How Iowa City police are changing response to people in mental health crisis

Law enforcement officers across the country increasingly are being put on the front line of the country’s mental health, substance use and homelessness crisis.

In many of these crises, officers are the first point of contact for people unsure who to call — other than law enforcement — for help with mental health crises. But are officers, who receive minimal training on how to help those with mental illness, best equipped to handle such situations? Cities increasingly are looking at ways to respond to mental health emergencies that involve more than just sending police.

The Iowa City Police Department recently launched its first-ever crisis co-responder team, pairing an officer with a mental health liaison to de-escalate crises, provide on-scene support and connect individuals with essential services.

Officer Kristie Davis has been with department since 2015. Kelsie Tomlin is a mental health liaison with CommUnity Crisis Services. She has seven years of experience in case management and crisis services, assisting individuals struggling with mental health and/or substance misuse.

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The approach aims to reduce unnecessary arrests and use of force by diverting individuals experiencing mental health crises away from the criminal justice system and toward appropriate mental health support.

The pair respond to a variety of calls, including welfare checks for individuals who may be suicidal, self-harming or have not been in contact with others. They connect people with resources like the GuideLink Center or offer other support based on the situation. Their goal is to provide quicker, more appropriate and compassionate response to individuals in crisis.

The crisis co-response team has been in the works for several years, inspired by models from San Antonio and Memphis. Initial funding came from a state grant, which supported the mental health liaison role. The police department has since worked to mold the model to suit the specific needs of the community.

Similar efforts are going on in other communities, too. For example, Cedar Rapids-based Foundation 2’s law enforcement liaison program supports nine liaisons in eight law enforcement departments: the sheriff’s offices in Linn, Buchanan, Benton, Delaware and Dubuque counties, and police departments in Cedar Rapids, Marion and Dubuque. Besides in Iowa City, CommUnity Crisis Services also provides mental health liaisons to other law enforcement agencies in Eastern Iowa.

But Johnson County Sheriff Brad Kunkel said last month he was canceling an agreement with CommUnity for a mental health liaison shared with North Liberty and Coralville, and said instead the position will be brought in-house to be part of the sheriff’s office.

Iowa City’s team has been operational for about a month. The Gazette recently sat down with Davis and Tomlin to discuss their work.

Q: So how does the team work?

Davis: “The idea is being paired up together, we can respond to crisis calls faster than what Kelsey was able to do when she was by herself. We have a little bit of routine going where we'll hit the streets in the morning, just be ready for calls that pop up that we can respond to — welfare checks, suicidal calls — and hit those right away to take the burden off of patrol.”

The pair also follow up with various individuals in crisis that they’ve helped or interacted with in the past to see how they're doing, and if they need any assistance. Then it’s back to the office to take care of paperwork, “and then we try to hit the streets again after lunch and be in the car ready to go so we can help officers with any calls.”

Q: What are kind of your respective roles, then, with within the team?

Tomlin: “For example, we get called out to an individual who is struggling with depression. We go up, we talk with that individual. If they need to be de-escalated, (Office Davis) is trained in several things, and then so am I. So we're able to show empathy, communicate with this person, working on de-escalating. Where my role comes in is I'm getting that person connected with resources … and following up on those referrals. I typically do that within a day. If it happens over the weekend, I'm calling them on Monday. … I'll check in with them two, three times.”

Tomlin said her role as a mental health professional — rather than a police officer — helps facilitate conversations with people in crisis.

Davis said one of her main roles is to make sure that Kelsie and others responding to individuals in a mental health related crisis, including those in crisis, are safe.

She spent most of her law enforcement career on late-night patrol, specializing in victim and trauma-informed response. She is also a member of the department’s crisis negotiation and peer support teams.

Q: What type of resources and referrals are you making?

Tomlin: “I always let people know about our mobile crisis team here in the area” and the 24/7 national 988 suicide prevention and crisis hotline.

“We send lots of referrals to GuideLink Center,” which offers urgent mental health and substance care, providing on-site assessment, triage, stabilization and follow-up resources for adults.

They’ve also made referrals to domestic violence shelters and to integrated health home services. The latter involves a team of professionals, including family and peer support services, working together to provide coordinated care for adults with a serious mental illness and children with a serious emotional disturbance.

“Iowa City does have lots of resources … and we do have another (mental health) liaison that comes in evenings. And that individual's been around this area for several years. I believe she's been a liaison for just over a year now, and so I kind of bounce ideas off her as well, kind of getting connected with other resources, especially with juvenile referrals and resources, because she deals a lot with that in the evening.”

Q: What are the benefits of having the team? What outcomes have you seen thus far from having this partnership?

Davis: “On the police aspect of everything is to help lower arrest rates and to help lower use of force, where we can contact people who know to help de-escalate a situation (for people) who are in crisis. And come up with a solution that is not going to jail, whether it's going to GuideLink, whether it's going to the hospital or getting them in contact with referrals, so we can bridge that gap and get more individuals to a mental health facility or referral doctors that they would benefit from, compared to going to jail.”

Tomlin: “And just showing that if they're going through a crisis or going through a time where they're like, ‘I can't call anyone. I don't know what to do,’ they can call us and we're coming. … Unfortunately, a lot of people don't have good, positive, natural supports, or they don't know where to go because paperwork is too overwhelming, or they have had bad experience with mental health providers in the past. It's just kind of meeting people where they're at, letting them know, ‘Hey, here's what we can do.’”

Davis: “Also working on just building that relationship with some individuals where they feel comfortable calling us first, or contacting us, instead of calling 911” if it’s not an emergency.

Q: Are there any barriers or additional resources that might be needed to continue to build those relationships and to provide stability to those who are in crisis?

Davis: “One of the benefits would be getting another co-responder paired up with our evening mental health liaison. Some of the barriers are just it's a new program, so we're kind of learning as we go. … And just, you know, getting more people in touch with the resources that are out there. We are limited with some of the resources what they can offer. … Another focus is to help those in crisis just feel less threatened. … Ideally, we would like to have more teams paired up to be able to help more people.”

Comments: (319) 398-8499; tom.barton@thegazette.com