Nashville program matches mental health workers with police on calls

Nashville plans to expand an experimental model that pairs mental health professionals with police after the program’s first seven months yielded promising results.

The Partners in Care program teams masters-level mental health clinicians with Metro Nashville Police Department officers on calls flagged as potential mental health crises, aiming to divert people in crisis to intervention and resources rather than the legal system.

Six mental health clinicians accompanied Nashville police on 247 calls during the pilot program’s second quarter, 43.8% of which required crisis assessment. Of those calls, 3.9% resulted in arrest, and 0.7% resulted in use of force.

Nearly 35% resulted in someone being transported to a hospital or the Crisis Treatment Center, and clinicians gave people referrals to resources in nearly 22% of those 247 calls for service.

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Call numbers were lower in the second quarter (the teams responded to 542 calls in its first three months) due to staff absence for COVID-19-related reasons or the holidays, though the slight downward trend toward the end of the year is consistent with historic trends for crisis-related events.

The Partners in Care pilot launched in June 2021 in Nashville’s North and Hermitage precincts, two precincts with a higher volume of mental health-related calls for service. The pilot program will continue through June, but the city plans to expand its services to the Central Precinct before the new fiscal year and offer additional resources to the county’s remaining five precincts.

“It is the right resource at the right time, and certainly last week’s tragic incident demonstrates the importance of this work,” Metro Senior Policy Advisor on Public Health and Safety Dia Cirillo said during a presentation of the pilot program’s second quarter report Thursday.

The report comes roughly a week after nine law enforcement officers — including six MNPD officers — shot and killed 37-year-old Landon Eastep on Interstate 65.

Eastep, who had a history of experience with mental health issues, was first approached by a Tennessee Highway Patrol Officer who found him sitting on an interstate guardrail with a box cutter and “unidentified cylindrical object” in his possession. No mental health professionals were present on the scene when officers opened fire.

Eastep’s death sparked outcry from community members and elected officials for greater focus on mental health crisis response and de-escalation. The Tennessee Bureau of Investigation is investigating the shooting, in addition to an internal review by the MNPD Training Academy and an independent investigation led by Nashville’s Community Oversight Board.

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Program gives more options than arrest

Partners in Care is modeled after a Denver program that’s shown early signs of success. 

The Partners in Care clinician team and the mobile crisis team work out of the Mental Health Cooperative’s Crisis Response Center, located north of downtown. The facility operates 24-7 and is free to anyone experiencing a mental health crisis.

All Nashville precincts have access to the city’s mobile crisis team, but the Partners in Care program allows clinicians to arrive on scene with officers to provide immediate assessments, cutting out the lag time between officer calls for crisis team support.

“When somebody’s in a state of crisis like that, it’s really easy for them to become more and more agitated as time goes on waiting for those things to happen,” said MNPD Officer Donovan Coble, who is part of the pilot in the Hermitage precinct.

MNPD Officer Gabriel Centeno, part of the North Nashville precinct pilot, said having a mental health professional present who is not in a police uniform helps, because people “have all different types of interactions with police officers.”

People “tend to open up” when the conversation shifts from law enforcement to mental health care, Centeno said.

Officers participating in the pilot program receive 40 hours of crisis training from the Mental Health Cooperative. 

MNPD Lt. Anthony Brooks said having mental health clinicians on the scene with officers “gives an officer a new way to think about that call.”

“In the past … an officer might go out to a call and maybe even think that jail might not be the best place for this person,” Brooks said, “But with our training and experience the only option we would have is to arrest them for the violation of the law, whether it be trespassing or public intoxication or something in hopes that maybe they can get connected to services through Mental Health Court or something like that.”

With clinicians on scene to assess people in real time, there are other options to help those experiencing a mental health crisis. 

“We’ll hopefully start to see in other precincts that they’ll reach out to these resources more often, even before Partners in Care ends up in their precinct,” Brooks said.

Program expansions considered

Six mental health clinicians — four of whom work full time — currently cover two shifts from 7:30 a.m. to 11 p.m. in the Hermitage and North Nashville precincts Monday through Friday.

