Care Response: The right tool for the job
Cleveland City Council; Mayor Justin Bibb; Mental Health Response Advisory Committee; Cleveland Dir. of Public Health, Dr. David Margolius
You wouldn’t use a hammer to paint a wall, or a paintbrush to hang a picture—you would use the right tool at the right time to meet the need you and your family face. The same is true in crisis services: Not every tool in our toolbox is right for every crisis.
A complete continuum of crisis services must include cop response (such as specialized CIT officers), co-response (when police officers are accompanied by a social worker, paramedic, or crisis interventionist), and care response (when social workers, paramedics, and crisis interventionists respond without a police presence). ALL THREE RESPONSE TYPES ARE NEEDED FOR A COMPLETE CONTINUUM OF SERVICES. Peer cities demonstrating this complete continuum — and the improved outcomes that result for community members — include Baltimore, New Orleans, Cincinnati, Minneapolis, Portland, and Albuquerque.
Cleveland’s continuum of crisis services is a two-legged stool, with the majority of crisis calls responded to by police officers, only some of whom are trained in crisis intervention, and limited co-response programs taking place in Cleveland and Shaker Heights.
Urge leaders in the city of Cleveland to take action today: non-police crisis response, also called care response, is a critical tool for our municipal toolbox. Care responders nationwide have been proven to create better outcomes for those experiencing nonviolent behavioral health disruptions, such as mental health conditions, or addiction or withdrawal symptoms. Care response programs can help individuals in crisis connect quickly to healthcare providers, and offer wraparound services to help prevent additional crisis moments from occurring.
Care response programs save cities and counties money, help police departments focus on the calls where they are needed most, and create better health and outcomes for our neighbors in behavioral health crises.
Tell the City of Cleveland to complete our continuum of crisis services NOW.
Learn more about the movement for care response in Cuyahoga County at REACHNEO.COM
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To:
Cleveland City Council; Mayor Justin Bibb; Mental Health Response Advisory Committee; Cleveland Dir. of Public Health, Dr. David Margolius
From:
[Your Name]
Dear municipal leaders,
As a resident of Cuyahoga County, I know that part of my own health and safety depends on the access my neighbors have to programs that support our public health and public safety. Every neighbor in Cuyahoga County needs access to care response, a non-police first response that offers specialized support for people experiencing behavioral health crises. Crisis services are specifically named in the consent decree for the City of Cleveland as an area where program expansion and continuity to other services in safety and healthcare is needed.
Behavioral health crises are on the rise across northeast Ohio, and have been for several years, as the opioid crisis and pandemic disrupted many families, with especially severe impacts on families already facing poverty. Care response teams across the country have been proven to create better outcomes (like faster connection to services, decreasing incidence of subsequent crises, and higher incidence of acceptance of services) for people in behavioral health crises.
Care response is an expansion of our continuum of crisis services, building on the legacy of positive engagement, community outreach, and specialized support that begins with our CIT departments, and has grown through the co-response pilots taking place in Cleveland and Shaker Heights. In 2021, CIT International published the following position:
"There is growing recognition nationally that many 911 calls for service could be handled by non-law enforcement responders if such resources were available. This includes a large portion of mental health related calls for service. Developing response capacity outside of law enforcement agencies avoids the potential harms of police response in situations that do not require their presence. CIT International believes that all communities deserve a well-coordinated and effective crisis response system that is less dependent on law enforcement." [1]
As CIT International acknowledges, who responds to behavioral health crises makes a big difference. Between 25-50% of all people killed by police officers are experiencing a behavioral health crisis.[2] Many complicated reasons lie behind this, including that each of our police officers does not receive intensive training on how to work with people experiencing mental health crises, addiction, or withdrawal symptoms. One thing is true: 100% of people experiencing a health crisis deserve a healthcare-based response.
The City of Cleveland must lead Cuyahoga County’s efforts to complete our continuum of crisis services. Our consent decree demands that we improve crisis response, and offer a right-sized response to each unique behavioral health crisis that occurs in the city.
A right-sized care response pilot in the city of Cleveland should have:
>A focus on community engagement, so that care responders can earn community trust as a non-police resource in times of crisis
>A focus on equity and diversity, so that every community member can feel safe when working with a care response team, and our care responders can feel that they directly contribute to the health of their community
>A focus on agency coordination with the new City of Cleveland health department’s crisis services strategist, so that everyone in the public safety system understands what kind of calls can be allocated to the care response team
>A focus on ongoing infrastructure improvement, so that care response can be folded into ongoing upgrades already taking place, like the implementation of 988 and MRSS
Additional research is available from Policy Matters Ohio and REACH on the best way to implement care response for Cleveland and Cuyahoga County. [3]
City residents desperately need additional tools, resources, and programming that create better outcomes for people experiencing behavioral health crises. Anxiety, depression, substance use, and other behavioral health symptoms have been continually rising since the onset of COVID. We cannot wait any longer for the full breadth of services to be provided. Clevelanders need our CIT officers, we need our co-responders, and we need care responders too. This complete continuum of services will help connect people to services that address root causes of crisis, rather than punishing community members who raise their hand asking for help.
I urge you to lead the City of Cleveland forward, and empower every family in the county to mediate crises in our families and neighborhoods without the engagement of the police force. By implementing care response, we can save our cities and police departments money and manpower, while offering a right-sized first response to every unique crisis in the county.
Thank you.
1-CIT International, “Embedded co-response position paper,” July 6, 2021.
2-Washington Post, “When a call to the police for help turns deadly,” June 22, 2022.
3-Policy Matters Ohio, “Survey shows need for ‘care response’ for Clevelanders experiencing crises,” October 24, 2022.