This article and photo first appeared in the Vail Daily on June 23, 2020.
In Avon, the standard response to 911 calls for mentally ill persons once required transport of the patient to Grand Junction, Boulder or Denver by two uniformed police officers.
It could take an entire eight-hour shift, or more, on a snowy day. In a small department where there might only be two officers on duty at the time, two additional officers were called in to take the patient on the long trip in the back of the squad car, where the patient would be handcuffed for the entire ride.
Now the police chief in Avon, then-deputy chief Greg Daly said there was “collective dissatisfaction” in the department for putting mental health patients in handcuffs. Bob Ticer, police chief at the time, decided to stop the practice.
“We said we’re not going to do that anymore,” Daly said. “That was Ticer. I give him credit for that; he was right.”
As a result, ambulances were used instead.
“That’s another massive resource to take off the streets,” Daly said of the ambulances. “But … that was a far more humane and respectful way to deal with somebody in a mental health crisis, than being in the back of a police car with bars on the windows, in handcuffs. That’s what started the dynamic change in this county.”
In the years that followed, attention began shifting to the 911 calls themselves. The Roaring Fork Valley had developed a system where mental health 911 calls were screened by a crisis clinician to determine risks, safety and need.
“They had changed the dynamic from police or ambulance transporting that person from their home, to the vast majority of those calls being triaged in the home,” Daly said.
By 2018, Eagle County had also started an in-home “triaging” effort, as Daly calls it. It’s being performed by Hope Center Eagle River Valley, an expansion of the program that had been operating in the Roaring Fork Valley. Licensed behavioral health clinicians now respond to 911 calls, as well as local police and ambulance services.
As a result, the county has seen a 74% reduction of transports to the hospital emergency department and county jail. From October of 2018 to October of 2019, 104 individuals who would have been otherwise transported were able to receive care in their home from a licensed behavioral health clinician, according to stats from Vail Health.
Within the new crisis clinician call screening process, often times a risk is identified. Sometimes there are reports of weapons present. Sometimes an immediate threat to one’s safety, and the safety of others, is identified by the screener.
In those cases, the standard procedure in Eagle County is for a law enforcement officer to make the first contact with the patient.
“When somebody is having a mental health episode of some sort in their home, and they’re violent, attacking family members, breaking things … we can’t send in a civilian to walk in that door and try to calm that situation down, because that civilian could get seriously hurt or killed,” Daly said. “That’s just the facts.”
In coming to grips with that reality, Daly said he has enlisted in extra training for all of his officers to best handle those situations. As of last week, 100 percent of the police force in Avon has received Crisis Intervention Team training through the renowned Memphis Model.
The 40-hour class uses professional actors to help police officers understand various forms of mental illness. A scholarly review of the program published in The Journal of the American Academy of Psychiatry and the Law found that the Crisis Intervention Team model of police-based intervention in behavioral crises “decreased the need for higher levels of police intervention, decreased officer injuries and redirected those in crisis from the criminal justice to the heath-care system.”
Daly said when officers are needed on scene in a mental health crisis, having them trained in the Memphis Model is a best practice he’s long been striving for in his department.
“We respond to that initial, usually suicidal, call, we go in and we make sure the scene is secure,” Daly said.
That part often involves separating the person from any weapons in the vicinity and calming things down a bit.
“Then we have our partners — community paramedics and Hope Center clinicians — arrive inside the house,” Daly said.
In some cases, Hope Center clinicians will then stay overnight with the person. After the crisis has passed, the patient is connected with the appropriate community resources to help address their long-term needs.
Funds from Police
Police in Avon say the new system is much better than the previous model. But it’s not cheap.
Eagle Valley Behavioral Health was formed in 2019 as a central repository of funding and fundraising for mental health in Eagle County. The organization receives regular infusions of cash from local governments and foundations, and local police departments are among them.
In Avon, the police have started contributing about $20,000 annually to the Hope Center and Eagle Valley Behavioral Health. The money comes directly out of the police budget and is money well spent, Daly said. But, one could argue, it’s money that would have otherwise been spent on traditional policing.
Is this effort similar to the ideas expressed in the “Defund the police” movement, which recently gained popularity during the George Floyd protests?
Perhaps, Daly said, but it’s a little more complicated than that.
In shifting funds out of police services into mental health services, and having police cooperation and enthusiasm in doing so, Daly said police play an important role in being a part of the solution.
But the police, in Daly’s words, only represent one seat “around this big table, that has been bringing mental health resources and progress in leaps and bounds (to Eagle County) in the last two years.”
$160 Million Target
The Avon Police Department, the Vail Police Department, the Eagle Police Department, and the Eagle County Sheriff’s Office are all partner organizations working alongside Eagle Valley Behavioral Health.
But the behavioral health problem in Eagle County, where a 360% rise in local emergency room visits for anxiety and depression has been documented since 2013, requires a lot more than can be provided through police resources and funding. Eagle Valley Behavioral Health has identified an approximately $160 million price tag on the requisite effort.
In addition to committing $60 million itself, Vail Health launched a $100 million fundraising effort in 2020.
The family of retired energy executive Jay Precourt kicked off the fundraising effort with a $15 million donation. Eagle County Paramedic Services contributed $100,000 and are also donating office space. Our Community Foundation donated $50,000. The list goes on.
More than two dozen local organizations have now partnered with Eagle Valley Behavioral Health through funding and other services.
“It’s taken a long time, and a lot of passionate champions, to summon this all together,” Daly said. “An incredible collaboration.”