Key to Success

Sarah Abbott-Carr

 The goal of the Jail Diversion program is to divert persons with mental illness, substance abuse, developmental disabilities and other behavioral issues from the criminal justice system to appropriate services within the mental health and substance abuse treatment systems. The program accomplishes this by cross training police and psychiatric emergency staff; providing clinical assistance when police intervene in disturbances involving emotionally or psychiatrically troubled individuals; coordinating a monthly meeting between the criminal justice and mental health systems; and making appropriate referrals to mental health services. Clinicians are available to the police 24 hours a day, seven days a week to assist police on call outs to individuals exhibiting signs of mental distress, provide assessments on-site or at the police station and to deliver rapid access to community mental health, substance abuse and psychiatry services.
  Through collaboration with local service providers, the program includes the following components:
  Advocates Psychiatric Emergency Services (PES) provides two Police Liaison Clinical Responders, who will spend 20 hours/week at the Framingham Police Station.
  Wayside Family services provides a Police Liaison Clinical Responder for situations involving children. South Middlesex Opportunity Council provides a Police Clinical Responder for situations involving persons or families who are homeless.
  PES provides on-site evaluations at the Framingham Police Station and lock-up.
  The Negotiation Team of the FPD Crisis Intervention Team is closely coordinated with the Psychiatric Emergency Service to ensure rapid access to psychiatric consultation during hostage, barricade and other situations.
  A monthly Clinical Integration meeting with the FPD, PES clinicians, mental health services providers, the local hospital emergency room staff, and clients and other representatives of the criminal justice system as appropriate. The purpose of the meeting is to develop pro-active crisis plans for repeat offenders, and share information.
  All first-responding officers have been trained in basic crisis intervention techniques.
  A group of supervisory officers and Dispatchers have engaged in more advanced training on topics in dealing with individuals with mental health problems.
  PES clinicians have attended an 8-hour training in assessing and assisting police in joint call-out situations.
  Protocols have been developed and put in place for dispatchers and first-responding officers to identify individuals with mental illness and to triage the person to appropriate resources.
   

  Dispatchers have been trained to recognize the behavioral signs of mental illness and substance abuse. Police Liaison Clinical Responders are at the police station or the dispatcher is able to reach them instantaneously via a Nextel phone that the Responder carries as a pager.
  The key to the success of the Framingham model is the close partnership between trained clinicians and street police officers. These dedicated clinicians are based at the Framingham Police Headquarters and accompany responding officers on police calls where their specialized training would be of assistance. Clinicians also do proactive outreach work to identify people in the community who need mental health or other support services. Clinicians are available to the police on a 24 hour basis to provide immediate on-site assessments, crisis counseling, and mental health assistance. Through their extensive contacts, they provide rapid access to community mental health, substance abuse, and psychiatry services.
  In addition to the immediate response component, the JDP collaborates with SMOC and Wayside by cross training police personnel and psychiatric emergency staff. Mental health training is fully integrated into the Police Department’s in-service training program.    Officers receive training on signs and symptoms of mental illness and de-escalation techniques. Protocols have been established for dispatchers and first-responders to identify individuals with mental illness and to triage the person to appropriate resources. The JDP is also available for death notifications, well being checks, and other valuable community based mental health services.
    A monthly Clinical Integration meeting occurs between the Framingham Police Department, PES clinicians, Department of Mental Health, SMOC, Wayside, the local hospital emergency room staff, clients, and other members of the criminal justice community. The purpose of the meeting is to develop pro-active crisis plans for repeat offenders, share information and develop resources.
The FJDP has been a tremendously energizing program for both law enforcement personnel and behavioral health professionals as it demonstrates on a daily basis how these usually disparate disciplines can form a real and effective team. As Sgt Mike Esposito, Framingham PD says, “I work on the street and I know this program works – I see it every day.” In this way, the team has provided superb leadership – and role-modeling – for both professions in forging a new path toward dealing effectively with mentally ill individuals affected by the criminal justice system.
  The program has also been inspirational to politicians responsible for allocating scarce resources, as they understand the tremendous savings achievable through collaboration between police and mental health professionals – savings achieved through avoiding useless, expensive “merry-go-around” arrests, over-use of expensive emergency room services, and wasted police resources providing security back-up in emergency rooms. Thus the program has provided political leadership toward paradigm-breaking partnerships that both save money as well as reduce harm and suffering.