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The city of San Ramon is playing host to a new pilot program for how first responders treat mental health crises, that includes training firefighters and emergency paramedics to respond to non-violent mental health emergencies, instead of police.
Reviewed by the San Ramon City Council during its regular meeting on Tuesday, the “Public Safety for Mental Health” pilot project is a collaborative effort by the San Ramon Valley Fire Protection District and the San Ramon Police Department that seeks to reduce avoidable law enforcement engagements and improve care for individuals facing a mental health crisis.
“We have to start treating mental health emergencies and crises like medical calls. That’s the key to our plan,” SRVFPD Fire Chief Paige Meyer told the council during Tuesday’s meeting.
“We are in position naturally as the fire district to get everywhere within seven minutes. So we are a perfect fit and have the capacity to be that first responder for non-violent mental health emergencies,” he added.
Through comprehensive and ongoing training, the program seeks to teach first responders to identify mental health issues early, training staff how to not only recognize the type of emergency a person is facing, but what type of treatment would provide the best benefit.
“What we are proposing is to make the necessary changes in our training and how we tactically deal with issues and make sure that our firefighters, when they go on these calls, that they have the tools necessary to identify different types of mental health emergencies… and how to de-escalate them,” Meyer said.
The plan seeks to use specialized mental health education for emergency paramedics, dispatchers, firefighters and law enforcement, in addition to de-escalation and crisis management.
With the idea that timing is key when responding to mental health emergencies, SRVFPD staff say the program starts as early as possible, with 911 dispatchers working to evaluate the situation when residents call in.
If incidents are deemed to be non-violent emergencies, then paramedics or firefighters can further assess the situation on the scene and make appropriate recommendations as needed. Responders can use the training provided by the program to de-escalate the situation and even connect a patient with video conferencing for treatment or with county health officials.
However, if incidents are deemed to be potentially violent — instances where a person is deemed to be combative, in chemical danger or a threat to themselves or others — then police will still be called in to secure the situation as is deemed appropriate by their training.
“Ultimately, we also want to try to reduce law enforcement’s interactions with the public during those times,” Meyer added. “They need to be available for crime; they need to be available for possible violent situations. The sooner we get in there and make a difference and these goals get accomplished, we feel that law enforcement and our staff will be less burdened with these calls.”
“It’s not the police — we love them,” he added. “It’s the system we need to fix when going to these calls.”
The need for quality mental health responses in San Ramon has only grown more and more important over the past several years, according to Meyer, who said that calls involving mental health emergencies have risen significantly in that time.
“The amount of mental health emergencies has risen dramatically and this year specifically we are on a very rapid pace up, and it has been that way for a while,” Meyer said. “Every 21 hours in San Ramon, we are responding to a mental health or behavioral call.”
SRVFPD staff added that behavioral health emergencies have risen at an alarming rate over the past decade, with a 20% annual increase in mental health crises related calls over the past several years.
With 50% of the district’s mental health calls coming from San Ramon, these incidents can cause a drain on district resources based on the current practices, which often recommends that individuals facing mental health emergencies be placed on hold and transferred to county psychiatric facilities.
“When we go to county health, we only have so many ambulances in the the district, and that ambulance could be gone for three hours,” Meyer said.
Instead, Meyer points to the pilot program as a way to reduce transfers to psychiatric facilities in favor of finding more customizable solutions based on the needs of each given patient and situation.
“There is really only one acute care facility that’s available when people are put on a hold, and they are sent to county psychiatric emergency services. For folks experiencing this, it’s not always the best outcome for folks who maybe just need to go to their primary care physician (for example),” Meyer said.
“Community outreach is a major issue that we need to address,” he added. “When people have a bad experience, they don’t want to call again if they think they are going to get the same outcome … I want to emphasize that if we are able to get the information to our community that we are taking a medical approach first, we feel like that will be a big turning point in years to come.”
The program has been enthusiastically received by the San Ramon City Council, with Vice Mayor Scott Perkins praising local first responders’ strategies.
“I’m thrilled to see that we’re making a lot of progress on this. Hardly a week goes by before we see someplace in the country where a mental health crisis goes sideways and everybody is traumatized and there’s some very, very bad outcomes,” Perkins said.
“So I am very grateful that we’re going to try and address these in a manner that hopefully de-escalates it and treats the problem in a manner that will actually help the person, their family and the entire community,” he added.
Interested residents can learn more and watch Chief Meyers’ full presentation at the San Ramon City Council’s May 11 meeting on the city’s YouTube channel.
So, firefighters are also going to be mental health professionals now? Paramedics too? Are they going to be trained to use lethal force should a mental health crisis escalate to violence? Are fire fighters and paramedics going to be trained in arrest and control techniques? Wow, talk about putting a strain on our resources!
Not all mental health emergencies often turn violent; however, take a look at two examples where firefighters and paramedics would have been out of their league.
Walnut Creek 2019:
When Miles Hall’s hallucinations and erratic behavior returned, his mother did what she had always done: She gave police a heads up.
The next day, police responded to multiple 911 calls about Hall, who was having a mental health episode and roaming around his neighborhood. Police say Hall was holding a pry bar that a neighbor had given him for gardening — and ran in their direction. After attempting to stop him with beanbag rounds, police fired at Hall. He died shortly after.
What if the fire department or paramedics had responded to this incident instead of the police? And remember, the police attempted to use non-lethal force before using lethal force.
Henrico County, Virginia 2019:
Police responded to a welfare check requested by Gay Ellen Plack’s psychiatrist. Plack, 57, was bipolar and “doing bizarre stuff.” Two officers went to Plack’s home and she hid inside a bathroom in a locked bedroom. The officers breached the bedroom door and approached the bathroom and Plack came out with an axe. Within seconds, both officers fired. Plack was pronounced dead at a nearby hospital.
Suppose a fire fighter or paramedic entered the premises instead on the police? And keep in mind, no one knew Plack had an axe until she came out of the bathroom.
Wow, in Walnut Creek all they talk about is how Miles was taking his 5 foot gardening tool and going home. That house just happened to be behind the Police, but they should have let him and his tool through.