Appropriately Fund A 24/7 Community-Led 911 Alternatives for Mental Health Crisis Response Program without Law Enforcement Involvement

Sacramento County Board of Supervisors

The Backstory:

Sacramento County budget hearings took place in September with a historic level of participation, thanks to widespread demands for law enforcement divestment, uprisings for long overdue racial justice, and the People’s Budget’s efforts to create a more equitable County budget.

Unfortunately, the Board largely voted for a business-as-usual budget. The exception was Supervisor Kennedy’s proposal to divert at least $1.5 million Sheriff dollars into community-based crisis response. This modest proposal was a huge step in the right direction and a refreshing example of electeds listening to their constituents’ priorities.

568 people participated in two community listening sessions and surveys held by County Behavioral Health regarding community-based crisis response and they overwhelming recommended the following:

  • Response teams should consist of mental health clinicians, peers with lived experience, social workers, and medical clinicians - not law enforcement. Police officers tend to escalate a situation, simply by showing up on the scene. It can be triggering for people with behavioral health disorders, as these individuals are more likely to have experienced negative or traumatic contacts with the justice system.
  • Expertise should be de-escalation, trauma-informed, behavioral health-centered, and responsive to race, culture, gender, and disability.
  • Crisis services must include housing and shelter, mental health assessment and services, food, water, and other survival needs, medical care and medication, and crisis stabilization and respite centers

County staff presented a proposal for a pilot Alternatives to 911 Program at the February 24 County Board of Supervisors meeting. The proposed pilot would operate Monday thru Friday, 9am to 6pm, with 4 mental health response teams paired with a Sr. Mental Health Counselor and Sr. Behavioral Health Peer Specialist. County staff used community input from listening sessions to develop a pilot model that prioritizes response that de-escalate situations, are trauma-informed, led by staff that are trained in how support individuals experiencing a mental health crisis rather than criminalizing behaviors.

While the pilot takes a step forward, it is not enough. Community members and some Board of Supervisors called for a pilot that provided 24/7 support.

Nationally, 1 in every 4 police killings is of a person with mental illness. That means they are 16 times more likely to be killed by the police than their peers without mental illness. Black men experiencing mental health crises are more likely to be killed by law enforcement than any other demographic. It is abundantly clear that dispatching law enforcement to respond to mental health crises only endangers our community, particularly Black and Brown residents.

Supervisor Nottoli broke it down for the Board members, stating that there would a significant volume of calls that won’t be routed through law enforcement, that will be calls for mental health services and human services. That’s the whole intent of this 911 alternatives pilot. He went on to say: “There are no wrong doors - 911, 311, or 211. Whatever your care line is, however they come in...whoever is responsible for receiving the call - that initial determination about dispatch for services are needed. It’s important that what we are working towards here is to have a mental health, community health and quality of life response team with trained dispatchers and trained skills professionals that can respond to those that don’t warrant law enforcement response. You are trying to get to a large bulk of calls for services and calls for people that are in need of help and get the appropriate people to respond and hopefully have much better outcomes for everyone involved.”

To be expected, some Supervisors rang the alarm bells during the presentation asking, "what about law enforcement?" Supervisor Frost: “I wasn’t thinking about the cities, I was thinking about the Sheriff. I didn’t think of this being county, until local jurisdictions brought it up to me…Why do we have to vote on something? Why do we have to pass on it and then have the conversation? It seems like it’s not fair and it does impact their business model. It impacts their ability to be fully on alert in their jurisdiction.”

Are we really more concerned about law enforcement’s business models? Or are we more focused on meeting the needs of our marginalized community members that are at risk of being killed by the inappropriate response model?

Appropriately funding this 911 alternative program will save lives. We need to shift how we view individuals experiencing a mental health crisis. Instead of viewing individuals as dangerous, that need to be controlled through aggressive or intensive policing, let's look at them as individuals experience a deterioration of their mental health functioning due to the lack of adequate treatment.

#My911Story is a community project to share the experiences of community members when using 911. Follow this link to watch:  #My 911 Story - Part 1, Black Zebra Productions

To: Sacramento County Board of Supervisors
From: [Your Name]

We are in strong support of significantly increasing the $1.5 million amount to
$15 million for the Alternatives to Law Enforcement proposal to ensure the needs of the entire county are met. We worry that the implementation of this pilot as anything other than a service that operates 24/7, is community-led, and operates without interference from law enforcement - while better than the current situation where law enforcement responds to all mental health calls - would be gravely insufficient and neglect almost half of our most vulnerable county residents.

Our community has voiced its demands for law enforcement to stop brutalizing and killing our most vulnerable and at-risk community members when they are experiencing a mental health crisis. If Sacramento County is going to seriously consider non-law enforcement crisis response for things like mental health, it needs to be sufficiently funded to be successful.

Here is what our community needs and deserves:

1. A Sustainable 24/7 Program
We don’t need another pilot – we need a solution. Sacramento already has Mental Health First, a successful, health professional, and community-run organization. Trained and unarmed civilian responders on the frontlines pose the least threat to people experiencing mental illness because they are trained to be effective while being the least confrontational, so as not to escalate the situation.

It’s important to note that a similar program in Eugene, Oregon called Crisis Assistance Helping Out On The Streets (CAHOOTS) showed that it has the potential to save taxpayers $8.5 million dollars by effectively handling mental health emergency situations in a non-punitive, life-affirming way.

2. Funding From the $4 Million Sheriff Surplus
Other county-run health-related departments are already severely underfunded. The Sheriff’s Department is the largest item that the Board has discretionary power over. In the 2019-2020 budget, 37% went to the Sheriff’s Department. Sheriff Scott Jones already said he wants to get out of the mental health business completely. There’s $4 million that goes unspent by the Sheriff’s Department that should be used to take the responsibility off of the Sheriff’s Department and put into mental health professions and dedicated community members.

Remember how just a few weeks ago the Board almost gave $10 million to start construction on a new jail but then voted against it? Yeah, they should use that money to fund a community-led, non-law enforcement 911 alternatives for mental health crises program, too.

3. An Independent Advisory Board
Sacramento County Sheriff’s Department uses more deadly force than 50% of all other Sheriff’s departments in our state. Deputies are often called to provide services for marginalized community members, and the lack of specific training within the department leads to arrest, injury, and trauma. Law enforcement tends to treat a person experiencing a mental health crisis as an armed and/or non-compliant suspect and excessive force results. 1 in every 4 police killings is of a person with mental illness. This means that people with mental illness are 16 times more likely to be killed by the police than other people.

4. No Police Interference
Although police have had training on how to deescalate confrontations with people with mental illness, it is not reasonable to expect a patrol officer to make a meaningful clinical assessment of a patient in the field.

For those with mental illness who are detained and taken to jail, 83% don’t have access to the treatments they need. People are often given medication while in jail and, at best, a bottle of pills and a referral when they are released, leading to a revolving door of arrests and short-term incarceration with no real improvement in the person’s underlying health.

Appropriately funding this 911 alternative program with a 24/7 service delivery model will absolutely save lives. We need to shift how we view individuals experiencing a mental health crisis. Instead of viewing individuals as dangerous, that need to be controlled through aggressive or intensive policing, let's look at them as individuals experiencing a deterioration of their mental health functioning due to the lack of adequate treatment. Let's give our community access to the treatment it deserves.