Strategies for Serving Individuals
with Frequent Justice System
Involvement
A Joint Meeting of the
City of San José Public Safety, Finance, and Strategic Support Committee and the
County of Santa Clara Public Safety and Justice Committee February 15, 2024
2.a. Strategies for Serving Individuals with
Frequent Justice System Involvement:
Strategies in the Field
988 and Behavioral Health Field Response Teams
12 Presenters: Darren Tan, Soo Jung, Lan Nguyen,
Bruce Copley, Sandra Hernandez
988
FEDERAL LAW
13 The National Suicide
Hotline Designation Act
was signed into law in
October 2020 and was
effective July 2022.
This Photo by Unknown Author is licensed under CC BY-NC-ND Source: Gamboa-Eastman, T. (2021, November 5). Vision and Components of 988 in California [PowerPoint]. CalBHB. https://www.calbhbc.org/ccc.html. 14 988 RESPONSE OPTIONS
15 Please note: Individuals with area codes other than 408, 650, and 669 should dial 800-704-0900 and press 1 for County CSPL services.
Trained counselors will provide
compassionate support to
individuals in crisis.
This service is free, 24/7,
and available in 200+
languages.
16 Santa Clara County Crisis and Suicide Prevention Lifeline (CSPL) Referrals to Crisis Ser vices
Mobile Crisis Response Team (MCRT), Mobile Response Stabilization Services for Youth (MRSS), Trusted Response Urgent Support Team (TRUST), In-Home Outreach Team (IHOT) 17 Key Takeaways
1. 988 call volume has
increased by 13.5% (1,833
calls in July 2022 to 2,199
calls in December 2023),
which corresponds with
the expected decrease of
local lines call volume
(12%), as significant
campaign efforts were
made to increase the
community's awareness of
988 and to use 988 since
its July
2022 implementation.
2. Answer rates have also
improved significantly for
both 988 and local lines.
CSPL Call Volume and Answer Rates
Month
988 (Started on July 2022)
Local Lines
855-278-4204 & 800-704-0900
Offered Answered Unanswered Answer Rate Offered Answered Unanswered Answer Rate Jul-22 1,833 1,437 396 78% 4164 2870 1294 69%
Aug-22 2,195 1,728 467 79% 3908 2949 959 75%
Sep-22 2,246 1,578 668 70% 3854 2659 1195 69%
Oct-22 2,139 1,591 548 74% 4010 2706 1304 67%
Nov-22 1,716 1,449 267 84% 3664 2794 870 76%
Dec-22 1,805 1,597 208 88% 3485 2859 626 82%
Jan-23 1,921 1,711 210 89% 3466 2901 565 84%
Feb-23 1,784 1,595 189 89% 3267 2641 626 81%
Mar-23 2,055 1,893 162 92% 4092 3447 645 84%
Apr-23 2,216 2,057 159 93% 4050 3332 718 82%
May-23 2,348 2,217 131 94% 3900 3140 760 81%
Jun-23 2,239 2,127 112 95% 4282 3565 717 83%
Jul-23 2,314 2,163 151 93% 4273 3519 754 82%
Aug-23 2,207 2,078 129 94% 3494 3053 441 87%
Sep-23 2,633 2,529 104 96% 3515 3056 459 87%
Oct-23 2,416 2,297 119 95% 3511 2977 534 85%
Nov-23 2,137 1,998 139 93% 3413 3017 396 88%
Dec-2023 2,199 2,049 150 93% 3520 2979 541 85%
July 2022 - Up to Date
TOTAL 36,266 32,096 4,170 88% 57,429 45,414 12,015 80%
18 CSPL Call Answer Rate Trends
Key Takeaways
1. The CSPL average answer rate has improved significantly since July of 2022. Within the last reported six months, we've maintained within a range of a 90% answer rate.
2. The 988 call answer rate has improved from 78% in July 2022 to 93% in December 2023, and the local lines answer rates improved from 69% in July 2022 to 85% in December 2023. 19 988 Rollover Trends
Key Takeaway:
Only 1% or less of calls roll over to another 988 Call Center, which is a significant improvement since July of 2022 when it was above 9%.
20 Peak Times for Calls
Key Takeaway:
The peak time for calls typically happens between 9am-12pm and then picks up again at 3pm and stays busy until 11pm.
