Combining clinicians and cops, Oakland’s response program helps those in mental crisis

Several days a week, Yesenia Lott begins her mornings by getting into a black unmarked police car. Lott is a behavioral health clinician with the Alameda County Behavioral Health Care Services, who partners with a police officer to respond to mental health distress calls: A homeless person is wandering around, talking to themself. A person has barricaded themself in their house, and is threatening suicide. Someone is walking down the street holding a machete. Someone thinks their food is being poisoned.

Both the officer and the clinician are trained in crisis intervention, and they work as a part of the Mobile Evaluation Team (MET) program, launched five years ago by Alameda County and Oakland’s police department in an effort to better help people in distress. There is only the one pair—a clinician like Lott and an officer—available to answer those calls in the entire city of Oakland.

According to a 2016 internal presentation by the Oakland Police Department (OPD) and Alameda County Behavioral Health Care Services on the MET, the OPD receives more mental health calls for service than any other city in the county. On average, officers respond to 26 to 30 calls per day. In the first quarter of 2015, the department completed 1,200 5150 psychiatric transports—shorthand for a California code that empowers peace officers, mobile crisis teams and county-designated healthcare professionals to hospitalize someone at a psychiatric facility. Hayward came in a distant second, at just over 400 transports. “The bulk of our calls are in Oakland,” says Lott. “It would be nice to have more resources in Oakland.”

Lott says on a typical day, she has already drunk her morning coffee by the time she arrives at the police substation next to the Eastmont mall. She collects the tools needed for the shift: a clipboard, an iPad, a mobile phone, brochures on mental health resources and programs, and log sheets for recording who they meet throughout the day. She dresses for comfort, usually in sneakers, jeans and a shirt. She avoids wearing any kind of jewelry—anything that would be easy for someone to grab.

The only part of Lott’s ensemble that looks official is her badge, identifying her as a clinician, which she wears around her neck. She also brings a lunch. Some days she might not get a break, and will eat in between calls.

Officer Stefan Edinburgh—the only OPD officer currently assigned to the program—picks her up, and they drive together in a special unmarked police cruiser, chosen to avoid attracting attention to someone’s house when they arrive. They check their computer system to see if there are any crisis calls pending. Calls that involve a risk of harm are given priority, but Lott says it really depends on the nature of each call.

Their goal is to help people in distress without traumatizing them with unnecessary hospitalizations, and to connect them to ongoing care: mental health support programs, housing, and other resources. The partnership with the police allows clinicians to answer more calls, and faster. For the police, it means that once the MET pair arrives, other officers who have been called to the scene can return to patrol faster, freeing them up to respond to other kinds of emergencies. And for callers who dial 911 during what might be the most stressful moment of their lives, it means they can have both a mental health expert and a law enforcement officer to assist them, an option that was harder to arrange before this partnership.

Once at the scene, the clinician takes the lead if the person doesn’t respond well to an officer’s presence—or vice versa. Lott says that they try to establish a rapport with the person, and collect information about what’s going on. She says typical questions include whether the person is able to clothe, shelter and feed themself, if they’ve had thoughts of suicide or of harming someone else, and if their symptoms are affecting others in their community. 

“On average, we’re on the scene at least 30 minutes before we make a decision as to what we’re going to do,” says Lott. She says the clinicians try to create a “safety plan” for the person by connecting them with services or getting them to a safe space. If they cannot do that, the clinician will decide whether or not that person needs to be placed on a 5150 involuntary hold.

The team will answer, on average, five to six calls per shift, which starts at 8 a.m. and runs until the team logs off at 3:30 p.m. The program only operates during daylight hours, Monday through Thursday. Then they spend the next couple of hours completing paperwork back at the office.

In recent years, calls have increasingly come from people struggling with existing mental health conditions that are exacerbated by outside environmental pressures, says Stephanie Lewis, division director of Alameda County Crisis Services, a part of the behavioral health department which runs the MET program. “I think that more people are struggling with housing, food insecurity, substance use disorders,” she says. “So sometimes we are encountering individuals who may have started having symptoms months ago, but never felt comfortable enough to seek support because of all those issues. And then by the time we get to them, someone has called 911.”

