A first-of-its-kind, advanced crisis intervention training program in California is being introduced by the San Mateo County Sheriff’s Office, opening a new chapter on reducing police use of force during mental health and violent interaction crises, the law enforcement agency told the San Mateo County Board of Supervisors last week.
Called Enhanced Crisis Intervention Training (ECIT), the program builds on the sheriff’s previous crisis intervention training by focusing on de-escalating, and in some cases disengaging its response to a person in crisis, Sheriff Carlos Bolanos said.
The goal is to reduce stressful mental health situations by putting time and space between the person and the deputies while a team gathers information about the situation and comes up with a plan. Engaging in specialized crisis-intervention communication, the deputies seek to gain voluntary compliance from the person rather than using force.
The ECIT program is the latest in a series of strategies the Sheriff’s Office has led countywide in behavioral health training and crisis response for the past 15 years. The office started in 2005 with the Crisis Intervention Training Academy for 17 county law enforcement agencies, in collaboration with the National Alliance on Mental Illness and the county’s Behavioral Health and Recovery Services. The training helps officers be better equipped to compassionately and effectively respond to calls for service by guiding the officers through scenarios they might encounter and examining their responses, Bolanos said.
In 2015, the Sheriff’s Office took its behavioral health response one step further, adding behavioral health experts who assist patrol deputies through the Psychiatric Emergency Response Team. The Sheriff’s Office and staff at the county’s Behavioral Health and Recovery Services pair a clinician with a sheriff’s detective. The team works with residents in crisis and offers behavioral health services to those in need and their families. They also support patrol deputies as first responders when possible.
In 2019, the Sheriff’s Office added a second detective-clinician team. The two teams are equipped to respond to an average of 35 to 55 behavioral health-related cases each month, Bolanos said.
The Sheriff’s Office began laying the groundwork for the new Enhanced Crisis Intervention Training in 2019 after learning about the program’s implementation in the Portland Police Department in Oregon. Portland developed its program as part of a 2013 settlement agreement. The U.S. Department of Justice found the Portland police had engaged in excessive force against people with serious mental health disorders, said Detective Erik Ruepple, one of the deputies on the county’s psychiatric response sheriff/behavioral clinician team. The ECIT concept was developed after a court in San Diego found that police tactics leading up to an incident are relevant to the overall outcome, said Detective Cole Armando, a law enforcement partner on the second sheriff’s team.
Bolanos asked his staff to investigate the ECIT program in Portland and to develop one in San Mateo County. The sheriff’s program is emphasizing its communication skills development on addressing people with psychosis, Armando said.
“We’re focusing on the high-risk crisis calls … This model is bringing modern best practices for our law enforcement crisis response. It’s giving us better tools to respond to these situations and better tactics to promote positive outcomes to reduce the risk for everyone involved.
“We’re trying to reduce actions that we take that can put ourselves and the person in crisis in more risk, and bring … de-escalation tactics into our standard crisis response: We don’t want to rush in and don’t rush to make contact with the person in crisis unless there’s an imminent threat to others.
By slowing things down — a de-escalation tactic — they are using distance and time as a de-escalation tactic as well, Armando said. While we’re doing that, they’ll be gathering information about everyone involved in the situation and what’s causing the person’s crisis prior to attempting to make contact.
“While we’re doing that, we’re going to begin to form a plan amongst the deputies involved on when and how to attempt to engage with the individual, and what type of techniques we want to use to give ourselves the best opportunity to gain voluntary compliance, and get that positive outcome,” he said.
Sometimes, a successful outcome means “disengaging.” When a San Mateo County man with a gun experiencing suicidal thoughts had barricaded himself in his home in January, deputies decided to back off since he wasn’t committing a crime and hadn’t endangered anyone else. They referred the case to the psychiatric emergency response team, which developed a plan and contacted the man’s family. The team was later able to “reengage” with the man and he was eventually taken to a hospital for help, Armando said.
“ECIT builds partnerships between law enforcement and the community by offering a more empathetic response by way of listening, offering appropriate resources before and at the time of a crisis, and offering to follow up by person, when it’s appropriate, for resource linkage,” Ruepple said.
Armando said the goal is to get the person help and possibly get them to psychiatric emergency services for treatment. “But we’re critically looking at it because we don’t want to force them against their will and start taking steps that might escalate this issue,” he said.
If communication initially fails to gain voluntary compliance and law enforcement chooses to disengage, they aren’t “doing nothing,” he said. Disengagement is chosen in part “because we feel that’s the best option to offer that person a chance to de-escalate themselves or we’re creating more of a distance so they can de-escalate.
“We will reach out to a family, if they’re involved, as we’ve done in the past, and try to enlist their assistance with that reengagement plan. So the family’s aware what steps we’re taking and when and how we’re going to contact, and in some cases we might not need to reengage because the family is in communication with us and they might tell us that the person is no longer in crisis,” he said.
The COVID-19 pandemic slowed down introducing the program to deputies in 2020, as had been planned, but during a two-day training session in late January, the department trained 25 deputies in ECIT, Assistant Sheriff Mark Duri said.
While the program isn’t the only type of crisis intervention being practiced, it is the one that Bolanos thinks is most suitable for the county. Supervisor Don Horsley asked if the Sheriff’s Office had considered the Crisis Assistance Helping Out On The Streets (CAHOOTS) program developed in Eugene, Oregon. The program sends outreach workers and medics from a community health clinic who are trained in crisis intervention and de-escalation techniques to respond to certain mental health crisis calls rather than police as first responders.
Bolanos said deputies respond to about two to five calls per day for mental health crises, and budgeting for an on-call, separate set of clinicians such as in the CAHOOTS program isn’t cost-effective, he said.
He is also concerned about safety. Some of these cases can turn violent in a matter of seconds, he said.
“I become very concerned about unarmed civilians being first responders to those types of incidents,” he said.
Email Sue Dremann at sdremann@paweekly.com
