Chicago plans to send medics on mental health calls; leaders divided on police involvement

The current proposed plan would create a dedicated line that would dispatch paramedics, clinicians and police officers to mental health crisis calls


Annie Sweeney and Jeremy Gorner
Chicago Tribune

CHICAGO — By the time police got to the apartment building earlier this month on South Burley Avenue, the situation was already escalating.

An anxious Patricia Bulmer stood outside as her 26-year-old daughter, who was upstairs in their apartment, threw things out a window at the officers.

Chicago has unveiled its $1.4 million plan to create a dedicated line that will dispatch paramedics, clinicians and police officers to mental health calls; some city leaders disagree on the inclusion of police.
Chicago has unveiled its $1.4 million plan to create a dedicated line that will dispatch paramedics, clinicians and police officers to mental health calls; some city leaders disagree on the inclusion of police. (Photo/Antonio Perez, Chicago Tribune)

Things could get ugly, the mother had told a 911 operator, repeating the warning to the officers as they tried to reason with her daughter.

Several minutes later, the younger woman emerged — brandishing two knives. Standing on the front porch, she cursed at the officers and slashed into her own legs before charging them.

The cops had to deploy a Taser multiple times to subdue her. In the melee, one of them, who was trained in crisis intervention, was stabbed in the stomach.

The scene on Burley had a better outcome than many similar cases, considering how many mental health calls for police end in tragic deaths. According to national estimates, 1 in 4 police encounters involve people with mental health concerns.

And yet the result — a person in crisis being tased and sent to Cook County Jail — is far from ideal, according to experts, community mental health advocates and, of course, the young woman’s mother.

“It’s horrible. It really is. You know, and especially to witness all of that," Bulmer said in an interview with the Tribune. She also said a call to police is a harrowing decision when her daughter is in crisis.

“You don’t know if they are going to come down off that level," she said of people experiencing a crisis like her daughter was. "You do call 911, there’s probably a (good chance) that it’s going to get combative, and that’s the ugly part about it.”

Police response to mental health calls has been the subject of intense debate and organizing in recent months in Chicago amid the national conversation over policing and police abuse, including the high-profile in-custody deaths of people who were experiencing a mental health crisis.

Chicagoan Daniel Prude, who had a history of mental illness, died in Rochester, New York, while visiting relatives after police there confronted him on a street, wrapped a hood over his head and pushed his face to the pavement.

To many, police simply are not suited to handle calls of people experiencing mental health-related distress, arguing their very presence, with sirens, flashing lights and guns, can increase anxiety and tension. In communities of color, the concern over how police will respond to a person in crisis is even greater, considering the long-standing mistrust minority communities have for officers and the fact that recent high-profile police-abuse deaths have involved Black victims.

A possible new direction

A group of aldermen and community activists are now calling for a plan to remove police from non-life-threatening mental health calls altogether by creating a dedicated emergency line that would dispatch a paramedic and a clinician instead.

And just this month, the Chicago Department of Public Health outlined its own idea: a $1.4 million plan to create three-person teams of clinicians, cops and paramedics to respond together to mental health calls, a concept that has been used in other cities for years. The plan, as outlined by the department’s director, Dr. Allison Arwady, at a city budget hearing, would be piloted in two police districts next year.

While Arwady called the plan a significant shift in crisis response for the city, she faced pushback from aldermen at the hearing as they questioned why law enforcement had to be part of the team at all, considering how often police have used excessive force and how much credibility they’ve lost in some Chicago neighborhoods.

“I think what we are talking about now, in terms of a co-responder, doesn’t do enough,” Ald. Rossana Rodriguez Sanchez, 33rd, said at the budget hearing. "I think it’s an emergency to get police out of the mental health response.”

Another troubling case

On the morning after Christmas in 2015, Quintonio LeGrier, a 19-year-old engineering student, called Chicago’s 911 center three times for help.

“I need to talk to an officer,” he told a dispatcher in the first call. “Someone’s threatening my life."

The emergency operator hung up on LeGrier when he failed to provide his full name.

Police showed up anyway after LeGrier’s father called to report his son was menacing him with a bat. When Officer Robert Rialmo reached the porch steps, LeGrier was there with the bat and Rialmo fired, later claiming the teen was swinging it at him.

LeGrier and his downstairs neighbor, Bettie Jones, were killed in the gunfire. Rialmo was later fired, and 911 operators faced discipline. The shooting became another example of a failed response to mental health calls.

“CPD’s documentation of these incidents is often insufficient to determine whether the force was necessary, appropriate, or lawful,” reads a 2017 report from the U.S. Department of Justice that investigated the Chicago Police Department in the wake of the shooting of teenager Laquan McDonald. "Consequently, all we know are the broad contours of terribly sad events — that officers used force against people in crisis who needed help.”

In the aftermath, the city announced new training at the 911 center and that it would increase the number of officers certified for a Crisis Intervention Team, a long-standing and well-regarded program that trains officers on de-escalation techniques and how to recognize symptoms of a mental health crisis.

Today, 3,100 Chicago officers are CIT-trained, nearly a quarter of the department.

The unit has also partnered with city mental health organizations so that officers can make referrals after responding to calls — the kind of referral that apparently was made after Patricia Bulmer’s daughter was tased and arrested. Bulmer said she got a phone call from a Chicago-based mental health organization.

But experts said CIT training by itself is not the answer to improving response to people having mental health incidents. Studies have shown that training does help officers change their attitudes, use more de-escalation and connect people to services, but there needs to be a fundamental shift away from continuing to let police policy alone drive responses.