“And we say to the loved one who called, ‘Okay so we’re here. Why didn’t you call a few months ago when you said the symptoms started?’” Lewis continues.

Typical responses include: “I was afraid.”

“We didn’t know where to go.”

“We were struggling financially.”

*****

Alameda County Behavioral Health started operating a mobile crisis team in 1988, comprised of two licensed clinicians who responded to mental health calls. But there was no partnership with the OPD. The original team drove around in a regular vehicle, and only covered West Oakland. Without the collaboration with the OPD, clinicians would have to wait for officers to arrive before they could make contact with the person in crisis.

“When we first started, one of the big things we had to do back then was win the cops over—all of a sudden these civilians appear with a police radio,” says Keith Olson, who joined the crisis team in 1988. “You have to develop some rapport with the police, so that they knew you were a good asset.” Olson is now retired, but came back to the behavioral health department recently to help answer calls with the department’s dispatch center. (911 calls are routed through the OPD, but people also sometimes call Olson’s department directly.) Olson will take calls and provide them to MET and another county program called the Mobile Crisis Team (MCT). MCT is composed of pairs of clinicians who cover South Alameda County and West/North Oakland.

Clinicians are limited in how they can respond to calls on their own. If a person becomes violent, they are not allowed to use force, the way officers can. If the person requires hospitalization, they can’t do emergency transport, which requires the presence of law enforcement.

“The vast majority of calls, we take the police for that reason—for safety,” Olson says. “Usually what the police will do is stand back while we do our thing. But if the person doesn’t want to go to the hospital, then we need them there to encourage them to get in the ambulance, because we’re not going to put hands on someone.”

In 2012, representatives from the OPD and the county’s behavioral health department began to collaborate on creating a new model, which led to the MET program: pairing a clinician with an officer. “We said, ‘They’re already going to calls when they happen,’” says Sergeant Doria Neff, the OPD’s mental health unit liaison. “So the most logical sort of branch-off was just putting [clinicians] in the police car with the officer.”

In 2014, the two departments launched a pilot version of the program. After six months, it became a permanent fixture within the county’s crisis services. In the last five years, the program has expanded its geographic reach, growing to include East Oakland. Lewis is hoping to double its current small staff of about a dozen clinicians in the next year or two. Neff says that the Oakland City Council has authorized the MET program to expand to four officer/clinician teams, but conversations about staffing are still ongoing, and the expansion depends on the number of available clinicians.

Lewis thinks the program is effective in ensuring the safety of the clinicians. “Initially, if we don’t really know the intimate details of the call and what’s going on, it’s helpful to have law enforcement there instead of waiting on them to get there when things go badly,” she says.

She also sees it as an effective division of labor. “We’re there to assess, provide support, and resources, and referral,” says Lewis. “We don’t make the decision on whether a person can stay or go, or get into the back of the ambulance, or open the door, not open the door. That’s where law enforcement is essential.”

Police officers’ primary purpose is law enforcement, but they do typically receive training in crisis intervention. On average, OPD officers who are certified for crisis intervention undergo 37 hours of training, designed “to teach officers better ways, more effective ways, to interact with folks with mental health challenges,” says Neff. She says the OPD’s policy is that when officers are dispatched to a call relating to mental health, “they shall attempt to get a CIT [crisis intervention] trained officer to that scene.”

Neff says that sending the MET is a better resource than just sending an officer, because the clinicians might have access to a person’s mental health and medical history. An officer would not, because of HIPAA (Health Insurance Portability and Accountability Act) restrictions, which ensure patient privacy. For instance, she says, a MET unit can look up a person’s caseworker and reach out to update them on their client and maybe get advice on how to handle that person. “It just gives a higher level of concentration on that call,” she says.

