprofit is in the process of providing data and training to the City of Galveston, among others to change the way cities think about responding to 911 calls.

The programs around the state are being modeled after what started in Dallas. In 2018, Dallas launched a pilot of the Rapid Integrated Group Health Team to think differently about how to respond to 911 calls. The team includes a police officer, a licensed clinical social worker, a paramedic, and off-site clinicians and responds to nonviolent mental health crises reported to 911.

The idea was to divert patients from the county jail by sending professionals with more experience and knowledge of resources for those with mental health issues. Residents who needed care would often end up in the county jail, the county’s largest mental health provider.

MMHPI partnered with the Pew Charitable Trust to report the data from the RIGHT team and found that 40 percent of interactions resulted in a connection to community services like health or housing services, 29 percent were resolved on the scene without any further assistance, 14 percent resulted in emergency detention, and 8 percent resulted in a person being taken to a hospital or psychiatric facility. Only 2 percent of the interactions resulted in arrests for new offenses.

Now MMHPI is using its experience and data to help other areas of the state replicate the results. One of the more advanced projects is in Galveston, where a team of police, mental health providers, and paramedics are expected to launch this spring. MMHPI analyzed data from call logs and 911 records to see how past calls connected to a mental health crisis have been handled. The work helped Galveston determine when they would need the teams, how many people they would need to staff them, and which types of calls the team would handle and avoid.

The work has resulted in a team called Compassionate Open Access to Services and Treatment that will work twelve-hour shifts from 7 am to 7 pm six days a week and consist of two groups of six professionals. There will also be a short shift on Sunday.

Like with RIGHT care, there will be a police officer present for the security of the scene, but the other members will be able to provide comprehensive health screenings, address comorbidities, and connect with resources connected to housing, substance abuse, or food insecurity. All this allows for a treatment option that doesn’t involve being arrested and going to jail.

“The whole design of the program is to alleviate law enforcement from being the primary responders to people experiencing a mental health crisis,” says Max Geron, the senior director of health and public safety at MMHPI. Geron is the former chief of police in Rockwall and a major with the Dallas Police Department.

In addition to responding to 911 calls, the teams will also have a proactive role. They will touch base with individuals who frequently use 911 as a mental health resource to see if they can head off issues before they happen. The teams will also follow up on calls that happened overnight or in the past to see if anything can be done.

COAST in Galveston is being funded in its pilot year by the Pew Charitable Trust, the Cynthia and George Mitchell Foundation, and the Permanent Endowment Fund of Moody Memorial First United Methodist Church in Galveston. Another critical financial partner was a $21 million federal grant from the Department of Justice as part of U.S. Senator John Cornyn’s Bipartisan Safer Communities Act focused on crisis intervention.

Meadows handled the data analysis on the front end in Galveston but will also be integral to measuring the program’s impact. As in Dallas, they will look at how many residents were diverted from the jail, connected with resources, and resolved without arrest. If the program is successful and worth the investment, the city of Galveston will take on the onus for continuing its funding. After the team launches this month, MMHPI will be able to report back its impact, Geron says.

Looking ahead, MMHPI is working with Dallas Area Rapid Transit to build a multi-disciplinary response team for public transit. Geron says they are still in the data collection stage but will look to launch a pilot in the next few months. In addition, MMHPI is in talks with others around the country who are hoping to launch their own MDRTs. Though many of these efforts were born out of the cultural shift and attitude toward policing that resulted from the death of George Floyd, Geron says the measure is about using the best tools for the job.

“We are actively working to improve how law enforcement and public safety in general respond to folks in crisis to alleviate and remove that traditional law enforcement response,” Geron says. “It’s not because law enforcement is bad, but because there are better ways of addressing those experiencing mental health crisis by introducing the clinician and the paramedic and focusing more on mental health than just the traditional responses.”

The Cynthia and George Mitchell Foundation is one of six Galveston-skewed foundations that partnered with Pew and Meadows and donated private funds to incentivize and support the city of Galveston in implementing this initiative.  The Moody FoundationMary Moody Northen EndowmentThe Permanent Endowment Fund of Moody Methodist ChurchIppolito Charitable FoundationHarris & Eliza Kempner Fund, and the Cynthia and George Mitchell Foundation collectively allocated $422,500 for the initiative.   

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