Just over a decade ago, police in Sioux Falls began a partnership with Southeastern Behavioral Health that allowed counselors to take over for officers during mental health crisis calls.
The goal of that mobile crisis team (MCT) was to de-escalate situations where a caller had expressed thoughts of suicide or self-harm by working through the crisis at hand, then working out a care plan that would keep the person at home.
To date, the team has diverted more than 5,000 people in the Sioux Falls metropolitan area from a mental health hold after a police-initiated crisis call. Area officials of all stripes frequently praise the MCT’s role in talking 90% of callers out of an involuntary committal.
Minnehaha County Commissioner Dean Karsky called out the team’s work a few weeks ago as the commission folded the most recent report from Southeastern into the commission’s public record.
“That’s 184 out of 211 people who stayed home,” Karsky said of the group’s work so far in 2022. “And a lot of those people would have been taken to the jail or put in a hospital bed.”
In recent years, however, the number of calls to the MCT has dropped precipitously – nearly 50% between 2017 and 2021. The year-to-date numbers are on track to maintain that reduced rate.
The trendline flies in the face of the narrative surrounding mental health in the COVID-19 era. Depression, anxiety and other mental health problems have increased nationwide and in South Dakota, as people struggled with remote school, remote work and a host of other stressors.
That story even tracks at Southeastern’s brick-and-mortar locations in Sioux Falls.
“We saw 500 more enrollments into the community mental health side of things than we normally would’ve seen over the course of those two years,” said Kim Hansen, a counselor at Southeastern who’s led the MCT since its inception.
What’s happened with the MCT, however, is less about a drop in mental health needs and more about a spike in situations too serious for talk therapy. More people are attempting suicide or threatening to do so while armed.
A wider range of options for crisis calls has also emerged. Officers are more skilled in de-escalation than they were 10 years ago, and the 988 suicide prevention line is handling more situations that may have sparked a 911 call in the past.
Serious calls more common
There were 202 suicides in South Dakota in 2021, a 50% jump from 2012 and the highest number ever recorded for the state. The number of suicides per 100,000 people in the state is the seventh-highest in the nation.
If a call to 988 or 911 comes from a person who’s pushed well past the point of just talking about self-harm, Hansen and her fellow counselors are unlikely to get a call.
“If they have a firearm and a note written, they’ve just been fired from their job … we would recommend that they not use mobile crisis because of the severity of the situation,” Hansen said.
Calls for service in Sioux Falls don’t point to a drop in mental health needs.
At the same time the team’s numbers were dropping, from 2017 to 2021, the total number of mental health calls to the Sioux Falls Police Department (SFPD) jumped 70% – and that’s only for calls that originate with that classification, such as suicide attempts, overdoses and mental health wellness checks. An officer responding to a disorderly conduct call may discover a mental health problem, according to SFPD spokesman Sam Clemens.
“These numbers can give a general idea but there is no way to determine every call that has a mental illness component,” Clemens said.
Sgt. Tarah Walton earned a master’s degree in counseling and practiced as a therapist before her career in law enforcement. She serves as the liaison for the MCT and other community mental health providers in the metro area, and said the launch of the national 988 suicide prevention hotline and the expansion of the 211 Helpline Center’s operations have factored into the drop in MCT calls in less severe situations.
Helpline Center operators handle 988 calls in South Dakota. In the past, around 80% of mental health calls that started with the Helpline Center ended without an operator placing a mental health call to law enforcement.
“Now, with 988, they handle 10% more of the calls than they used to,” Walton said.
More officers handling situations
Improved officer training is also a factor, according to Hansen and Walton.
More than 40% of SFPD officers have completed Walton’s 40-hour crisis intervention team (CIT) training. That training, as well as the decade of focus on de-escalation techniques and a push to see involuntary commitment as a last resort, translates to more officers helping those in crisis without the help of the MCT, Walton said.
“We’ve got officers gaining more confidence on these calls,” Walton said. “We are getting better at it and more comfortable with it in those social situations.”
Every school resource officer is CIT trained, she said, which has helped those officers handle issues in the school system. Walton also opens her twice-yearly trainings to officers from nearby jurisdictions. She’s also traveled to teach in Brookings and led coursework for trainees at the Law Enforcement Academy in Pierre.
Even so, Walton said, the mobile crisis team continues to serve a critical role for the area. Officers from Tea, Harrisburg, Brandon and other nearby communities lean on the MCT, though 173 of the team’s 211 calls through October originated in Sioux Falls.
“Our officers love mobile crisis,” she said. “Any time they can avoid a hold, that’s a win for everybody. The county’s not looking at a bill, they’re not filling a bed, and we’re not taking people away.”
The notion that mental illness ought not be dealt with by jailers has gained significant traction statewide in the decade since Sioux Falls began sending counselors out with officers. Former South Dakota Gov. Dennis Daugaard championed diversions and mental health programs as alternatives to detention in his successful overhauls of the adult criminal justice system in 2013 and the juvenile justice system in 2015. Officers in training in Pierre hear far more about mental illness and deescalation than they did in 2002, when Walton attended the academy.
Telehealth diversions have gained traction in both Sioux Falls and Rapid City, the latter of which maintains a crisis care center that serves between 1,500 and 2,000 people each year. The Rapid City Council voted to devote half a million dollars to a crisis stabilization unit last year, which would offer five-day stays, as opposed to the 24 hours a person can stay at the crisis care center.
Back in Sioux Falls, Commissioner Karsky’s comments lauding the work of the MCT came on the heels of a trip by commissioners to Tucson, Arizona, where they toured triage centers that could serve as models for an intermediate care facility in Sioux Falls.
For Hansen, the 5,000 diversions figure is strong evidence that diversion and de-escalation offer real-world evidence that such discussions pay off.
“The important thing to focus on is that we have touched over 5,000 lives,” she said. “We’ve been able to successfully leave people at home so they can go to work the next day, go to school, and just be with their families.”
This article originally appeared on Sioux Falls Argus Leader: Declining use of mobile crisis team is good and bad news for Sioux Falls area