*****

On a sunny morning in November, MET members respond to a call that came in the previous night—after the team’s working hours—in East Oakland. “Chronic issues since 2013,” the report on the system reads.

Clinicians Tim Henry and Sarah Ou and OPD Officer Stefan Edinburgh drive together to the woman’s residence. Henry has worked with the county’s behavioral health department for over 15 years; he loves helping families whose children have mental health issues navigate social services. On this day, he’s wearing a leather jacket, jeans, a badge on a lanyard, and he’s carrying a police radio. Edinburgh, a nursing school graduate originally from Manchester, England, sports a full police uniform, including a stun gun and handgun. Ou, a clinician starting a job with the county, tags along in plainclothes.

After meeting with the caller in her apartment, the team emerges from a locked gate in front of the building. The caller is claiming that a person entered her house, bypassing security cameras, and stole her clothing and blankets. She believes her security system is hacked. Edinburgh says the crisis team had responded to this woman’s calls in the past.

During the call, Henry says, “We didn’t get very far as clinicians.” The woman only wanted to talk to Edinburgh because she wanted to file a police report about her missing clothes and blankets. Edinburgh does write a police report. “We have to step kind of lightly around that,” Edinburgh says, so as not to “upset her or make her more paranoid.”

So, although the workers identify a mental health component to the call, there is nothing else to do, because the woman is not interested in talking to Henry. The team says the woman does not meet the threshold of behavior required for involuntary hospitalization: She is not a danger to herself or others, nor unable to care for herself. “If someone does not meet the criteria for 5150 hold,” says Henry, “everything is voluntary.” The person could be “completely out of their mind, but if they don’t meet the criteria and they don’t want services, that’s their choice,” he adds.

The conundrum is typical, according to the team. “The majority of people who we come across are reluctant to accept services,” Edinburgh says. “That’s why they’re in a crisis.”

There are no more outstanding calls from the night before, or at least not any that the team can do anything about. Often, low-priority night calls are irrelevant by morning because the person in question has left the scene. For example, Edinburgh says, there had been a call about a woman in a car acting strangely, but she has likely moved on since then. The team will drive by the location to be sure.

The workers discuss the team’s limited daytime hours. “Guess what? People actually experience crises at nighttime as well. Who knew, eh?” Edinburgh says with a wry smile.

The biggest obstacle for MET, Henry says, is that there aren’t enough resources to provide people with ongoing counseling and housing. That means they treat the same people over and over. “People go to John George for a day and they’re discharged and they’re out on the streets again,” Henry says, referring to the John George Psychiatric Hospital, which is operated by Alameda Health System, a public health system that operates multiple hospitals in the area. “They’re really not getting treatment.”

Another pressing issue is a lack of treatment for drug addiction, especially for methamphetamines, the drug Henry says he most commonly sees in Oakland. “I would say the number one reason why people are on the street is because of substance abuse, and I would like to have a facility for that population,” Henry says.

It’s a huge relief for Henry to have a police officer at his side during mental health calls. “I worked at John George years ago,” Henry says. “People got assaulted at John George all the time.” According to logs kept by the hospital, between May, 2018 and May, 2019, there have been 80 reported instances of John George staff getting punched, slapped, kicked and spit on by patients.

In his time with MET, Henry says, no clinician has been injured during a call. “With the police it’s so much safer,” he says. And it’s rare that police have to step in when he’s trying to work with a client. He thinks “their presence kind of puts a chill on the situation.”

The presence of both a plainclothes clinician and a uniformed officer, Edinburgh says, creates advantages. “If that individual is reacting better to an officer, then I will probably take the lead. Whereas if they’re a bit concerned about speaking to an officer, they don’t really want to, then we have someone else,” he says.

“It’s hard to get away from this,” Edinburgh adds, gesturing to his uniform.

Henry says bystanders who are critical of the police will sometimes try to film or criticize the way officers on the team handle clients. “I like when they’re willing to talk to us. I would try, as a social worker to try and explain why we’re here,” Henry says. “We’re not actually out looking to harass people or cuff people or to send people to the hospital.”

