County's mental health crisis team expands into west county – Sonoma West

Who would you call if a loved one had a psychotic break? Many people’s first impulse is to call the police, but in high-profile cases in Sebastopol and around the country, a visit from law enforcement has sometimes ended in the death of the mentally ill person they’d originally been called to help.

When The Washington Post analyzed 462 police shooting deaths nationwide in the first half of 2015, they found that one-quarter of those deaths involved people “in the throes of emotional or mental crisis.”

That’s why Sonoma County created the Mobile Support Team, a crisis response team of trained behavioral health professionals who accompany police to calls involving people experiencing mental health emergencies.

The Mobile Support Team was the brainchild of 3rd District Supervisor Shirlee Zane, a former therapist who is well known for her advocacy of mental health.

Zane began advocating for the creation of a Mobile Support Team as soon as she became supervisor in 2009, inspired in part by the shooting death of Sebastopol teenager Jeremiah Chass, who was killed by two Sonoma County Sheriff’s deputies during a mental health emergency in 2008.

“I thought, ‘Why are we expecting law enforcement officers to be therapists?’” said Zane, who had worked with law enforcement as an on-call therapist for runaways through Social Advocates for Youth. “That’s not what they’re trained to do. They’re not hardwired like a therapist at all.”

Working with law enforcement, health services and mental health advocates, Zane helped launch the Mobile Support Team in Santa Rosa and Windsor in 2012. In 2015, it expanded into Rohnert Park, Cotati and Petaluma. Last week the program expanded into west county, including Sebastopol, Graton, Forestville, Rio Nido and Guerneville.

 “It took my first four years as supervisor to launch the Mobile Support Team program,” Zane said, “and it is wonderful to see it grow to include more areas in the county.”

Sonoma County’s Mobile Support Team consists of six full-time behavioral health experts — two drug and alcohol specialists, three therapists and one social worker. They work a swing shift from 1 to 9 p.m. because that’s when the majority of mental health calls come in.

According to Karin Sellite, who manages the program, the Mobile Support Team was involved in over a thousand encounters last year.

Concerned family members can’t call the Mobile Support Team directly, however. The team is set up to act as a support for law enforcement; the responding officer has to make the choice to call them in.

“Law enforcement calls us whenever they think we’d be useful,” Sellite said. “They go out first, and we meet them there.”

Lt. Adrian Mancilla is the liaison between the county sheriff’s office and the county’s behavioral health department.

“Sheriff’s deputies are always the first people on the scene,” he said. “We make the first contact with the people who need help, and it’s our job to diffuse the situation and make sure there are no weapons involved. The Mobile Support Team comes in behind us after the scene is secured to talk to the people and get them the help they need.”

“Mobile Support Team members always go out in teams of two people,” Sellite said. “The officer briefs us on what they know. Then one of us will talk to the person in question, while the other team member gathers information from family, friends or neighbors.”

“We have a standard crisis assessment and violence risk assessment that we do,” Sellite said. “After talking to the people on the scene, my two staff members come back together and share information and decide what to do.”

Between a quarter to a third of the time, Sellite said, team members decide that the person is a threat to themselves or others and invoke a 72-hour involuntary psychiatric hold, known as a 5150. They write the order for the hold, then law enforcement transports the person to the crisis stabilization unit on Challenger Way in Santa Rosa.

“If we don’t do an involuntary hold, then we talk to them about what the plan is,” she said. “We do a lot of talking about how to get through tonight and who can you talk to tomorrow. Do you have a doctor, a psychiatrist, a therapist you can get in touch with? If not, we get them in touch with those services.”

“Back at our office, we write up assessments,” she said, “and, with the individuals’ permission, we share those assessments with people’s treatment providers so they know what’s going on with their clients. And then we do follow-up.

“Because we’re seeing people in crisis, we call them the next day and a couple days later and ask them how they’re doing and if they’re following through with the plan we made and if not, why not? Do they need more resources or more help getting connected with services?”

According to Zane, the Mobile Support Team program was founded on the skinniest of budgets, but now has three sources of funding: the California Mental Health Services Act (Proposition 64), a tax on luxury items over $1 million which California voters passed in 2004; the Mental Health Wellness Act of 2013 (SB82), which provides grants for mental health crisis services; and a special allocation from the Sonoma County General Fund.

While the main purpose of the Mobile Support Team is to get those experiencing behavioral health emergencies the services they need, the program also reduces strain on law enforcement and prevents individuals in crises from impacting the jail system.

“The County’s Mobile Support Team has been a great mental health resource for our deputies in the field, handling crisis situations,” newly elected County Sheriff Mark Essick said. “I’m very excited to see the expansion of these services to new areas of the county.”

Mancilla said that, although all sheriff’s deputies take a 32-hour crisis intervention training, most officers are happy to have other professionals on site to help out.

“They make our job so much easier,” he said.

Zane agrees.

“It saves valuable man-hours for law enforcement, and it’s another valuable tool that law enforcement has in their tool belt to do their jobs better and to save lives,” she said.

It’s hard to measure how many lives the Mobile Support Team has saved. No one keeps records on suicides and police shootings that don’t happen.

“I know it’s making a difference,” Zane said. “In the very first week after it started, I was at a ribbon cutting and a woman came up to me and said, ‘I just want you to know that you saved my client’s life. He was having a psychotic break, and they called 911. I honestly believe that he would have killed himself or been killed had the Mobile Support Team not come out, talked him down and gotten him back into therapy.’” 

“Providing the right intervention at the moment of crisis is so important,” Zane said. “It can change somebody’s life. It can literally save a life.”

To learn more about the DHS Behavioral Health Division’s Mobile Support Team, go to https://sonomacounty.ca.gov/Health/Behavioral-Health/Community-Response-and-Engagement/Mobile-Support-Team/.