CSD Dec 2021 update

Community Safety | Nov/Dec 2021 Update

WHERE WE’RE LEARNING

This department exists to bring people together across neighborhoods and agencies to reimagine what public safety can look like in Durham. Our initial focus is on sending the right response to crisis calls involving behavioral health needs and other quality of life concerns. Here’s an update on how we’re approaching planning new responses and some of the insights emerging from this work.

Data Data Data

We’ve been connecting with many US cities leading similar work, including Austin, Atlanta, Charleston, Denver, Philadelphia, & San Francisco, among others.

We’ve been spending time with Durham 911 calls for service and CAD details as one way to understand the landscape of needs.

Other cities

Durham responders

We have an ongoing partnership with the Safety & Wellness Taskforce, collaborated on a Town Hall, and we have been holding resident interviews, focus groups and listening sessions.

We meet often with EMS, DPD, 911, & behavioral health providers, have participated in CIT ride-alongs, & have been conducting interviews with peer support specialists, community health workers, and clinicians.

WHAT WE’RE LEARNING FROM THE DATA

The Durham Emergency Communications Center receives approximately ~128,790 DPD calls for service from residents every year.*

Durham community members

To view the data yourself, visit Durham’s Open Data Portal and search “DPD calls for service”.

We’re digging deeper on call types that fall within Quality of Life and Mental & Behavioral Health, representing about 18,710 of those total calls per year: Of these 9 call types, 15%

Assist Person Mental Health Crisis Follow Up Indecency Intoxicated Person Panhandling / Solicitation 7. Suicide Threat 8. Trespass or Unwanted 9. Welfare Check 1.

2.

3.

4.

5.

6.

<5%

**

resulted in any kind of police incident report

~9

**

Resulted in DPD “use of force”

*This data has been derived from 2018 and 2019 data publicly available at www.opendata.durhamnc.gov. Note that the numbers presented here only include resident calls, not calls initiated by police officers or calls categorized under “Directed Patrol.” They also only include completed calls, i.e. the caller does not hang up before a call type can be entered into CAD. **Per year

CSD north stars: Collaborative | Transparent | People-centered | Equity-focused | Trauma-informed

WHAT WE’RE LEARNING FROM OTHER CITIES

Types of 911 Calls: Collectively, cities responded to a wide array of 911 calls, ranging from Assist calls to Welfare Checks to Trespass to Suicidal Thoughts/Attempt. Some cities auto-exclude calls with any weapons present, while others do not.

Continuum of Crisis Response: Cities demonstrated the variety of crisis response approaches — and the need to tailor responses to particular types of crises. In some instances, a 911 caller speaking to a mental health counselor over the phone may be appropriate. In other cases, dispatching a mobile crisis unit might be more suitable. In some situations, cities felt a co-responder model (where clinicians respond with law enforcement) best served their residents. Importantly, crisis response should be considered a series of interdependent programs rather than an isolated, singular kind of response.

Crisis Call Counselors in 911 Emergency Communications: In cities with crisis call diversion (CCD) programs (e.g. a counselor responds to particular mental and behavioral health crises over the phone), staff highlighted the importance of co-location: counselors in the same location as Emergency Communications staff helped build teamwork, clarify operating protocols, and coordinate call responses.

Mobile Crisis Teams: Cities built their mobile crisis teams in multiple ways. Two- and three-person teams were most common, with licensed clinicians or qualified mental health professionals as the most common member. Other potential roles sometimes included a Peer Support Specialist, a Harm Reduction Specialist, or a Paramedic or EMT.

Following Up: Some cities lifted up the importance of helping residents navigate various services available to them in times of need, or to check up on people who have been in crisis.

This form of follow-up seems key to addressing long-term challenges, building connective tissue between systems, and potentially reducing the likelihood that a resident may need to call 911 in the future.

WHAT WE’RE LEARNING HERE IN DURHAM

A desire for a new kind of responder: In our engagements so far, there has been broad support for dispatching trained, unarmed responders to certain kinds of crises — particularly those involving people with unmet mental health needs, people who are unsheltered, welfare checks, and a number of other quality of life calls.

An inclination toward team-based approaches: We have seen strong support for a team-based approach that includes a mental health clinician and peer support specialist, and in some instances a medical professional (EMT or community paramedic). Residents have also identified other types of personnel that could support individuals experiencing certain kinds of crises.

