'You've got to be on their time': Greensboro aims to help those in mental health crisis by pairing police and clinicians

Jun. 4—GREENSBORO — The phone call in May last year was a nightmare. Ultimately, though, it turned out to be a blessing.

Wendy Harrison's then 75-year-old father was wandering in and out of traffic on U.S. 29.

Someone called 911 and the city's Behavioral Health Response Team responded and got her father, William Harrison, safely back to his apartment. The team pairs officers with licensed counselors in responding to behavioral health crises.

"I am just so thankful because (the team members) were kind, they talked to my dad, they treated him with respect when they got him into the car to go with them," Harrison said. "You know, you've seen so many horror stories, and it was nothing like that."

Harrison had found her father walking in the middle of English Street earlier that same week.

"I didn't know of the early signs of dementia, I didn't realize," said Harrison of McLeansville. "Sometimes you feel like you're alone. ... I was so exhausted."

But with the help of the Behavioral Health Response Team, Harrison was able to get her father evaluated and placed in the memory care unit at Guilford House.

"They were able to provide me some assistance and some things to do to help me get my father the care that he needed so desperately," Harrison said, "because I was at my wit's end."

Marcus Smith

The Behavioral Health Response Team started as a $500,000 pilot program in 2019. Police officers with special training in mental illness and homelessness are paired with licensed counselors in a co-response model. Team members help facilitate care, transportation to appropriate facilities and support for family members.

BHRT was launched after the death of Marcus Smith, who died in September 2018.

Smith, a homeless Black man, was seen running in and out of traffic on Church Street, shouting that someone was going to "kill me."

Video footage shows that while Smith was not violent, he was so agitated that police chose to restrain him — by binding his hands to his feet behind him, leaving him face down on the pavement.

Within minutes, Smith had stopped breathing and died shortly thereafter. Advocates for Smith and some City Council members said that if police had been able to enlist mental-health professionals, the situation might have ended differently.

The city initially contracted with the Greensboro-based S.E.L. Group to provide trained counselors, who were summoned by officers when needed. But that process created delays and made it difficult for officers and counselors to work closely as a team.

So the city decided to keep the entire team in-house. It hired seven crisis counselors and a part-time outreach coordinator who helps with follow-ups when the other clinicians are busy taking new calls. Erin Williams, a licensed clinical mental health counselor, oversees this side of the team.

And from the police ranks, the city recruited seven officers, a corporal and Sgt. Sheila Lennox-Spaulding to lead the police side of the team.

Types of calls

"When we started in 2021, I don't think we really knew what kind of calls we would get, what kind of issues people were presenting," Williams said. "Dementia was one I didn't anticipate we would get a number of calls about."

Paranoia, which can result from many different illnesses, suicidal ideation and substance abuse also often are behind the initial call to police, Williams and Lennox-Spaulding said.

"I knew that there was a mental health crisis ... but until I actually started working on this squad, I just didn't realize how big of an issue it is," said Lennox-Spaulding, who's been with the department for nearly 16 years.

Brian James, who retired as the city's police chief at the end of May, told the City Council in March that shortly after the city's team was formed, it helped peacefully resolve a hostage situation.

The city's hostage negotiation team was already dispatched to another jurisdiction and wasn't available, so the Behavioral Health Response Team was called to help de-escalate the situation.

"A clinician was actually able to essentially negotiate a peaceful resolution to that situation," James said.

Exchanging ideas

Both sides of the team have learned from each other, the two leaders said.

On the officer side, Lennox-Spaulding said they've learned how to approach people in a manner that's less threatening.

"As officers, we're kind of trained as say 'hey, I'm officer such and such," she said. But the officers saw how the counselors just used their first names and people responded to that as a more friendly approach.

The officers, who wear khaki pants and black polo shirts, began using their first names instead and that made them seem more approachable, Lennox-Spaulding said.

It helps reinforce the message she tries to give people in crisis: "I'm here to listen and just trying to figure out what you need. I'm not trying to lock you up ... I see you've done this, but let's look at another option."

Williams said the counselors, who also get formal safety training, have learned how to be more adept at sizing up the possible danger in a situation.

"The counselors are so used to going into an environment where most of the time people want us there — like somebody has signed up for services and they want therapy," Williams said. "And now we're just showing up on scene."

Officers are always the first to leave the police vehicle and make contact, while the counselors wait for a signal that they can join in, she said.

