MONTEREY COUNTY’S RESPONSE TO COMMUNITY
MEMBERS EXPERIENCING A MENTAL HEALTH CRISIS
SUMMARY
Throughout Monterey County, law enforcement officers respond to multiple incidents during a typical day. A significant portion of these calls involve individuals experiencing some form of crisis or distress. Studies suggest that 15% to 37% or more of police calls involve a mental health crisis, substance abuse issues or other situations where immediate intervention is required. Sometimes these calls result in the hospitalization or incarceration of the individual, or in tragedy, either for the individual or the responding officer. The public is often left asking what happened and how it could have been prevented.
Training in Comprehensive Crisis Intervention helps officers respond more effectively and safely to situations involving people experiencing behavioral instability. It reduces escalation, and the possible use of force, and in some cases costly litigation. In addition, Monterey County and many municipalities have Mobile Crisis Response Teams (MCRTs) comprised of trained mental health professionals. Law enforcement agencies (LEAs) can utilize these teams to assist them when responding to people in crisis.
Despite ongoing staff shortages and mandatory overtime hours, County staff and law enforcement representatives do their best to provide emergency assistance to people in crisis.
Several areas warrant improvement. These include:
• Providing short, in-service crisis intervention training sessions for first responders throughout the year in addition to the more formal, 40-hour training that is only offered once or twice a year to a limited number of participants • Conducting annual law enforcement training needs assessments • Devising plans to ensure that training courses remain relevant and comply with changes in legislation
• Formalizing regular collaborative meetings among entities providing emergency crisis response
• Strengthening and expanding the public awareness campaign regarding the newly available 24/7 mobile crisis team service effective January 1, 2024 • Making law enforcement education and training materials more accessible on LEA websites
BACKGROUND
Law enforcement officers face high-stress and potentially dangerous situations daily.
They must be prepared to make split-second decisions that can have significant consequences for themselves and others.
Public interest in how law enforcement officers respond to high-stress situations has increased over the past decade, particularly regarding their interactions with people experiencing a mental health crisis, or who are under the influence of drugs or alcohol.
High profile cases resulting in the death of community members, and sometimes police officers, have led to closer scrutiny by the public, the District Attorney’s Office, and the U.S. Department of Justice.
As a result, there is now more transparency and accountability for officers through body cameras and publicly available data collection and analysis. There have also been changes to policies and guidelines regarding the use of force to emphasize de- escalation techniques. Efforts have been made to improve police training, focusing on areas such as cultural sensitivity, implicit bias, crisis intervention, and mental health awareness. The goals are to equip officers with the skills needed to serve diverse communities and handle sensitive situations more effectively and safely.
The Civil Grand Jury (CGJ) reviewed the type of Crisis Intervention Training (CIT) law enforcement officers receive, focusing on two of the County’s largest law enforcement agencies: the Salinas Police Department (SPD) and the Monterey County Sheriff’s Office (MCSO). The CGJ reviewed how these departments interface with trained mental health professionals from Monterey County’s Department of Behavioral Health (MCBH) when responding to crisis situations.
METHODOLOGY
The CGJ reviewed mandatory training requirements for law enforcement officers in California, and reviewed how easily the public can access information regarding education and training materials at law enforcement agencies in our community.
The CGJ reviewed California Penal Code Sections and other legislation relating to law enforcement training and training requirements from the Commission on Peace Officer Standards and Training (POST) website. Additionally, the CGJ examined procedures manuals and websites of the SPD, MCSO, the MCBH website and internal service call tracking data provided upon request. The CGJ reviewed California Civil Grand Jury Reports from other counties on related law enforcement topics and many media articles regarding national, state and local law enforcement responses to those experiencing a mental health crisis. Finally, the CGJ conducted interviews with County staff and local law enforcement officials knowledgeable about law enforcement training and the current policies and procedures regarding crisis intervention response.
