Delaney Kirwin is not a cop, but she helps respond to 911 calls.
Kirwin, a mental health clinician, will often spend an hour or two with someone in crisis who spawned a 911 call — much longer than a typical Orange County patrol deputy could, even if they had her same extensive training for responding to people dealing with mental health, substance abuse or other behavioral health emergencies.
Her goal is not only to deescalate the situation without force — a common complaint about law enforcement’s interactions with people in crisis — but also to appropriately assess the immediate and underlying issues to connect that individual or family with appropriate resources, ideally so they can remain safely in the community.
It’s a big shift in practice for the Orange County Sheriff’s Office, where many deputies have historically felt like they have two options when responding to such a crisis: determine whether the person qualifies for involuntary mental health treatment, through Florida’s Baker Act, because they are a threat to themselves or others, and if not, arrest them.
And so far, the agency says it has promising results.
Since late December when the program began, OCSO’s two Behavioral Response Unit teams have gone to more than 150 active calls for service, assisting or taking over from deputies.
They’ve completed more than 600 follow-ups with residents flagged for potential mental or behavioral health issues, without making any arrests, and utilized the Baker Act only 26 times, according to agency data.
“A lot of the deputies do feel like, … ‘If I’m leaving them in the community, then I didn’t do my job,'” Kirwin said, a clinician for Devereux Behavioral Health. “But when I come in, … [they realize] it’s OK that they’re in their home right now, that they’re not being Baker Acted, not being arrested. I’ve provided them these resources and I can call them tomorrow.”
“It doesn’t have to be A or B, there’s also a C option now, which I think is beneficial to both deputies and the community as well,” Kirwin said in a recent interview with the Orlando Sentinel.
Kirwin and her partner Orange County Master Deputy Kimberley Burk operate as “second responders” meaning they arrive only after another deputy has assessed the scene to ensure it’s safe. Though the teams pale in comparison to the more than 1,800 OCSO patrol deputies, Sgt. Bruce Vail said the early success and impact of the new Behavioral Health Unit is promising.
“We try to keep [individuals] in the community as much as possible, with the assistance from our clinicians,” said Vail, who oversees the unit. “… We’re doing everything we can to prevent an arrest.”
“The follow-up, that’s a huge part of it,” Vail said. “We’ve never done that before. Law enforcement would Baker Act, but you don’t see them again until you get another call, and then it’s already too late.”
A ‘changed response’
Alternative crisis response teams, both in conjunction with law enforcement and separate, have operated in different cities and towns across the U.S. for decades, but the motivation to implement such models became increasingly urgent in the year since the May 2020 murder of George Floyd, that sparked a national reckoning of policing. While “defunding the police” quickly became a catchphrase of activists calling for officials to reimagine public safety budgets, it also drew fast ire from law enforcement agencies and conservatives.
But a spot of common ground emerged in how mental health emergencies could be better handled by officers and deputies, both in the Orlando area and across the nation. Law enforcement advocates and community activists agreed that officers had unfairly and often without proper training become de-facto behavioral health responders when families didn’t know where else to call — creating difficult outcomes for both officers and the community, including disproportionately high uses of force and increased interactions with the criminal justice system for people with mental illness.
Orange Sheriff’s Office leaders had, even before Floyd’s death, been researching how to implement such a program, but countywide budget cuts from the pandemic — despite an increase in agency funds — meant dedicated dollars for the Behavioral Response Unit were taken off the table last fall. But Sheriff John Mina later decided to start the pilot program on a short-term basis with existing dollars. He is hoping, however, that the county will permanently fund the three current deputies — Burk, Vail and another specially-trained deputy on a “co-responder” team with a Devereux-funded clinician — plus another corporal and civilian analyst, according to his 2022 budget proposal submitted to county commissioners last month.
“We are absolutely thrilled with the way it’s been going,” Mina said about the BRU. “… The need for it, the amount of calls they’re taking, and the way they’re able to successfully, not only deescalate, but get [individuals] the services that they may need.”
OCSO is not the only local agency that started a program.
The Orlando City Council, under pressure from activists to improve local policing, also decided this summer to find a new way to respond to some mental health and non-violent crisis 911 calls, which have been typically answered by police officers. The city, with Orlando Police Department support and training, formed a separate Community Response Team, made up completely of mental health experts and case managers, who started responding independently from police to certain 911 crisis calls in late February.
According to data from the city, the team has responded to 210 calls and conducted 125 follow-ups, as of mid-May, referring 151 people to community resources and completing 50 Baker Acts. The team, which doesn’t have arrest authority but can call for OPD backup, has not had any calls that ended in arrest.
Orlando Mayor Buddy Dyer said the program has been “extremely successful” so far.
“It’s what we had hoped,” he said. “We’re sending them out to low-risk incidents, and they’re replacing people with guns and badges. Some of the individuals who are being contacted seem to be more comfortable in that environment, and we’re able to make referrals to other services that OPD would not necessarily be able to make on the spot.”
The majority of incidents that the CRT has responded to is attempted suicides, according to David Arnott, the mayor’s public safety advisor. The team has also not faced any safety concerns so far and is “incident-free,” Arnott added.
Dyer said the city is still looking at how the CRT operates by responding to a limited number of 911 calls in the pilot stage, but they envision expanding the program’s coverage and adding more teams. After the pilot, Dyer says the city will evaluate how the CRT did in comparison to the county’s program.
“It just shows we’re not afraid to try new things that will benefit the community,” Dyer said. “It’s a different way to respond than we have traditionally done it, but it’s important that we adjust with the times.”