That’s especially true when it comes to mental health, said University of Wisconsin professor Amy Watson, who has studied training in Chicago and police mental-health response nationally.

“It’s exciting to see there a possibility that we really can develop more on the mental health side," Watson said. “You can train officers, you can get people who are really good at mental health response, but in the end, they are still police.”

Alternate emergency line?

The women laughed and chatted in darkness at McKinley Park, the moon still bright overhead as they stretched hamstrings on the steps of the field house.

It was 6 a.m. on a Tuesday in early October. Carmen Orozco was leading neighbors from the Southwest Side on a walk around McKinley, a sprawling park of ball fields, tennis courts and a prairie path that snakes along a large lagoon.

Orozco, 44, and other community health promoters at the Brighton Park Neighborhood Council do outreach on a variety of health concerns, such as asthma to diabetes.

These days, mental health is a big worry. City neighborhoods had already lost community mental health clinics. And now the pandemic has added stress, including economic worry, to many homes, as has the closure of schools as parents are trying to manage remote learning. The early morning walks aimed to help relieve stress.

The women take pride that they have been able to connect with neighbors, who now call them for help — like a mother who called Orozco recently about her despondent teenager. What they struggle with is finding help.

Calling 911 is not always an option, especially since some families fear police because of immigration concerns.

“I have been able to gain the trust of the people," Orozco said. "(But) I feel powerless because I do not have a safe, accessible tool. I do not have anywhere to turn.”

Orozco and other health workers want to see more investment in the community by hiring more culturally competent and bilingual counselors and reopening the shuttered clinics.

What they said they don’t need is more police, which is why Orozco and others back a plan put forward by Ald. Rodriguez Sanchez and others for a separate emergency line that sends responders who are not police officers to mental health calls.

“Face it,” Estela Diaz, 41, said matter-of-factly as the women briskly bounded around the north side of the park. “Police are not prepared for a crisis of mental health. … When you are in that situation and crying for help, you need somebody to listen to you, not medicate you, tackle you to the floor.”

Modeling their effort after a plan in Eugene, Oregon, Rodriguez Sanchez and the City Council’s progressive caucus are calling for the Department of Public Health to establish mobile crisis teams of a paramedic and a nurse or social worker that could be dispatched from community clinics on a 24-hour basis. The new emergency phone line would be established for residents to call for help with nonviolent incidents, supporters of the plan said.

The response could possibly weave in health workers like Diaz and Orozco, who are "connected to the fabric of community,” said Arturo Carrillo, director violence prevention and health initiatives at the Brighton Park Neighborhood Council.

“We would actually love to see the expansion of the community crisis response units to include peer advocates,” said Carrillo.

Police remain in city plans

For now, at least, it seems that the city is poised to keep Chicago police as part of its response to mental health-related calls.

Under the plan, starting in 2021, two teams would be assigned to two police districts, based on calls for mental health service. The teams would travel in unmarked vehicles that have medical supplies, and would include a mental health professional, a paramedic and a CIT-trained officer.

Arwady, speaking at the budget hearing, told aldermen that after surveying eight police departments, including ones in other large cities, Chicago concluded that it would be better establish a police co-responder unit first so those teams can gain a better understanding and collect data about the mental health calls in the city.

The teams, with a police officer present, would also be able to respond to any type of call — including those that are violent.

Meanwhile, Carrillo, of the Brighton Park Neighborhood Council, said there are other cities that have rolled out response teams that do not include police even as they plan to launch teams that might eventually include officers.

Chicago Public Health Department Deputy Commissioner Matt Richards stressed that that the co-responder teams are just one part of a larger push to get mental health services into the community and to reach people in crisis more directly.

The department will continue to invest in current services that bring mental health clinicians to places like homeless shelters. And the $1.4 million city plan would, in addition to creating the teams, pay for clinicians to work in the 911 center to assist with calls that have a crisis component.

“This is the first time we are weaving mental health into crisis response," Richards said. “All of this together amounts to a coordinated strategy.”

Ald. Rodriguez Sanchez, reached by the Tribune Sunday, said talks were continuing with the city late last week to consider whether both ideas could be launched at the same time.

A mother’s worry

As painful as it was for Patricia Bulmer to watch police physically subdue her daughter, who goes by the name Ariel, Bulmer said she does not regret seeking help from police.

Bulmer said her daughter was first diagnosed about 10 years ago with mental illness, had knives and was harming herself. Bulmer said her daughter, who was charged with battering an officer, identifies as a woman. The charges were filed under her prior name, Francisco Bulmer.

Police said they understood the challenges such calls pose.

“We deeply understand that police officers should not be the sole response to mental health crises but dangers like these are exactly why the City is establishing a co-responder model that partners mental health professionals with CIT-trained police officers so that we ensure the safety of all individuals,” Chicago police officials said in a statement.

Still, the scene that unfolded on her block was surreal, Bulmer said. The tasing. The surge of police who surrounded her daughter after the confrontation. She watched in fear as one drew their gun.

Like the experts and advocates, Bulmer, who works in the health care field, agrees that fixing the problem is complex.

There are times, she explained, that her daughter starts to get agitated and seems to need help — but not from the police. So a nonemergency line or a softened response seem like good options to her.

But so does a health care system that supports people before they are in crisis. Leading up to that night, her daughter had slipped from therapy and then stopped taking her meds because she didn’t have a prescription.

“She gave up on the system,” Bulmer said.

The Tribune’s Abel Uribe contributed.

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