Mental Health & Homelessness: LAPD Chief Moore will NOT disband Mental Evaluation Unit

LAPD Chief Michel Moore will not disband the LAPD-LA County Mental Health partnership, called the Mental Evaluation Unit (“MEU”), which is a support team for patrol officers, under the current reimagining of the Los Angeles Police Department due to the recent hit of significant budgetary cuts.

At the February 4, 2021 Community-Police Advisory Board meeting, the participating community listened to guest speakers from the Mental Evaluation Unit, Senior Lead Officer Jasminka Jursaga, and Los Angeles County Health Licensed Clinical Social Worker, Mr. Ivan Gonzales. They discussed several aspects on their function and listed below are some notes from that meeting:.

• Mental health crisis 911 calls are mainly generated by family members or community members and range from someone who is suicidal, acting bizarre in nature, exhibiting dangerous behavior, or maybe someone in the street who could be hit by a car. The calls are usually urgent where the caller needs an immediate response.

• A range of calls come into the 911 Communications Dispatcher and, after a series of questions, will get coded (see below).

• If a 911 call gets dispatched as a mental illness call, LAPD patrol calls will be the first to respond. These patrol officers will get as much information from the call that was reported. — so information given to the 911 disptacher is CRITICAL.

• The responding patrol officers will arrive and make contact with the person having a crisis. They will complete their investigation and do their assessment. If the patrol officers determine if the person having a crisis fulfills the requires for a “5150 Hold."

• What is a 5150 hold? A 5150 Hold (the “Welfare and Institution Code”) means that someone is a danger to themselves, a danger to others, or gravely disabled due to a mental illness. This is important to remember.

• The responding patrol officers will call the Mental Evaulation Unit (MEU). The MEU triage desk is based downtown and there are three to four officers who man the desk 24/7.

• The responding patrol officers will provide all the information, name, what’s going on, what was reported, any mental health diagnosis, any medication taken, if they’re under the influence. If the MEU unit feels the person needs further assessment, they will dispatch the SMART unit (Systemwide Mental Assessment Response Team).

• Every police department has a response team, the Sheriff’s Department calls it MET (Mental Evaluation Team). Santa Monica PD has one. LAPD has the largest response team - a police officer and a mental health clinician. Clinicians range from psychologists to social workers to psychiatric nurses, family therapists (many different practices with various experiences.

• One of the main questions from the community: Can that SMART team respond without patrol. Unfortunately, no because SMART teams are a support system for patrol officers.

• Sometimes the SMART until will report to people’s residences, out in the field but the majority of the time, they respond at the police station — after the MEU front desk triages the patrol’s report.

• The SMART team police officer will provide transport of the LA County licensed clinician to the police station. The SMART team meets the officers there. do their assessment, and determine whether or not to take over the call from the patrol officers.

• Generally, these types of calls — mental illness/crisis call, from start to finish—can take hours and that means the patrols officers will be off patrol of our communities. In hospitals now, and even before the pandemic, it would take 6-7 hours of wait time to complete just one call when someone is in crisis. So, if patrol is handling that call — imagine a call comes out in Brentwood. The patrol car in Brentwood responds, you now have that car out of the field from 3 to 6-7 hours without another patrol car replacing them. The surrounding patrol cars have to cover calls. So the SMART team is able to take over, stabilized the situation and can finish up this investigation, evaluation and will do the follow-up to the hospital, thus releasing the patrol back into the field to handle more calls. Also, it gives a better level of care because now you have a social worker involved who is able to provide that extra training and support to a person that is in crisis and maybe some additional resources that frankly the police are not able to provide.

• This partnership with a LA County Mental Health licensed clinical social workers, LAPD now has access to different hospitals, LAPD patrols are not only allowed to transport to urgent care or country hospitals, but also are able to partner with the Department of Mental Health. They now have access to hospitals that have psychitratic beds all over the County, and sometimes out of the County (Ventura County, West Covina, etc.) that LAPD patrol officers would not be able to access.

• From there, partners from Department of Mental Health, provide information for follow-up and, hopefully, reduce any additional costs.

• How does someone get a 5150 Hold?

Many times LAPD get calls that someone acting bizarrely or danerously. They see a lot of drug-induced psychosis. When officers and the social worker are writing an application for a 5150 hold, that’s merely what it is — an application — all the reasons why they think this person should be hospitalized against their will for up to 72 hours. The only person who can actually place a person on a 5150 hold is a psychiatric physician.

