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What one Greater Minnesota city’s experience says about the state’s efforts to integrate mental health and police work

Alexandria is seen as a leader in coordinating efforts among law enforcement and mental health professionals. But the city’s experience also illustrates the complexity of responding to mental health crises in Greater Minnesota. 

Alexandria PD
Alexandria is an example of a department navigating policing and mental health well, said Sue Abderholden, executive director of the Minnesota chapter of the National Alliance on Mental Illness.
Alexandria Police Department

In late October, Alexandria Police Chief Scott Kent convened a meeting over Zoom with officials from a local hospital, an emergency department, Douglas County social services and behavioral health providers.

The group has met roughly once a month since 2016, with one main focus: handling mental health problems in the area.

This time, county leaders talked about using money from the federal American Rescue Plan for beds to care for patients in mental health crises. A representative from a mental health center detailed how a staffing shortage has made them consider telehealth therapy services from other states. Then an Alexandria officer explained a new program the department is testing in which police and paramedics specialize in lower-urgency calls from people who need help with things like basic necessities, or just a human connection.

“I have one elderly lady in town that every time she feels like her memory isn’t working well, she just calls me,” said officer Darcie Zirbes. “She even remembered my birthday and made me banana pudding …. So yeah, it’s working.”

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For Kent, the roundtable meetings have become a mainstay for a reason: They’ve fostered relationships and created a better understanding of how complex government systems work and intertwine, with the end result being an improved response to mental health problems in an area with few resources. 

Amid a debate over the future of policing, some activists and lawmakers have pushed for more mental health intervention alongside — or in place of — law enforcement.

Alexandria Police Chief Scott Kent
Alexandria Police Chief Scott Kent
While the notion of replacing police is controversial, there is broader support for mental health professionals playing a larger role in public safety. Earlier this year, legislators in the Republican-led Senate and DFL-controlled House passed a law that says 911 operators in Minnesota must refer calls to mental health crisis teams when available.

Alexandria is an example of a department navigating policing and mental health well, said Sue Abderholden, executive director of the Minnesota chapter of the National Alliance on Mental Illness. “Especially in rural Minnesota, it’s so important that people collaborate,” she said.

But the city and its experience also illustrates some of the complexity of responding to mental health crises in Greater Minnesota, where a lack of funding, differences in police leadership and the sprawling geographic size of many rural counties often means public safety practices vary widely.

A growing call for a mental health response

Police reform advocates have long argued law enforcement should be less involved in responding to mental health crises, particularly after Minneapolis police killed George Floyd last year.

But Minneapolis is not the only place where that debate has resonated. At the state Capitol this year, lawmakers passed what’s known as Travis’s Law, which directs the 911 system to call crisis teams, which are made up of professionals trained to evaluate people and de-escalate serious mental health episodes. The bill was named after Travis Jordan, a Minneapolis man shot and killed by police in 2018. Jordan approached two officers with a knife after police were dispatched because Jordan had said he was considering suicide. The officers weren’t charged with a crime, though Jordan’s mother in November sued the city and the officers.

There are currently 34 state-certified “mobile” crisis teams already spread across the Minnesota , according to the state Department of Human Services, providing around-the-clock services for every county meant in part to help divert people from unnecessary emergency room visits or from being arrested. Before the legislation, 911 operators had the ability to call the crisis teams, but now they are required to, at least when the services are available. 

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State Rep. Jessica Hanson, the Burnsville DFLer who sponsored Travis’s Law at the state Capitol, said at a March hearing in the Minnesota House that she hopes the measure will lead to fewer people being killed by police while having a mental health emergency.

Sue Abderholden
NAMI
Sue Abderholden
Hanson and others testified that they hoped mental health professionals would act more as first responders under the law, the same way a paramedic would. She said people often call 911 to ask for a mental health professional, only to get a police-only response.

“When someone is having a heart attack or is injured, EMTs and paramedics are the professionals that are dispatched and they are the primary professionals managing the  emergency,” Hanson said. “When someone’s home is on fire the firefighters are dispatched and are the primary professionals managing the crisis. I believe it is time that we intentionally empower our operators to dispatch our existing mental health crisis intervention teams when someone with a mental health emergency needs help and when it is appropriate to do so.”

Michelle Gross, president of the advocacy group Communities United Against Police Brutality, echoed that sentiment, saying Minneapolis police respond to many mental health calls where no one has a weapon or is thought to be dangerous.

