A new lifeline for mental health emergencies-healthcare blog


Ben Whitley

Miles Hall, a 23-year-old black man with a mental illness, was shot and killed by the police after receiving a call from riots near Walnut Creek, California on 911.Tauern Hall Measures taken Warned the local police that her son was diagnosed with schizophrenia and may have a mental health crisis. She believes that she has done enough to ensure that her son will be taken care of in the event of a crisis. But when the crisis came, the authorities viewed Miles’ behavior from a public safety perspective rather than a mental health perspective, which cost him his life.

June 2ndIn 2019, on the day of the shooting, Miles believed he was Jesus.He believes that a large iron gardening tool similar to a crowbar has been God gave himBut according to police reports, Miles used a crowbar to break the sliding glass door of his parents’ residence. 911 received a call from his grandmother, she said Miles threatened her, and his mother said he was Rough behaviorOn the phone, they all reiterated that Miles had mental health problems.

In addition to phone calls from family members, nearby residents also called 911. A resident said that he could hear “arguments and possibly gunfire.” Another said that a man wearing a red bandanna on his head and face, “holding a huge crowbar in his hand,” kept knocking on his front door.

After receiving the 911 call, the police rushed to the scene.this Police report Said, “Officials have repeatedly ordered Mr. Hall to put down the crowbar. [However,] Mr. Hall ignored these orders and ran towards the police officer with a crowbar in his hand. “They first shot him with a bean bag, but when he didn’t stop, they shot him with a pistol.

June 2 eventsnd2019 constitutes a mental health emergency for Miles Hall and a public safety emergency for those around him. However, a series of incidents involving 911 calls and police dispatch determined that his case will be completely regarded as a public safety issue. The deadly force used by the police was seen as an appropriate response to the threat posed by him.

A lawyer for the Hall family said that a police officer who had dealt with a mentally ill person and who “knowledged Mr. Hall very well” was on his way to the scene. “but Instead of waiting for her In order for her to help him calm down, the police officers approached him actively and drew their weapons. ”

After the shooting, the police chief said: “My heart is with the family of Miles Hall. This is the result that no one wants to happen. “In September 2020, Walnut Creek City agreed to pay the Hall family $4 million settlement As compensation for losing his son. No official He was charged with a crime in a shooting case.

This family has established the Miles Hall Foundation and is working hard to ensure that other families will not face similar situations in the future. “We really want to see Non-police response Received a mental illness call,” Tauernhall said. For its part, the police expanded its Crisis Intervention Team, The goal is to get someone to deal with mental health emergencies around the clock.

988 for mental health emergencies

In October 2020, the federal government enacted legislation Build 988 As a national number dedicated to the mental health crisis. According to the law, a call to 988 will be connected to the National Suicide Prevention Hotline (800-273-TALK). Like 911, the new number will be implemented at the state and local level. The federal government stated that by July 2022, every jurisdiction in the country will need to open 988 routes.

Federal law allows states to raise funds in the following ways Impose a surcharge Monthly bills for mobile and landline phone services. This money can be used in a variety of ways, including supporting dedicated call centers, paying for well-trained mobile response teams, and providing more stable services for people in crisis. Telecommunications company It has been argued that part of their funds should only support the call center and not the other components of the response.

The California Department of Health Care Services has announced that it will Invest 20 million US dollars Support the opening of a new 988 hotline in the state. The legislator Rebecca Bauer-Kahan said: “Miles Hall Lifeline and Suicide Prevention Act A new three-digit telephone number 988 will be developed and designated as a universal number to request an appropriate response to an emergency mental health crisis. With 988, callers will be connected to 24/7 interventions, including mobile crisis teams composed of qualified mental health professionals and well-trained counterparts, rather than traditional law enforcement responses. She said: “Mental illness is a health condition, not a crime. Health practitioners should respond to crisis calls, not law enforcement. “

A well-known and highly regarded model of this type of response is called CAHOOTS (Street Crisis Assistance) and is based in Eugene, Oregon. The plan includes mobile crisis teams that work closely with local police to assist in non-violent cases, such as cases involving homeless people in need and people who overdose or are drunk. These are cases where the police are not well-trained, and in many cases, would rather Does not participateHowever, CAHOOTS will not immediately resolve violent situations or cases involving potential weapons. In these cases, The 911 dispatcher sent the police to the scene first, The police issued “Full Qing“Before CAHOOTS members approached.

In May 2020, George Floyd was murdered and “Cancel funding for the police“Sports happening across the country. There are serious concerns 25% of shootings involving police officers Involved People with signs of mental illness. However, public safety is clearly still a core issue. Most people see the need To maintain the presence of the police.

Make 988 work

In order to work, 988 needs to resolve (and eventually reconcile) two very different situations. In one case, the person in distress calls for help for himself (suicide helpline model). In another case, people who are afraid of other people’s weird behavior will call the police for help (911 model).

The existence of 988 by itself will not alleviate public safety issues. The 911 operators and police saw Miles Hall as a potential violent, wielding a 5-foot-long sharp weapon, not a suicide risk. Miles did not call on his own behalf. The neighbors (and the family themselves) hope to use some power to restore peace to the chaotic situation. But the family expects to use force with compassion, focusing on easing the situation. To quote the National League of Mental Illness (NAMI), there are situations that require “Help, not handcuffs. ”

In responding to mental health emergencies, personal safety is the core issue.This applies to Each participant, Including family members, neighbors, strangers, people in crisis, and the police themselves. The members of CAHOOTS began to realize that when they arrived at the scene, their first step was to ensure that the situation was as safe as possible. The Eugene police chief once stated that CAHOOTS “has a tendency to ease the situation almost immediately,” and this is its “Secret sauce. “

Solving the needs of people in a mental health crisis involves care and control. The long-standing close working relationship between CAHOOTS and the Eugene Police Department illustrates this point. David Zeiss, co-founder of CAHOOTS said, “Cooperate with the police Has always been essential to our model. A CAHOOTS-like program that is not closely related to the police is very different from anything we do. For a society without police, I have no coherent vision. “

But the question left to us is: what should we do with 911 calls involving potential weapons or violence? Miles Hall is not the first mental patient to use a potentially lethal weapon, nor will he be the last. To ensure that downgrade steps are taken, the 988 must be combined with the 911 response. Dialing 988 will remind the respondent that the person posing a threat is someone in a mental health emergency and it is still possible to avoid tragic mistakes.

Ben Wheatley has 25 years of health policy work experience, having worked in organizations such as AcademyHealth, the Institute of Medicine, and Kaiser Permanente.



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