DISCUSSION
Evolution of Law Enforcement Training to Meet Community Needs In the 1950s and 1960s, states throughout the country gradually moved away from institutionalization for those suffering from mental illness. In 1967, the Lanterman-Petris- Short Act was passed in California ending the practice of institutionalizing patients against their will without Court oversight. Many institutions closed their doors. In 1981, federal legislation put the responsibility of caring for mentally ill patients on the states.
With dwindling support from the federal government, many states struggled to provide adequate mental health treatment and housing for the mentally ill.
Our communities have witnessed increases in both homelessness and the incarceration of those with mental illness. Studies indicate that more than one third of currently incarcerated individuals have been diagnosed with a mental illness, a rate much higher than that of the general population.
Source: Flickr, Mike Dunford, Creative Common License
According to background information for Proposition 1, an update to the Mental Health Services Act on the March 2024 ballot, one out of every 20 adults in California now lives
with serious mental illness, one in 13 California school aged children suffers serious emotional disturbance, and one in 10 Californians has some sort of substance abuse disorder.
First responders have several options when responding to people experiencing a crisis including:
• De-escalate the situation and refer to local service providers • Request assistance from the Mobile Health Response Team • Arrange for transportation for the person to the hospital for a psychiatric evaluation if they appear to be a danger to themselves or others, and/or appear to be “gravely disabled” (Welfare & Institutions Code §5150) • Arrest the person if they are breaking the law
According to the Salinas Police Department, its officers respond daily to situations that result in a person in crisis being transported to the hospital for a psychiatric evaluation that may result in an involuntary 72-hour hold (§5150 cases). In 2022, 510 individuals were taken to the hospital for an evaluation. During the first 10 months of 2023, 369 individuals were taken to the hospital. The Monterey County Sheriff’s Office classified 98 of its calls as §5150 cases in 2022 and 76 in 2023.
As law enforcement officers respond more frequently to situations involving those with mental illness and/or substance abuse, it is imperative that they are sufficiently trained to respond appropriately. Instead of resorting to force, trained officers use de-escalation techniques leading to better outcomes for themselves, the individual, and the community at large.
Development of Training Standards for Law Enforcement
In 1959, the California Commission on Peace Officer Standards and Training (POST) was established. POST sets minimum selection and training standards for California law enforcement officers. It develops and certifies training courses, including Basic Academies, specialized training, and continuing education. Basic law enforcement
training in California includes courses on firearms, criminal law, report writing and more.
Over time, training courses
have evolved to include
additional hours focusing on
topics such as crisis
intervention, cultural diversity,
ethics, community policing, de-
escalation techniques, conflict
resolution, cultural sensitivity
and more.
The Basic Academy takes 888
hours over six months. Law enforcement officers in California may also receive additional training in several other ways including:
• Field training (on the job training)
• Continuing education training (shorter in-service training), and • Roll call briefings (occurring at the beginning of each shift)
Penal Code §13515.26 requires that all peace officers receive 15 hours of training at the Basic Academy on the topic of “Persons with Mental Illness, Intellectual/Developmental Disability or Substance Abuse Disorder.” Penal Code § 13519.10 requires the commission on Peace Officer Standards and Trainings to develop uniform, minimum, guidelines on the use of force for adoption and promulgation by California Law Enforcement agencies. There are different mandatory training requirements for different ranks of officers. For example, Penal Code §13515.28 (a) (1) requires Field Training Officers (FTOs) to have eight hours of crisis intervention training within six months of assuming the position.
During their careers, officers must continually log onto POST’s website to determine if they are up to date with their mandatory training requirements and to sign up for courses as needed. LEAs keep their own records regarding officer participation at non mandatory training.
Law Enforcement Leadership Academy
Source: U.S. Marshalls Office, Commons.wikimedia.org
Development of Crisis Intervention Team (CIT) Programs
The Memphis Model, developed in 1988 in Memphis, Tennessee, is often cited as the first structured CIT program. It was a collaboration between mental health professionals, law enforcement, and advocacy groups.
In 1989, the Eugene Police Department in Oregon developed a program known as “Cahoots” (Crisis Assistance Helping Out on The Streets) which involves a specialized emergency response model that pairs mental health professionals with law enforcement officers to respond to crises involving mental health, homelessness, and substance abuse. The program’s purpose is to divert individuals away from the criminal justice system and towards appropriate care and support.
