Nov. 26—Hector Matascastillo has a chip in his front tooth that serves as a reminder of where he was nearly two decades ago — suicidal and desperate for help.
During a January blizzard in 2004, Matascastillo, an Army Ranger veteran, awoke from a dissociative flashback to find himself sitting in the snow on his front step, facing a line of Lakeville police officers with guns drawn, pointed at him.
Through the haze of post-traumatic stress disorder, he thought they were enemy combatants. He credits the officers for not firing at him as he struggled to lay down his own unloaded weapons. He chipped his tooth during that time practicing his own suicide.
Fast forward 17 years.
In September, Matascastillo, now a psychotherapist, was on the other side this time. He was standing with Dakota County South Metro SWAT officers in a stairwell in a West St. Paul apartment complex facing a suicidal man with a knife, talking to him about all the reasons he should choose life.
The man surrendered after three hours, and the incident serves as a positive example of what can happen when police and social workers team up. Departments treading this mostly uncharted territory have found training for embedding social workers to be scarce and have taken to handcrafting programs to meet their needs.
"There isn't a formal training for social workers being embedded," Matascastillo said. "It's been kind of a mess, actually. My fear is that eventually social workers are going to get themselves into a jam that they can't get out of."
He's currently writing a training program designed to help his colleagues better understand how to work with police. A possible title? "A Day in the Life of," he said. It will be geared to teaching social workers how police operate, and how to stay out of their way when necessary.
MENTAL HEALTH CRISIS NUMBERS INCREASING
In Ramsey County, plans for law enforcement to partner with social workers were in motion nearly five years before the murder of George Floyd pushed the topic to the headlines.
"Between 2006 and 2015, calls for mental-health-related incidents doubled," said Sgt. Justin Tiffany with the St. Paul Police Department. "We knew that there was going to need to be a response on the law enforcement side as to how do we best mitigate some of those calls and connect them with appropriate services."
St. Paul police have three embedded social workers in their Community Outreach and Stabilization program.
The Maplewood Police Department began putting together a mental health outreach team in 2018 which partnered specially trained officers with community paramedics. As they began to do their work, they found that an embedded social worker was needed. This month they hired a second one.
Civil unrest and the COVID pandemic exacerbated mental instability for many. Matascastillo said the public's issues are affecting first responders and therapists.
"We're losing therapists in huge numbers across the United States," he said. "We now have waitlists. Everybody's looking at their waitlists and saying, 'I can't keep up.' There's a nervousness and people aren't doing well with it."
MORE THAN A CRISIS NEGOTIATOR
How is an embedded social worker different than a crisis negotiator or a case manager?
"Negotiators are very specific to the emergency situation," said Lt. Mike Dugas of the Maplewood Police Department. "Our embedded social workers are trying to solve the overall problem."
Working closely with police, embedded social workers act as a bridge to conventional case workers. They assess, often on the scene, the needs of the person in crisis. Their expertise helps them quickly connect the person to receiving the best help, specific to the person's needs. It's often proving more effective than an officer making a general referral to a case worker far removed from the initial incident.
As an example, Dugas told about one call in which a suicidal woman was not armed, nor was she threatening anyone else. Amy Kuusisto-Lathrop, a social worker hired in April through Ramsey County, was called to the scene and worked with the woman, connecting her to programs that could help her address the underlying causes of her problems.
Another example was a woman who was calling 911 constantly about a domestic violence situation. After Kuusisto-Lathrop reached out and connected her to short-term case management and counseling, her 911 calls disappeared.
In the last quarter, Maplewood police dealt with 200 people who were experiencing some sort of crisis. Of those, 117 were mental health related, 54 were substance abuse, 18 were medical, 13 were self-care or vulnerability issues, 11 were housing and nine were relationship-based contacts.
In the last three years St. Paul police have seen more than 1,400 referrals to community services and mental health resources. Within the last six months, the department launched a recovery access program which connects people with chemical health issues. That program has helped 60 people so far.
"Having an embedded social worker partnering with public safety, we are able to address and solve so many community issues and needs that we've never been able to do before," Dugas said. "The positives have been overwhelming."
POLICE: SAFETY FIRST, THEN SOCIAL WORK
But what about the calls in which the person is armed and threatening to harm others?
Matascastillo said that's where policymakers need to understand that while police officers may not all have crisis negotiating skills, social workers don't usually have tactical skills.
For Matascastillo, when he was standing in the stairwell last September talking to the man armed with a knife, he was not standing there alone. He was flanked by shielded SWAT team officers. SWAT was there to make sure Matascastillo didn't get hurt and to intervene if necessary. He said he was in awe watching the officers work.
"Those guys are amazing," he said. "I really respect them."
Maplewood has taken precautions to protect their social workers.
"Our social worker has all the same protective gear that our officers have," Dugas said. For the social worker to be at an unsafe scene, it requires clearance from a supervisor. "We're not going to put her into a position that would put her at risk without significant safety planning around that."
St. Paul police officials said they put safety first.
"Our social workers really are never at dynamic situations, like those barricaded individuals or individuals that are armed with a weapon," Tiffany, with SPPD, said. "We're always very mindful of the safety of our social workers, and that is absolutely our priority."
WHO PAYS FOR EMBEDDED SOCIAL WORKERS?
Ultimately, the taxpayer funds embedded social workers. However, within the police department, some wonder if embedded social workers are contributing to the defunding of police.
The idea of "defunding police," a rallying cry following George Floyd's death last year in Minneapolis, can actually run from abolishing police altogether to reallocating funds toward more humanitarian efforts. In Ramsey County, police departments have so far found a way to bring in social workers without tampering with the police budget.
"We do not replace officers with social workers," Dugas said.
The social workers in Maplewood and St. Paul police departments are made possible through county grants or partnerships.
This means that while the social workers are embedded, their funding is not, as Tiffany explained: "We currently have three grants to support our programming," he said. "Each one of those is provided a time frame of about three years. They expire at different points throughout the next two to three years. So, we're constantly revisiting different funding options."
'NOT A ONE-STOP SOLUTION'
What do police and social workers wish policymakers understand?
"Social work is a very important aspect of emergency services," Dugas said. "But it's not a one-stop solution for everything."
Matascastillo has become a bridge himself between social workers, law enforcement and the patient. To the policymakers, he suggests a dose of humility.
"Humble yourself," he said. "Spend a day in the life of an officer before you create policy that impacts them. Ask them, 'How will this impact you?' because their voice isn't heard right now. And we, as a community of civilians, need to hear from the professional that's doing the job."