A System In Distress: Reevaluating Montgomery County’s Mental Health Crisis Approach

Community Reports – Anonymous Submission

December 11, 2023

Councilmember Shares Crisis Response Gone Wrong

“Let’s be honest with the public. If you don’t want the police to come, don’t call MCOTs.”

This was the public yelp-like review from Councilmember Kristin Mink during the November 29th EC/HHS/PS Joint Committee Worksession. MCOTs are the mobile crisis outreach teams that have been proliferating across the country through a program called Crisis Now which has been Federally-recognized as the science-based, real-world tested best-practice guidance to  behavioral health crisis.  The MCOTs component are behavioral health teams that make “house calls” with the intent to divert mental health and substance use crises away from a police response.

Getting emotional at times, Mink’s statement followed her sharing the story about a constituent who was evicted from his home and also had mental health concerns. A neighbor and Mink’s staffer called the MCOTs and waited several hours for its arrival. It came. But accompanied by three police cars who took the man, exhibiting no violence, away in handcuffs. From Mink’s testimony, it appeared that the MCOTs staff even assisted the police in encouraging the handcuffed response.

According to Sharon Dietsche, Executive Director for the Montgomery County Chapter of the National Alliance on Mental Illness (NAMI-MC), “unfortunately, the incident that Councilmember Mink described is not unique and is yet another example of what is wrong with our current crisis response system. “  However, Dietsche still advocates for the MCOTs approach noting that it has “significantly reduced police encounters in many communities across the US including New Mexico, Denver, and Washington. Rather than dismissing the MCOT approach for some crisis responses, we urge Montgomery County’s health system and elected officials to redouble their investment so that a mobile crisis team takes the lead in every response to a mental health crisis. “

Montgomery County Health Services staff were sitting at the panel table when Mink shared her story. Moderately MOCO reached out to the County’s Chief of Public Health Services, James Bridgers for any comments, specifically on follow-up efforts since the November 29th hearing.  However, no response has yet been received.

New Bill Focused on the Police-Clinician Co-Response Approach

A few days after Mink’s public statement, her colleague, Councilmember Dawn Luedtke, introduced a bill to establish crisis intervention teams (Bill 43-23) intended to better coordinate the police/clinician co-response to mental health calls. Luedtke notes that nothing in the bill eliminates, supersedes, replaces or otherwise interferes with the Mobile Crisis Outreach Teams’ clinician-only responses. Rather “CIT adds another option in a menu of options for response.”

In her response to the legislation, Dietsche cited the 2019 CIT (Crisis Intervention Team) Guide developed by CIT International and NAMI which cautions against the use of an “embedded co-response” (law enforcement with mental health professionals) approach for CIT implementation.

Dietsche notes that the CIT approach “often deters individuals from calling for help due to fear of the police officers and concern for potential arrest” and that “law enforcement policies often dictate the response.”

A social worker by profession who has done frontline clinical work with adolescents, Diestche cited the example that police department policies typically require any person in crisis to be handcuffed regardless of whether there is any true need for such restraints.  She also noted that “embedding co-response approaches can often be severely traumatizing for the person in crisis, add to mental health stigmatization, and further reduce the possibility that the individual or family members will reach out for help when crises arise.”

 The hearing for Luedtke’s CIT Bill is January 16th.

Moderately MOCO reached out for comment from the County’s Department of Public Health, Councilmember Mink, Councilmember Luedtke and have not received comment at time of posting. We will update this article with any additional comments received.

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