The Police - Clinician Co-Responder Model

Mental health calls to the police can be challenging for many reasons.  One of the primary problems with sending the police is that they are not usually properly trained to handle a person experiencing a mental health crisis.  The past few years have seen shifts from a law enforcement to a service response.  The Co-Responder model melds police officers and social service clinicians with the goal of improving services while maintaining safety for the responders, the public, and the patient.  Dr. Vaughn Crichlow, the dean of the School of Justice Studies at Roger Williams University joins the podcast to discuss his recent study exploring the perspectives of police and clinicians and their perceived impact of the co-responder program.

Main Topics

• Both officers and clinicians bring different perspectives that needed to be understood by each other to develop a successful co-responder program.
• The research uncovered different themes, such as sense-making, collaboration, and safety, that will be important for agencies interested in developing a co-responder model.
• The public believes these programs are important, but there can still be hurdles in their acceptance if they have questions about police legitimacy.
• The co-responder model does not replace the police; it is a collaborative approach to handle these calls for service.

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Transcript

SPEAKER_02 0:13

Welcome to the Police in Service Training Podcast. This podcast is dedicated to providing research evidence to street-level police officers and command staff alike. The program is intended to help the police and law enforcement community create better programs, understand challenging policies, and dispel the myths of police officer behavior. I'm your host, Scott Phillips. While many people believe that a police officer's job includes a lot of crime fighting, the role of an officer is mostly peacekeeping and order maintenance. This can include handling mental health incidents, which make up about 1 to 3% of calls. There are more general public health or medical calls, and these can make up roughly 8% of calls for service to the police. If we broadly define non-criminal and social service related activity, this can take up to 40 to 60% of an officer's time. Most medical calls for the police to deal with people who have a behavioral health issue involved nonviolent incidents. Nevertheless, violence and sometimes deadly encounters can occur between police and community members experiencing mental health crises. These events often lead to calls for better public response and questions about sending someone with a gun to handle a person having a mental health episode. About a year ago, I had a podcast episode that focused on police agencies that were working with social service providers to help people get into drug treatment. The idea was that policing can shift its focus from law enforcement to service. That's the idea of the co-response model in which clinicians are physically located at police departments as an alternative approach for responding to medical health needs of community members in crisis. Embedding clinicians within police agencies is intended to facilitate real-time communications within crisis intervention teams. This approach is relatively new, and an important component to understanding if a co-responder model will work, is understanding if it's accepted by those tasked with making it work. In other words, we need to know the perspectives of those responsible for implementing the program. Joining the podcast to discuss the co-response model is Dr. Von Critchlow. His study, titled Messing Into One: An Assessment of Law Enforcement and Clinician Perspectives on Professional Roles in the Embedded Co-Responder Model, explores the perspectives of police officers and clinicians and their perceived impact of the co-responder program. Dr. Critchlow is the Dean of the School of Justice Studies at Roger Williams University and was the Director of Research at the Institute for Municipal and Regional Policy at the University of Connecticut. Prior to that, he was a professor at Florida Atlantic University. Quite their introduction, everybody, but I want to thank Fawn for coming on the podcast.

SPEAKER_01 3:01

Thank you, Scott. It's a pleasure to be here and join you.

SPEAKER_02 3:04

I was taking a look when I was exploring this, taking a look at your other research, and you've studied a variety of policing topics, including uh community policing, police legitimacy, de policing, and even bodyborne cameras. What drew your attention to the idea of a co-responder model?

SPEAKER_01 3:19

I had started thinking about communities and crime, uh, particularly from the angle of public health. And the fact that a lot of the solutions, or I should say that the public relied very heavily on police for solutions to problems that manifested themselves in a way that may have required a first responder response, often police, that were not typically things that police were trained to handle. And uh and funny enough, um, my colleague Cassandra Atkin Plunk uh you know she she and I had been doing separate projects in South Florida Palm Beach County area, and she got wind of an opportunity to work with the Palm Beach Sheriff's Office. Uh that just received uh a pretty significant grant from the Department of Justice, Bureau of Justice Assistants, and we're looking for a research partner to come in and help them with their evaluation of their violence prevention efforts. Uh it's a was part of a wider initiative built on the pillars of threat mitigation, okay, uh a task force and a public awareness campaign. And so we we we kind of decided to partner together, and well, one thing led to another, you know, and this this this this particular project came out of uh us focusing in on what was going on in the targeted violence unit in their incorporation of clinicians.

