Calif. city's targeted mental health crisis team marks 1 year
Santa Rosa's inRESPONSE team, which includes a paramedic, was dispatched to more than 2,800 calls since it hit the streets last January
By Paulina Pineda
The Press Democrat
SANTA ROSA, Calif. — Brady Kellogg hadn't been able to sleep in weeks and his memory was foggy.
The 46-year-old had gone to visit family in Seattle last August and suffered a seizure while at the grocery store, slamming his head on the concrete, he said.
He began to feel anxious when he returned to Sonoma County, where he was living in his car with his chihuahua, Benni. He sought medical help to no avail, he said, and turned to alcohol to help cope.
"I felt manic," he said.
The episode eventually led to run-ins with law enforcement before he was connected with Santa Rosa's civilian inRESPONSE team.
The team, comprised of a licensed behavioral health clinician, paramedic and an outreach specialist from Catholic Charities, provided Kellogg with a mental health evaluation and follow-up care.
"It was scary when I didn't know if I was going to have another fit," he said. "InRESPONSE saw me when I was in my dark spot and they were patient and compassionate and helped me calm down instead of picking me up off the street and throwing me in the back of a police car."
The team specializes in providing a more targeted response to mental health, substance use and homeless services calls than might be had from traditional first responders, including firefighters and police officers.
The civilian mobile support team has been dispatched to more than 2,800 calls since it hit the streets last January, helping divert hundreds of calls away from police and fire and connect people with health and social services, according to a recent data snapshot from the city.
The team also is reaching people that otherwise may not have called for help, said Santa Rosa Police Chief John Cregan, who as a captain spearheaded the initiative.
"It took a lot to get off the ground but overall we're ecstatic with the success of this team and all of the momentum we have going into year two," he said.
The Santa Rosa program was first envisioned in 2020 in the wake of local and national protests against police brutality and amid rising calls for mental health and homeless services. It's modeled after the Eugene, Oregon, program called CAHOOTS.
Annual operations, equipment and training cost $2 million and are paid for through a mix of federal and local funds.
Two vans are currently in operation, providing 15 hours of service Monday through Thursday and 10 hours the rest of the week.
The city hopes to expand operations round the clock this year with the goal of diverting 5,000 calls from law enforcement annually.
Most calls for service related to mental health
The team was dispatched to 2,893 calls between Jan. 11, 2022, and Jan. 11, 2023, according to data shared through the city by inRESPONSE.
InRESPONSE didn't provide services on all dispatched calls.
Sometimes people refused assistance from the team and in other cases the calls were canceled once en route, Program Director Katie Swan said.
Mental health services were the primary service on 1,284 calls, the bulk of calls where the team did provide aid.
About 550 of the calls, or 24%, were related to homeless services.
The team responds to the majority of calls on its own but can respond jointly with police or wait nearby until officers ensure the scene is safe, Swan said.
The data showed the program helped divert 1,762 calls from police and 677 calls from fire service.
Cregan said such calls used to tie up police and fire resources. InResponse has allowed officers to focus on other emergencies.
In addition to diversion efforts, the team provides more specialized care to residents.
Clinicians have a bachelor's or master's degree, 3,000 hours of clinical work in the field and are certified by the state Board of Behavioral Sciences. That's compared to just eight hours of related training officers receive in the police academy, Cregan said.
Swan knows firsthand the importance of having specialized professionals assist during a mental health call. Swan, who is queer and uses the pronoun they, said they have children with mental health challenges and there have been situations when the children need help beyond what the family can provide.
Calling law enforcement for help during a crisis can be a difficult choice, Swan said.
"One of the hardest things for families to do is to call law enforcement when their person is struggling," Swan said. "Having a team that can offer the appropriate service at the appropriate time is important."
The team is trained on how to spot someone who is in crisis and de-escalate the situation. Members spend time talking with the individual or family members, understanding what led to the crisis, and will conduct a mental health assessment and plan out next steps, rather than addressing just the current emergency and rushing off to another call.
Swan hopes this can help reduce stigma around mental health and make people more comfortable seeking help.
Wraparound care helps address cycle
Beyond responding to calls for service, the inRESPONSE program includes a team of five people whose job is to help those in need navigate social service and health care systems and provide follow-up support.
The team, staffed by nonprofits Buckelew Programs and Humanidad Therapy and Education Services, can help connect clients and their families with resources, find housing and address other barriers to seeking help, such as coordinating transportation to appointments.
Cregan said this component is critical to ensuring people don't get stuck in a cycle of needing emergency services.
"I've seen time and time again in my career that when people were going to the crisis stabilization unit" — the county's emergency department for mental health patients — "that within hours of getting put back out on the street or sometimes days, still not knowing where to go from there, surprise they're back into crisis," he said.
The navigator team served 494 people in the first year and had more than 2,300 contacts with them, according to inRESPONSE data.
Data showing the long-term outcome of those calls was not provided in the latest snapshot but could come from future reports.
The help has been key to Kellogg's recovery, he said.
While he was in the hospital, he said the navigation team helped find a low-cost kennel for his dog and helped him connect with appropriate medical services.
He and Benni found a room for rent in Cotati and he's six weeks sober now, something he also attributed to seeking comfort in a higher power.
Now he's working to apply for a peer-support program at the Wellness and Advocacy Center that the system navigator recommended.
"The extra effort that they provide that law enforcement doesn't helped me get over the ladder between the chasm and the cliff," he said.
The navigators are seeing an average of 50 new referrals per month on top of the people they're serving from prior months, Swan said.
Swan said some people require just a follow-up call while others remain engaged with the team for six months while they are stabilized.
"Our goal is to make sure people are grounded in the services they need before we take a step back," Swan said.
Plans call for growing team by 2024
Heading into the second year of operations, the team will look to continue educating residents about the program and expanding.
The police department plans to launch a third van by summer and roll out a fourth team to provide 24-hour coverage by the end of the year or early 2024, Cregan said.
The department had hoped to expand the program within a few months of launching, aiming to go from 15 hours a day and to 24 hours daily by the end of 2022, but staffing challenges have prevented that so far.
Behavioral health clinicians, who are contracted through Sonoma County, are in short supply. The county is working to recruit additional clinicians by offering higher pay and other incentives, Cregan said.
The police department also is working to secure a new home for inRESPONSE, where the team will be able to meet clients and provide services at a facility on Sonoma Avenue near downtown.
The City Council was set to approve the lease at its Tuesday meeting.
Cregan said he also would continue to seek outside grant opportunities to help cover program costs, though there is enough funding available to cover operations through the end of 2025.
The voter-approved 20-year extension of Santa Rosa's public safety tax, Measure H, makes it possible to sustain the program long-term, but grant funding can help bolster the initiative, he said.
Mary-Frances Walsh, executive director of NAMI Sonoma County, the local arm of the National Alliance on Mental Illness, said inRESPONSE was "phenomenally better" at responding to mental health calls than law enforcement and provided dignified help to people in need.
However, she noted that the city needed to do a better job of advertising the program and making people feel more comfortable with calling for help. She also wants to see the program expanded to help more people.
"While inRESPONSE is a fantastic step in the right direction, we still have work to do," she said.
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