MENTAL HEALTH UNIT

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INFORMATION AND DATABASE MANAGEMENT

MENTAL HEALTH UNIT

WORKSHOP AGENDA

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Brief historical perspective prior to CIT program

Inception of the CIT program and how it evolved into the Mental Health Unit

Unit organization chart

How the creation of a CIT database benefits our police department

Implementing your own CIT Tracking Program

Information management

CITY OF HOUSTON STATISTICS 2011

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City of Houston Population: 2,100,000

HPD Calls for Service: 1,145,734

CIT Calls for Service: 25,500

CIT Offense Reports: 11,528

Total CIT Reports Catalogued: 8,270

Total HPD Officers: 5,300

Total CIT Officers: 1,848

Total CIT Cases Investigated by MHU: 1,155

Total Mental Health Unit (MHU) Investigative Staff: 5

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HISTORICAL PERSPECTIVE PRIOR TO THE MENTAL HEALTH UNIT

1991- Impetus for Working on Mental Health Issues• The process of obtaining an emergency detention order

was very complicated and time consuming• Officers spent on average 5 to 6 hours filing 7 pages of

affidavits, locating a judge, a notary, and a hospital bed.• Only one hospital facility available with 12 beds – limited

area resources for law enforcement to utilize

1992 – The Roots of inter-agency collaboration & CIT• One officer took initiative and met with MHMRA director

to streamline the EDO process and reduce time• Developed plans for a future facility that would handle

consumers brought in by police in a timely manner

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1993 – First Class on Mental Illness• Prior to the 1990’s there was no formal training available

for police officers regarding different mental disorders• No tactics or techniques for crisis de-escalation

available for officers dealing with individuals with serious mental health crises

• Officers had mostly negative attitudes about mental illness and the lengthy, time consuming process of obtaining an emergency detention order

• Most officers did not feel responding to individuals with mental illness was role of law enforcement

• Officer Frank Webb and Dr. Schnee developed 8 hour in-service class ‘Dealing with the Mentally Ill’

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1996 – Mandatory 16 hour class for Patrol Sergeants• Chief Nuchia approved and mandated 16 hours of

training regarding mental health issues for all patrol sergeants.

1998 – Harris County Criminal Justice Workgroup• A multi-agency workgroup was formed to address

barriers to responding to the mentally ill in Harris County.

• Committee decided primary issue to address was the law enforcement’s response to individuals in serious crisis situations.

• This paved the way for the development of the CIT program in the Houston Police Department.

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1999 – CIT 6 month pilot program• 40 hour class taught by Officer Frank Webb.• Program was voluntary and offered to patrol• 63 patrol officers became CIT trained• Opening of the Neuro-Psychiatric Center (NPC)• Average time on EDO – 15 minutes

2000 – Department-wide Implementation• 213 patrol officers trained.

2001 – CIT Coordinator Position Approved• Over 700 officers have received training• This position reported directly to Executive Assistant

Chief over Patrol Operations

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2005 – State Mandated CIT training; Senate Bill 1473• Senate Bill 1473 mandates 16 hours of CIT and de-

escalation training for all Texas peace officers.

2006 – CIT Administrative Unit formed• The size and complexity of Houston’s CIT program,

along with increased training responsibilities related to Senate Bill 1473, resulted in a program too large for one person (Senior Officer Frank Webb) to coordinate. Chief of Police Harold L. Hurtt approved the formation of a CIT administrative unit in August 2006.

TRANSFORMATION OF THE C.I.T. PROGRAM

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2007 – Formation of the Mental Health Unit• The CIT program is the foundation of the unit• This unit oversees the department’s multi-faceted,

comprehensive program for responding to individuals in serious mental health crisis

• Programs under this unit include the following: 1) Administration & CIT Training Unit2) Investigations 3) Crisis Intervention Response Team (CIRT)4) Chronic Consumer Stabilization Initiative (CCSI)5) Homeless Outreach Team (HOT)6) Sobering Center (January 2013)

a) A peace officer, without a warrant, may take a person into custody if the officer:1) has reason to believe and does believe that:

A. the person is mentally ill; andB. because of that mental illness there is a substantial risk of serious harm to the

person or to others unless the person is immediately restrained; and2) believes that there is not sufficient time to obtain a warrant before taking the person

into custody.

b) A substantial risk of serious harm to the person or others under Subsection (a)(1)(B) may be demonstrated by:

1) the person's behavior; or2) evidence of severe emotional distress and deterioration in the person's mental

condition to the extent that the person cannot remain at liberty.

