Harris Center for Mental Health and IDD

Barbara Dawson and Jennifer Battle present on the time-line of crisis center development and law enforcement and first responder integration, including a co-located partnership with 9-1-1.

1. First Responder Collaborations with our Comprehensive Psychiatric Emergency Programs

2. Psychiatric Emergency Services PES at the (Neuropsychiatric Center-NPC) Mobile Crisis Outreach Team (MCOT) MHMRA Helpline Crisis Intervention Response Team (CIRT) Critical Time Intervention (CTI) Crisis Stabilization Unit (CSU) Crisis Residential Unit (CRU) Chronic Consumer Stabilization Initiative (CCSI) PEER Supports CPEP Program Timeline CIRT Expansion to include Harris County Sheriff’s Office Homeless Outreach Team (HOT) 2015 1986 1999 2002 2003 2008 2009 Projects for Assistance in Transition from Homelessness (PATH) 2004 1990 Harris County Psychiatric Intervention (HCPI) Branard Co-Occuring Disorders (COD) 2011 Post Hospitalization (PHCRU) & 911 HelpLine Project 2013 Interim Care Clinic (ICC)

3. Psychiatric Emergency Services (PES)

4. Psychiatric Emergency Services (PES) Open 24 hours, 365 days per year for psychiatric crises and emergencies: Consumers can be held up to 23 hours for observation Voluntary and involuntary admissions Walk ins accepted for all ages and must be in mental health crisis Assessment , medication and stabilization services Provides referrals and linkages with continued mental health treatment, both inpatient and outpatient

5. Psychiatric Emergency Services (PES)

6. Psychiatric Emergency Services (PES)

7. Law Enforcement Collaborations Crisis Intervention Response Team (CIRT) Chronic Consumer Stabilization Initiative (CCSI) Homeless Outreach Team (HOT) 911 Crisis Call Diversion Program

8. Crisis Intervention Response Team (CIRT)

9. Crisis Intervention Response Team (CIRT) Program partners a CIT officer or deputy with a licensed mental health clinician from the Harris Center 10 Teams with Houston Police Department (HPD 10 Teams with Harris County Sheriff’s Office (HCSO) Only program in Texas One of three programs nationally

10. CIRT Overview Hours of Operation: 24/7 except major holidays Respond to calls involving the most serious mentally ill individuals Conduct proactive and follow-up investigations on chronic mentally ill individuals

11. CIRT Overview, cont. Respond to SWAT and Hostage Negotiation Team calls as a resource for the scene commander Prisoner assessments at the city jails Transport involuntary individuals in crisis from local MHMRA clinics to emergency psychiatric facilities

12. Chronic Consumer Stabilization Initiative (CCSI)

13. Chronic Consumer Stabilization Initiative (CCSI) CCSI is a collaborative effort between the Houston Police Department and the Harris Center CCSI was designed to identify, engage and provide services to individuals who have been diagnosed with serious and persistent mental illness and who have had frequent encounters with the Houston Police Department

14. Chronic Consumer Stabilization Initiative Overview Hours of Operation: M-F 8am-5pm (on call 24/7) Case Managers maintain case load size of 15 Reduce the number of interactions for clients with serious mental illness with the Houston Police Department Identify unmet needs and barriers in the community Link and coordinate clients with needed mental health treatment and psychosocial services Reduce the number of crisis admissions to local hospitals and emergency rooms

15. CCSI Successes Since its inception the program has Decreased the number of interactions between CCSI clients and the Houston Police Department by approximately 53% Decreased admissions to Psychiatric Emergency Service (PES) by 24% Decreased admissions to Harris County Psychiatric Center (HCPC) by 25%

16. AWARDS AND RECOGNITION 2010- IACP Community Policing Award 2015- Michael Shanahan Award for Excellence and Public/Private Cooperation Finalist 2010- Herman Goldstein Award for Excellence in Problem-Oriented Policing 2011-2016 Simmons Foundation Grant 2013 -2014 Frees Foundation Grant

17. Homeless Outreach Team (HOT)

18. The goal of HOT is to reduce the number of homeless persons by helping them overcome the obstacles that have resulted in them living on the streets. The team is relationship oriented and has established an excellent working relationship with the homeless population, government agencies and the provider community. Homeless Outreach Team (HOT)