The critical role of peer support specialists: Various partners highlighted the importance of this role. By virtue of personal experience with crises, they play a critical role in relating to, connecting with, and helping people in crises in an approachable, non judgemental way. In their unique capacity, they assist in steering people in crisis through what are often confusing, overwhelming, and potentially frightening situations.

The centrality of highly qualified and experienced clinicians: Bringing in highly qualified clinicians will be highly important to the pilots’ success. As much of a priority should be placed on years and type of experience as on licensing. A non-licensed qualified mental health provider who has worked on an ACT team, for example, may be more suited to working on our mobile crisis team than an LCSW that has worked primarily in private practice.

Physical care as a part of a more holistic approach: Advanced EMTS, paramedics, and community paramedics are well equipped to handle any physical care needs we encounter and make any assessments. Community paramedics often have more tie-ins to other support services and could be useful in helping navigate further care.

Safety and risk: Confidence in dispatching unarmed responders significantly decreased when there was the presence of a weapon, but not necessarily because there was a disturbance or yelling. No city we’ve spoken to has experienced major responder-related safety issues. For instance, Denver had over 1,700 responses with 0 calls for police backup; San Francisco’s Mobile Crisis Response Team called for backup on less than 2% of their calls.

Coordinating with existing responders: Communicating closely with staff in Emergency Communications, Fire and Police will continue to play an important roles. As we transition calls, working collaboratively with 911 Dispatch and understanding protocols and safety considerations are key to building successful pilots that we can continue to learn from and improve upon.

LEARNING MORE

WHAT WE’RE HEARING

Community Safety | Nov/Dec 2021 Update You could argue that you have community workers already doing this work, without the benefit of a dispatch and police radio — I could be gone for three days before anyone noticed. This is safer than any case management I’ve done in the community before we launched an unarmed responder program.

– Clinician leading an unarmed responder program

It’s important that we expand the program meaningfully by running a small, flexible pilot that shows boots on the ground evidence of need.

– Unarmed responder program lead

Durham residents: we want to hear from you!

Ensuring people are connected to someone who can help is so important. Follow up is about more than just checking in to see if an appointment was made.

– Durham service provider

Our “bi-monthly pulse” survey offers an easy way to share your feedback about Community Safety developments.

[I would want] somebody to come talk to me, to diffuse the situation – someone like my peer support specialist. They would show love, compassion, understanding, patience...

– Durham resident

This new team would have the time to listen and sometimes that’s all it is… People want to be heard.

– Durham service provider

CSD plans over the next month

I think of safety not as the absence of trouble, but as the conditions of care needed to prevent harm … that honors the humanity & value of everyone.

– Durham resident

Continue working with Durham residents, workers and organizations through input & ideation sessions.

Continue building out and refining pilot plans based on what we’re learning from the data and community.

ACT – Assertive Community Treatment consists of a community-based group of medical, behavioral health and rehab professionals who use a team approach to meet the needs of a person experiencing mental health challenges.

CAD – Computer-Aided Dispatch systems are utilized by call-takers and 911 operators to prioritize and record incident calls, identify the status and location of responders in the field, and effectively dispatch responder personnel.

ACRONYMS

CSD – City of Durham’s Community Safety Department. Visit our webpage to stay involved and up to date on this work.

CCD – Crisis Call Diversion diverts appropriate mental health-related calls received by a 911 call taker to a Call Center Clinician, de-escalating calls from people in crisis.

CIT – Police Crisis Intervention Team officers and a clinician take crisis calls, follow up on referrals, and proactively connect and/or reconnect individuals experiencing crisis with appropriate services and resources.

DPD – Durham Police Department EMS / EMT – Emergency Medical Services / Technician medical professionals who respond to 911 calls and treat and transport people in crisis health situations LCSW – Licensed Clinical Social Worker a social worker who is trained in psychotherapy, and who helps individuals with challenges with mental health and daily living.

MCT / MCU – Mobile Crisis Team / Unit provide care to individuals experiencing a mental or behavioral health crisis in the community, and/or other needs determined by the team

Check out our webpage to meet our team. Interested in joining us? We will be posting several new positions in the coming weeks! Keep an eye on City of Durham’s Jobs and Careers page.