(c) The peace officer may form the belief that the person meets the criteria for apprehension:3) from a representation of a credible person; or4) on the basis of the conduct of the apprehended person or the circumstances under

which the apprehended person is found.10

TEXAS MENTAL HEALTH CODE: APPREHENSION BY PEACE OFFICER

WITHOUT WARRANT

SECTION 573.001

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DEPARTMENT POLICY: SUBJECT:

PERSONS SUSPECTED OF MENTAL ILLNESS

GENERAL ORDER: 500-12

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Officers will complete an incident report on all incidents involving persons suspected of mental illness. The title of the report will be the same as the offense. If no criminal offense was committed, the offense report will be titled Investigation-Mental Illness. The report will include the name of the psychiatrist who examined the personsuspected of mental illness

MENTAL HEALTH UNIT

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ORGANIZATIONAL CHART

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Sergeant P. PlourdeCIRT

Lieutenant M. A. LeeMental Health Unit

Sergeant M. LoeraINVESTIGATIONS

SPO M. RubinInvestigator

SPO D. AndersInvestigator

PO P. RayonInvestigator

PO M. PateInvestigator

SPO F. WebbTraining

PO R. AriasCIRT Officer

SPO J. OsborneCIRT Officer

PO N. BainesCIRT Officer

PO R. DunnCIRT Officer

PO C. VaughanTraining

PO C. McKinneyCIRT Officer

Sergeant S. WickHOMELESS OUTREACH

SPO J. GiraldoH.O.T. Officer

PO J. TerryH.O.T. Officer

PO R. SkillernTraining

PO S. AugustineCIRT Officer

Sergeant J. Ramirez CIRT

PO M. StevensCIRT Officer

PO J. LlorenteCIRT Officer

PO J. GarciaCIRT Officer

PO R. ConcholaCIRT Officer

DEVELOPMENT OF THE C.I.T. DATABASE

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Define it’s purpose

Information source – offense reports, calls for service

Type of data collected

How will the information collected be used

Investigations and follow-ups

Research and analysis – Response strategies

Statistics

IDENTIFYING THE MENTAL HEALTH POPULATION

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Proper Dispatch Call Codes and Titles

a) Non-Family Disturbance/CITb) Suspicious Person/CIT

Proper Offense Report Titles

a) Investigation Mental Illness (CIT)b) Harassment (CIT)c) Trespassing (CIT)

EXAMPLE OF AN ACTUAL OFFENSE REPORT TITLE

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EXAMPLE OF AN ACTUAL CALL FOR SERVICE TITLE

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SCREENING OFFENSE REPORTS AND FILTERING INFORMATION

The initial steps to help identify who your mental health clients are within your jurisdiction starts with a thorough screening procedure

a) Source of information: Offense Reports

A report screener reviews every printed offense report that has been coded ‘CIT’ and makes notations of all relevant mental health components and major indicators that were documented by the patrol officer at the scene

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MAJOR INDICATORS AND MENTAL HEALTH COMPONENTS

Filtering out the major indicators and mental health components from a police report will be crucial when collecting this information and imputing this into a comprehensive database (Statistics)

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Examples of Mental Health Components and Major Indicators:

Delusional Paranoia Hearing Voices Suicidal Homicidal Off Medication

Violence/Threat Weapons used Use of Force Request Suicide by cop Suicide Attempt/Method Jail Diversion

MENTAL HEALTH UNIT

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INFORMATION WORK FLOW

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OFFENSE REPORT

Lieutenant M. A. LeeMental Health Unit

Sergeant M. LoeraInvestigative Supervisor

SPO M. RubinInvestigator

SPO D. AndersInvestigator

PO P. RayonInvestigator

PO M. PateInvestigator

INVESTIGATIVE ASSIGNMENTS

DATABASE ENTRY

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WHO GETS ENTERED INTO THE MENTAL HEALTH UNIT DATABASE?