In the program’s second quarter, the Department of Emergency Communications dispatched 80% of the PIC team calls. 

People who call for service are rarely familiar with a person’s mental health history and may not identify a situation as a mental health issue, Department of Emergency Communications Director Stephen Martini said. Instead, calls may come in as reports of a suspicious person, disorderly behavior, or a welfare check. It’s up to Martini’s department to identify which calls are likely to have a mental health component.

Dispatchers are trained to ask callers a series of questions — similar to diagnosing symptoms — that help identify whether a situation could be a mental health crisis. In the last seven months, dispatchers identified more than 1,500 calls that could fit in those parameters, about 800 of which did end up involving someone experiencing a mental health crisis.

Following Eastep’s killing, Martini said the program may expand the types of calls for service that qualify.

“That could be yet another opportunity for us to expand those codes, that if we receive a request for backup from a neighboring incident or a neighboring agency requesting service, that we could seek a mental health co-response unit to respond to calls like this,” Martini said.

PIC teams can be called out to other precincts in “exigent circumstances,” but the police department tries to keep them largely in their pilot precincts to gather data, MNPD Commander David Imhof said. The teams are not a substitute for S.W.A.T. teams or negotiators, but can provide additional input in some situations.

MNPD will train all officers in the community service bureau on crisis intervention teams, and anticipates more than 550 officers and front-line supervisors will be trained in the next three years, Cirillo said. 

Metro is also exploring a non-law enforcement model — potentially with teams comprised of a medic and a mental health clinician — to complement the Partners in Care program. Metro applied for technical assistance to develop this model from the federal Substance Abuse and Mental Health Services Administration last week, Cirillo said.

Call outcomes, by the numbers

Of the 247 calls PIC teams responded to in the program’s second quarter, 43.8% required crisis assessment, and 34.8% resulted in someone being transported to a hospital.

Types of crisis included:

  • 47% suicidal ideation
  • 43% psychosis
  • 13% homicidal ideation

Outcomes of the joint calls in the program’s second quarter include:

  • 25.2% Support or rapport building
  • 21.8% Community referral to resources
  • 21.2% Transport to an emergency room
  • 13.6% Transport to inpatient services
  • 6.5% Transport to the Crisis Treatment Center
  • 3.7% Transport to jail
  • 3.9% of total calls resulted in arrests, compared to 3.7% in the program’s first quarter
  • 0.7% of second quarter calls involved use of force, compared to 1.5% in the first quarter
  • Four people were injured, including one consumer, one officer and two other parties (compared to seven in quarter one)

Demographics, by the numbers

Gender

Age

People presenting with suicidal ideation tended to be younger, with an average of 35.8 years old. People presenting with psychosis were 42.1 years old, on average.

Of those served in all quarter two calls:

  • 5.6% were ages 0-17
  • 14.1% were ages 18-24
  • 24% were ages 25-34
  • 19.8% were ages 35-44
  • 13.6% were ages 45-54
  • 11% were ages 55-64
  • 11.9% were ages 65 and up

Race

  • 35.6% identified as white
  • 28.5% identified as Black or African American
  • 28.5% did not provide race information or race was unreported
  • 7.3% identified as “other race”

Ethnicity

  • 67.5% identified as not Hispanic or Latino
  • 30.8% did not provide ethnicity information or ethnicity was unreported
  • 1.7% identified as Hispanic or Latino

Language

  • 78.5% spoke English
  • 20.3% were listed “unreported” or “refused” for language
  • 1.1% spoke a language other than English

Housing

  • 63% rent or own
  • 22.3% were unhoused or in temporary emergency housing
  • 7.6% were in a group or transitional home

Mental Health Clinician Demographics

The program’s current full-time clinician staff includes three white females and one Black female. Two white male clinicians work part time. 

Partners in Care is actively seeking additional mental health clinicians as the program plans to expand its reach.

Reach reporter Cassandra Stephenson at [email protected] or at (731) 694-7261. Follow Cassandra on Twitter at @CStephenson731.