19. Partners case managers with HPD Officers on the streets of Houston, working with homeless individuals. The Harris Center case managers work with homeless individuals who also experience a mental illness to assist with housing, access to social services and to engage individuals in mental health treatment Once opened to the Harris Center, the client is assigned a Rehab Worker or Case manager attached to one of the clinics for ongoing support Homeless Outreach Team (HOT)

20. Hours of Operation: M-F 7am-6pm The Team Members: Build personal relationships with those living on the streets and to find out why those living on the streets are not taking advantage of the available help Network and build relationships with the providers in order to find out what help is available Match the person with the provider and then assist them though the process to the best of our ability Homeless Outreach Team Overview

21. 911 Crisis Call Diversion Project

22. 911 Crisis Call Diversion Project Mission Statement Pairing the skills of mental health phone counselors with the 911 system to divert consumers not at imminent risk away from any police interaction and toward more appropriate levels of care, in addition to de-escalating consumers before police involvement on scene, is consistent with the strategic directions of both The Harris Center for MH and IDD and The Houston Police Department.

23. Vision Statement The collaboration with 911/HPD will reform the way consumers are connected to mental health resources and diverting them away from the police/criminal justice system and de-escalating callers in crisis to aid in public safety before police arriving, simultaneously reducing the recidivism rate of police interaction. 23

24. Key Players The 911 Crisis Call Diversion Program is a c ollaboration of The Harris Center for Mental Health and IDD Services - HelpLine , Houston Police Department – Mental Health Division, and the Houston Emergency Communications Center. The HEC Center processes approx. 9,000 calls for service daily. 24

25. Brief History Building on the successes of prior HPD/MHMRA collaborations (such as the Crisis Intervention Response Team, Chronic Consumer Stabilization Initiative, and Homeless Outreach Team) and the steady increase of mental health related calls for service through 911, the idea was formulated to look at diverting non-imminent risk calls that concern mental health issues away from HPD and to Harris Center Phone Counselors. 25

26. Psychiatric Emergency Services PES at the (Neuropsychiatric Center-NPC) Mobile Crisis Outreach Team (MCOT) MHMRA Helpline Crisis Intervention Response Team (CIRT) Critical Time Intervention (CTI) Crisis Stabilization Unit (CSU) Crisis Residential Unit (CRU) Chronic Consumer Stabilization Initiative (CCSI) PEER Supports CPEP Program Timeline CIRT Expansion to include Harris County Sheriff’s Office Homeless Outreach Team (HOT) 2015 1986 1999 2002 2003 2008 2009 Projects for Assistance in Transition from Homelessness (PATH) 2004 1990 Harris County Psychiatric Intervention (HCPI) Branard Co-Occuring Disorders (COD) 2011 Post Hospitalization (PHCRU) & 911 HelpLine Project 2013 Interim Care Clinic (ICC)

27. 911 Call Statistics HPD Mental Health Related Calls for Service: 2010 25,105 2011 25,489 2012 27,655 2013 29,272 2014 32,544 Typically, less than 1% of this call volume result in criminal charges. Between 9,000 and 12,000 calls coded as mental health related in 2014 were cleared as “information only” which means that an officer took no action on the scene. 27

28. Program Phases Phase 1 – 0 – 6 months – Project Clinical Team Lead will work directly with HEC, HPD, and The Harris Center to solidify processes at all levels and prepare for the team to go live in Phase 2. During this phase the Clinical Team Lead will also be available to provide on-site crisis call de-escalation for crisis calls in progress while an officer is in route. Phase 2 – 6 months – 24 months – Phone Counselors will take calls at HEC as routed to them by the Call Takers. Clinical Team Lead will do quality assurance on all calls, Data Analyst will track data, adjustments will be made as needed. 28

29. Funding 2 years of funding has been awarded for this project from private philanthropy. Year 2 of funding is contingent on submitting a sustainability plan to these funders for how the project will be funded past the end of the pilot. 3 years of partial funding has been awarded through a Department of Justice grant. We are working with city, county and state government to form a sustainability plan for permanent funding. 29

30. For more information please contact: Barbara Dawson Deputy Director, CPEP The Harris Center 9401 SW Freeway Houston, TX 77074 713-970-3344 [email protected] Jennifer Battle HelpLine Director The Harris Center 9401 SW Freeway Houston, TX 77074 713-970-8240 [email protected] 30