Crisis intervention training for law enforcement continues to change in response to legislative mandates, societal changes, increased public awareness of mental health issues, and the need for officers to effectively manage crisis situations.
Crisis Intervention Training, Source: Hamilton County Sheriff’s Office, TN website
In 2008, CIT International, a nonprofit organization, was formed to assist communities worldwide with crisis response system reform by developing CIT programs at the state/province, regional, and local level. CIT International certifies courses that train officers to effectively handle situations involving individuals experiencing mental illness
and/or addiction disorders. The goal is to provide officers with the skills to de-escalate such encounters without resorting to unnecessary force. According to CIT International’s website, communities that prescribe to the CIT Program model have higher success rates in safely resolving crisis situations.
Crisis Intervention Training (CIT) in Monterey County
While many counties in California provide CIT
Training for first responders, not all these
training programs are 40-hours in length.
Monterey County is fortunate that the
Monterey County Department of Behavioral
Health (MCBH) has developed a
comprehensive 40-hour Crisis Intervention
Training that has been certified by Police Officers Standards and Training (POST). It is offered twice a year for a maximum of 35-40 law enforcement officers/first responders per session in Monterey County.
Monterey County had 662 sworn officers employed with 21 different jurisdictions in 2022, according to the California Department of Justice. The table below shows the number of sworn officers in Monterey County.
Sworn Officers by Year in Monterey County
2013 2014 2015 2016 2017 2018 2019 2020 2021 2022
All Monterey Co.
Police Depts 356 334 334 343 367 377 377 380 364 363 Monterey Co.
Sheriff's Office 281 300 291 295 296 304 295 312 288 283 CHP/Other 20 19 21 20 19 15 14 15 16 16
TOTAL 657 653 646 658 682 696 686 707 668 662 Source: https://openjustice.doj.ca.gov/exploration/crime-statistics/criminal-justice-personnel
Both SPD and MCSO have a goal of sending 100% of sworn personnel to CIT training according to officials from both agencies. Smaller jurisdictions find it more challenging to
divert officers away from their regular patrol responsibilities to attend a full week of training.
The CGJ was unable to determine how many law enforcement officers currently working in Monterey County have attended the 40-hour CIT training. However, since only 35-40 participants are accepted into the CIT training offered once or twice a year, it is unlikely that all 662 officers have received this training.
Expanded Mobile Crisis Team Services in Monterey County Monterey County Department of Behavioral Health (MCBH) launched mobile crisis services in 2015 to respond to calls for service received through the 911 system when requested by law enforcement. Through December 2023, the team’s operating hours were Wednesday-Saturday from 12:30 to 10:00 p.m. and alternating Tuesdays from 1:30 to 10:00 p.m. As of January 1, 2024, services are available 24/7. The goal is to de- escalate and stabilize situations, connect individuals with appropriate voluntary resources and treatment in the community, coordinate with existing treatment teams/providers, and avoid unnecessary hospitalization and incarceration.
The table below shows the number of contacts the Monterey County Mobile Crisis Team had with community members from 2018 to 2023.
Mobile Crisis Team Frequency Report
(Serving all of Monterey County)
2018 2019 2020 2021 2022 2023
Total Contact Counts Countywide 865 918 187 543 679 1076 Status: New episode 248 210 50 105 201 257
Location of contact: Home 458 531 116 271 293 474 Location of contact: Police Dept. 66 74 7 110 157 278 Location of contact: Public Place 87 94 24 49 65 116 Substance abuse involved 161 182 36 123 121 210
Disposition: §5150 (involuntary hold) 166 211 54 118 114 211 Disposition: Arrest 10 11 2 7 17 33
Disposition: Crisis intervention &
Referral
256 225 30 104 105 215
Source: Monterey County Behavioral Health
Expanded Mobile Crisis Team Services (January 2024)
There are two Mobile Crisis Teams operating in Monterey County: the County Behavioral Health Mobile Crisis Team (MCT) and the Seneca Children and Youth Mobile Crisis Support Team (MCST) serving youth under age 21. To meet a new federal mandate requiring 24/7 mobile crisis response by January 1, 2024, MCBH signed a new contract with Sierra Mental Wellness Group (SMWG) to add mobile crisis dispatch. The new contract provides an additional two-person team operating 24/7 in Salinas for countywide in-person, community-based mobile crisis response for adults.