SPEAKER_02 4:57

That's often the way it works for us, uh you know, academics. We've we bump into each other, we talk to each other and say, hey, look, I get this idea. Okay, let's go with it. Now, something you mentioned just a moment ago was the idea of whether they're trained well for this or not. I I I often go back to my own training, but the problem is that was a long, long time ago. So I remember there was not a lot. In fact, very little that had to do with any kind of mental health issues of any kinds, and not even close to this. So, okay, that leads nicely into the next uh question of why is this uh area of inquiry of relevance to the police?

SPEAKER_01 5:30

This is certainly relevant to the police, uh, in part because of what you mentioned in your introduction, that there's a sizable portion of calls for service across any police agency that are not crime related uh in terms of maybe the substance of the call, but also in terms of what type of uh what type kind of response is needed at the time. And often there's nothing much for the police to do other than well you you should call X, Y, or Z Social Service to help you with this. Uh there's no one to detain or arrest here, or just simply to have a conversation. Sometimes people just need to talk. Um and and well, while you know many of our police do those things, they are not trained to do some of these things. And if they can invest their efforts in a way that really is more effective in helping those people who need to be helped, as well as being able to address serious crime problems, we'll improve overall efficiency and the community would be happier. So the police want the community to be happier, they want the community to be safer.

SPEAKER_00 6:45

Right, right.

SPEAKER_01 6:45

And and in some cases, feel that you know, there are a lot of things that are happening out there that distract them from what their mandate is. And so uh and then when accusations come in and criticisms, uh the questions arise, you know, well, why don't we get more funding for social services, for mental health services, et cetera? It's not just our fault. So so there's frustration all around as well. And so this was definitely something important to police.

SPEAKER_02 7:14

Right. Uh a colleague of mine, uh, somebody you know, Sean, he had mentioned that he's uh he's fond of avoiding the word law enforcement agencies because they don't just enforce the law, they do policing, which involves you know dozens of different things that aren't actually you know crime related. So so let's get into your study a little bit. Can you tell us the difference between the police-only and the clinician-only models now? How good or efficient are these different models for dealing with calls involving people with mental health issues?

SPEAKER_01 7:41

Let me give you some some context. So I'll I'll answer your question directly, but I I think it's important to note that post-COVID-19, right? Remember those days?

SPEAKER_00 7:50

Oh, yeah.

SPEAKER_01 7:52

Right? That you know, first first responders uh began facing an in many places an overwhelming surge in complex kind of interconnected social problems like homelessness and substance abuse and and even severe mental illness. And so this has made it even more important to consider like what what model works best to address problems in the community. And when we speak of police only models, we're we're we generally refer to traditional policing, which focuses primarily on immediate threat mitigation types of issues and you know law enforcement, uh, take it for whatever you however you wish. Uh officers might receive training in in CIT, that is uh crisis intervention training, uh, but they aren't equipped for long-term case management, which often you know there are individuals out there who may be may be willing to uh uh to enroll in case management or participate in case management. Police don't offer that. Um and so there are some steps that need to happen in order for those people to get the care that they need. Uh so a police-only model will fall short in terms of its its efficacy in addressing those clinical issues, and also in their responsiveness to issues, being able to know what to look for, right? And how to match the need to the response that's needed. Um, and so you'd have a kind of a differential across officers based on their capacity, their their their train their training from prior to becoming law enforcement or their life experiences that helps them to navigate those issues. But it but you tend not to get the standardized types of efficient responsiveness to those types of issues that are not within the traditional scope of policing. So that's where the police-only model tends to fall short. Clinician-only model, well, you you there's there's a safety issue, right? Where uh you know there are there are times where a clinician may be faced with a difficult situation that needs uh uh to be controlled. And police work really well in those settings in terms of control and making sure that their uh the the threat uh is is reduced. Uh it could also be a a disincentive for certain types of situations for a threat arising that clinicians aren't able to do. However, clinicians have the advantage of coming in to folks who might be all the way up here and being able to de-escalate much more much easily. And so they have they have that strength, they have data, uh, they have uh uh uh uh the a host of uh partners that they can connect individuals to and the ability as well to follow up, which often there's there's no follow-up built into a police-only model, right? And so, right? Oh, yeah, I've I've got a thousand things to say as I'm gonna keep my mouth shut. Right. So those are some of the main differences.

SPEAKER_02 11:00

Okay, so what is the co-responder model? Tell us about that approach.

