The Illinois Mental Health Task Force Virtual Summit Session 1—The 21st Century Crisis System: Strategies for Mental Health and Law Enforcement Collaboration to Prevent Justice Involvement

On September 29, 2020, the National Judicial Task Force to Examine State Courts’ Response to Mental Illness and the State Justice Institute hosted the first of five virtual sessions to support the Illinois Supreme Court’s ongoing efforts aimed at coordinating solutions for our community members living with mental illness. The first session’s title and focus was: The 21st Century Crisis System: Strategies for Mental Health and Law Enforcement Collaboration to Prevent Justice Involvement. These sessions are free to attend online and are also available on-demand at www.ncsc.org/mentalhealth. The first virtual event had approximately 700 attendees.

Chief Justice Burke personally played a role in overseeing this important program’s coordination and provided opening remarks during this first session. She detailed the various stakeholders that have come together from courts, agencies, and the community to deliver this vital program. Chief Justice Burke also highlighted how critical a coordinated response is to our community problems and thanked those involved for their efforts and willingness to come together.

Grace Hou, Secretary of the Illinois Department of Human Services (“DHS”) then provided remarks and detailed how COVID-19 affected the important work of DHS. Ms. Hou stated how DHS ensures nearly 1 in 3 Illinois residents receive food, shelter, or access to medical care. She also detailed that DHS is operating during unique times because of the pandemic and social unrest. DHS is mindful and concerned for how people of color with mental illness are treated differently by our community and law enforcement.

Next, the keynote speaker, Dr. Margie Balfour then presented. Dr. Balfour is an associate professor of psychiatry in Arizona. She first highlighted the ongoing dilemma for when someone is experiencing a mental health crisis and what can or cannot be done for that individual. She detailed how some typical solutions like 911 or a local crisis center are not always appropriate. Dr. Balfour explained that a behavioral health crisis is an emergency, and, as such, it requires a systemic response with the same quality and consistency as our responses to a heart attack, stroke, fire, or other emergency. She explained that most communities do not have an appropriate response system in place for such mental health emergencies and, as a result, individuals with mental illness end up in our criminal justice system and jail. Incarceration only compounds existing issues for the individual and even adds new setbacks and issues. For instance, once someone with a mental illness is incarcerated, studies indicate they may be held twice as long as other inmates and are three times more likely to be assaulted while incarcerated. What’s more, once that person is released, they likely face a host of other challenges with finding reliable housing and employment. Dr. Balfour also detailed how emergency rooms are also not the ideal solution. She explained that 84 percent of emergency rooms end up holding that person with mental illness until a free bed is available elsewhere and, during that time period, the risk of altercations increases (as well as the costs of holding the person).

Dr. Balfour then highlighted that there are ongoing efforts to establish a national standard for mental health crisis care. Part and parcel of this effort is the need for stakeholders to recognize that a collection of services is not enough. What is needed is for these various services to form a system and work together through collaboration that involves accountability and data. As proof of concept, she then went into detail about how Arizona’s system operates with centralized planning and centralized accountability. This type of approach allows for an alignment of clinical and financial goals.

Another key component of Dr. Balfour’s presentation was how various law enforcement agencies in her area have reconfigured their approach to mental health crises to divert individuals away from jail and instead to treatment. With the added implementation with a voluntary Crisis Intervention Team (“CIT”), these local agencies have seen higher rates of success and less time-consuming encounters for officers.

Following Dr. Balfour, Kurt Gawrisch from the Chicago Police Department and Dr. Amy Watson from the University of Wisconsin at Milwaukee, presented to the session about crisis intervention team training. This panel explained the importance of stakeholder involvement, collaborative development, and subject matter experts. Further, the presenters detailed how, exactly, Chicago’s CIT program works and what each program includes. For example, Chicago’s CIT training includes, among other things, education about psychotropic medications and family dynamics for those living with disabilities. Dr. Watson then discussed the ongoing data and research about CIT and its effectiveness. One notable finding is that CIT may improve an officer’s knowledge, attitude, and confidence when responding to a mental health crisis. Her research also indicated that a CIT program is more likely to succeed at its stated objectives when it operates as a voluntary model for officer engagement.

The session then turned to Geri Silic, a social worker employed with the Park Ridge Police Department. She indicated that several counties and villages throughout the state are now involving social workers within local police departments with success. In some instances, a social worker may accompany officers on a mental-health call to assist and provide insight into a particular situation. Ms. Silic also works with the various courts about diversion ideas and viable strategies for addressing mental health issues rather than emphasizing incarceration.

Commander Marc Buslik (ret.) then presented about how his former district in Chicago operated in coordinating a proper response to calls that came into the department regarding mental health crises. He found it essential to localize certain features for better community engagement, including a dedicated mental health resource officer.

Finally, Nathan Whinnery from the Rosecrance Mulberry Center in Rockford, Illinois, discussed what his particular crisis center encounters. Mr. Whinnery indicated how his center operates as a resource with local police to coordinate drop-offs and community engagements. This model is less expensive and less time-consuming than an emergency room drop-off. The community members are given access to a comfortable “living room” atmosphere and provided an opportunity to talk one-on-one with a team member from the center to coordinate what level of care may be needed.

Overall, the session was very informative and provided critical data and examples for how systems can be created through collaborative agreements. As daunting as the task ahead is for this new project and task force, this session provided real examples of what can be achieved through joint efforts to address ongoing mental health crises in our communities. If a practitioner is interested in being a part of reconfiguring how we respond and care for our community members, this session should not be overlooked. Consider reviewing it and getting involved.

Matthew R. Davison is an attorney with the Illinois Guardianship and Advocacy Commission. He can be contacted at matthew.davison@illinois.gov.