Minute in Support of Mental Health First Responder Program

Madison Monthly Meeting of the Religious Society of Friends (Quakers) supports the development of a more robust mental health crisis response system in Madison and Dane County with the understanding that this will both better serve people with mental illnesses and reduce the workload of the Madison Police Department.

Madison Monthly Meeting urges the City of Madison and Dane County to cooperate in implementing a mental health non-law enforcement first responder team. The program, which is currently being referred to as Community Alternative Response to Emergencies (CARE), is modelled on the CAHOOTS program (Crisis Assistance Helping out on the Streets) that has operated in Eugene OR since 1989.

The experience of a number of Madison Monthly Meeting members who are familiar with the mental health system is that law enforcement is not optimally trained to intervene in mental health crises, nor do police officers wish to do so. Importantly, CAHOOTS has demonstrated that law enforcement response is not required in the vast majority of cases. In 2018 86% of CAHOOTS calls were handled without police involvement. At the initial 911 call triage decisions sent some initial calls to police. However, of the 24,000 calls that year CAHOOTS staff needed to call police for back-up for only 150 of them. Calls to CAHOOTS were much more likely to be initiated by police (3300).

At this time, when there are calls to defund the police, this program makes a significant impact on the role of police. CAHOOTS handles about 20% of what would formerly have been police calls for an amount equivalent to about 2% of the police budget. We hope that over time, as this program matures, we can see funds moved from law enforcement to non-law enforcement first response and other programs that “remove the occasion” for police involvement.

While we understand that the plan is to locate this service within the Madison Fire Department Emergency Medical Services Unit, it is critical that there be close collaboration with Dane County, which has primary responsibility for mental health crisis response. It is important that the City and County do not create barriers for individuals in need of services where these programs intersect.

We also understand that, for budget reasons, there are discussions about operating the program less than 24/7 or only in certain areas of the city/county. While we understand budget realities, these types of limitations would be unfortunate; we cannot know when or where such crises will occur. However, if such limits are implemented for a limited period of time, we trust that City and County staff will use available data to identify when and where crises are most likely to occur and focus interventions accordingly. In the hopeful event that this service demonstrates success, we urge Dane County to bring it to scale county-wide as promptly as feasible.

In order to best meet people in crisis where they are at we also ask for the following:

  • A creation of a culturally and ethnically diverse staff trained in cultural competency who can address the different cultural understandings of mental illness and minimize stigma that can be associated with these encounters.
  • The integration of peer specialists into response teams recognizing their unique role as people who have lived experience of mental illness in responding to folks in crisis.

Madison Monthly Meeting further supports the development of other services that will complement the mental health first responder program and facilitate a prompt, non-law enforcement response to people in crisis. One example is a proposed triage center which would accept referrals from the mental health first responders, law enforcement, and self-referrals while providing a stabilization location for community residents other than the jail. This model, as outlined in a Sept. 18, 2020 paper to the Criminal Justice Council Behavioral Health Subcommittee would incorporate a “no wrong door” philosophy and would facilitate collaboration and coordination among the City, County, area health and behavioral health care providers and the criminal justice system. Staffing would include certified peer specialists.

Madison Monthly Meeting supports a specific amendment approved on a 5-1 by the City Council Finance Committee to increase funding for the mental health first responder program from $350,000 to $600,000. The increase for the program would be paid for by reducing the Police Department’s recruit class from 39 to 33 or 34. The increase would accelerate the implementation of the program. If Madison/Dane County see results similar to Eugene OR this will reduce the burden on the police department resulting in the need for fewer new officers.

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