Three Things To Read This Week
1. Momentum For Crisis Stabilization Centers Around The Country:
In San Francisco, New Crisis Stabilization Center “Shows Promise in Treating Drug-Fueled Public Breakdowns.” For The New York Times, Heather Knight reports on the Crestwood Geary Stabilization Unit in downtown San Francisco, an “urgent care clinic” showing “early success” treating “people experiencing mental health breakdowns in public.” The unit’s success, Knight reports, “may serve as a model for other communities trying… to address drug addiction and mental health issues on the street.”
The facility is welcoming, “without the patients, [it] could be mistaken for a nail salon… two lines of blue lounge chairs sporting throw pillows and blankets face each other under exposed beams and high-end lighting… There are a couple of small bedrooms, medical exam rooms and a laundry area. Lockers up front store people’s belongings — no street drugs or other contraband are allowed inside.”
The facility is “always open… [and] is always staffed with a nurse and several mental health specialists… [with a] doctor is always on call.” The trained staff “treats patients’ low-level medical needs, prescribes anti-psychotic medication, gives them access to laundry facilities and showers, and provides space to rest… [and] connect people to longer-term help, such as a methadone or buprenorphine prescription to fight opioid addictions or a bed in a residential treatment center.” First responders—“police officers, paramedics and street crisis counselors”—can “drop off people who need help at any time. And as of October, the facility was certified as an “alternative emergency room” by the state, “which means that ambulances can drop people there” now, as well.
The Times also detailed some of the powerful, “heart-rending” stories of people who have had their lives transformed after receiving treatment at the facility:
“There was a homeless woman addicted to methamphetamines who had climbed down onto subway tracks searching for cigarette butts. She hears voices and yells in public without knowing she is doing so… she is now in a 90-day residential treatment program and on medication.
A homeless man, also addicted to drugs, was having delusions related to artificial intelligence and the Church of Scientology, but is now sticking to a treatment plan that includes medical care and counseling…”
The facility opened in early summer “and new data from its first five months showed that 344 people were admitted, and 88 went on to enter residential treatment programs, a higher percentage than other city programs achieve.”
Clackamas County, Oregon Opened A New “24/7 Stabilization Center… To Help People Experiencing A Mental Health Crisis.” KATU News reports that the facility will “help people experiencing panic attacks, hallucinations, or other mental health conditions” and also has “transitional housing options for people facing homelessness.” Clackamas County Chair Chair Craig Roberts explained to Lake Oswego Review that the center fills a vital gap in the public safety infrastructure in the county: “When individuals suffering from behavioral health issues are in crisis … they are many times taken to jail or an emergency room… Neither of these places are equipped to meet their needs. This new stabilization center is a major advance in meeting the need to have a healthy community.”
In DuPage County, Illinois, “Early Numbers Show Crisis Recovery Center Making A Positive Impact. For The Daily Herald, the Editorial Board “applauded DuPage leaders” for opening the county’s new crisis stabilization center, “a specialized facility where people suffering a mental health or substance use crisis can get immediate help,” reporting that “early numbers indicate that it’s making a positive impact…. it’s clear that they made the right move.”
The center, which “serves as an alternative to hospital emergency rooms or law enforcement intervention,” provides treatment to patients experiencing a crisis around the clock with a staff composed of “trained mental health and substance use professionals.” After the acute crisis is resolved, patients are then “connected to community resources for continued support.” The center has only been open for seven weeks, and has already provided care to nearly 400 people in the community, with “steady admissions” for “withdrawal management” services and “adult and youth mental health pods and sobering services.”
2. Study: “Helping People With Serious Mental Illness Hinges On Giving Better Tools And Guidance To Those Who Take Emergency Calls.”
In a new study published in Criminology & Public Policy, Suffolk University sociologist Jessica W. Gillooly and NYU law professor Barry Friedman examine how 911 rules shape public safety outcomes. Drawing on interviews and fieldwork in Denver and San Francisco, they conclude that “these tools, as currently structured, are poorly suited to handle the uncertainty, subjectivity, and ambiguity that characterize many street crisis calls.” Without better guidance, they write, “dispatch staff routinely work around the rules to attain the response they believe is most appropriate.” The full study—and their article about their study published in Vital City—is worth your time, but here some of their key findings:
Rigid Rules Miss The Reality Of Crisis Calls: City leaders, the authors write, “have relied too heavily on coded instructions and rule-based protocols to guide call diversion decisions, without paying sufficient attention to the design of these tools. They have adopted rigid, formulaic protocols that are ill-equipped to handle the uncertainty, subjectivity, and ambiguity dispatch workers routinely face.”
