Police were summoned to an ice cream parlor’s parking lot this week on a mental health call involving a 30-year-old woman who was walking around barefoot.
The woman, sunburned and with badly blistered feet, didn’t satisfy criteria for police to take her into protective custody for help without consent. She was cognizant of “person, place and time,” even in a delusional state. The officers ended up contacting her mother, who came to the scene.
Cue the Community Response Team, one of the Tulsa Police Department’s latest efforts to better handle mental health crises. The specially trained trio — a Tulsa Police officer, a Tulsa Fire paramedic and a Family & Children’s Services mental health counselor from COPES (Community Outreach Psychiatric Emergency Services) — were sent to meet with the woman. Her mom had called COPES out of concern that her daughter’s mental state was deteriorating.
The Community Response Team is a pilot program that began in January based on a similar model used in Colorado Springs, Colorado. The Tulsa effort started as a one-day-a-week deployment targeted at streamlining 911 services and reducing costly visits to a hospital, mental health clinic or jail. The team also hopes to de-escalate situations and avoid uses of force that could turn deadly.
“This is designed to be kind of like a one-stop shop for emergency services,” said Megan Henderson, a licensed professional counselor with COPES — a mobile psychiatric crisis program offered by Family & Children’s Services.
The Community Response Team discusses the patient while en route to a convenience store parking lot on Tuesday morning in east Tulsa where the 30-year-old has since moved from the ice cream shop.
Henderson pulls up her name in the Family & Children’s Services database and finds a “pretty extensive” mental illness history involving schizophrenia. The woman recently had been released from a mental health hospital.
Community Response Team members spot her inside a parked van, with her mother inside the convenience store.
Officer Susannah Ralston makes first contact but slips to the back when the woman, in her delusional state, accuses Ralston of arresting her 11 years ago. That allows one of the other two team members to try to open a line of communication and side-step escalation of the situation.
“They’ll project you into their reality,” said Tulsa Fire Capt. Bill Esmeyer.
Esmeyer hopes to gain a modicum of trust with the woman by offering to treat her badly damaged feet. She accepts.
Henderson chats with her, notebook in hand. Esmeyer said the woman was “completely shut down,” but Henderson was able to use her skills to coax conversation out of her. Part of Henderson’s assessment involved determining whether the woman needed a higher level of care.
Seated back inside a Tulsa Fire Department Emergency Medical Service truck, the three appraise the results of the call. They chalk up a prevention of a mental health visit, as well as possible avoidance of a hospital trip.
Ralston notes that if she were a typical patrol officer pulling up on the scene, she wouldn’t have access to the woman’s mental health history or advance notice that she was schizophrenic.
Esmeyer said paramedics and officers are geared toward fixing a problem in the moment, not longer-term solutions.
With a mental health counselor present, that person can schedule follow-ups or even obtain an emergency intake appointment.
“It changes everything,” Esmeyer said.
13,078 mental health calls in 2015
The Community Response Team is in the first week of a one-month stretch of gathering data to analyze the costs and benefits of the program, trying to quantify whether each of the three agencies can net positive gains.
Instead of a single day a week, the team will now work four 10-hour shifts each week from 10 a.m. to 8 p.m.
In 2015, the Tulsa Police Department fielded 13,078 mental health calls, according to data provided by the agency. The most frequent were suicidal people, with 3,323 calls.
Second is a “10-85,” Tulsa police code for a possible mental health situation, with 2,392. Third are calls that involve transporting a mentally ill person to an out-of-town facility for mental health care, with 2,314.
Esmeyer, who has served as the Community Response Team’s paramedic at least a dozen times, said his most important takeaway from participating is the sheer need for this type of program.
“I don’t think I’ve run into the same person twice,” Esmeyer said. “You’d think you’d run into the same person over and over again.
“We talk amongst each other — the calls you have — (others who rotate in on the team) never have the same people, either. So you’re looking at six months, and you see very few of the same people over and over.”
‘That is genius’
The Community Response Team went to a north Tulsa address on Tuesday afternoon after a man called 911 and reportedly didn’t make sense twice in the past two days.
On the door was written in all caps: “This resi has alz/dem pls do not remove unless med ness care is coming! They are loved.”
The resident allowed in Ralston, who is TPD’s mental health liaison officer, as well as the other CRT members and two Tulsa World reporters. Written prominently on a wall in black permanent marker were several names and phone numbers of people who could be called if necessary.
“That is genius,” Ralston said.
She got in touch with the man’s daughter, who said she would swing by to see him after work. His nurse showed up and informed Ralston that for some reason he had been “extremely agitated” recently, which was unusual for him.
Esmeyer said it was obvious that the man was “well-cared for.” He relayed to the others that the man told him he had dialed 911 in an attempt to obtain an attorney.
The man said he had taken his morning medications. He smiled and laughed as he spoke with the CRT members.
Afterward, Ralston shared with his nurse information about signing up online for “Smart911,” a system that allows a person to log key information to aid first responders that pops up when a phone number dials in.
Examples include names, descriptions or photos of people, as well as any medical conditions. A home address can be added to a cellphone’s number. She explained that the personal information is only available if that phone number calls 911 and then disappears after 45 minutes.
“Our whole goal is to keep people living with mental illness healthy and happy and living in their homes,” Ralston said. “We know that they don’t like to have the police involved in their lives.”