So many times when you make a call for someone’s behavior, the police respond, and you think they’re going to the hospital (and often times they are) and six hours later, you see that person back out there. As frustrating as it is, the SMART team are not physicians and their evaluations are based not only on information that is given to them, but also from family members and citizens. The SMART team writes these applications based on behavior as well. and since we’re not doctors, we evaluate in the field. Could this behavior be based on mental illness? Could this behavior be based on solely on drugs or a combination of both?

Often times, the SMART team takes the person to the hospital, they submit the 5150 application, and then later find out a person was just high on meth and they were give meds at the hospital that got them off their high and the hospital feels they no longer need to be on a 5150 Hold. Perhaps the behavior is due solely to drugs (and the SMART team doesn’t know this in the field. The doctor has 72 hours to get that person stabilized.When they are discharged from the hospital, they are given information from the hosptial for resources for drug and alcohol abuse or additional mental health services for housing. But there is nothing that doctor can do to make that patient comply.

• What about those individuals who are mentally ill and generate many 911 calls “high utilizers”?

The “CAMP” Unit — Case Assessment Managment Program) — was established in 2005. The SMART team is an officer and a clincian. The CAMP Unit is a detective and a clinician that work for the Mental Evaulation Unit (MEU). So they handle what we call a “high utilizer” for example, I’m working on a high utilizer that has been transported over 150 times in one year by the fire department. Sometimes there is a disconnect because not all systems communicate on one system. The Fire Department has a separate system from LAPD and the Department of Mental Health has a separate system. Currently, there is no “one” system services can access. Sometimes LAFD will bring cases to the attention to LAPD. It’s important to contact our Senior Lead Officers regarding suspected “high utilizers.” Those high utilizers, when they are brought to SMART’s attention, will be referred to the CAMP unit and the work together with the SLOs or with the City Attorney — anything they can do to either get them connected to services, or if there is a criminal case going, assist with that criminal case and try to get them linked to services. Because there are some of the people with mental illness are constantly getting arrested. CAMP can work with the Courts and advocate for that.

• The Los Angeles County Department of Mental Health has their own response to a crises —called ACCESS and they 24/7 — just like the police — but it’s two social workers that get dispatched. Often, family members call, we give them a call and sometimes they don’t want the police to come — they feel that police presense might escalate the situation or they don’t want their family member or loved one feel they’re in trouble — so they will ask if there is another option. You can be connected to ACCESS by calling 911—HOWEVER, you will be told a team will be sent but you will not get an estimated time of arrival (“ETA”).

Click here for the CHECKLIST on questions dispatch officers want to know during a 911 call!

For the MEU LAPD Community Health Resource Guide, click here.

From the LAPD website:

Systemwide Mental Assessment Response Team (SMART)

In 1993, Los Angeles was one of the first communities to develop and implement its police-mental health co-responder SMART program to supplement MEU activities. This program, which is co-supported by the Los Angeles County Department of Mental Health (LACDMH), helps uniformed officers effectively respond to and link people in crisis to appropriate mental health services. As of 2017, they deploy 17 SMART teams on a 24/7 basis.

Senior Lead Officer Program
The MEU Senior Lead Officer (SLO) is responsible for the Police Bureau they are assigned and all of the Area Commands within their assigned Police Bureau. They act as a liaison with the Area Senior Lead Officers to provide an interface between the Area SLOs with Department the community, and Countywide resources to manage mental health related issues or concerns. This includes community meetings, COMPSTAT related concerns, and response strategies.

Case Assessment Management Program (CAMP)
In 2005, CAMP was implemented to help identify, track, and develop customized long-term intervention strategies. The program uses a case management approach to facilitate individuals’ treatment and minimize violence and repeat encounters involving emergency first responders. CAMP pairs police detectives with psychologists, nurses, and social workers from the LACDMH.

Triage Desk
The MEU’s long-established Triage Desk fields calls from patrol officers seeking guidance for managing situations involving people who appear to have mental illnesses. The triage officer consults the MEU database to learn if the person in question has a history of police contacts. A triage mental health nurse sits alongside the officer and can check the LACDMH databases to identify the case manager, psychiatrist, or treatment centers. The triage staff determines whether to dispatch a SMART team or have the patrol officer take the person directly to a mental health facility. LAPD personnel encountering a person believed to be in a mental health crisis must contact the Triage Desk for assistance and provide a detailed incident report. Subjects of frequent calls or interventions are referred to the CAMP coordinator for follow-up. Those follow-up reports and related database have more limited access to ensure privacy protections.

Administrative-Training Detail
The Administrative Training Detail is responsible for conducting the 40-hour Mental Health Intervention Training, which is delivered every other week. The Detail is also responsible for addressing mental health-related topics during training for Field Training Officers, Police Service Representatives (911 operators), and Adult Custody Officers (jail personnel).