*****

One of the most well-known recent examples of a lethal interaction between Oakland police officers and a person with a history of mental health illness was the March, 2018, death of 31-year-old Joshua Pawlik.

Joshua, who was raised in Virginia, had above-average intelligence and was a fairly happy kid, according to his mother, Kelly Pawlik. But, she says, Joshua also had “bipolar-schizoaffective disorder.” She says they started noticing issues around when he was 5 years old. He was impulsive, and he couldn’t handle certain life stressors the way other kids could, like schoolwork. “If he was not 100 percent on, he was devastated by that,” she says. Things that wouldn’t be a big deal to most people, like getting a parking ticket “could just send him on a spiral for a week,” she says.

Despite those struggles, he grew up well in their Virginia home. “He was hilarious. He was a very good friend,” says his mother. “Girls loved him. He was very sympathetic and understanding. All the girls would call him up with their problems.”

But Kelly Pawlik says the medications prescribed for her son’s condition took a toll. At around age 18, she says, he went off prescriptions. She says around a year later he began self-medicating with heroin. Eventually, job options and housing became hard to come by in their bedroom community in Virginia, so Joshua wanted to start fresh out West. He lived first in New Mexico, then San Francisco, where he lived for a time in Golden Gate Park. He checked in with his mother often, usually calling her every week or two. She says her son preferred to spend his time in the park or couch-surfing with friends, and spent little time in Oakland.

According to a federal civil rights lawsuit filed in February by Kelly Pawlik on Joshua’s behalf against the City of Oakland and several police officers, the series of events that led to her son’s death began on the evening of March 11, 2018, when someone called 911 and stated that a man was lying on the ground, unconscious, between two houses on 40^th Street.

Pawlik’s complaint alleges that firefighters initially responded to the scene and called the OPD after seeing a handgun near Joshua. According to her lawsuit, after officers arrived, Joshua remained unconscious for 45 minutes. Next, the document continues, officers positioned themselves behind an armored, military-grade vehicle and pointed AR-15 assault rifles at Joshua while calling out to him with a loudspeaker. “Inexplicably, none of the assembled officers made any attempts to approach Mr. Pawlik and/or retrieve the weapon as he lay unconscious,” the suit states.

The lawsuit alleges that when Joshua began to regain consciousness and move, officers then fired multiple rounds at him from behind the vehicle, killing him. The suit claims that Joshua did not reach out for the handgun or grab for it. “Tragically, Mr. Pawlik died from the Defendant Officers’ use of deadly force despite Mr. Pawlik not presenting an imminent threat at the time they elected to shoot and kill him,” the suit alleges, citing video footage of the incident taken by officers. The lawsuit seeks financial compensation for the pain and suffering endured by Joshua and his mother, with the amount to be determined by a jury.

Pawlik’s lawyer, Oakland civil rights attorney John Burris, says the officers were unaware of Joshua’s history of mental illness, that they should not have approached a sleeping person by shouting, and that they should have given him a chance to awaken and comply with the officers’ commands. “They treat people as felons as opposed to mentally ill people,” says Burris. “It’s a policing mental attitude that they have—to take charge, use force—as opposed to appreciating the person that they’re dealing with maybe has mental problems.”

Kelly Pawlik alleges the police officers failed to follow proper de-escalation procedures for dealing with a mentally ill person. She says when she was informed of her son’s death, one of the first things she asked the detective who called her was what de-escalation tactics were used. “What did you all use? What did you try to do to stop this? And he didn’t answer me,” she says. “I feel like he skipped right over it.”

The lawsuit is still in the deposition phase and has not yet gone to trial. For that reason, a spokesperson from the Oakland City Attorney’s Office declined to comment for this story. But staff from that office filed a response to the lawsuit on behalf of the city and the involved officers on May 9.