SPEAKER_01 11:04

The co-responder model really what what that refers to is a partnership um between police and clinicians or social workers, and those partnerships can you know, there's a whole range of ways in which that can be implemented or conceived. And it it can involve in uh clinicians embedded within an agency, but it could also involve clinicians that are elsewhere but work very closely with the police, and they and the the two agencies work closely when it comes to training to mitigate risk and to address community problems. Um and the fact is that regardless of what the model is, the actual core response model, it's about people who have received different types of training getting on the same page in terms of how to approach one problem but from different perspectives and ensuring that the outcome is what we that we achieve the outcome that we go in for, that what we're aiming for is what we're able to accomplish together.

SPEAKER_02 12:10

Okay, so I'm gonna skip ahead. Can you tell us about your study? What was the overall goal and how did you uh conduct it?

SPEAKER_01 12:17

Well, the goal of the study uh was it came out of the recognition that there not a whole lot is known about an embedded approach where clinicians actually work in the same agency as police.

SPEAKER_02 12:35

Okay.

SPEAKER_01 12:36

Clinicians or social workers, etc. Uh and certainly there's no qualitative work, right? And qualitative research can be really useful, particularly in an area that where there's just not a whole lot of data to really help in terms of defining the concepts in terms of helping us to understand what does this really look like. And so, as I'd mentioned earlier, this was part of a larger evaluation that was looking at different components within uh violence prevention. And this this large police agency, Sheriff's Office, uh had the resources to develop what they referred to as a targeted violence unit. And within that unit you had detectives as well as clinicians working together, but they they all report to a police leader, a police captain, right? And so it's clinicians in police world, right? So to speak. Uh and we wanted to know more about that and see whether or not we can help in terms of the development of best practices around that.

SPEAKER_02 13:43

All right. So as I I read the findings, I saw you uncovered a few themes, so I want to make sure we hit on each of these themes. The first one was the idea of sense making with respect to an officer's professional identity. Can you dig into the idea of sense making in the various subs sub-themes in that area?

SPEAKER_01 14:00

Sure. Sense making is a process that we all go through and we see it in all kinds of different organizations. We try to make sense of things, right? Uh and in the case of this this unit, almost every detective we interviewed came into the unit completely blind or skeptical, viewing it as kind of soft or hand holding. They weren't too sure. Right? Is this handholding? Is this really policing? Right? Um once once they saw the proactive nature of the work, they completely reframed their professional identities. And as a matter of fact, they became ambassadors, right, for to the rest of the agency, which actually became a good recruitment tool. Sure. But more importantly, um it it wouldn't work unless there's participation across the agency in terms of referrals. You need referrals from uh from uh folks on the street, officers out on on the beach, uh, in in order for this to work properly. And so that there's that that sense making on that side. Um you know, there was a mass shooting that occurred not too far away um uh not too many years before at Parkland uh at the high school there. Okay, yeah. Um, Marjorie Stoma Douglas, officers were highly aware of that failure to properly uh assess a threat that could lead to mass violence. So mass violence was something that was on the minds of many, and it was actually written into the grant as you know, in checking a number of boxes in terms of the efficiency of handling these issues in the community, actually, we're also reducing violence. And here's how, right? And so the sense making of that was was a was an important piece of that, that we can actually share the burden of this as police and clinicians. And the clinicians experience a different shift in that some felt a loss of professional autonomy, right? They they're working with a rigid hierarchy and they spent much more time on case management uh prior, right? And so had to learn about this kind of crisis intervention approach uh and just how to make sense of working together.

SPEAKER_02 16:02

Now, the second theme gleaned from your in uh interviews was the need for good communication. Uh I found I found it a bit funny. You had mentioned the problem of, and I'm gonna quote role-specific jargon, and I found that funny because that's something I'm trying to avoid in all of these podcasts. Anyway, can you explain the idea of uh good communication?

SPEAKER_01 16:20

Yeah, well, speaking of jargon, you know, every every organization develops its jargon, its acronyms, all of these acronyms, and there's an assumption that everybody knows what all of these things mean.

SPEAKER_02 16:31

I've told I've told people they use acronyms, and it's like you'd be better off just talking to me in English because it's gonna take you way too long for me to ask you what the hell are you talking about?

