San Diego Law Enforcement Teams With Mental Health Workers For Psychiatric Emergencies

Wednesday, September 27, 2017
By Susan Murphy
Photo by Matthew Bowler / KPBS
Above: Newly graduated San Diego Police officers attend Psychiatric Emergency Response Team training at the force's academy at Miramar College, Sept. 13, 2017.

As police are increasingly responding to calls about people in mental crisis, a San Diego organization is working with them on how to handle the potentially deadly encounters.

The numbers are staggering, said Mark Marvin, director of San Diego County’s Psychiatric Emergency Response Team (PERT).

“Since 2009... these calls coming into dispatch of (a) psychiatric nature have increased 92 percent,” Marvin said. “San Diego Police Department in the last year alone was roughly 110 percent.”

The nonprofit works with every law enforcement agency in the county, helping officers and deputies sharpen their communication skills when dealing with people suffering a mental breakdown. The training includes decision-making about when to fire their weapons.

“In trainings I really stress the point that it’s all about the relationship,” Marvin said. “If you can develop a compassionate relationship, it’s almost as if de-escalation will occur automatically because trust has been established.”

Marvin recently worked with a few dozen newly graduated San Diego police officers at the force's academy at Miramar College. During a role-playing exercise, officers stood in front of a large screen showing a simulated video that displayed a knife-wielding man sitting in a tree, acting threatening and mentally unstable.

Police Officers Ruben Berton, Jr. and Colton Hofrichter worked to calm the man, while an instructor sat behind a control board, pushing buttons to increase or lessen the intensity of the situation, depending on the evolving conversation.

“Sir, how are you doing? I’m officer Berton,” Berton called. “Can I have your name? Sir, please put the knife down.”

The officers tried talking to the man for several minutes, but he abruptly jumped from the tree and lunged at Berton with the long, sharp blade. Hofrichter shot the man, who fell to the ground.

Fortunately on this day, there’s no stabbing or bullet wound, and nobody died.

There are a number of factors behind the rise of mental illness, Marvin said.

“It involves access to services,” Marvin said. “It’s funding, not enough hospital beds. It could be the substance-use impact. People being released from prison without adequate supports once they’re released into the community.”

PERT employs 51 licensed mental health clinicians who pair up daily with law enforcement officers. They spend their entire shift on patrol.

“When a 9-1-1 call comes into dispatch, the dispatcher can look at who’s out in the field and can basically dispatch a PERT team to that scene when that person is in the midst of a psychiatric crisis,” Marvin said.

The need for crisis teams has drawn renewed attention across the nation in recent years following several high-profile police shootings of people experiencing a mental crisis. Nationwide, a quarter of all people shot by police were impacted by mental illness. In San Diego, 62 fatal police shootings have occurred since 2010.

“We are on the sidelines in a lot of these scenarios hoping for an opportunity to be able to engage that person,” Marvin said. “For our clinician to interact with a person in crisis there has to be a guarantee of public safety.”

Marvin’s team of clinicians has more than doubled in the last two years, but it still falls far short of meeting its skyrocketing demand.

“Last fiscal year we responded to just about 8,000 of these calls in San Diego County,” Marvin explained. “Meanwhile, recognize that’s about one-fourth of all these calls coming into dispatch, because we’re not 24/7.”

One of those missed calls was for Alfred Olango in El Cajon. The 38-year-old man was erratically walking in traffic on September 27, 2016. His sister had called the police saying he was mentally ill. When two officers approached Olango, he pointed something at them, later determined to be a vape pen. One officer tased him, the other shot him. Olango died.

The PERT team had been responding to a different call.

“Unfortunately I know some people almost believe that it’s as if we come in from the sky wearing a capes and it doesn’t work that way,” Marvin said. “In some of the movies there’s always a great outcome and the piano music is playing in the background. I wish that were the case.”

Marvin said PERT clinicians are assigned to the most needed areas, including the San Diego Police Department’s central division, in and around downtown. It’s where hundreds of homeless live on the streets.

“The other tragedy is there are so many people who are homeless living with severe mental illness. But we know no bounds. We go into the wealthiest communities as well as those most impoverished,” Marvin said.

PERT hired an additional 10 clinicians since last year and trained more than 1,000 officers and deputies in its one- to three-day academies.

“I think we can come to a better place collectively to find a solution somewhere, how everybody can enhance the likelihood of a successful outcome," Marvin said. "That’s my hope. That’s why I’m in this.”