Frontline Staff Are Often Forced To Improvise: “Given that the protocols failed to provide dispatch staff the guidance they needed—and even mandated responses they felt were wrong at times—call takers and dispatchers felt forced to make additional judgments on their own to implement alternative response appropriately… Sometimes, dispatch staff reframed the information callers reported…. to ensure an alternative response was sent when they judged it to be necessary. Other times, however, they gave up on the goals of the new programs, bypassing the protocols and defaulting to the police… In the absence of more thoughtfully designed guidance… call takers and dispatchers sometimes develop workarounds to justify sending an alternative to police response when their protocols would advise otherwise, whereas at other times they retreat into old habits and send the police when unnecessary….”
Smarter Guidance Can Strengthen Public Safety: The researchers call for a “two-pronged approach that dispatch agencies can use to improve call diversion guidance. First, they can refine existing protocols and decision trees by grounding them in the experiential knowledge of frontline staff. Second, they can supplement these tools with more flexible forms of guidance — such as organizational value statements or collaborative decision-making frameworks — to aid decision making when protocols reach their limits. Together, these changes can produce guidance that is more responsive to the realities of dispatch work and better aligned with the goals of public safety.”
3. Cities Turning To Transit Ambassadors To “Enhance Safety And Security” On Public Transportation Systems.
In Olympia, Washington, Transit Ambassadors “On The Bus Routes Enhances Safety And Security.” For ThurstonTalk, Kristina Lotz reports on the new transit ambassador program Thurston County leaders launched this summer to be a highly visible “presence on the bus routes [to] enhance safety and security.” Outfitted in bright blue uniforms, the transit ambassador has a range of duties, everything from:
“[D]e-escalating situations” with passengers having a mental health crisis
“CPR, first aid and Narcan” deployment for passengers experiencing a medical emergency
“[S]upporting the [bus] operator” ensuring that “they can focus on driving safely, while the ambassador assists passengers” with their needs. This includes targeted bus route patrols, “if drivers are having problems on a route consistently, they can ride the bus with that operator and help calm situations and create a better, safer, more efficient transit experience.”
“[W]alking with a passenger and take them from one bus to another in order to help them facilitate an effective transfer.”
“[F]ace-to-face customer service… addressing passenger needs behind the yellow line; and engaging in friendly conversation with bus riders.”
Lois Thomas, a transit ambassador on the team, explained to the newspaper that the team receives regular feedback from passengers that “seeing an ambassador onboard the buses makes them ‘feel better,’ ‘safer,’... They know there is someone onboard focused primarily on helping them have a successful transit experience.”
In Sacramento, California, Leaders “Approves $1M Funding Increase To Enhance Passenger Safety” With Transit Ambassador Team Expansion. For Fox40, Noah Anderson reports on the Sacramento Regional Transit Board “unanimously approving a $1,000,000 increase to its operating budget earlier this week to enhance security services and improve passenger safety” which will expand and enhance the city’s existing transit ambassador team. The funding will “expand the Transit Ambassador team from 40 to 50 employees… hire two additional employees to improve camera monitoring and incident response… [and added] security staffing across light rail trains, stations, and parking lots.”
Roger Dickinson, a Sacramento transit board member, explained to the news station that this Transit Ambassadors expansion “will provide passengers with additional layers of safety… [and is] ‘calibrated to have the right level of response for the particular incident… we want to make sure that everybody is confident that when they ride a train or they ride a bus, it’s going to be a safe and comfortable ride.’”Illinois Lawmakers Pass “Historic” Transit Bill That Creates Ambassador Program Across Public Transit System. The Chicago Metropolitan Agency For Planning announced the passage of the sweeping legislation last week which addresses several long-term public transit priorities across the state, “including the creation of a transit ambassador program to deploy unarmed staff at transit stations and on vehicles across the system.” The new team will “increase safety for passengers and personnel, provide passenger education and assistance” through “connecting persons with relevant social, medical, and other … social services, and community resources to address unsafe conditions,” as well as “liaising with law enforcement” to respond to serious crimes on the transit system, and “help passengers navigate all transit systems” across the state.
