El Cajon is no longer automatically sending police officers to some mental health crisis calls.
In May, the city’s police department quietly halted automatic deployments when someone threatens to harm themselves, if there’s no apparent crime or danger to others. That has meant clinicians from the county’s Mobile Crisis Response and the Psychiatric Emergency Response teams sometimes also didn’t respond to those calls or couldn’t get police support when they sought it.
A log obtained by Voice of San Diego after a public-records request details more than a dozen instances since mid-May where the county and its contractors reported that El Cajon police declined to intervene, including six instances where someone threatened suicide and had a plan to harm themselves.
El Cajon police dispute some of what the county documented and say officers are still responding to the majority of mental health crisis calls – just not those where they decide a person is only a risk to themselves. They say they evaluate each call on a case-by-case basis.
The new approach – one also taken by some other law enforcement agencies in California – followed a federal appeals court ruling that two Las Vegas officers forfeited their qualified immunity when their use of force led to the death of an unarmed man with schizophrenia. Qualified immunity generally clears police of personal liability.
El Cajon Police Chief Jeremiah Larson decided a few months ago to stop automatically sending officers to crisis calls without a criminal element or threats to others.
In an interview this week, El Cajon police Capt. Keith MacArthur said those calls created risks under the 2024 ruling and noted his department’s lack of capacity and significant training on mental health.
“In an attempt to protect our officers and our qualified immunities, there are instances where we do not respond to certain calls,” MacArthur said.
The El Cajon Police Department is the only local law enforcement agency to make this call.
County behavioral health officials had two meetings with El Cajon officials last month to discuss the change. Officials said they saw an “immediate risk” to El Cajon residents.
“(County Behavioral Health Services) has significant concerns about the safety and well-being of children and adults within the city of El Cajon who may experience an urgent behavioral health crisis and need immediate support from emergency personnel but aren’t able to receive it,” county spokesperson Tim McClain wrote in a statement. “It will inevitably result in an adverse outcome for someone in need of crisis intervention but who law enforcement (and Psychiatric Emergency Response clinicians) did not respond to.”
Advocates and Supervisor Joel Anderson, who represents El Cajon, have also raised alarms about the shift and what it means for civilian responses to mental health crises.
Per San Diego County policies, Mobile Crisis Response Teams can’t respond when there are threats such as the presence of a weapon or injuries that require medical treatment and police must accompany Psychiatric Emergency Response Team, or PERT, clinicians. Paramedics also often won’t respond if there are safety concerns.
Now, PERT Director Mark Marvin said his teams are responding to far fewer calls in El Cajon than before the change. PERT responded to 33 percent fewer crisis calls and saw a two-thirds drop in crisis detainments in El Cajon over the past seven weeks than during the same period in 2024.
“We could be doing that quite a bit more in El Cajon,” Marvin said.
From May 18 through July 10, the county tallied 14 instances reported by its Access & Crisis Line, an outpatient clinic, PERT and mobile crisis teams where El Cajon’s policy complicated responses to crises.
On May 18 at 7:51 a.m., for example, the county log reads, a caller was “suicidal with a plan, means and also under the influence.” The log described the police department’s refusal to respond and its suggestion that the caller take a trolley to Sharp Grossmont Hospital. The county’s mobile crisis team had refused the call “due to concern for safety” and the county’s Access and Crisis Line repeatedly tried to follow up with the caller without success.
In an email to Voice, MacArthur described the situation differently. He said that the Access & Crisis Line called police to report that a man at an El Cajon trolley platform had “unintentionally taken drugs and alcohol the day before and wanted to cut his throat” but did not have weapons with him. The man wanted to connect with PERT or have police take him to the hospital. MacArthur wrote that El Cajon police told the crisis line the man should take the trolley to the hospital.
“If he was willing to seek treatment on his own, he could take the trolley to get to Grossmont hospital,” MacArthur wrote.
Retired San Francisco police deputy chief James Dudley, a consultant who has followed the 9th circuit case, said he thought El Cajon police had the discretion not to respond based on the information from the county and police.
Andy Prisco, a training consultant who founded Washington state’s psychiatric emergency response team and co-authored a crisis intervention certification handbook, disagreed. He argued the safest approach likely would have been a police response given that the man said he was in crisis and possibly under the influence.
In a July 11 letter to El Cajon city leaders, Anderson implored the City Council to hold a public discussion and noted the limitations it causes for civilian responders who rely on police. One councilmember responded that he was unaware of the change. When reached by Voice, El Cajon Mayor Bill Wells and Councilmember Michelle Metschel said they wanted to gather more information. Metschel said she wasn’t aware of the change until July 11.
Anderson argued a public discussion is crucial given the devastating impacts he thinks the El Cajon policy could have on people and families struggling with mental illnesses.