SPEAKER_01 16:40

And it's a shorthand that develops just a it's kind of it it it it makes speaking and communicating much easier among those who've bought in and understand and have that experience. But those who are not part of that core, what are you what are you talking about? So clinicans clinicians struggled uh with the police code, radio, radio acronyms and legal shorthand, and sure, and uh and one of them actually asked, Well, could we have a glossary of terms and a workshop just to understand? And you know, officers looked around like understand what, right? It's kind of like what are you what are you talking about? And so that was just one of the things within communication, extremely important in working together, particularly if there it's unprecedented and there has not been a structure that's developed for communication, right? Right, um, and then different types of expectations around what that communication should look like. Uh and having a workshop. Hey, we should have a workshop. Think about how officers receive that. What are we gonna do? We're gonna sit around and talk and take notes, right? Um, and there's some that'll be with that, and there are others who, well, this is let's just hurry up and get to actually going out in the going out into the community, right? Let's just get to that part.

SPEAKER_02 17:54

I was really interested in the third theme, the notion of collaboration. And the this seems to be something that's growing in policing the policing world more in general, is the idea of collaborating between police and other organizations, whatever it is. Can you discuss this as part of the uh corresponder model?

SPEAKER_01 18:10

Yes, indeed. Um, this this this idea of humanizing the badge, um it's something that police leaders were aware of that they did think about, but maybe didn't have all the tools to to really do that themselves or resources. Um detectives admitted that years on the road had made them hardened or desensitized. So there's an introspection that was a part of the sense making, right? Uh and we found that in conducting the interviews that this was an opportunity for them to unpack some of these things.

SPEAKER_02 18:49

Okay. Yeah.

SPEAKER_01 18:50

Some things that maybe they had not unpacked. And so, of course, as a researcher, you want to maintain that that uh distance, but there was also those sessions being used as an opportunity to make make sense of what I'm doing here as a detective, as a as a as a sworn law enforcement uh officer. So they found that having a clinician present reintroduced empathy to the to the scene, right? Because they the clinicians would talk about that. We're talking about what about the family members that are present? Are their kids there?

SPEAKER_02 19:20

Yeah, right.

SPEAKER_01 19:20

Are you thinking about what's happening with them? While if there's a commotion or conflict happening, are you thinking about all these other folks that are are affected? Not just in terms of their immediate safety, but what are what about the trauma? Right? So th this notion of of breaking down barriers with families and suspects alike, um, it helped a great deal in the sharing of insights around that uh to help to make the police better, right? Uh not that they would be not that the police would become clinicians, but that the police would become better able to utilize the services that uh clinicians can provide, and as well as the uh coordinator uh uh health healthcare coordinator that uh worked with this program to divert these individuals into their respective uh paths of service.

SPEAKER_02 20:15

There's a lot going on there that I can probably dig into if if I had more time, which we unfortunately don't, but that was interesting the way you said that. You know, humanizing the badge is part of this. That's why I made a note about that. Um the the last theme, which I think is still important, is uh you even though you say I think you saved it because it this is something in the article I saw as really important. I thought maybe this would come first, but I think if it had come first, people might not have read the rest of the article. But it was the idea of safety. Can you expand on that?

SPEAKER_01 20:46

You're right, Scott. Uh with without safety, the whole model collapses, right? Um police carry the immense psychological weight of uh protecting uh the civilian clinicians, right? And this this this was this is something that uh is discussed uh among law enforcement when the idea of some sort of a collaboration or embedded model is is introduced. Um some of the the detectives shared that uh it would be the nightmare scenario if a clinician caught a right hook on a home visit. That that one guy actually said that. Right. And uh so to mitigate this, they they develop strict operational boundaries, right? There are conversations out there about clinicians carrying weapons, right? But that's not the case in this agency at all. Um you still continue to be a clinician. I'm police, you're a clinician, right? But this is how we work together, and together they were able to develop uh protocols uh around when to enter an active scene. Well, never, right? Cops secure the location, de escalate the immediate physical threat, and only uh invite the clinician. Forward once it is safe. It even involved there were there were tactics involving clinicians driving in a separate vehicle. So they aren't trapped waiting at a scene if an intervention turns into many hours. It could be many, a many hour criminal investigation and all of this. Those logistics had to be worked out. Well, everybody has to be safe. Police have to be safe when they're going.

SPEAKER_02 22:51

So just to summarize, the the co-responder model is not trying to figure out a way to replace, okay, down the line the police, if it's a call, if it's a mental health call, we're not going to send the police anymore, we're just going to send the clinicians. This is a a true co-responder model. If it's something, then the officer goes, does a quick assessment, if it can be quick, and then says, okay, here and he kind of hands it off to the clinician.

