A mental health crisis will sometimes prompt a call to 911. But police officers, even those who have received special training, aren’t always equipped to handle the situation.
Occasionally, things go awry – like when police shot and killed a 52-year-old man in Roseville in 2016, or when Wright County authorities shot and killed a 21-year-old man in Otsego earlier this month.
Starting as far back as 2016, the St. Paul Police Department decided to try a different approach to mental health calls. In 2018, they partnered with the nonprofit community based mental health provider People Incorporated to embed social workers in their department as a way to avoid unnecessary arrests and hospitalizations and get people the help they need. This tactic has proven so successful that a number of police departments across the state have begun to follow St. Paul’s lead and embed social workers into their ranks.
About a year ago, Amanda Terwey, a mental health professional and People Incorporated social worker, began working a split position in the Coon Rapids and Blaine police departments. Dressed in street clothes, she accompanies officers on daytime mental health calls, offering support, resources and information to people in crisis. She also does follow-up visits with people who’ve interacted with police when she wasn’t on the clock, making sure they get the help they need.
Though Terwey arrives at calls with police, she’s noticed that her different mode of dress makes it clear that she is not a law enforcement officer, and that cuts the tension.
“Mental health is not a crime,” Terwey said. “Oftentimes people associate someone in a uniform, such as a police officer, as a person of authority, someone who carries a gun and could make an arrest.” She said that her “softer,” ununiformed look helps people feel more comfortable, less threatened: “They feel more at ease and willing to talk about what is going on.”
Too often, police officers, lacking the tools and resources needed to assess and redirect individuals in crisis, end up either transporting people to the hospital or even arresting them and taking them to jail. Embedded social workers, with their extensive background in mental health support systems, are able to help change the direction of an interaction, said Jill Wiedemann-West, CEO of People Incorporated.
“The social worker brings a far deeper knowledge of the human condition,” she said. When it comes to mental illness, Wiedemann-West added, “Police have limited tools in their toolbox.” An embedded social worker “can sit down and try to understand what’s going on with that particular individual, try to figure out at a very basic level, ‘Is this individual in danger if we were to up and leave right now? Do they have the tools they need so they can manage? If they don’t, how can we help?’”
Terwey said her role is a good compliment to police officers’ work.
“I find that mental health is so prevalent and it’s a need that definitely should be addressed. As a social worker, I feel like it is a good fit to work with the police department. Historically, law enforcement and social work have not always worked together as closely as they do in this program, but the reality is it can be a great partnership.”
Responding to the needs of the community
In 2016, concerned about a rising number of mental health calls, the St. Paul Police Department decided to take a closer look at call records, said Sgt. Justin Tiffany, coordinator of the department’s Community Outreach and Stabilization Unit.
“When we looked at what was going on in our community, we learned that from 2006-2016 the number of calls for mental health-related issues had doubled,” Tiffany said. He and his department colleagues decided they needed to do something to respond to this increase. They took a look around the country, researching how police departments in other cities responded to mental health calls.
They visited Madison and Albuquerque, Tiffany said, where police departments were embedding social workers to respond to mental health-related calls. Officers in those departments reported lower rates of dangerous interactions, he said, and callers generally reported that the social workers helped them get the services they were seeking.
Looking to mirror what they observed in those visits, Tiffany said that St. Paul police officials reached out to People Incorporated to propose a partnership. Wiedemann-West was excited about the idea. “It was a pretty brilliant plan,” she said. “I think St. Paul was ahead of the game when they started putting this together.”
People Incorporated staff wrote grant proposals to fund the bulk of the program, and the remaining budget shortfall was covered by federal grant funding secured by the police department. After a few years working with one, and then three, social workers, the decision was made in 2021 to add a licensed alcohol and drug counselor to the Community Outreach and Stabilization Unit to help respond to the continuing opioid crisis and rising overdose rates in the city.
“The idea is to connect people with resources for their chemical health, mental health or both, to divert them away from the criminal justice system,” Tiffany explained. “Since we brought on our first clinician, she has done almost 1,000 diagnostic assessments, or the tool that gets you in the door for treatment and other services.” The licensed alcohol and drug counselor has also helped in measurable ways, he added: “Since she’s been here she’s done over 150 Rule 25 assessments. These offer the same kinds of keys to the door where you can access treatment.”
A day in the life
Though mental health calls take many forms, Terwey said that most happen when “a person or a concerned family member or friend reaches out. In those cases, we go out there, check their welfare, see what’s going on and come up with a plan of how to address their concerns.”
During these calls, Terwey focuses on the person in crisis, assessing and de-escalating the situation. Having the full attention of a mental health professional helps bring a person down from the edge, she said, and often in less than an hour plans can be made to get them the help they need.
Witnessing Terwey at work has helped Coon Rapids and Blaine officers gain a better understanding of the larger range of situations that can be dealt with through a mental-health rather than a criminal-justice lens.
“We’ve expanded the types of calls I go on,” Terwey said. “On the surface level some calls might not at first indicate mental health, but when you take time to look, you realize that oftentimes mental health is an aspect of the call. That’s why it’s helpful when I am there so I can take the time to figure out what’s actually happening.”
On most calls, officers go in ahead of Terwey to make sure the situation is safe.
It works the same way in St. Paul. “I’m grateful to say that we have not had any of our clinicians involved in a physical altercation with anybody,” Tiffany said. While he explained that some people in crisis can be, “a little vulgar or aggressive, it has worked really well to have the clinicians with officers on the calls. They are adept at identifying behavior vs. a personal attack.”
Wiedemann-West said that experience working with traumatized populations helps social workers understand how to handle stressful situations in a “very non-confrontational” manner. “It’s basically someone sitting down, focusing, asking what is going on and hopefully starting some engagement with the client so they can build a relationship.”
Before social workers and licensed alcohol and drug counselors were embedded in police departments, law-enforcement officers often felt hamstrung in how best to respond to individuals in crisis, Terwey said.
“If this position did not exist and it was police who respond on their own, they are able to do only so much with mental health. It really doesn’t leave a lot of options outside of helping someone get to a hospital. Law enforcement are not mental health professionals. That’s why adding this option to a department is so critical.”
Wiedemann-West added that she thinks her nonprofit’s partnership with St. Paul police has become a model for a progressive approach to policing that takes callers’ humanity into account. It builds a key understanding of and empathy for people facing mental illness.
“I’m really proud of this work and feel so excited about all of the things that have been done with it,” she said. “Police departments that are leaning into this work are appreciating that it is a better way of dealing with the vulnerable people they come into contact with every day.”