Cleveland mental health co-response team says new approach is helping people

Dispatchers and police struggled to locate a woman who repeatedly called 911 between November and January.

In January alone she called 14 times, reporting that she thought people were following her and trying to hurt her. Dispatchers recognized the person was experiencing a mental health crisis, but she provided false names and incorrect addresses, making it difficult for police to respond.

Last month, officers finally found her outside a shelter. They called Emma Borrelli and Charles Leonardi, the Third District mental health co-response team, asking them to meet the woman.

This repeat 911 caller’s story is one of several they described when discussing how the new co-response approach has helped people experiencing mental health crises.

Borrelli, a licensed mental health counselor, and Leonardi, a Cleveland police officer, listened to the woman as she told them about her past experiences and traumas. They spoke with her for two hours outside the shelter. And after that, they were able to get her real name and take her to University Hospitals’ main campus for intensive inpatient care, Borrelli said.

Cleveland’s co-response pilot program, which launched in January 2020, calls for five teams made up of a police officer specially trained in crisis intervention and a mental health case worker. The teams respond to or follow up on emergency mental health crisis calls.

The department has three open positions – two in the Fifth District and one for a mental health specialist in the First District, said Sgt. Maggie Crespo, the Crisis Intervention officer in charge.

Council members in November approved the expansion of the co-response program, allocating $5 million of American Rescue Plan Act funds to double the number of teams to 10, which would add a second team to each district.

Signal Cleveland met with Borrelli and Leonardi, the longest-standing co-response team, to better understand how the program works in Cleveland.

‘You see people in real time get relieved’

Building trust with a person experiencing a mental health crisis is one of many benefits of the co-response teams, Borrelli and Leonardi said.

“A lot of our clients live in crisis,” Borrelli said. “So it often is a long process in engaging them and building rapport.”

They’ve also gotten to know community members over time through follow ups, Leonardi said.

“We are able to respond to these 911 calls for service; it makes it a lot easier for everybody on scene if we’re familiar with that person,” Leonardi said.

When asked for examples of people they feel they’ve helped, Borrelli and Leonardi rattled off first names or addresses, looking at one another as they recalled some of their experiences.

“You see people in real time get relieved when they realize what our role is,” Borrelli said.

Leonardi said he’s learned a lot from Borrelli and other mental health professionals about the resources available to people in Cleveland and about how to better communicate as he de-escalates a situation. He also reads to learn more about mental illness.

“He just stays really curious about the mental health role,” Borrelli said of her partner. “So he’s always wanting to learn our clinical process and the ins and outs of different diagnoses and why we approach certain things the way we do.”

Borrelli tries to find the mental health history of people they follow up with. This helps the team understand who they are about to encounter, the person’s needs and how best to approach that person. Leonardi is able to convey some of that information to officers already at a scene.

A push for more crisis intervention specialists

Between Oct. 1, 2021, and Sept. 30, 2022, Cleveland co-response teams responded to more than 1,700 calls, the majority of which were follow-ups. Ten percent of the time, co-response teams were the first to arrive on scene, according to a recent report reviewing the co-responder program.

More often, co-response teams follow up with people after officers make a referral or if officers request that a team respond to the situation.

New Cleveland police officers are required to go through an 8-hour crisis intervention training program through the police academy. Officers who want to be Crisis Intervention Team specialists take a weeklong class.

There are currently 92 officers in the department who have completed the specialist training, according to a report by The Marshall Project – Cleveland and Eye on Ohio. Department policy calls for them to be deployed to crisis situations whenever possible.

But only 17% of crisis response incidents between February 2020 and April 2022 included a responding officer who was a Crisis Intervention Team specialist.

The police department is encouraging more officers to go through the specialized CIT training, Crespo said. In 2022, the department started requiring field training officers – who help train new officers – to complete the weeklong training. The new requirement was a mandate under the consent decree between Cleveland and the Department of Justice, Crespo said.

“I think the DOJ mandated it because if you are rising to the level of training new officers, you’re gonna train them the right way,” she said. “And … in taking this CIT class, it teaches you de-escalation skills as well. And that’s what we want you to teach our new officers… how to deal with people in a mental crisis.”

‘I’m familiar with trauma’

Borrelli always knew she wanted to work in crisis counseling. She didn’t see herself providing counseling services in an office space.

“It doesn’t take long working in this niche to realize that the system is not serving our clients the way that it should be,” Borrelli said, adding that it’s been exciting to be part of changing that system.

For Leonardi, the work is a little more personal. His mother died when he was seven years old. His father died five years ago. One uncle was murdered and another died of suicide, he said.

“So I’m familiar with trauma and how to deal with it,” Leonardi said.

Leonardi is also a veteran and said the teams often encounter veterans experiencing homelessness. It can be difficult for co-response teams to follow up with unhoused people because they don’t have an address and often don’t provide a phone number when they call 911.

“We’ve had to get creative in our approach for sure,” Borrelli said. “If we encounter somebody and we know that they’ve been tough to track down or locate, [we need to be] able to be flexible in that moment and take advantage in that encounter to get them some help.”

One man experiencing homelessness who lived in Public Square for years was recently able to get permanent housing, they said. Borrelli and Leonardi worked with a local homeless outreach team and a local mental health agency to monitor his well-being while he was on the street.

“It got to a point where it really was a crisis and we couldn’t continue to monitor from a distance anymore. We had to get him to the hospital,” Borrelli said.

After his medical and mental health needs were addressed, they worked with his mental health case manager and with the inpatient mental health staff to make sure his hospitalization was a stepping stone to get him more permanent help, she said.

“That was really an ‘it takes a village’ kind of a case,” Borrelli said. “And now he’s housed and, from what we’ve heard, doing really well. So we’re happy.”