The response maintains that the 911 caller said there was possibly a pistol in the hand of a man lying on the ground between the two houses that evening. The response also contends that Joshua Pawlik did not comply with the officers’ commands to stop moving and take his hand off the gun, and that officers saw him aim the gun at them. The response reads: “At least 45 minutes after Oakland Police officers first saw Mr. Pawlik, the officers used lethal force after they saw him point a pistol towards the officers and Mr. Pawlik did not comply with the officers’ commands to stop moving and to get his hand off the pistol. Unfortunately Mr. Pawlik did not survive.”  

OPD Public Information Officer Johnna Watson says her office cannot comment on the lawsuit, because it is still ongoing. But she says it is important to talk about cases like these. “It’s a conversation, not only with Joshua Pawlik, but with so many other cases,” says Watson. “And it’s not just here, it’s everywhere.”

Speaking broadly about mental illness or drug use calls that end with police officers using lethal force, Neff says that when the police show up, they may be dealing with a person who has been repeatedly failed by social services and public agencies. People might already be in crisis before the police are called, she says, and they may be dealing with “external factors that have nothing to do with us.” She says that most mental health treatment is voluntary, which can make it difficult to keep people in treatment and on medications. She hopes that Oaklanders understand the position the officers are in—that they are often at these scenes “for a minute, less than a minute, two minutes,” and must act quickly to ensure public safety.

“That officer, who is making split-second decisions on preventing them from hurting themselves, preventing them from hurting the nearby citizens or that officer, how is that 100 percent the officers—you know, ‘Shame on them?’” she asks. “Shame on the mental health system.”

*****

On a November afternoon, three women who volunteer with unhoused people are leading a workshop at Omni Commons called “Know Your Options for Health: Emotional Crisis, Acute Injuries and Overdoses.” Around 50 people have gathered in the auditorium to learn how to de-escalate crises and connect distressed people with social services—without calling the police. For leaders and audience members, officers’ ability to use force means they are unsafe to call on, especially when the person in crisis is homeless, suffering from mental health issues, or a person of color.

The workshop is part of a series of events on alternatives to calling the police organized by members of Critical Resistance, a prison abolition organization founded by activist and academic Angela Davis, and Oakland Power Projects Health Workers, a collective of emergency health workers.

Oakland resident Talya Husbands-Hankin and Angela Shannon, a nurse with experience in emergency rooms, start roleplaying what it might look like for someone to have a mental health crisis on the street, and ask the audience members to try engaging them. Husbands-Hankin pretends she is walking in and out of oncoming traffic. Pointing her fingers at the people in the front row, she yells “Fuck you! What the fuck! Fuck you!”

“What’s your name?” asks an audience member, standing up from her chair.

“You! Fuck you!” Husbands-Hankin replies.

“Do you want some water?” the person asks in a measured tone, keeping a few feet of distance.

The nervous giggles coming from the audience reach a crescendo.

“Wow! She engaged the person,” interjects Shannon. The audience responds with applause. “Okay, what comes next? Now what?” asks Shannon.

Gabby Falzone, a graduate student at the UC Berkeley Graduate School of Education who studies trauma and racism, takes over the roleplay to demonstrate her approach.

“What’s going on? What happened?” Falzone asks Husbands-Hankin.

“My sister threw me out,” Husbands-Hankin replies. 

“Oh that’s so fucked up. Do you have a place to stay? Do you need anything?” Falzone continues. Husbands-Hankin asks to use Falzone’s phone to call her doctor, and says she wants to be taken to a clinic where she can get medication and emergency housing resources. Falzone says she would be happy to take her.

Earlier in the day, Falzone had led a presentation about alternatives to calling 911. She encouraged people to think about whether situations are truly emergencies that warrant law enforcement intervention. “I seriously cannot overstate this enough. You’re deciding whether—is this really life-threatening? Am I just really uncomfortable with this situation?” she asks.

“It’s not an emergency if someone is talking to themselves,” she stresses.