“What we’re really trying to do with this bill is to let mental health professionals and practitioners be the primary responders,” Gross said. “But they are certainly able to call in law enforcement if they need to. If there is a belief the situation may be escalated there could be a co-response.”

What’s happening on the ground

Nearly six months after Travis’s Law was signed by Gov. Tim Walz, however, the vision of mobile crisis teams as first responders is a “work in progress,” Abderholden said. 

A task force for 911 operators is looking into new training for dispatchers to make them more aware of crisis teams and how to use them, she said. But there are other reasons beyond dispatch why police and crisis teams haven’t adopted a co-responder model, or often send mental health professionals instead of cops.

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In Greater Minnesota, one reason is physical distance. With just 34 teams, the state’s mobile crisis teams can be more than an hour away from a 911 caller. Another reason is concern for the safety of crisis responders. 

James Tadman, the sheriff of Polk County in northwestern Minnesota, said his agency was already collaborating with mental health crisis teams before, though he said the new law will ensure quicker contact of those professionals. But Tadman said even if police are in contact with crisis teams and believe they’re best at dealing with mental health calls that don’t involve anything criminal, the crisis teams are not typically responding to a scene initially with police, or instead of them.

Polk County Sheriff James Tadman
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Polk County Sheriff James Tadman
Often, sheriff’s deputies are making the first contact, Tadman said, to ensure no one is in danger. Then a crisis team could respond. More often, the department is bringing people into hospitals for them to get evaluated and for treatment. 

“They don’t show up with us,” Tadman said of the crisis teams. “We’ve talked about it. It’s, ‘How do we do that with a county so big?’ Because we don’t have the manpower to pick up the mental health (workers) and go with us, which would be great. But some of our calls are 45 miles away. To go 45 miles, pick that person up and go back 45 miles — I think the better process would be to get there and at least start a process to make sure that they’re OK and not harming themselves or anyone else during that mental health crisis.”

The situation has even led some areas to equip officers with tablets so police can connect people at a 911 call with mental health providers remotely, according to Abderholden and Jeff Potts,  executive director of the Minnesota Chiefs of Police Association.

Whatever the reason, in some parts of Minnesota, 911 dispatch is not referring calls to mobile crisis units. 

Sarah Richter, crisis program manager for the Region 4 South mental health consortium — which runs a crisis team for Grant, Pope, Stevens, Traverse and Douglas County in west-central Minnesota — said police get dispatched and then law enforcement contacts them once on the scene. “That’s what’s happening presently.”

Kesha Anderson, administrator of Region 4 South, said there is “room for improvement” with dispatch and said police also vary widely in how often they engage with crisis teams. But Anderson said the crisis team is also mindful that some calls where there may be immediate danger aren’t appropriate for them, or may not actually involve their work — such as when people are homeless or hungry. But the 15-person mobile crisis team for Region 4 South does respond directly to scenes to provide help and to do mental health assessments.

Another issue that limits response for crisis teams is staffing. The services are underfunded, Abderholden said, and while lawmakers this year approved $16 million in the next two-year budget for grants helping mobile crisis services, Kent, the Alexandria police chief, said the funding wouldn’t do much good when spread across the entire state. Abderholden said the staffing shortage is so tough that even more money might not necessarily draw enough people into the industry.

In an interview at the Alexandria police station, Anderson, the Region 4 South administrator, helped illustrate the complexity of dispatching mental health teams as first responders in potentially dangerous situations.

She said some members of law enforcement in their region have actually wrongly deferred to Region 4 South on some calls because of a controversial new statute that limits when police can use deadly force. The law, passed in 2020, says police can’t use deadly force against someone who is not a threat to others — even if they are a threat to themselves.

Many police around the state have pushed back against the law — which their trade orgnizations helped craft — because they believe if someone is armed and potentially suicidal, then a cop wouldn’t want to enter the person’s home because they would feel uncomfortable using force if the situation turns dangerous for an officer or others.

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While that deadly force law had been suspended by a judge since mid-September before largely being reinstated Friday, Anderson said some local chiefs and sheriffs did not want to be involved in calls where someone is suicidal and said they would have to assess other mental health cases as they come into dispatch. 