Mental health consumers who were reported to be in a mental health crisis and met the criteria for an Emergency Detention Order (EDO)

Mental health consumers who were reported to have committed a criminal offense or were likely to have committed a criminal offense due to their untreated or uncontrolled psychotic behavior

Known mental health consumers who pose a danger or serious threat to themselves or the public

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MENTAL HEALTH UNIT DATABASE CRITICAL INFORMATION SHARING

Critical information gleaned from the CIT database can be shared with segments of the law enforcement community and the local police department under specific circumstances:

1) Safety awareness to first responders2) Safety alert bulletins disseminated to the

appropriate Patrol Division or Precinct where the mental health consumer resides

3) Premise histories on certain locations issued to the Emergency Communications Division (Dispatcher)

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MENTAL HEALTH UNIT DATABASE LOGIN SCREEN

The database is not a department wide program and it cannot be accessed by anyone outside the agency

Maintained on secure server

INVESTIGATIONS & FOLLOW-UPS

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900 to 1000 offense reports (CIT) are reviewed each month

75 to 125 cases are assigned to all 4 investigators each month

Such cases include:

a) Criminal charges on serious offensesb) Firearms investigationsc) Premise histories on locations or persons with serious

mental illness who engaged in violent behaviord) Chronic consumers involving numerous contacts with

the policee) Referrals

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AGENCY REFERRALS

Properly reviewed offense reports are developed into case files and are assigned for follow-up investigations or referred to outside agencies for appropriate handling. Some examples are the following:

a) Child Protective Services (CPS)b) Adult Protective Services (APS)c) Department of Public Safety (DPS)d) Mobile Crisis Outreach Team (MCOT)e) Crisis Intervention Response Team (CIRT)

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ASSIGNMENT EXAMPLES

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MENTAL HEALTH UNIT DATABASE RESTRICTIONS

All files and records are retained solely within the police department’s Mental Health Unit.

Access is only authorized to investigators and supervisors assigned within the Mental Health Unit.

HOUSTON POLICE DEPARTMENT

MENTAL HEALTH UNIT

2011 ANNUAL DEMOGRAPHICS AND STATISTICS REPORT

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MENTAL HEALTH UNIT 2011 STATISTICS

C.I.T. INCIDENTS 2007 2008 2009 2010 2011 2007/2008 % CHANGE

2008/2009 % CHANGE

2009/2010 % CHANGE

2010/2011 % CHANGE

TOTAL CIT CALLS FOR SERVICE 15,122 21,109 23,913 25,105 24,771 39.6% 13.3% 5.0% -1.3%TOTAL CIT REPORTS REVIEWED N/A N/A 6503 10628 11528 - - - 63.4% 8.5%TOTAL REPORTS CATALOGUED 2102 3642 4811 7024 8270 73.3% 32.1% 46.0% 17.7%TOTAL CASES INVESTIGATED N/A N/A N/A 1514 1155 - - - -23.7%

TOTALS BY GENDER MALES 1254 2112 2699 3822 4580 68.4% 27.8% 41.6% 19.8%FEMALES 846 1528 2106 3115 3696 80.6% 37.8% 47.9% 18.7%

TOTALS BY SEX/RACE WHITES (TOTAL) 635 1120 1735 3014 3233 76.4% 54.9% 73.7% 7.3%WHITE MALES 398 606 966 1634 1795 52.3% 59.4% 69.2% 9.9%WHITE FEMALES 237 514 769 1380 1438 116.9% 49.6% 79.5% 4.2%BLACKS (TOTAL) 1113 1843 2225 3223 3711 65.6% 20.7% 44.9% 15.1%BLACK MALES 636 1094 1250 1782 2020 72.0% 14.3% 42.6% 13.4%BLACK FEMALES 477 749 975 1451 1691 57.0% 30.2% 48.8% 16.5%HISPANICS (TOTAL) 305 604 680 521 1125 98.0% 12.6% -23.4% 115.9%HISPANIC MALES 188 370 386 324 682 96.8% 4.3% -16.1% 110.5%HISPANIC FEMALES 117 234 294 197 443 100.0% 25.6% -33.0% 124.9%ASIANS (TOTAL) 45 66 109 158 181 46.7% 65.2% 45.0% 14.6%ASIAN MALES 30 35 60 75 76 16.7% 71.4% 25.0% 1.3%ASIAN FEMALES 15 31 49 83 105 106.7% 58.1% 69.4% 26.5%OTHERS (TOTAL) 3 3 62 5 5 0.0% 1966.7% -91.9% 0.0%