If the situation is not life-threatening, she advises people to call “warm-lines” (phone peer-support services); to go to Sally’s Place, an peer-run respite house in Oakland; or to call a non-emergency police line or the MET dispatch line. “Be like, ‘Hey, I have someone who is extremely non-violent. I’m pretty sure they are white and middle class, and they just need someone to come and talk to them,’” she tells the audience, as everyone laughs.

Falzone gives examples of life-threatening situations: physical or sexual abuse, suicide attempts, a person with a gun, or a person who is so dissociated that they are unaware of hazards around them, like oncoming traffic. Falzone says in these situations, people should always first introduce themselves, ask if a person wants help, ask what they need, and listen without judgement. She also advises that if someone wants to go to a hospital, to take them to the emergency room at Alta Bates, because it is connected to the Herrick Campus, which offers psychiatry services and what she feels is preferable care than what’s available at John George.

If police arrive, she says, community members should stay calm so as to elicit a calm response from the officer, and act as a “buffer” against potential use of force by not leaving the distressed person’s side.

As the workshop concludes, members of the crowd help put away chairs and grab flyers listing health and mental health resources. Tess Dufrechou says she enjoyed the workshop because it presented her with a lot of resources—she works at a local small business and says occasionally people come in presenting signs of emotional crises. “I feel like there’s this politically correct culture that I live in, which is like: Don’t call the fucking cops. But most of my friends don’t know what to do. So it’s really nice to be presented with clear options,” she says.

*****

Some local activists are working with Oakland city officials to develop a community response to mental health crises that won’t involve the police at all. But how such a program would work and be funded remains up for debate.

In June, Oakland City Council members allocated $40,000 of city funding to prepare a report on how Oakland might implement a pilot program based on Crisis Assistance Helping Out On The Streets (CAHOOTS), a service in Eugene, Oregon. Through the city’s 911 system, CAHOOTS dispatches a medic and crisis worker to calls related to mental health, substance abuse or housing concerns and family disputes. Oakland’s study is being compiled by Urban Strategies Council, an Oakland-based research organization, and is expected to be released in 2020.

Breeanna Decker, the Opportunity Youth Initiative Program Associate at Urban Strategies Council and the lead on the report, said that the envisioned program is not an alternative to policing, but “a community response and approach.” She said her team is studying CAHOOTS, along with other similar programs across the country. Decker said she hopes to base Oakland’s pilot program on a partnership with county programs like EMS Medical Corps, which trains young people to be emergency medical technicians.

The police will be excluded from this response team. Consequently, responders will have “no capacity to detain somebody, to take them anywhere, to require them to do anything,” said Anne Janks, a member of the Coalition for Police Accountability, a group formed in 2011 to establish a police commission in Oakland. Janks’ group has partnered with Urban Strategies Council to write the report, and she researches people’s stories and opinions about policing for the project. She’s found that people who lack housing or have criminal records typically do not call the police for fear of arrest. “One of the things we’ve heard repeatedly,” Janks said, is “this idea that we need somebody to call, but it’s not the police always.”

Janks says there is political support for a model like this in Oakland. “It doesn’t really matter who you talk to. People say developing this type of program is very, very important,” said Janks. “Now it’s just a matter of translating that support as quickly and efficiently as possible into a credible pilot and getting that off the ground.”

Neff says that under the direction of OPD Chief Anne Kirkpatrick she plans to visit Eugene in January to learn more about the CAHOOTS program.  

Cat Brooks, a former Oakland mayoral candidate and founder of the Anti-Police Terror Project (APTP), a coalition to stop violence committed by police officers, is trying to encourage city officials to develop an alternative model, too. “People have to be willing to admit that what we have isn’t enough and we’ve got to do better,” she said.

But for Brooks, CAHOOTS “is absolutely not a model that can transfer here” because Eugene is a primarily white community and the program is rooted in a trusted, 40-year-old clinic. In Oakland, she said, “we don’t have the investment in mental health that we are going to need to actually get this model off the ground, nor do we have a facility that can be the anchor.”