21 Psychiatric
Emergency Response
Team (PERT)
Mobile Crisis
Response Team
(MCRT)
Mobile Response
Stabilization Services
(MRSS) – Youth Services
Trusted Response
Urgent Support Team
(TRUST)
COUNTY BEHAVIORAL HEALTH (BH) MOBILE PROGRAMS
Activated through the County BH Services Department Call Center (800-704- 0900) or 988 County Operated
Target Population: Ages 18 and older
• Team consists of BH Licensed and Licensed Waivered Clinicians. • Services individuals who display medium to high risk of behaviors • Moderate to immediate concern that the individual may meet 5150 criteria. • Law enforcement involvement is based on the nature/criticality of the call Activated through County BH Services Department Call Center (800-704- 0900) or 988
Target Population: Ages 18 and older
• Community-based approach
• Lowest level of intervention
• CCP: Pacific Clinics and Momentum
Activated through Pacific Clinics Crisis Phone Line (408-379-9085) or 988 Target Population: Children and Youth ages 4-20
• Team provides mobile response and/or crisis intervention for support with de-escalation of behaviors and/or crisis
• CCP: Pacific Clinics
Activated through 911 calls County Operated
Target Population: Ages 16 and over
• Consists of BH Licensed Clinicians paired with Law Enforcement Officers/Deputies are in a dressed down look and unmarked vehicle • Imminent Risk/Most Intense Level of Service
22 BEHAVIORAL HEALTH CRISIS CALL OUTCOMES
CSU = Crisis Stabilization Unit
Mobile Response & Stabilization Services July August September October November December Total In-Person Field Responses 46 68 103 106 103 75 501
5150 15 19 34 34 27 20 149
Referred to CSU 13 15 30 30 20 20 128
Referrals Managed Over Phone 257 335 451 475 456 456 1974 Arrests Data not collected-MRSS is primarily a non law-forcement program 23 BEHAVIORAL HEALTH CRISIS CALL OUTCOMES:
TRUSTED RESPONSE URGENT SUPPORT TEAM (TRUST)
Pacific Clinics July August September October November December Total In-Person Field Responses 118 128 127 173 129 186 861
5150 0 1 2 0 2 1 6
Referred to CSU 6 7 4 4 7 5 33
Referrals Managed Over Phone 226 188 176 184 177 52 1003 Arrests 2 1 2 3 0 4 12
Momentum July August September October November December Total In-Person Field Responses 26 36 41 39 16 46 204
5150 0 0 0 0 0 0 0
Referred to CSU 2 4 2 1 1 2 12
Referrals Managed Over Phone 0 0 0 0 0 0 0
Arrests 0 0 0 0 0 0 0
24 PREVIOUS AND FUTURE REPORTS ON BEHAVIORAL HEALTH
CRISIS ACCESS & RESPONSE
PREVIOUS REPORTS
• Under advisement from August 30, 2022 (Item No. 10): Receive monthly report from Administration relating to mental health and substance use as a public health crisis. (January 10, 2023, Item# 12, Board of Supervisors Meeting (Slides 3-6; 9-20) • Receive report from Behavioral Health Services Department relating to the expansion of the Trusted Response Urgent Support Team (TRUST) program, as part of the Fiscal Year 2023-2024 Budget adoption process. (Referral from December 13, 2022 Board of Supervisors meeting, Item No. 13). (March 22, 2023, Item # 7, Health and Hospital Committee) • Under advisement from August 30, 2022 (Item No. 10): Receive monthly report from Administration relating to mental health and substance use as a public health crisis. (April 4, 2024, Item #13, Board of Supervisors Meeting (Slide 25-27; 39-40) • Receive report from Behavioral Health Services Department relating to the 988 national three-digit number for individuals with suicide and mental health crises. (August 23, 2023, Item #11, Health and Hospital Committee) • Under advisement from August 30, 2022 (Item No. 10): Receive quarterly report from Administration relating to mental health and substance use as a public health crisis. (Office of the County Executive) (November 7, 2023, Item #9, Board of Supervisors Meeting (Slides 23-26)
FUTURE REPORTS
• February 27, 2023 Board of Supervisors Meeting – Public Health Crisis Report o 988 metrics, mobile crisis data and staffing, and updates on outreach o Report back on TRUST direct line referral
25 26
27 28 28
SAN JOSE
POLICE
DEPARTMENT
MOBILE
CRISIS
ASSESSMENT
TEAM
29 Mobile Crisis Assessment Team
Specially trained
officers respond to
mental health calls for
service
When deemed
appropriate,
Behavioral Health
Clinicians meet MCAT
officers to jointly
handle calls
MCAT team responds
throughout the City,
specifically targeting