AGE GROUPS 2007 2008 2009 2010 2011 2007/2008 % CHANGE

2008/2009 % CHANGE

2009/2010 % CHANGE

2010/2011 % CHANGE

16 - 19 73 135 178 241 301 84.9% 31.9% 35.4% 24.9%20 - 29 467 786 999 1493 1742 68.3% 27.1% 49.4% 16.7%30 - 39 336 572 805 1115 1191 - 70.2% 40.7% 38.5% 6.8%40 - 49 387 655 748 918 1157 69.3% 14.2% 22.7% 26.0%50 - 59 205 387 549 883 941 88.8% 41.9% 60.8% 6.6%60 - 69 58 96 153 226 330 65.5% 59.4% 47.7% 46.0%70 - 79 17 37 44 114 110 117.6% 18.9% 159.1% -3.5%80 - 89 0 0 0 0 50 - - - -90 - 99 0 0 0 0 10 - - - -

JUVENILES 8.2%JUVENILE MALES 51 108 122 217 262 111.8% 13.0% 77.9% 20.7%JUVENILE FEMALES 35 98 114 197 211 180.0% 16.3% 72.8% 7.1%COMPLETED SUICIDES 0 0 0 0 2 - - - -

MAJOR CATEGORIES TASER INCIDENTS 19 33 26 30 30 73.7% -21.2% 15.4% 0.0%REQUEST SUICIDE BY COP 40 44 47 82 77 10.0% 6.8% 74.5% -6.1%SWAT INVOLVED INCIDENT 5 10 10 9 9 100.0% 0.0% -10.0% 0.0%THREAT OF VIOLENCE 780 153 741 1237 782 -80.4% 384.3% 66.9% -36.8%WEAPONS INVOLVED 228 25 262 317 221 -89.0% 948.0% 21.0% -30.3%FIREARMS INVESTIGATIONS N/A N/A N/A N/A 83 - - - -ILLEGAL DRUG USE / ALCOHOL 231 371 484 337 493 60.6% 30.5% -30.4% 46.3%


REPORTED DIAGNOSES 2007 2008 2009 2010 2011 2007/2008 % CHANGE

2008/2009 % CHANGE

2009/2010 % CHANGE

2010/2011 % CHANGE

SCHIZOPHRENIA 235 457 634 742 1063 94.5% 38.7% 17.0% 43.3%BI-POLAR DISORDER 327 620 808 1110 1375 89.6% 30.3% 37.4% 23.9%MAJOR DEPRESSION 303 593 848 1148 1743 95.7% 43.0% 35.4% 51.8%PTSD N/A N/A N/A 44 78 - - - 77.3%DEMENTIA N/A N/A N/A N/A 89 - - - -

SYMPTOMS/BEHAVIORS HEARING VOICES 317 400 641 940 1099 26.2% 60.3% 46.6% 16.9%DELUSIONAL 443 932 920 1186 1216 110.4% -1.3% 28.9% 2.5%PARANOIA 120 18 167 647 975 -85.0% 827.8% 287.4% 50.7%SELF MUTILATING N/A N/A N/A 139 181 - - - 30.2%HOMICIDAL N/A N/A N/A 462 584 - - - 26.4%SUICIDAL IDEATIONS 924 1454 1881 2208 2313 57.4% 29.4% 17.4% 4.8%SUICIDAL THREATS 220 184 257 350 540 -16.4% 39.7% 36.2% 54.3%SUICIDE ATTEMPTS 182 272 514 1158 1423 49.5% 89.0% 125.3% 22.9%COMPLETED SUICIDES N/A N/A N/A 62 122 - - - 96.8%OFF MEDICATIONS 667 1160 1393 1677 2172 73.9% 20.1% 20.4% 29.5%

