When 911 Is The Only Option For A Mental Health Care Crisis

Family members of people going through a mental health crisis are sometimes reluctant to call the police out of fear for their loved ones. Violent behavior and outbursts can be met with lethal force. 

Mental health advocates are hopeful though that a new co-responder program – that pairs responding Cleveland police officers with social workers -- may help.

The program is the result of a court order that also mandated de-escalation training shortly after the death of 37-year-old Tanisha Anderson, who had a mental illness and died in Cleveland police custody in 2014.

However, there are still families in communities, outside of the city of Cleveland, who are worried about calling 911 for help when faced with a mental health crisis.

Shaker Heights resident Neil Greenspan’s 35-year-old son has autism and sometimes has outbursts or can’t control his emotions. Greenspan is often forced to call the police to help.

“I don’t want the police at all,” he said. “I don’t want them to be the ones who are chosen to come. I don’t want people coming with guns and a tough guy attitude because they’re not going to be helpful.”

The Shaker Heights police department has received crisis intervention training through the Cuyahoga County Alcohol, Drug addiction, and Mental Health Services (ADAMHS) Board, said Carole Ballard, director of education and training.

Shaker Heights police officials did not respond to a request for an interview about the training.

Despite this training, Greenspan said he still has issues with the way police treat his son.

“They have these so-called crisis intervention teams, but as a general rule, police do not have the requisite training,” Greenspan said. They do not have the educational training to appreciate the medical complexity. They do not have in some cases—and I emphasize it depends on the officer—the personality, the empathy, the patience, or the time to perform the necessary tasks.”

Calling the police may put his son in danger, instead of helping him, Greenspan said. 

Recently, the way all police departments respond to people with mental health issues and developmental disabilities has gained national attention and prompted calls for a different way of handling these situations.

A Philadelphia family is calling for police reform after they called 911 and asked for help last month. Within one minute of police arrival, officers killed Water Wallace, Jr., a 27-year-old Black man who had mental health issues. Police officials have said he ignored commands to drop a knife.

The family said they wanted an ambulance, not police, to come because Wallace was having a mental health crisis. 

Greenspan is also concerned about the safety of his son when he is having a mental health crisis. Greenspan sometimes needs help when his son is having an outburst, but the only option is to call 911, he said.

“There is no one else to call, in that setting. If you call any hospital, any doctor’s office, any county agency, any state agency, almost anyone, really. They will say if it’s an emergency, call 911 or go to the ER. We’ve tried both of those options many times, but there is no one else to call.”

There are resources available to Greenspan, like a crisis hotline and a mobile crisis unit available to everyone in Cuyahoga County, but Greenspan said those services have not worked for his family.

“They will not come out to our home, particularly at night,” he said. “Their focus seems to be suicide prevention and opioid issues, and they don’t know how to talk to my son, of course, no one has really figured that out, and so there’s no place else to turn.”

Since Greenspan lives in Shaker Heights, he won’t be a part of the new Cleveland co-responder program, which will bring social workers and those trained in crisis intervention to the crisis after the police have assessed the situation, said, the ADAMHS Board's Carole Ballard.  It is important to have police respond first to protect the social workers, she said.

Stories like Greenspan’s family situation are common. But many times families wait until a situation has escalated to call for help, Ballard said.

“Families are very uncertain and feel very, very nervous about making that call,” she said. “In fact, a lot of times families wait until the very last minute to actually call, because they’re trying to get other family members or other people to help. If the family can’t do it, or the situation has reached over their head, they make that call, but they are very scared to make that call.”

She hopes families will start to make emergency calls for their loved ones sooner, before the situation gets out of control, so a crisis intervention team can help.

The ADAMHS Board is helping the Cleveland Police Department develop its co-responder program. They are also facilitating de-escalation training for many other police departments in the Cleveland area. Police want this training because one in every ten 911 calls they are sent on is connected to a mental health issue. Ballard said

“So police departments, what they’re realizing, is that more training is always going to be helpful, but they also realize they’re not social workers. They’re not case managers, and so that partnership is really important,” she said.

Cleveland’s co-responder team is five programs, according to information from the Cleveland Police Department. There is one team for each Cleveland neighborhood district. Those teams will follow up with 911 calls, crisis intervention reports, and high-risk mental health calls to get people needed help and resources.

The consent decree, which was ordered by the courts because of excessive force allegations against Cleveland police officers, mandated increased training to help officers learn to help people in the midst of a mental health crisis.

The ADAMHS Board is also helping to craft new training and policies to satisfy the terms of the consent decree.

“This model has been very beneficial in our county, to departments both large and small,” she said. “We find that when we communicate together, we can solve problems together, and not only is the division of police doing that a lot more, but our area police departments throughout Cuyahoga County as well," Ballard said.

The ADAMHS Board has been working with departments throughout the county to find gaps in coverage and to make sure families can find the resources they need, Ballard said.

While he is still searching for help for his son during times of crisis, Greenspan is hopeful that programs like Cleveland’s co-responder program, and programs in other cities and states, can help someone else’s child or family member.