Cities across the country and in Florida, including many in the Tampa area, have also recently implemented new approaches to respond to mental health calls — becoming one of the most tangible changes that came out of summer protests on police brutality and racial justice.
Sgt. Jamie Sipes, a St. Paul, Minn., police officer who helped found his agency’s Community Outreach and Stabilization Unit a few years ago — which responds to mental health, substance abuse and homeless issues — is scheduled to teach classes this summer in Florida through the Institute of Police Technology and Management called “Establishing a Law Enforcement Mental Health Response Unit.” He said he wants to help other agencies find innovative ways to create what he calls a “changed response,” because law enforcement has “to do something different” when it comes to these crisis situations.
“It’s really about creating a collaborative response with the community for these crisis calls for service,” Sipes said. His agency established what he called a co-response and case management model, similar to the BRU team at OCSO, but said in his classes he doesn’t push one particular model for crisis response to officers but recommends they focus on their community’s needs and desires.
But Ron Bruno, a former police officer in Utah and now executive director of Crisis Intervention Team International, said he and his team have found the best way to operate such crisis response teams is to have them mostly independent of law enforcement, like Orlando’s model.
“We know the majority of calls that go into a 911 call center do not require a law enforcement response,” Bruno said. “What we really need to do is follow the philosophy of [Crisis Intervention Teams], which is to divert from the criminal justice system, as often and as early as possible.”
While he understands there are safety concerns — which OCSO leaders have cited as the main reason they chose the model that pairs clinicians with deputies – Bruno said there are many examples of successful programs that have run for years with clinicians or social workers working independently, as one in Eugene, Ore. which has worked for the last three decades. He said having the presence of law enforcement, even if they’re just observing or off to the side, can raise someone’s anxiety or adrenaline, an unintended response that can make de-escalation or intervention less effective.
“Only utilize law enforcement when necessary, the rest of the time, it’s behavioral health handling it,” Bruno said. “… They’re more apt to speak to that individual, and it doesn’t raise [and individual’s] anxiety levels as it does with an armed law enforcement officer.”
‘Overwhelming’
When Kirwin accepted the hybrid position as a Devereux clinician working on OCSO’s BRU, she said she expected to be busy, as she was in her prior role in Devereux’s mobile crisis unit focused on youth 24 and younger in crisis.
“But I don’t think I knew how busy we were going to be,” Kirwin said. “It’s been eye-opening to see the amount of people in crisis.”
Vail said he spends each morning going through referrals that came through the day or night before — which include any calls deputies responded to that involved mental illness, substance abuse, homelessness, PTSD or other behavioral health issues — prioritizing which cases the BRU teams will tackle that day, but said it can feel like they won’t ever address them all.
“It is really overwhelming to think of the number of people in crisis in our community,” Vail said. “This is just Orange County. …I don’t think anyone really had any idea of the real numbers we’d be looking at.”
From mid-December through April, the OCSO BRU, which still only works during daytime weekdays, received more than 1,300 of those referrals and were able to refer about 40% of them to community resources, whether through Devereux or other behavioral health facilities.
But even when the team can reach someone, Kirwin said it’s common to run into other issues, often beyond their control: like lack of health insurance, waitlists for mental health providers, or people not having the transportation to get to appointments or refill medication.
“We do have resources and referrals we can make, but it’s still so difficult; it feels like there’s never enough,” Kirwin said. She said the pandemic has exacerbated the shortage of mental health resources with more people under stress, making waitlists that were already a challenge, even longer. And while she said there are some local resources for people without insurance, sometimes those options only last so long or are even more limited.
“I think everybody in the mental health community right now is being inundated,” Kirwin said. “But that’s where we can still come in as support, to be there in the meantime while they’re waiting to get connected.”
Kirwin and Burk will often circle back with someone they visited the day or week prior, sometimes multiple times, to check-in and see how things are going.
And though they said many people are unwilling to engage or accept help, Burk, Kirwan and Vail said when they help someone get needed resources, support or medication, it makes it all worth it. They told stories of helping a man who’d been living in the woods, not getting proper nutrition, who they helped get needed medical and mental health care. And another instance where they helped a family ease their brother out of his bedroom, which he rarely left, to get the help he needed.
The city of Orlando declined requests to interview members of its Crisis Intervention Team.
Changing the culture
Most exciting for Vail, however, is seeing how the BRU team and its philosophy are changing how some deputies respond to people in crisis, sometimes learning from watching the clinicians in action, or even realizing when mental health or substance abuse may be the underlying cause of a call.
Vail said he’s also seeing deputies more frequently wait to pursue criminal charges and take someone to jail, if possible, and more immediately address mental health issues.
“If you believe the call for service was for mental health, if you believe when you went there that this incident occurred because of their mental illness, consider going with the Baker Act and filing the charges,” Vail said he tells deputies. “We’re seeing a lot more of that across the agency as well.”
And while these changes can bring better outcomes to the community, he said it also saves taxpayers money, because time in jail, as well as involuntary hospital stays, can be expensive.
“Who knows how much money that the clinicians have already saved between those two processes already?” Vail said.
He said they are still working to track their success, but hope that if they can expand the unit, ideally to working seven days a week, they can have more of an impact. And as the team continues to explore the best ways to support the community, they started collaborating monthly with mental health experts and providers, as well as other local law enforcement agencies, to expand their reach and collaboration, because the need for better mental health response is not going away.
“It’s great for us to be able to start changing the culture of the agency, and working with other agencies as well,” Vail said.
gtoohey@orlandosentinel.com
Staff writer Monivette Cordeiro contributed to this report.
