MHST
Mental Health Investigative Support Team
Sgt. Terry Staten
Pima County Sheriff’s Department
October 2013
What Are We Doing Different
Now
Mental Health Support
Team (MHST)
• The Sheriff’s Department recognized the need
to take a different approach to mental health
issues related to law enforcement
• The wave of mass shootings and the increased
mental health related calls served as a
catalysts for taking a fresh look
Overview
• Background/History
– Started December, 2012
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The Process Before MHST
Significant Events
Philosophy Shift
Development and Approach of MHST
Where We Are Now
The Old Way
• Civil Division Deputies
– Serving Mental Health Orders
• Evaluation orders
• Treatment orders
– Service rate about 30%
• Patrol Deputies
– Service rate even lower
SIGNIFICANT EVENTS
• October 28, 2002
– Three nursing
professors killed at the
University of Arizona
Medical school
– Multi-agency response
to an active shooter
SIGNIFICANT EVENTS
• Shooter – Robert Flores
• Previous contacts
– Mental health
– Law enforcement
SIGNIFICANT EVENTS
• Dep. Timothy Graham, PCSO
• End of Watch - August 10, 2005
• Responded to a convenience
store where Aaron Swyers with
history of mental health issues
was in crisis
SIGNIFICANT EVENTS
• Tucson Police Officer Erik Hite
• End of Watch – June 2, 2008
• Responded to “officers need
assistance” call
• Deputy wounded
SIGNIFICANT EVENTS
• Shooter – David Delich
• Previous contacts
– Mental health
– Law enforcement
SIGNIFICANT EVENTS
• January 8, 2011
– Mass shooting at grocery
store parking lot event
– 6 killed, 19 wounded,
including Congresswoman
Gabrielle Giffords
SIGNIFICANT EVENTS
• Shooter – Jared Loughner
• Previous contacts
– Mental health
– Law enforcement
Philosophy Shift
• Has to be a better way to approach problem
• Need to
– Decrease risk to officers/deputies
– Decrease risk to community
– Decrease waste of taxpayer dollars
– BREAK THE CYCLE
Philosophy Shift
• Goals
– Improve officer safety
– Improve community safety
• Identify and intervene sooner when possible
– Improve efficiency & save taxpayer dollars
– Reduce liability to the department
• Fewer “hands on” situations
– BREAK THE CYCLE
Philosophy Shift
• To help meet goals
– Need changes in the legal system
• Courts’ expectation to treat individuals with mental
illness differently
– Changes in community resources
• Active Crisis Intervention Training (CIT) program
collaboration
• Collaboration with mental health system
• Collaboration with other law enforcement agencies
The Old Approach
• Patrol deputies would look for the quickest,
easiest solution to a situation with a mental
health nexus
– Often resulting in arrest and incarceration
– As a result, the Pima County Jail is now the largest
behavioral health facility in southern Arizona
– The problems continue
The Costs
• Repeated responses to
same mental health
related calls
• Frequent consumers of
services
• Frustration with the
system
• People fall through the
cracks in the system
The Costs-continued
• Man hours spent
by departments
on mental health
issues are a drain
on resources
1 repeat
consumer
2080 hours
in a year
1 new
officer
Where We Fail
• Many people suffering
from mental health
issues fall between the
cracks of the system
• They always become
the burden of law
enforcement
Law
Enforcement
MHST
Courts
Behavior
al Health
Development of MHST
• Personnel
– 7 full-time personnel
• 3 uniform deputies
• 2 detectives
• 1 sergeant
• 1 civilian support specialist
– Developing into a regional resource
The New Approach
• 100 % service rate on mental health orders
• Mental health facilities and providers
communicating with law enforcement
• One central location for patrol to go to for
answers to problems
• Law enforcement talking to law enforcement
How It Works
• MHST is responsible for the service of all
mental health related court orders
• All field calls where the core issue is a mental
health crisis AND a threat to public safety is
identified are tagged for follow up by MSHT
detectives
Triaging The Calls
• Calls where there is not a threat to public
safety (danger to self) are handled as they
always have been-referred to the appropriate
mental health provider
– Voluntary committal
– Involuntary committal
– Referral to various providers
Triaging The Calls
• Calls for service where there is a criminal
component, and the person is a threat to
others (public safety)
– Routed to the MHST Unit for follow up
– A full criminal/mental health investigation is
conducted where appropriate
– A unique 2-pronged process is initiated
The MHST Investigation
Long term care,
medication
Adjudication
or mental
health
diversion
Presentation to
evaluating
provider
Presentation
to
Prosecutors
Start of
criminal
investigation
Criminal Investigation
Start of the mental
health investigation
Initial Call
Mental Health
Investigation
Prioritizing Solutions
Medical- Medical issues that are critical must be addressed first
Criminal – Criminal charges will take priority over an immediate
mental health solution
Mental Health – Mental health solutions will generally be the third
priority and can be begin along with both the medical and criminal
processes
MHST Focus
MHST
Partnership with
Providers
• MHST will focus on those cases with a criminal
nexus
– Allowing for a law enforcement action & ownership
– No HIPAA issues for law enforcement
• MHST will not focus on danger to self cases
– No role for law enforcement beyond immediate care
and referral
SUCCESSES
• John
– History of mental illness
– History of assaulting dad and destroying his house
– History of not staying on his medication program
– Now staying on his program
– Dad now helping his son stay on the program
– No new law enforcement interactions
SUCCESSES
• Brandon
– Texted girl friend and threatened to shoot up school
and “do it better than Columbine”
– Arrested and evaluation ordered
– Failed to continue counseling and violated restraining
order
– Determined counselor was not a right fit
– Brandon back in counseling with new counselor
Questions