“If someone is actively suicidal, our mobile crisis team can take 45 minutes to 90 minutes to get there depending on where people are dispatched,” Anderson said. “We had some really icky situations, a couple … that did not go smoothly.”

As a real-world example, Anderson said the crisis team was called when someone actively suicidal had a knife. “They were calling 911, 911 told them: call the crisis team. We were like, ‘Whoa, we can’t respond out if they have a knife and they’re actively suicidal.’” (Richter said Region 4 South may respond but would want police there first.)

Abderholden and other advocates for Travis’s Law say crisis teams are not trained to handle dangerous calls where someone has a weapon. And in March, the DFLer Hanson said the legislation acknowledges workforce issues and “the limitations that geography poses in many emergency situations” by saying referrals are necessary only when crisis teams are available.

But Abderholden said these obstacles don’t mean mental health crisis teams can’t be something of a first responder in more rural areas. “Police don’t respond to everything within a few minutes, they triage,” she said. “We have to triage as well in the mental health system to make sure that the highest need is covered as soon as possible and some of the other needs can perhaps be taken care of later or be taken care of over the phone.”

Why Alexandria stands out

Alexandria, the seat of a deep red county where more than 65 percent of voters chose Donald Trump in 2020, is an example of why the reality of policing in rural areas is more complicated than political stereotypes might suggest.

Kent and his department defy easy categorization: the chief is quick to criticize ideas like defunding the police and leads a department where offices and break areas are adorned with “thin blue line” paraphernalia. At the same time, Kent and the agency have won praise and awards for their approach to mental health and public safety.

When it comes to Travis’s Law, Kent is wary of the concept of mental health crisis teams responding alongside police officers to 911 calls, an idea he called “absurd.” He also didn’t want crisis teams following cops, in part because calls can be potentially dangerous. Kent said if police are at a scene, it doesn’t make sense in a situation that could potentially escalate for them to wait for a mental health provider that could be 45 minutes away.

Instead, Kent said typically in the city and in Douglas County, law enforcement arrive at a scene and deploy de-escalation or crisis intervention training if someone is a harm to themselves or others, and then get the person to an emergency room. “That’s when Region 4 comes,” he said. “They meet them at the hospital and then it’s a conversation between Regional 4 mental health providers and our ER doctors to say we need a 72-hour hold.”

Nevertheless, Kent said Alexandria police have worked hard to build meaningful connections with the regional crisis team and incorporate them into their work. So much so that Kent said not much will change for his department because of Travis’s Law.

Kent speaks passionately about the problems of childhood trauma and the ACES training (Adverse Childhood Experiences) he has embraced, and the task force he chairs has won kudos from others outside of law enforcement like Region 4 South. Abderholden said NAMI gave a previous Alexandria chief an award for mental health work. Kent has been with the department for more than two decades and became chief in October of 2020.

Regular meetings with the county, behavioral health and medical providers began earnestly in 2016, Kent said, as the area struggled with a lack of psychiatric beds.  While that problem hasn’t been solved, Kent said the collaboration means responses to mental health issues run more smoothly and sometimes does mean the crisis team or others meet with people instead of police. “There’s been a lot of situations that have been highly successful that haven’t led to law enforcement interaction, yet we’re at the table,” Kent said.

Additionally, Kent this year started a pilot program with a North Memorial “community paramedic” to help people in ways that aren’t tied to traditional law enforcement. Zirbes, the Alexandria officer running the program for the department, said she tries to find repeat callers to the department to connect them to proper services that could fix the problem, whether they’re having a mental health issue or other problems like help for an older person who fell down. 

“We took a lift assist that we had already been on like four times by April and just helped get services in place,” she said. “And really all we do is connect the pieces.”

In all, Anderson said Alexandria police is one agency doing good work on mental health. Kent is “very open-minded and futuristic” compared to others in law enforcement, though Richter said smaller cities and counties may not have the same time and resources that Alexandria or Douglas County do. 

Still, Richter said the task force Kent leads means officers have her cell phone number and work with the crisis team far better. Richter said when people connect with mental health services, the chance of them calling police again has been reduced.

“I would say that if there’s other people who are really struggling with their relationships with law enforcement, mental health agencies, that they try to duplicate that kind of task force,” Richter said. “Once we sat at the same table and understood what others could and couldn’t do … I think that was the beginning of being able to open some eyes and see where there really are gaps and room for improvement.”