Therapy in Blue 

Portland Police Look to Create a Specialized Mental Health Unit

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THE PORTLAND Police Bureau is exploring a dramatic shift in the way it handles what's become a flood of calls involving the mentally ill—with plans in the works for a new, specialized unit that would pair cops with clinicians 24 hours a day.

According to city budget documents released this month, police officials are sketching out how much it would cost to assign officers to a standalone mental health unit that would work hand-in-hand with Multnomah County's Project Respond. The unit would come on top of the crisis training already required of every officer and replace current plans to have Multnomah County's crisis hotline handle low-level 911 suicide calls.

And, unlike the bureau's current partnership with Project Respond—which pairs one day-shift cop and one clinician on patrol in just one precinct—the new unit would operate around the clock. There's just one catch so far: At a time of budget cuts citywide, the new program is expected to cost as much as $2.5 million.

"There is still a lot of vetting being done with the budget," cautioned Sergeant Pete Simpson, a bureau spokesman, "so nothing is set in stone."

The unit is based on a nearly 10-year-old project created by the Los Angeles Police Department that closely links officers with county mental health workers. Unlike Portland's proposal, the Los Angeles program also includes follow-up care for people deemed most likely to be suicidal or become violent with police. The project is well regarded enough that it was plucked as a national example of how cops ought to deal with people enduring a mental health crisis.

That's been a sore subject in Portland. In the 13 officer-involved shootings since January 2010, at least 10 victims had battled addiction issues or were in a mental health crisis.

Portland's outline is fairly detailed. It calls for a 24-hour "triage" officer who, when a call comes in about someone in crisis, would be tasked with checking if that person has a mental health history and deciding whether to send over county workers, Project Respond, or patrol officers. Two clinicians from Project Respond would work all day, taking calls currently handled by 911.

Also, expanding on the bureau's current Project Respond "mobile crisis unit," all three precincts would see a cop and a clinician paired for day-shift patrols.

The proposal has cautious interest from mental health advocates who applaud the police bureau for trying to devise new solutions in the wake of high-profile shootings and an ongoing federal probe of how the bureau uses force against the mentally ill.

Beyond working to send some 911 calls out to Multnomah County (a still-ongoing process), the bureau in recent months has instituted a "walk-away" policy in some cases involving people in crisis and launched a pilot program requiring better documentation of when officers use force.

But advocates also question why police have to step in and do a job—treating the mentally ill—that's supposed to be done by the county.

"The Portland Police Bureau has become our community's most active advocates for additional services for persons with acute mental illness—especially when it comes to launching new efforts," says Jason Renaud of the Mental Health Association of Portland, adding that there are "reasonable concerns about police bureaus providing any routine health care service. When police officers are our front-line mental health service, we criminalize mental illness."

David Austin, a spokesman for Multnomah County Chairman Jeff Cogen, welcomed the effort by Portland police. But he bristled at the notion that it meant the county's mental health system is broken. He pointed to the county's mental health line—503-988-4888—and said a new crisis treatment center that opened last summer, the Multnomah County Crisis Assessment and Treatment Center, had already served nearly 330 people through January 31. After patients are stabilized, they're released to nonprofits.

"That's something that works," he says. "People say the system is broken, but we don't see it that way. It's people not knowing there are resources out there."

Austin did acknowledge that budget cuts have made it hard to build more facilities like the crisis treatment center—and said that at some point, voters will have to step in and decide they want to better fund mental health.

The police bureau wouldn't say much more about the program than what was mentioned in budget documents. Talk of creating a mental health unit in the police bureau surfaced recently at a mayoral candidates forum on police issues that also touched on the federal probe of the bureau, announced last spring. Asked if the bureau was responding to the federal probe, Simpson said it's been discussed longer than that.

"What I can say at this point," he says, "is that [the] proposal captures a number of things that the police bureau has been working toward for a long time."

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