areas with the greatest
number of mental
health calls
MCAT links people
with mental illnesses
to appropriate
services
30 Staffing and Operational Hours
7 days per week 10:00 am-8:00 pm
2 Sergeants & 4
officers
31 MCAT Collaboration
Response with
MCRT on calls
when deemed
appropriate
Referral to SCC
Behavioral Health
via LE Liaison
(160 in 2023)
Referral to CAMP
(24 in 2023) NAMI 1424
32 Direction: Alternatives to
Incarceration
Engage with Behavioral Health Services, Probation and
Reentry Services to understand how law enforcement
may better assist persons who do not meet the criteria
for 5150 W&I, suffer from mental illness, are chronic
substance abusers, whose conduct is repeated and
problematic and refuse services. Investigate the need
to also involve additional County partners…
Former Vice Mayor Chappie Jones
33 Stakeholders: Alternatives to
Incarceration
SuDDA Brandon Cabrera
District Attorney’s Office
Supervising Public
Defender Meghan Piano
Public Defender’s Office
Captain Antonio
Fernandes
Sheriff’s Office
Division Director Sandra
Hernandez and Police
Liaison John Costa
Behavioral Health
Director Javier Aguirre
Office of Reentry
Services
Division Manager
Michael Clarke
Adult Probation
San Jose Police
Department
34 DUI Pilot Warrant Cite
and Release
Narcotics
Pilot
Behavioral
Health Crisis
Referral
Form (MCAT
and Patrol)
Accomplishments
35 Goals
Community
• Increase Safety
• Reduce Traffic
Collisions (injury
and fatalities)
Individuals
• Increase use of
treatment and
services
• Reduce number
of contacts with
police
Work Group
• Increase
collaboration,
communication,
and datasharing
• Reduce partner
workload
Monitor effectiveness through data analysis
Mission Street Recovery Station (MSRS)
Utilization and Discharge Outcomes
◦ During Fiscal Year 2022-23, 79% of admissions were completed successfully, while 21% of admissions ended before full discharge; individuals removed from the MSRS due to behavior or discharged to medical services, such as EMS or Ambulance services
◦ 41% of clients were referred upon discharge to detoxification services, residential treatment, outpatient treatment, or community supports (e.g., Alcoholics Anonymous, Narcotics Anonymous, Recovery programs, Reentry Resource Center Services etc.). (FY23-24 First Quarter, increased from 41% to 81%) ◦ 73% of clients stayed six hours or longer, surpassing the objective of at least 50%. (FY23-24 First Quarter; decreased from 73% to 70%)
◦ MSRS achieved a program utilization of 21% using 12 recliners as the capacity level (FY23-24 capacity is 20)
Presenter: Javier Aguirre, Director of the Office of Diversion and Reentry Services 36 Mission Street Recovery Station (MSRS)
Utilization and Discharge Outcomes
37 MSRS Utilization with DUI Pilot Program
◦ On October 16, 2023, the County, in partnership with San Jose Police Department (SJPD), launched a program that utilizes MSRS as an alternative to booking for clients arrested on a first-time misdemeanor DUI offense
◦ DUI participants avoid jail entirely, as they are cited in the field and released to MSRS, but still need to report for processing in the days post arrest. From there, they will appear in court for adjudication. Officers in the field have discretion regarding when to offer MSRS in lieu of booking
◦ As of January 31, 2024, there have been 62 DUI cite and releases to MSRS, with no behavioral challenges. While many participants stayed the full night, the average length of stay is over four hours
38 MSRS New Location at the Reentry Resource Center
39 The new location is a large open space with ample natural lighting and private ADA bathrooms and showers. The new location has laundry services, and the larger space allows for more recliners, increasing the capacity from 20 (contract levels) to 30 recliners if needed for future expansion.
40 Next Steps
• Explore collaborative solutions:
• Work with stakeholders to establish common criteria
and definition for those with frequent interactions with the justice system (aka "High Utilizers")
• Create “Broadcast Hits” via SJPD Communications
• Custodial Bookings for on-view charges and/or warrants • Affidavit of Probable Cause and Bail Setting
• Post-arrest or discharge planning
• Continue exploring policy alternatives to potentially include a custody-component such as those models in
Seattle and San Diego