"It's nice that the same officers are on our team because the counselors have really learned how they operate and there's not as much that has to be said in situations," Williams said.

"They're really, really close. So when it comes to safety concerns, of course, the officer is going to take primary and is going to take control and the job is going to be able to have everybody safe and get the clinician out of there in a safe manner," Lennox-Spaulding said.

Team members also get training that is tailored to either a crisis response or first responder model, Williams said.

"So we've had one on psychosis, one on dementia, one with the Autism Society," she said. "We recently did a trauma-based training. But all of it is kind of tailored so that it's information for not just the counselors but the officers to really think about like how we're responding to different calls."

Forming relationships

The team's goal is to help those in crisis obtain lasting solutions to their problems, which also can reduce repeated calls to 911.

"And we know with the history of law enforcement, it's been a history of incarceration," Lennox-Spaulding said. "In Greensboro ... we realized that there's other solutions for people with mental health and that's not necessarily the answer. The answer is to find out what's wrong ... and get them connected to people."

That means forming relationships based on trust — something hard to come by for people who see officers and/or counselors as a threat.

"People don't necessarily always want us there," Williams said. "Sometimes people have never had any contact with a counselor or therapist and there is stigma that exists there, just like with a law enforcement officer."

"There's some people that don't want the resources, so you just have to reach out — not bug them, but let them know that you're here and build that relationship with them," Lennox-Spaulding said. "You've got to be on their time.

"I've had some people who said, 'I don't really like talking to officers. I have a certain mental illness and they just don't know how to respond, but I'll talk to officers dressed like you or your team, because you guys get it," Lennox-Spaulding said. "So that to me, that's a success story."

The team also works with a host of agencies to find help for people in crisis.

"It would be impossible to do without networking," Lennox Spaulding said. "We do work with a lot of organizations that help with the homeless."

Team expansion

It's a problem that's too big for the team members, who work weekdays, to handle entirely by themselves.

Lennox-Spaulding said the team handles about 39% of the total mental health calls dispatched by the police department. James put that percentage higher, at 75%, when speaking at the City Council's retreat in March.

"Our team is just not big enough for a city of this size," Lennox-Spaulding said. "So my officers try to listen out to the calls and try to prioritize them."

A call where someone is threatening to harm themselves will take priority over one where the person is not in immediate danger, Lennox-Spaulding said.

The department has 184 officers trained in crisis intervention that can help in the less intense situations, Lennox-Spaulding said.

"They aren't on the team, but they're still trained," she said, adding that another 60 officers are slated to attend training this year.

And the nature of BHRT's work — building those relationships and finding resources for those who want help — is time-consuming.

"I think that's been challenging how to navigate the relationships we have (along) with the new crises that are showing up," Williams said.

"As time goes on, we need to look at how to expand the program as far as dedicating more officers to it," James said at the March retreat.

Although he didn't provide any statistics, James said the team is increasing the department's efficiency.

"The biggest thing is that is that the follow-up is preventing future calls, because they're actually connecting people to mental health care providers," he said. "It's preventing officers from responding to the same calls over and over again."

The city also has been awarded a $330,000 grant from the state which will pay for a paramedic, a clinical case manager, training, three up-fitted vehicles and a case management system.

"So we're looking at attaching a paramedic to the team that can also respond when medical assistance is needed," James said.

He said he'd like to add "some softer vehicles," such as minivans, for the team to use when responding to calls. The team currently uses a mix of marked and unmarked vehicles.

Other cities

The concept of pairing mental health counselors and police officers is still fairly new in North Carolina, but it's attracting the attention of other cities.

"I think we're one of the few in the state ... that actually have a full complimentary follow-up with a clinician and then an initial response piece," James said. "So I feel like we're ahead of the game."

Greenville and Durham are getting similar programs in place, officials said, and Winston-Salem has one that is still in the approval process.

"Different cities are now kind of consulting us, which is kind of cool," Williams said.

"I really think that we have made a positive community impact," Williams said. "We've gotten so much good feedback from people who never would have like interacted with a mental health professional or people who are seeing officers in a really new way."

Harrison, who had to quickly navigate the complicated task of getting her father into an Alzheimer's care unit, said the team touched her heart.

"The fact that this young man called me ... and made sure that I was OK — they're treating me as if I mattered," she said. "Not only was he there to make sure to help with my dad ... but the fact that they cared about me, that meant so much."

Contact Kenwyn Caranna at 336-373-7082 and follow @kcaranna on Twitter.

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