According to Sacramento County Sheriff Jim Cooper, the policy change follows a ruling by the United States Court of Appeals for the Ninth Circuit, which held that law enforcement officers may not be entitled to qualified immunity when responding to non-criminal mental health incidents.
"This is not a brand new conversation. This is not an idle reaction," Porteus said.Before 988, 911 was the only option in a mental health crisis. The call would then be transferred to EMS or fire to a hospital, or to police and sheriff, to jail. Now, the behavioral health crisis continuum has grown, with the addition of 988. Trained crisis counselors are available 24/7 by talk, text, or chat. In these calls, Porteus said, 95% of calls are resolved by counselor intervention. On these calls, the trained counselors identify what steps happen next. In Sacramento County, that may be calling on the Community Wellness Response Team. Through 988, counselors may also refer to EMS or fire to the hospital or a Crisis Receiving for Behavioral Health, or law enforcement.
Sheriff Cooper said that the department expected the number of calls to 988 to increase due to the policy change. Porteus explained that 988 is staffed for an increase of calls, and because it is a national lifeline if Sacramento County counselors are engaged, the calls may be picked up by counselors across the system. In Sacramento County, 911 and 988 are interoperable, which is a state goal for every county.
"The sheriff's office is just one piece of our law enforcement across the region. We have this conversation with Sac PD and other departments across the region," he said.
"We can set the best practice. I believe that we—WellSpace Health and law enforcement—are going to work it out," he said.
Building the Future of Crisis Response
"We still need to build places to go that are not hospitals, not jails, not acute care environments. We still need to give people an opportunity to work through a crisis," he said.
Ultimately, Porteus and the 988 team are ready to engage in ongoing conversations to improve Sacramento's mental health crisis system. The sheriff's policy change has "forced the issue," Porteus said, and now he believes the region has an opportunity to lead the way in developing a comprehensive, compassionate response system.
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