OTHER GROUPS MILITARY VETERANS 4 46 63 127 168 1050.0% 37.0% 101.6% 32.3%HOMELESS 189 311 359 528 517 64.6% 15.4% 47.1% -2.1%PERSONAL CARE HOMES 107 120 275 233 341 12.1% 129.2% -15.3% 46.4%


REPEAT CONSUMERS 2007 2008 2009 2010 2011 2007/2008 % CHANGE

2008/2009 % CHANGE

2009/2010 % CHANGE

2010/2011 % CHANGE

CHRONIC CONSUMERS 2X 133 225 228 322 267 69.2% 1.3% 41.2% -17.1%CHRONIC CONSUMERS 3X 37 50 52 92 79 35.1% 4.0% 76.9% -14.1%CHRONIC CONSUMERS 4X 6 16 19 29 33 166.7% 18.8% 52.6% 13.8%CHRONIC CONSUMERS 5X 7 11 6 13 16 57.1% -45.5% 116.7% 23.1%CHRONIC CONSUMERS 6X 3 3 2 5 7 0.0% -33.3% 150.0% 40.0%7X 0 3 2 0 1 - -33.3% -100.0% -8X 0 1 1 2 1 - 0.0% 100.0% -50.0%9X 0 1 0 0 1 - -100.0% - 100.0%10X 0 0 0 1 0 - - - -11X 0 0 0 0 3 - - - -12X 0 1 0 2 0 - -100.0% - -100.0%13X 0 0 0 0 0 - - - -14X 0 0 0 0 1 - - - -

ADMITTED TO N.P.C. 1959 2688 2604 3617 4198 37.2% -3.1% 38.9% 16.1%ADMITTED TO BEN TAUB 71 302 805 413 1406 325.4% 166.6% -48.7% 240.4%ADMITTED TO V.A. HOSPITAL 4 46 64 144 165 1050.0% 39.1% 125.0% 14.6%ADMITTED TO ST. JOSEPH’S N/A 46 73 N/A 16 - 58.7% - -OTHER AREA HOSPITALS 12 126 223 341 138 950.0% 77.0% 52.9% -59.5%


JAIL DIVERSIONS / CRIMINAL OFFENSES 2007 2008 2009 2010 2011 2007/2008

% CHANGE2008/2009 % CHANGE

2009/2010 % CHANGE

2010/2011 % CHANGE

JAIL DIVERSION TOTALS (DEP’T) 814 1244 1508 2099 1847 52.8% 21.2% 39.2% -12.0%JAIL DIVERSION TOTALS (CIRT) N/A N/A N/A 242 614 - - - 153.7%AGGRAVATED ASSAULT N/A N/A N/A N/A 66 - - - -AGGRAVATED ASSAULT D/W N/A N/A N/A N/A 14 - - - -ASSAULT BY THREAT N/A N/A N/A N/A 135 - - - -ASSAULT CLASS C N/A N/A N/A N/A 421 - - - -ASSAULT CLASS A N/A N/A N/A N/A 75 - - - -CRIMINAL MISCHIEF N/A N/A N/A N/A 163 - - - -CRIMINAL TRESPASS N/A N/A N/A N/A 59 - - - -DISORDERLY CONDUCT N/A N/A N/A N/A 201 - - - -CITY WARRANTS N/A N/A N/A N/A 19 - - - -IMPEDING TRAFFIC N/A N/A N/A N/A 163 - - - -INDECENT EXPOSURE N/A N/A N/A N/A 79 - - - -PUBLIC INTOXICATION N/A N/A N/A N/A 60 - - - -RESISTING ARREST/DETENTION N/A N/A N/A N/A 13 - - - -TERRORISTIC THREAT N/A N/A N/A N/A 268 - - - -THEFT N/A N/A N/A N/A 22 - - - -

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QUESTIONS?

Mental Health Unit LieutenantMike Lee, M.A. [email protected]

Mental Health Unit SergeantPatrick Plourde [email protected]

WWW.HOUSTONCIT.ORG

CONTACTS

mailto:[email protected]

MENTAL HEALTH UNIT

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