Cities across the country are increasingly looking at ways to respond to mental health emergencies that involve more than just sending police. The two basic approaches are often called co-response and care response.
In Cleveland, the police department has co-response teams, made up of a police officer and a mental health expert, to respond to or follow up on mental health calls.
The Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board of Cuyahoga County is also putting together a care response program, which will not involve police.
People with mental illness are more likely to be victims of violent crime than to be perpetrators.
What is care response?
In care response, a mental health expert — and, in many cities, a paramedic — respond to emergency mental health crisis calls. This program does not involve police at all.
Non-police response teams are typically only dispatched when there is no risk of violence and nobody is in immediate danger.
In Cuyahoga County’s proposed program, teams will include a licensed behavioral health professional and a peer support specialist. A peer support specialist is someone with lived experience with mental health or substance use disorder who has been through training and certification.
When the pilot program launches, people who need a care response team will call 988 or 216-623-6888, FrontLine’s mental health crisis hotline. FrontLine, which has a mobile crisis response team, will provide and manage the initial five care response teams to serve two ZIP codes, 44105 and 44102. The goal is to launch the program in late summer.
The goal is to eventually coordinate with Cleveland’s 911 Dispatch Center. Dispatchers will be trained to assess whether they should send police, fire or emergency medical services or should transfer the call to 988.
Community groups that pushed for a non-police response program have stayed involved in its implementation. They say such a program will only be successful if it includes guidance and feedback throughout the process from the people most likely to use it.
What is co-response?
In Cleveland, co-response teams include a police officer and a caseworker. They work from noon to 10 p.m., four days a week. The teams ride in the same vehicle and respond to or follow up on mental health crisis calls.
When a person calls 911 – often about a relative or friend experiencing a mental health crisis – dispatchers ask a series of questions to determine whether a crisis intervention team (CIT) officer should respond to the call, said Carole Ballard, director of education and training with the ADAMHS Board.
Once a dispatcher determines a person is not violent and does not have access to weapons, they send a specially trained CIT officer or a co-response team if one is available. Co-response teams are more likely to follow up with people than to be the first to respond to a call.
Officers and case workers usually wear bulletproof vests. The officer makes sure the scene is safe before the case worker joins to help the person in crisis.
If a co-response team is not available, ideally an officer with 40 hours of crisis intervention training will be on the call, Ballard said.
Most people who received service between October 2021 and October 2022 from Cleveland’s co-response teams were either reconnected with their mental health or substance use disorder expert or were admitted to an inpatient hospital, according to a 2022 report reviewing the co-responder program.
Cleveland currently has five co-response teams. City Council approved using American Rescue Plan Act funds for co-response in 2022. The city has been working to expand to 10 teams.