*****

A couple of months ago, on a quiet street in Uptown Oakland, a freshly painted blue house opened its doors to people in the throes of mental health distress. This is one of the places where the MET team can take people who want to get help, and it’s a symbol of a new type of follow-up care that can support people after that initial call.

Amber House can shelter up to 24 people at a time. “Pretty much anyone could walk in,” says counselor Tabatha Flores. “They’re having some sort of psychiatric crisis or will eventually go into the psychiatric crisis later on throughout the day—they are all welcome here.”

The house is run by Bay Area Community Services, an agency that provides mental health, housing and older adult services in Alameda and Solano Counties. The entryway is lined with shiny white lockers where people can store their belongings. There is a hushed tone to the low-lit first floor. A small office for staff has clear glass windows that look out into the main room.

In the center of the main room a collection of large, gray reclining chairs are arranged in two rows, facing outwards. Some are occupied, with one person snoozing soundly, fully reclined. Another person sits upright and rifles through some papers. There are games and magazines on shelves. A colorful painting of macaroon cookies hangs on a grey-blue wall. In the far corner is a small kitchenette, and glass doors lead to an outside area, where people are welcome to smoke a cigarette.

“We try to do our best to make it less institutionalized, because that’s what most people are used to,” says Flores. “Our whole point here is for harm reduction. We try to give them as much freedom as we can.”

Flores says they offer a variety of resources to people seeking help, everything from snacks and a quick shower to the opportunity to meet with psychologists or be prescribed medications. While the first floor acts as a short-term, 24-hour solution for people in crisis, people on the second floor can stay for as long as two weeks. Flores says one of the staff’s goals is to help keep people out of John George, “just so they don’t have to be 5150’d every time they’re going through some sort of crisis.”

Matthys Moreno-Derks, Amber House’s program manager, says that another goal is to connect people with other programs once their stay is over. He noted one case in which a client was going through heroin withdrawal. “We were able to get him connected with our psychiatrist and provide him with locations for specifically dealing with withdrawals. And he maintained sobriety the entire time he was here,” Moreno-Derks says. They also connected him to some housing resources for after his departure.

Amber House is the only facility of this kind in Oakland, with both a 24-hour program and a longer program in the same building. Neff has spent many years of her career hoping for more services like it. “We have never had crisis stabilization units in the city of Oakland,” says Neff.  She says she is pleased with Amber House’s success so far. “There is a movement to recognize the seriously mentally ill population in different ways,” says Neff.

And for MET clinician Henry, “Amber House is a decent option. We can drive people there and they’ll just take them in off the street.”

But Amber House has only 24 beds available. And MET has only one trained police officer and about a dozen clinicians like Henry and Lott. And the calls they handle each day are a small fraction of the 26 to 30 mental health calls the OPD receives on an average day. And that only represents a slice of the city’s mental healthcare needs, as many emergencies go unreported.

The collaborators behind MET agree the program is working—their response times are faster, they are able to redeploy officers back to patrol more quickly, and they are more able to connect people to resources other than hospitalization. But they know the current staff cannot keep up with demand. “In order for us to grow our program in the way that we want to grow it, we need to be able to hire more people, more clinicians who want to do this work,” says Lott.

Lewis says they currently have 16 vacant clinician positions to be assigned to both the MET and the MCT.

And both Lewis and Lott hope to expand mobile crisis services to work with other law enforcement departments in Alameda County. “We want to build those relationships with Hayward Police Department, with San Leandro, and with other jurisdictions,” says Lott. “We’ve done presentations for the [Alameda County] sheriff’s department and also San Leandro Police Department.”

Oakland isn’t the only city that could use a model like the MET program, but Lewis says that county crisis services needs to build their capacity to meet those needs. “It’s going to take a while for the rest of law enforcement agencies to use us in a way that Oakland does,” says Lewis. “But that’s the goal.”

This story was updated on December 18. 2019 to correct that John George Psychiatric Hospital is operated by Alameda Health System.