City of Half Moon Bay Launches Civilian-Response Model for Mental Health EmergenciesApril 7, 2023
Photo: Half Moon Bay CARES team (in blue) with Councilmember Deborah Ruddock
In the summer of 2020, the video of George Floyd’s murder quickly captivated the world and sparked widespread racial justice protests and calls for police reform across the country. In response, public agencies throughout the US have spent the last few years re-examining policing and public safety models.
The Need for Reform
The Black Lives Matter movement succeeded in bringing to light the urgent need for police reform around issues of race. For example, the Center for Policing Equity reports that Black people are two to four times more likely to be met with force when interacting with law enforcement than are white people.
Importantly, the movement has put a spotlight on the (often-overlapping) problem of over-policing in situations involving mental health crises. According to the American Psychological Association, at least 20 percent of calls for police response involve a mental health or substance use crisis. Since 2015, almost one in four people killed by police officers were suffering from mental health conditions. Police officers suffer from these interactions too: up to 50 percent of police fatalities may involve encounters with a mentally ill person.
Addressing mental health crisis situations with law enforcement, rather than with mental health services, costs lives and causes trauma. It also consumes substantial public resources. A 2020 study found that the City of Chicago spends $4 million a day on the city’s police department. According to the study, just one day of that spending is equivalent to what Chicago spends for five months of mental health services, 18 months of substance abuse treatment, or 32 months of violence prevention programs. In the absence of adequate police training, alternatives to policing, and a robust system of services, many people with mental illness become stuck in a cycle of repeated arrests and incarceration. This cycle drives up costs for taxpayers and fails to serve some of the most vulnerable individuals.
In response to calls for reform, many law enforcement agencies have adopted some or all of the “#8CantWait” use of force policies. The “#8CantWait” initiative outlines eight concrete changes to police procedures, which are intended to de-escalate police confrontations and reduce the risk of injury when police interact with civilians. The policies: (1) ban chokeholds and strangleholds; (2) require de-escalation; (3) require a warning before shooting; (4) require that all alternatives be exhausted before shooting; (5) require officers to intervene when excessive force is being used; (6) ban shooting at moving vehicles; (7) establish a force continuum; and (8) require comprehensive reporting. All of these policies are critically important and help reduce negative outcomes.
However, much remains to be done. Police reforms have been signed by governors in 45 states since George Floyd’s murder, but many have already been rolled back, watered down, or hindered by lack of funding. The Center for Policing Equity points out that the best solution to over-policing is to reduce the frequency of police contact altogether by implementing community-based alternatives. Communities around California and across the country are experimenting with different approaches to redesigning public safely and mental health crisis response. There is no one-size-fits-all solution.
Reducing the Risk of Over-Policing
The City of Half Moon Bay’s newly-adopted Crisis Assistance Response and Evaluation Services (CARES) program is one model for how municipalities can effectively address unnecessary over-policing of residents in need of mental health services. Launched in March 2022, CARES is an innovative, civilian-response model for mental health emergencies. While rooted in the success of similar programs in cities like San Francisco, Santa Rosa, Eugene, Oregon, and Austin, Texas, alternative crisis response programs are still considered a new approach. The CARES team responds to 911 calls involving individuals experiencing a mental health crisis. The team consists of a certified emergency medical technician (EMT) and an experienced behavioral health care clinician.
Half Moon Bay’s program follows a trend of new pilot programs around the country attempting to shift police away from acting as sole first responders to people experiencing mental health issues. This need is particularly acute in Half Moon Bay, which has lost two community members in officer-involved shootings where the individuals brandished weapons, but also suffered from mental health issues. Now, sheriff deputies in Half Moon Bay frequently request a CARES unit in situations where mental health responders are needed in addition to or instead of law enforcement response.
The City has contracted with a local nonprofit service provider, El Centro de Libertad, to develop an alternative response to mental health-related 911 calls traditionally answered by fire, ambulance, or law enforcement. The program has been incredibly successful and may serve as a model for the rest of San Mateo County. Service calls appropriate for the CARES team include welfare checks, suicidal ideation and other mental health distress, substance abuse, and low-level, nonviolent concerns related to behavioral health. The CARES team does not consider their job finished at the end of their shift: as explained by El Centro Executive Director Jeff Essex at a recent City Council meeting, “We go back the next day.”
The unarmed bilingual CARES unit consists of two El Centro staff members, one licensed health clinician, and an EMT or health care practitioner who respond to calls screened through 911 by the San Mateo County Office of Public Safety Communications call center. The CARES unit does not respond to calls if there are reports of violence or medical emergencies. The staff members are trained in de-escalation, suicide prevention, and crisis intervention.
The CARES team operates seven days per week, from 8:00 a.m. to 6:30 p.m. Outside of those working hours, community members may call San Mateo County’s 988 crisis hotline, which provides phone support to individuals experiencing a mental health or other crisis 24 hours a day, seven days a week.
In its first nine months of operation, the CARES team responded to over 300 calls for mental health emergencies, and has managed to stabilize 87 percent of those engagements.
Responding to a Local Tragedy
The City’s focus on mental health was reinforced following the January 23, 2023 mass shooting event that took place on two farms, and killed seven people and critically injured one person. The victims were all farmworkers and coworkers of the alleged shooter. In light of the dangerous circumstances, the CARES team was not dispatched to the scene. However, CARES contractor El Centro played an important role by ensuring that community members had resources to obtain mental health support and counseling after the tragic event.
While the program is still in its infancy, the CARES program provides a model for improving public safety while simultaneously reducing the risk of putting law enforcement officers in situations that could lead to an unnecessary use of force.
Contact Catherine Engberg for more information on the CARES program. Catherine thanks law clerk Jesse Honig for his research assistance.