The Community Services Crisis line number (866-615-1060) is available for the public to access the newly available 24/7 Mobile Crisis Team service. Personnel answering the line will work with the caller to determine the type of response needed. This can range from providing crisis intervention over the phone, to dispatching first responders and/or the Mobile Crisis Team depending on the situation. Publicity regarding the newly expanded services has been limited to posting flyers in various public locations and with partner agencies. There have been no posts to County social media accounts and few print/television stories regarding the expanded availability of the service.
Collaboration Among Entities Responding to Crisis Situations From 2019-2021, leaders in Monterey County worked with the Council of State Governments Justice Center (CSG) to study policies, processes, and resources for individuals with behavioral health needs who have entered the criminal justice system.
Monterey County Behavioral Health, Monterey County Sheriff’s Office, and the Monterey County Probation Department collaborated to prepare a report providing recommendations for a wide range of system improvements known as the Stepping Up Monterey System Mapping Project. The project results were published in June 2021.
One of the recommendations of the Mapping Project was to improve cross-system collaboration, specifically, to establish a quarterly meeting with justice, health, and housing/homelessness representatives in attendance. Collaboration in the form of meetings have been held on an ad-hoc basis; one specific recommendation was to establish a more regular meeting schedule with an agenda.
An additional recommendation was to “develop and provide training on mental illness, substance use disorders, and co-occurring disorders for various justice partners. For example, the county could provide training on mental illness for dispatch personnel, build on existing Crisis Intervention Team training for law enforcement, and train attorneys, judges, and jail staff of behavior health needs.”
Policies, Evaluation of Training Programs, and Plans for Future Training at SPD and MCSO
Both SPD and MCSO have lengthy (800+ page) policy manuals posted on their websites that include information regarding the number of hours of training required for different positions within the departments. Both policies include the requirement to prepare an annual training needs assessment and an updated annual training plan. The plan considers any legislative changes, state-mandated training, and critical incident training. The CGJ determined that neither department has prepared updated training needs assessments and training plans in the last few years.
Public Awareness Regarding Law Enforcement Training
To increase communication and community trust and enhance transparency, effective January 1, 2020, California Senate Bill 978 requires all law enforcement agencies to:
“Conspicuously post on their Internet Web sites all current standards, policies, practices, operating procedures, and education and training materials that would otherwise be available to the public if a request was made pursuant to the California Public Records Act.”
Other than limited information in their policy manuals, the CGJ was unable to find specific education and training materials on either SPD’s or MCSO’s websites. Many police departments in other counties have posted such information on their websites with clear references to SB 978. One such example is the Petaluma Police Department (referenced in the Bibliography below).
FINDINGS
F1. In 2022, there were 662 sworn officers in Monterey County. Those without the 40- hour CIT training, offered twice a year for 35 first responders per session, are unlikely to be as effective at responding to people in crisis, leading to potentially dangerous outcomes for officers and community members.
F2. There has not been a comprehensive public awareness campaign to inform County residents of a specific crisis line number and the new 24/7 (as of January 1, 2024) capacity of the Mobile Crisis Team to respond to individuals experiencing a mental health crisis causing the public to remain unaware of the availability of this resource.
F3. The Mapping Project found no formal collaboration exists among the various entities that respond to people with mental health difficulties who are in crisis. A case-by- case response is not a consistent or effective strategy and does not serve the community well.
F4. SPD and MCSO have not prepared annual training needs assessments and plans as required by their internal policies. Consequently, their training plans are out of date leaving officers and deputies less equipped/prepared to respond to crisis calls for service and putting themselves and the public at risk.