“If they don’t believe this an issue worth being agendized, if they don’t believe lives are worth saving, that’s their call,” Anderson said.
El Cajon resident Michelle Routhieaux, who leads San Diego’s Depression and Bipolar Support Alliance and regularly assists people in crisis, said she felt sick when she learned of the police department’s new approach.
“They could just leave you and your loved one there to die because they don’t want to get sued or they just don’t feel like coming today,” Routhieaux said.
El Cajon police argue residents can call 9-1-1, and that dispatchers can offer resources such as the county civilian teams, an ambulance or maybe a police response.
“ECPD’s policy has not changed and the narrative that we are not doing anything to help is just false,” MacArthur wrote in an email.
The El Cajon Police Department’s decision to dial back its responses to mental health crisis calls came months after Sacramento County Sheriff Jim Cooper announced a similar policy. He also cited the 9th Circuit Court of Appeals case, Scott v. Smith, as the catalyst.
In the Las Vegas case, two officers responded to a call for help from Roy Scott, who had schizophrenia. As they tried to restrain Scott, the officers applied pressure to his neck and chest. A court found that led to his death. While qualified immunity allows government officials freedom from personal liability if they violate someone’s constitutional rights, courts deny it when they deem officers used excessive force. The 9th U.S. Circuit Court of Appeals ruling decided this applied in Scott’s case, allowing his daughter to file suit because he was not suspected of a crime and did not present a risk to others.
The Sacramento sheriff was the first to announce a policy change tied to the ruling and publicized his position at a press conference and on his agency’s first-ever podcast.
A law firm that provides advice to the California Police Chiefs Association and the California State Sheriffs Association disagreed on how the ruling should guide police responses to crisis calls.
In a memo sent to sheriffs and chiefs statewide that was obtained by CalMatters, attorney James R. Touchstone of the firm Jones Mayer wrote that the ruling does not mean officers are personally liable for any use of force against people with mental illnesses.
As the debate ensued, El Cajon police and other law enforcement agencies in San Diego County studied the ruling.
MacArthur said El Cajon police decided if officers were only responding to a person who could harm themselves, the ruling didn’t provide a “lawful reason” to respond and detain them.
Interestingly, MacArthur said, El Cajon police haven’t changed their written policy on responses to mental health calls. He said the agency is continuing to follow its policy stating that it “will collaborate, where feasible, with mental health professionals” to develop a strategy to guide interactions with people struggling with a mental health crisis.
Dudley, the retired San Francisco police official and Prisco, the Washington-based consultant, disagreed over whether the El Cajon police interpretation of its own policy was sound.
Dudley argued it appeared to be.
Prisco said otherwise.
“It would appear to me that this policy contemplates the agency’s response to all calls that would be associated to behavioral crisis to at least render emergency situational evaluation and assessment,” Prisco said.
But both Dudley and Prisco agreed the police department’s decision to halt some responses could lead to more liability for the city than simply responding – and potentially disastrous consequences.
“You can’t say that someone in crisis is non-violent until you start talking to them and dealing with them,” Dudley said.
MacArthur said El Cajon police are doing their best to respond appropriately to the ruling.
He acknowledged the approach sounds “harsh” but argued the impact to the community can be amplified when officers respond to crisis situations, especially if they shoot and kill someone – and that officers’ presence can often escalate crises.
San Diego National Alliance on Mental Illness CEO Cathryn Nacario, who also chairs the county’s PERT community advisory committee, said El Cajon’s shift prompted the PERT committee to discuss the appeals court decision and what to do about El Cajon’s response at its July 15 meeting.
“There’s a duty to protect and serve and I don’t think it’s fair to cherry pick who you protect and serve,” Nacario said. “It’s just really mind boggling to me.”
Nacario said she and others are determined to persuade El Cajon police to resume responses to all mental health calls.
“This is really going to take a combination of city, county and community-based organizations working together to reverse what’s happening, to give El Cajon PD a level of support where they feel it is OK to go out on these calls again,” Nacario said.
El Cajon City Manager Graham Mitchell said his city might consider changing the policy based on what the data shows in the months to come – and if it gets more resources. He said it would be ideal, for example, if the county could fund the police officer tied to PERT and take on the liability associated with those calls since his city doesn’t have the funds to support that.
Anderson has said he and the county have increased mental health resources throughout the region, including in East County.
The county reports its budget for the PERT and MCRT programs this fiscal year totals $37.7 million.
Mitchell said it hasn’t been enough and that his city’s move to minimize mental health crisis responses is also a response to outcry after Floyd’s death.
“At what point do we become the babysitters or the nanny supervisors of every resident in our community?” Mitchell said. “It’s interesting, as PERT has become a thing, balancing out the roles of government in the lives of individuals that want to harm themselves. It’s a bigger societal question. The county has a very specific direction it wants to go but they don’t want to fund it.”
