COLUMBIA — In an effort to better handle non-criminal calls, the Richland County Sheriff's Department has been operating a crisis intervention team since February that pairs a deputy with a state Department of Mental Health clinician, who arrive at scenes together.
The duo has responded to incidents such as when a person is suicidal or worries they may hurt someone else at least 70 times in the past two months.
“Being mentally ill does not mean you’re a criminal," Richland County Sheriff Leon Lott said at a Feb. 24 press conference where he introduced the team’s creation. "And unfortunately for too long, it’s been treated that way."
His department, one of the largest law enforcement agencies in the state, is among several in South Carolina integrating mental health response into its daily work.
The Charleston County Sheriff's Office, city of Greenville police department and Oconee County Sheriff's Department all have initiatives of their own, and officials expect those services to be in greater demand following a spike in mental health-related calls through the COVID-19 pandemic.
Richland County fielded 232 monthly non-criminal service calls related to mental emergencies in 2020, compared to 69 a month over the prior year.
Now, when dispatchers receive a call from somebody in the middle of a mental health emergency, Sheriff's Capt. David Soto and a state Department of Mental Health counselor take over.
Soto is currently the only deputy on the newly formed team, so his availability is limited, but Lott is hoping to add more officers, which would also help improve response times in a county that’s 772 square miles.
The team arrives in plainclothes and an unmarked car to help defuse tension.
“There are certain things that are a learning curve for law enforcement, but we're catching up,” Soto said.
The intervention by Soto and the counselor are not done in lieu of arrests. Lott said people who break the law will be punished. But the team could identify people who need treatment and long-term support rather than a trip to jail.
"This pairing allows us not only to respond in a very evidence-based way, but also to provide some preventions so things don't escalate," said Allison Farrell, director of emergency services for the S.C. Department of Mental Health. "We don't want people to end up in jails. We don't want them to end up in emergency rooms unless that's where they need to be."
It can save on medical expenses, since ambulance trips can cost upwards of $600.
The state Department of Mental Health has had mobile crisis units in all 46 counties since 2018, but most of those workers don’t travel to scenes with law enforcement.
“We’re meeting people in the community literally where they are, and sometimes it’s their front yard,” said Denise Morgan, director of the Columbia Area Mental Health Center. “We can provide care and evaluate them right in the community.”
Lisa Broderick, who runs an Arizona-based nonprofit focused on improving relations between the public and police, said programs like Richland County's are a new frontier of law enforcement.
"If you give the police the tools to do a different job, they will do that job," said Broderick, founder of Police2Peace.
Another of South Carolina's biggest law enforcement agencies has placed a newfound emphasis on the interplay between mental health and policing.
At the Charleston County Sheriff's Office, where more than 90 percent of its 900 deputies have received training to handle situations involving people with mental illness, an almost decade-old collaboration with a local chapter of the National Alliance on Mental Illness has brought innovative approaches to law enforcement, said Capt. Roger Antonio, a department spokesman.
Cruisers in the agency's therapeutic response team, created in the early 1990s as a way to transport people to area hospitals, are outfitted with DVD players that can help calm children and others caught in stressful situations. Deputies are trained in methods such as active listening, which relies on non-verbal cues, body language and timing to help avoid conflict.
"Every law enforcement officer deals with people in crisis, and they do so every day, and they do so well, but doing something well doesn't mean that they're doing the best job they can," Charleston County Master Deputy Don Frichtl said in an October promotional video highlighting the agency's work with NAMI. "We're starting to see that mental health services are key. On every single police car you see 'serve and protect,' and how do we get there? We can't get there by doing what we've always been doing."
The city of Greenville's police department launched its crisis intervention team in 2010, and 154 of its officers have completed a 40-hour training course to de-escalate potentially volatile situations, according to information on its website.
Creating a response team in the capital region made sense as the nation begins a gradual return to normalcy after more than a year of quarantines, social distancing and isolation that has increased the number of people in need of mental health care.
“Our world has endured a very stressful event. It's been prolonged. It's resulted in a lot of isolation, economic stress for families, so really, we won't know the effect on mental health until we really begin to recover,” said Farrell with the state mental health agency. “I would expect that whatever we've seen in the past would underestimate the need going forward.”
Early studies suggest that’s true.
A February Kaiser Family Foundation health tracking poll found that 41 percent of adults surveyed at the start of the year reported symptoms of anxiety and depression, compared to just 11 percent during the first half of 2019.
Oconee County Sheriff Mike Crenshaw said practices being used in the state's metropolitan areas can be more difficult to implement across rural parts of South Carolina because of budget constraints and geographic isolation, though police agencies like his are doing their best.
"I do hope going forward smaller counties such as mine and others would have what our larger counties have. I think that's a great thing that Richland County has, but we need that in every county in South Carolina," said Crenshaw, who is also president of the S.C. Sheriff's Association governing board.
Last year, his department won a $560,000 federal grant that will bring a state Department of Mental Health clinician into the Oconee County Detention Center to assist with case management and referral services to treatment courts.
Crenshaw's 115 deputies have all completed 40-hour training courses created by the National Alliance on Mental Illness. It helped to defuse a situation earlier this month that allowed police to get a man into treatment rather than arrest him, Crenshaw said.
"Years ago, people would end up (in jail) instead of getting the help they needed," Crenshaw said. "I think our state wants to move in the right direction, but we've still got a ways to go."
Lott also hopes the work of his team will remove the stigma around mental health — an issue close to his heart because his father waged a lifelong battle against depression, which the sheriff never learned about until he was in college.
“My family kind of mirrored what society is when it comes to mental illness, which is you just don’t talk about it and keep it hidden, which I think is a huge mistake,” Lott told The Post and Courier. “My dad was not a criminal.”
Lott said the expected post-pandemic uptick in non-criminal calls will present more challenges than ever before for law enforcement, and he wants his squad of 700 deputies prepared to avoid tragedy.
NAMI estimates 2 million people a year with such conditions are booked into jails, and the population is 16 times more likely to be killed during police encounters, a 2015 Treatment Advocacy Center report found.
“We haven't had it in Richland County where we've responded to someone in a mental crisis and then we've ended up having to shoot someone, but we've seen it across the United States,” Lott told reporters on Feb. 24.
A 2018 paper by one of the world’s leading law enforcement professional development groups says partnerships like Richland County’s are considered best practice.
“Because it is not possible for officers to diagnose mental illness or understand the degree to which some persons may need professional care in order to avoid violence to themselves or others, use of a trained mental health professional is often a preferred option,” an International Association of Chiefs of Police report states.
Broderick said Lott's department is "tip of the spear" when it comes to this more empathic policing strategy.
"Introducing mobile mental health crisis response is the next wave of compassionate public safety in this country," she said.