F5. Current standards, policies, practices, operating procedures, and education and training materials are not conspicuously posted on either SPD or MCSO websites causing them to be out of compliance with California Senate Bill 978 and making it more difficult for the public to obtain such information.
RECOMMENDATIONS
R1. Monterey County Department of Behavioral Health develop a POST-certified, abbreviated in-service training course on CIT by December 31, 2024, designed for law enforcement officers who have not taken the 40-hour course to be facilitated annually by Field Training Officers.
R2. Monterey County increase its public awareness campaign regarding the Mobile Crisis Team’s 24/7 availability to include more social media posts, news articles, and advertising by July 31, 2024.
R3. Monterey County appoint a liaison to establish regular meetings among entities such as MCBH, LEAs, 911 dispatchers, hospital ER staff, and relevant nonprofit service providers that respond to individuals with mental health difficulties by July 31, 2024.
R4. The Salinas Police Chief and the Monterey County Sheriff prioritize the completion of an annual training needs assessment and plan by no later than July 31, 2024, and by the end of each fiscal year thereafter.
R5. The Salinas Police Department and Monterey County Sheriff’s Office conspicuously post all current standards, policies, practices, operating procedures, and education and training materials to their websites by June 30, 2024.
REQUEST FOR RESPONSES
The following responses are required pursuant to Penal Code Sections 933 and 933.05:
From the following governing bodies within 90 days of the publication of this report:
• Monterey County Board of Supervisors
o Findings: F1-F5
o Recommendations: R1-R5
• Salinas City Council
o Findings: F1 and F3-F5
o Recommendations: R1 and R3-R5
From the following individuals within 60 days of the publication of this report:
• Monterey County Sheriff
o Findings: F1 and F3-F5
o Recommendations: R1 and R3-R5
INVITED RESPONSES
From the following individuals:
• Chief of Police, Salinas Police Department
o Findings: F4-F5
o Recommendations: R4-R5
• Monterey County Chief of Behavioral Health
o Findings: F1-F3
o Recommendations: R1-R3
• Monterey County Director of Health
o Findings: F1-F3
o Recommendations R1-R3
Reports issued by the Grand Jury do not identify individuals interviewed. Penal Code section 929 requires that reports of the Grand Jury not contain the name of any person or facts leading to the identity of any person who provides information to the Grand Jury.
GLOSSARY & ACRONYMS
CGJ Civil Grand Jury
CIT Crisis Intervention Training
LEAs Law Enforcement Agencies
FTO Field Training Officer
MCBH Monterey County Behavioral Health Department
MCHD Monterey County Health Department
MCRT Mobile Crisis Response Teams
MCSO Monterey County Sheriff’s Office
POST Police Officer Standards and Training
SMWG Sierra Mental Wellness Group
SPD Salinas Police Department
BIBLIOGRAPHY
Commission on Peace Officer Standards and Training, Mental Health Training for Law Enforcement
https://post.ca.gov/mental-health-training-in-law-enforcement
South Bay Regional Public Safety Training Academy, Basic Police Academy https://theacademy.ca.gov/basic_police_academy/
Crisis Intervention Team International (CIT)
https://www.citinternational.org/
Monterey County Sheriff’s Department Policy Manual
https://montereysheriff.org/wp-content/uploads/2023/09/policy_manual_2023-09-27.pdf
Salinas Police Department Policy Manual
https://salinaspd.org/wp-content/uploads/2023/08/California_LE_Policy- Manual_Updates__August_2023.pdf
Senate Bill 978
https://legiscan.com/CA/text/SB978/id/1821983
Medi-Cal Mobile Crisis Services Benefit Implementation Plan. Proposed launch date:
12/31/23
https://www.co.monterey.ca.us/home/showpublisheddocument/126955/6383451006824 70000
Stepping Up Monterey County System Mapping Project, Council of State Governments Justice Center, June 2021
https://csgjusticecenter.org/publications/stepping-up-monterey-county-system-mapping- project/
California Department of Justice Statistics, Open Justice https://openjustice.doj.ca.gov/exploration/crime-statistics/criminal-justice-personnel
Petaluma Police Department
https://cityofpetaluma.org/police-training-records/
APPENDIX
Mobile Crisis Team Expansion Services Flyer
Monterey County System Map from The Mapping Project
DISCLAIMER
Unless otherwise noted, all photographs in this report are license free stock images.