SPEAKER_01 23:16

Is that reasonably accurate? Absolutely. A corresponder model does not involve the replacement of police. That that that is that is an another that's another type of phil philosophical approach to crime and community. And the you know, there have been you know, from time to time, it seems like every every couple decades there there's a movement uh that that's probably comes out of a flashpoint with community versus police, uh, usually with some sort of uh officer involved shooting. Uh and you'd get things like defund the police, concern about the treatment of black and brown individuals, in particular youth, uh, in in these these communities, some communities that are highly criminogenic, or in some cases, depending on your perspective, over policed. And so this idea that, well, we we need to replace we need to replace police with something else, that's another conversation uh that is not within the paradigm of co-response. The the paradigm of co-response, uh, which which I happen to believe through through studying these issues is a response that the actual communities that are being served can get behind. I I've not met community members, uh, particularly in areas where there have been you know high high crime, high-index crimes that want police to be abolished, right? And of course you have the abolition abolition movement and from a scholarly perspective, an activist perspective, um, to be fair to them, they're not always meaning that we shouldn't have police at all, but it gives that impression, yes, right, in terms of how it re how it's received, right, right, particularly by police, right? But these these communities, they're not asking. I've not met, I I should say that I have not met a community member in the work that I have done who has said that I wish that we did not have police. Right? I wish that we could replace this with something else. Maybe aspirationally, kind of I wish we didn't have crime so that we wouldn't have a need for police. But you do need uh a law enforcement response in certain there's certain situations where it just would not you would not be able to mitigate threat without it.

SPEAKER_00 25:45

Right.

SPEAKER_01 25:45

But police uh should work in partnership with the wider community and all of the resources and other agencies that are involved, and often there's a there's a disdysfunction or a lack of collaboration that leads to police being on the front line and being asked to solve society's problems. That's the perspective that I, you know, that I come from uh when up when approaching this. And the corresponder models offers uh a workable solution in the midst of all of these disagreements and conflict that I think that community, and notice I'm saying community, I'm not I'm starting with community, that that community in all its forms can get behind, that you can get support around the table. Yes. Uh we would like we would like for there to be uh clinical response as well. We would like social workers present. We would we want our community members to know that there are services that exist. And there are hurdles to get over, Scott, in that in some of these places, uh police legitimacy perspectives or the police are not perceived as as being trustworthy by all, right? Right? Are not perceived as you know, there's a kind of a well, we need them, but I don't know if I trust them, right? So so the notion of police offering clinic clinical services, right? That might be surprising to some community members, right? And it takes kind of time to adjust to that. But it can also, this was beyond the scope of our study, but kind of looking ahead, it can it can help in terms of improving trust if you know that. Oh my goodness, the police are actually trying to do this in a way that really helps us. Maybe I should start trusting them more.

SPEAKER_02 27:30

Well, Vaughn, this was really interesting information, uh, particularly again that the idea of the uh the collaboration, uh it's not new, but it's different and a different approach to doing things. And as you were just saying in the in the conclusion you were giving, the idea of the community getting on board this and maybe if they if the community sees an improved response in at least some of these areas, then they will see the police as more legitimate even if they're still having a tense relationship with the police in some of those areas.

SPEAKER_01 28:02

Yes, I agree. Uh and and that improving trust is a difficult task, very challenging task. If it was easy, then there'd be just a whole lot more trust in the in the police.

SPEAKER_00 28:14

Right.

SPEAKER_01 28:14

Because police do want to be trusted, right? Um, and respected, of course. So respect and trust going hand in hand. Uh but it's it's easier to measure the trust. You know what it looks like, and you can create metrics to measure it. It's easier to measure the trust than to measure whether or not we're reducing uh potential acts of violence that could have happened. No, you're you're you're 100% right. Right, right, right.

SPEAKER_02 28:41

Trying to study those things that didn't happen. But uh again, if you're if you make if you're finding an improvement in this area, you and if there's more trust and more calls to the police to handle these things, then that you can actually measure those things. Vaughn, we're we're just about out of time, but again, I really do appreciate you coming on the podcast to uh talk about the uh uh the co-response model. This was good information.

SPEAKER_01 29:01

Thank you. I enjoyed it. Uh I look forward to talking to you again.

SPEAKER_02 29:05

Uh all the best. You have a great day. Take care. Thank you, Scott.

unknown 29:08

Yeah.