Care response also needs community
Posted May 09, 2024 in Op-Eds
This piece was previously published on Cleveland.com and is reprinted here with permission.
CLEVELAND -- It’s promising that non-police response for people experiencing behavioral and mental health crises is coming to Cleveland, funded by the Alcohol, Drug Addiction and Mental Health Services Board of Cuyahoga County with a $1.7 million pilot.
Known locally as care response, this health-first approach provides support and resources for people not acting violently, a model for which community members have been advocating and organizing for more than three years. Care responders are better-trained than police to provide support, rather than escalate non-violent situations or leave people without the help they need.
The pilot, in two Cleveland ZIP codes, will send two-person teams – one behavioral health clinician or social worker and one trained peer – on calls made to 988, the national mental health and suicide hotline. Other city teams include paramedics, just social workers, or just community responders.
To make this work, the city of Cleveland and the ADAMHS Board must address key issues.
First: staffing and hours of operation. FrontLine Service, a behavioral health agency, will run the program and is working to hire and train clinicians as early as this month, and peers later this summer.
Staffing can be tough. Cincinnati has seen success with its Alternative Response to Crisis program, which started in July 2022, but its effort to expand has been slowed by hiring challenges.
Cleveland is planning to provide 24/7 coverage, the gold standard, but Cincinnati and other cities have found that most of the calls they answer happen during day or evening hours. That’s why Cincinnati is expanding, for now, from its one weekday shift to a second shift that overlaps first shift for three or four hours. They’ve decided it doesn’t make sense to spread scarce resources thin by having care responders work overnight when there are few calls.
Another key challenge: routing calls between 911 and 988. Cincinnati’s ARC program responds only to 911 calls that meet established criteria; other cities also route 911 to non-police responders, shifting the burden from police for calls for which they are not the best option, allowing them to focus understaffed law enforcement on violent crime.
Cleveland’s pilot will respond only to 988 calls, at least at first, limiting benefits for the city, given its struggles to fully staff the police department, and for people in crisis who don’t know to call 988 and don’t want or need police to come. Community advocates have pressed for care response to be available for 911 callers, and a federal grant is helping the city strengthen the dispatch center’s ability to respond to mental and behavioral health calls. But that’s not how our program is being structured.
Finally, community voice: Residents, including those who need the services, must be front and center in shaping and evaluating the program in the long run. Members of the Mental Health Response Advisory Committee, created as part of Cleveland’s use-of-force police consent decree, have recommended to the city’s health department the creation of a steering committee to provide ongoing input and oversight. The city seems supportive.
In recent community engagement meetings hosted by the ADAMHS Board, the city and FrontLine, residents have spoken clearly about the need for this kind of oversight. Involving the community from the start will also help with staffing.
Without the community to help shape it on an ongoing basis, the care response program – and the people it intends to serve – will suffer.
If we start working closely together to create this program, we will all be better off, whether we struggle with mental health or not. Our communities will be safer for everyone.
So let’s make sure we provide the right support and care for everyone who needs it by listening to the voices of the community.