Expansion of
Mobile Crisis Services
January 2024
Path to 24/7 mobile crisis services in Monterey County
MCBH Mobile Crisis
Team
November 2015
Seneca Mobile
Response Team
(Children / Youth)
July 2020
Community Crisis Line
of Monterey County
(1-866-615-1060)
December 2023
Sierra Mental Wellness
Group Mobile Crisis
Services
December 31, 2023
Fig. 2. Monterey County System Map
COMMUNITY
Event
Behavioral health
crisis, unclear criminal
activity
•Behavioral health
crisis, non-serious
criminal activity
•Behavioral health
crisis, serious criminal
activity
•Criminal activity,
unknown behavioral
health needs
Crisis outreach
COMMUNITY
24/7 crisis line at
Natividad
•California & OMNI
peer warm lines
•Suicide prevention
hotline
•24/7 crisis text
support
•24/7 Behavioral Health
(BH) 888 Access
number
•Peer navigators
•911
Crisis response
CRIMINAL JUSTICE SYSTEM
Mobile Crisis Team
•Seneca Mobile
Response Team for
Children & Youth
•16 police departments,
including some
specialized outreach
through Multi-
disciplinary Outreach
Team (Monterey);
Community Action
Team (Monterey);
Homeless Outreach
Team (Salinas)
•Crisis hostage
negotiation team
(MCSO, Salinas Police
Department, Special
Response Unit)
•MCSO
•California Highway
Patrol
Response disposition
COMMUNITY
CHOMP Crisis
Stabilization Units
(in development)
•Inpatient care
•County BH clinics
Sun Street Sobering
(Salinas, limited hours)
•County BH clinics
•Emergency Room
(CHOMP, Natividad)
•5150 hold
CRIMINAL JUSTICE SYSTEM
Jail
Jail intake
CRIMINAL JUSTICE SYSTEM
Intake screening
conducted by
Wellpath nurse with
follow-up based on
risk for suicide level
Pre- adjudication
CRIMINAL JUSTICE SYSTEM
Courts
Public defender may
know clients’ BH
history or be made
aware of BH needs by
custody sta/uniFB00, but no
universal process
•Pretrial risk
assessment (ORAS-
PAT) upon court order
after arraignment
•Potential for defense
motion for mental
health diversion
•Potential for military
diversion
Jail
Wellpath can
provide medication-
assisted treatment
maintenance for
opioid use disorders
•Programming is ad
hoc and self-initiated
•Jail-Based
Competency Program
•Limited practice of
forced medication
Post-adjudication
CRIMINAL JUSTICE SYSTEM
Courts
CNC collaborative
court available for
people on SSI/SSDI
•Drug Court
•DUI Court (2 tracks:
1 DUI track in Drug
Court for drug-related
DUIs)
•Veterans Treatment
Court
Jail
Programming to
address criminogenic
needs based on GEO
Needs Assessment
•Wellpath
programming for
serious mental illness
(SMI)
Discharge planning
CRIMINAL JUSTICE SYSTEM
Jail
Wellpath provides
prescriptions
to community
pharmacies
•Referral pathway
exists from Wellpath
to County BH through
BH jail liaison for SMI
and co-occurring
disorders
•BH liaison can do
in-reach for AB109
program and
collaborative courts
•In-reach with 2 Prop
47 positions (1 filled)
•Direct referral to
substance use
treatment provider
Community supervision
CRIMINAL JUSTICE SYSTEM
Probation
County BH co-located
with probation
Parole
Parole and
Community Team
Reduce bookingsReduce average length of stayReduce recidivism Increase connections to care and treatment 5 Stepping Up Monterey County System Mapping Project