In Skagit County, there’s a different approach to how first responders are showing up for mental health crises — one that is changing the outcome of behavioral health emergencies and helping people stay out of the hospital or jail.

The program is called IMPACT, which stands for Integrated Model of Police and Crisis Teams. It partners county sheriff’s deputies with mental health professionals, or MHPs. It’s a partnership with Compass Health, a behavioral health organization operating in Snohomish, Skagit, Island, San Juan and Whatcom counties.

Amy Pereira, director of crisis response and the stabilization program for Compass Health, said IMPACT staff will often ask law enforcement what would have happened had they not been there. The response: having a different option for interventions has helped. Officers are seeing individuals who they typically would have been taken to a hospital or booked into jail instead get help that keeps them out of these facilities.

Lisa Zurek, program manager for IMPACT in Skagit and Snohomish counties, shared an example of a teenager who had left home and was suicidal. Typically, law enforcement would have sent an individual in that circumstance to the hospital. Instead, the MHP was able to create a safety plan that allowed the teenager to go back home.

Avoiding jail and the ER

Zurek said the program is about getting specially trained first responders to mental health calls. MHPs can determine what resources folks may need and what roadblocks might be in the way of them getting care. Ultimately, the goal of this is to have fewer folks ending up in emergency rooms and jails.

“We work with one person, we’re able to support that person and as a whole, then we start to see the collective numbers that will really help decrease the hospitalizations and jail [bookings],” Zurek said.

When people do have to go to either the hospital or jail, IMPACT follows up to see how this can be prevented next time, Zurek said.

After the immediate crisis is averted, Zurek said, the goal of the program is to connect people with resources that they can reach out to in the future, instead of having to call 911.

IMPACT can also help transport people to resources and services they may need outside of Skagit County.

Zurek said she’s seen the shift of callers from the 911 line to calling IMPACT. [Additional changes are anticipated with the debut of the national crisis line 988, scheduled for July.]

Skagit has been partnered with IMPACT for about two years — the only Washington county currently partnered with the program. In Snohomish County, Lake Stevens, Arlington and Marysville police departments have partnerships with IMPACT.

“There is more interest in the behavioral health system and helping people where they need it and finding unique ways to help them,” Compass Health’s Pereira said. 

A ‘beyond valuable’ partnership

Shaun Dalton, the first Skagit County deputy sheriff to be partnered with a MHP, said he’s learned a lot through this partnership. He has been part of the IMPACT program since September 2020. 

“I think it’s been great for the department,” Dalton said. “I know it’s been great for my squad. Just having that resource to rely on is beyond valuable.”

Dalton goes through various crisis trainings each year to understand how best to respond. He said partnering with the MHPs allows for a continuum of care.

“The most that a peace officer can offer is more or less a Band-Aid, to resolve the immediate problem,” Dalton said. But a MHP can provide counsel, follow-up referrals and help with scheduling appointments.

“It’s a matter of being able to continue care down the road and develop a relationship with those folks who are really needing our help” Dalton said.

Dalton said having this program in Skagit has made a difference for the community — and for his own work. Sometimes, he said, community members they’ve helped will text him with updates on their lives, such as a new job or a sobriety milestone.

“We want to be known as a resource, we want to be known as the people that, when we show up, we’re going to do everything that we can to help out,” Dalton said.

Where’s a police officer when you need one?

Showing up, in the right way, might be important now more than ever.

IMPACT is operating in the context of a decline across the state in law enforcement officers responding to behavioral health calls.

Alison Wedim works for the state’s Health Care Authority for the division of behavioral health and recovery. She said they have tracked a decline in involuntary detentions statewide since July 2021, perhaps a response by some law enforcement agencies to House Bill 1310. 

The law, which passed in April 2021, addresses permissible use of force by law enforcement and correctional officers in the state. 

Police departments around the state objected to the law as exemplified by a public letter signed by Whatcom County law enforcement sheriff and police chiefs.

Historically, Wedim said, law enforcement officers have assisted Designated Crisis Responders (DCRs), the mental health professionals who determine whether someone qualifies for involuntary treatment. When DCRs respond to a crisis, Wedim said they always explore other options before deciding someone needs involuntary commitment. 

“The issue is that there are people who meet the criteria, but we’re unable to take them into custody to get them into the hospital without the assistance of law enforcement,” Wedim said.

Not responding to calls is not part of HB1310, Attorney General Bob Ferguson clarified in a memorandum last August: “Bill 1310 does not address when law enforcement officers may respond to calls, including community caretaking calls, which do not involve criminal conduct. Washington statutes and case law recognize responding to community caretaking calls as part of a law enforcement officer’s duties. Bill 1310 neither alters nor limits that authority.”

Whatcom County sheriff Bill Elfo and interim Bellingham police chief Flo Simon both said that their officers would respond to behavioral health incidents when requested but said the law’s use of force and “leave the area” requirements were not clear. [See “Police, mental health workers face challenge, confusion with new use-of-force law,” Salish Current, Aug. 20, 2021.]

Rep. Kirsten Harris-Talley (D-Seattle) was a sponsor of HB 1310 and agreed with Ferguson that the law does not prohibit police response. House Bill 1735 (Modifying the standard for use of force by peace officers) is intended to provide further clarification this current session.

“[This bill was] introduced to clarify specifically … those instances where behavioral health professionals need additional assistance, reclarifying again, what is already clear in 1310 that officers, if needed, can be contacted to assist and can do their duty as peace officers,” Harris-Talley said.

HB 1735 is cosponsored by 42nd and 40th district representatives Alicia Rule, Sharon Shewmake and Alex Ramel. It passed in the House 95-0 and had its first reading in the Senate this week.

Declines related to 1310?

Beginning last October, DCRs have been asked to submit reports of instances where a law enforcement officer declined to accompany them into the field, to assist a DCR into getting someone into custody or to execute a custody authorization issued by court for the DCR to take a person into treatment.

Since October 2021, DCRs statewide have reported 312 instances such instances.

“We don’t have the data and analysis enough to the point that we can say that there’s causation between them,” Wedim said. “We certainly know that there’s a correlation.” 

She noted that it’s important to consider other possible factors, including the pandemic and staffing shortages, which may contribute to less law enforcement help with detentions. 

Wedim said DCRs and crisis systems are not refusing referrals from the community. They are still working on continued outreach and solutions, including possibly getting someone to voluntary treatment, or to the emergency room for evaluations.

“As these cases continue, there’s still a person out there in crisis, they’re still possibly meeting criteria for detention,” Wedim said. “And so DCRs are really spending time to continue to track those cases.”

In Bellingham last summer, social workers Lee Bennett and Crescent Munsen emphasized that police and behavioral health workers need to work together on the streets. (See “Police, mental health workers face challenge, confusion with new use-of-force law,” Salish Current, Aug. 20, 2021.)

In Skagit County, deputy sheriff Dalton said they are still responding to calls and always “try to put our best foot forward.” He also acknowledges that it is different in localities across the state. 

“There are numerous officers out there that have changed their approach with how they respond to mental-health-related calls,” Dalton said.

Harris-Talley said she ultimately would like to see more investment in other modes of response beyond law enforcement to behavioral health crises.

“For most people who find themselves with loved ones or family members who have behavioral health needs, the only option we have currently is to call in officers,” she said. “And I would like to see investment into other types of models of first responders, who could be the persons to answer that call.”

— Reported by Lauren Gallup

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