In St. Petersburg, Florida, Eve*, a woman experiencing delusions, called 911 about 10 times in one day—and dozens of times in the few months prior.

It’s the kind of call that most police in St. Petersburg—who are not required to complete any mental health–related training—are not equipped to handle. The St. Petersburg Police Department also recognized that. In 2020, the department decided not to hire more officers and instead invested those funds in a new initiative. And Eve eventually found the help she was looking for because of it.

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CALL Community Navigator Nina Candongo. Photo by Tina Russell.

Nina Candongo is a navigator at the Community Assistance and Life Liaison (CALL) program, which responds to 911 calls related to, for example, mental health, homelessness, substance use, and neighbor disputes. Local nonprofit Gulf Coast Jewish Family and Community Services launched the program in partnership with the St. Petersburg Police Department in February 2021. In the program’s first year, CALL’s 12 navigators responded to more than 4,300 calls and diverted more than 1,200 potential hospitalizations.

The first time Nina met her, Eve had driven her car through her family’s garage door because she thought she was being chased. Nina worked with Eve to schedule an appointment with a psychiatrist and even offered to accompany her and her family there.

Eventually, they created a plan together: every morning, Eve would take her medication in front of her mom. Nina followed up with both her and her mom over the next few weeks, and they said things were going well.

“I told her to call me instead of 911, and she hasn’t called me in three weeks,” Nina said. That’s a good thing, because it means she’s been taking her medication.

“All is fine,” Nina said, followed by nervous laughter as she knocked on wood.

CALL is the kind of crisis response program that a growing number of cities have rolled out, with many piloting new programs in the last few years. These cities—including Denver, Rochester, and Portland, to name a few—are taking a different approach to 911 calls that involve people with mental health conditions or substance use issues—situations often referred to as behavioral health crises. In these cases, police have historically been the default first responders.

“911 is such a universal ‘help me’ line,” Nina said.

A high proportion of calls that come in through 911 don’t actually demand a police response, and law enforcement is often not trained to respond safely and effectively to behavioral health–related calls. In fact, police responses can often worsen these situations. In many cases, the mere presence of armed, uniformed officers causes distress. Every week, interactions between officers and people experiencing mental health crises end in handcuffs—and can even turn deadly.

“Law enforcement officers aren’t trained to handle mental health or substance abuse or things of that nature,” said Heather Loychik, another CALL navigator.

That became apparent to Heather in her last job as a mental health technician at a psychiatric hospital in St. Pete. She regularly saw people brought in by law enforcement under the Baker Act, which allows police (and doctors, judges, and mental health professionals) to involuntarily commit a person to a mental health treatment center for up to 72 hours.

She often saw the same faces over and over. And in many cases, she says, she thought, “there’s no way this person should be here. There had to have been something somebody could have done on the front end to prevent them from being here.”

The opportunity to fill that role drew her to CALL.

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CALL Assistant Program Director Demetrius Williams. Photo by Tina Russell.

Although Heather has a background in mental health and social work, CALL Assistant Program Director Demetrius Williams says that’s not a prerequisite for the job.

“You name it, our people have done it,” said Demetrius, noting the diverse backgrounds of current and former navigators. A former navigator previously worked at a Pizza Hut, while another navigator on staff previously worked as a sheriff's deputy.

“Just because you didn't have a background doesn’t mean you can’t be trained, and we invest so much time and energy into training and developing our staff,” Demetrius said.

Sometimes, he even prefers that navigators have limited experience, because they’re less likely to be disillusioned: “The system is rough, and we all get very frustrated . . . . And so, by having a few people who don’t have that underlying frustration, we get fresh eyes, fresh perspectives.”

Part of that frustration stems from a lack of resources. One ranking of states puts Florida near the bottom of the list, at 48, for access to mental health services. Psychiatric appointments must be scheduled weeks or months in advance. With little affordable housing in St. Petersburg, even people with Section 8 vouchers struggle to find a place to live.

“I was dealing with someone a couple weeks ago, and he says, ‘so you’re going to let a 73-year-old man become homeless?’ and there was literally nothing I could do,” Demetrius said. “It takes a lot out of me when we can’t help someone.”

A lot of people end up with criminal charges because they’re in a mental health crisis. [We’re] keeping people out of the criminal justice system that don’t need to be there.

Demetrius previously worked at a county jail in Florida, and before that, in forensic mental health, administering court-ordered evaluations and overseeing treatment for conditions related to mental health and substance use. He saw firsthand how easily people with mental health conditions end up entangled in the criminal legal system.

“A lot of people end up with criminal charges because they’re in a mental health crisis,” Demetrius said. “A call for help turns into battery on a law enforcement officer, resisting arrest, or aggravated assault.”

At CALL, he feels like he can actually make a difference. “[We’re] keeping people out of the criminal justice system that don’t need to be there,” he said.

And the statistics back up his observations. Too often, encounters between police and people in crisis end in handcuffs. People with mental health conditions are incarcerated in disproportionate numbers, and, in the worst cases, encounters between law enforcement and people experiencing a mental health crisis turn deadly. In 2021, at least 104 people were killed across the country after police responded to reports of someone “behaving erratically or having a mental health crisis.” People with mental health conditions are 16 times more likely to be killed during encounters with police than those without.

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From left to right, CRU team members Aana Sundling, Buck Williams, and Eric Andersen. Photo by Justin Katigbak.

Crisis responders in another corner of the country—Olympia, Washington—echo that frustration over inadequate resources.

Olympia launched its Crisis Response Unit (CRU) in 2019. It is modeled after the first civilian crisis response program—the Crisis Assistance Helping Out on the Streets (CAHOOTS) program in Eugene, Oregon—which was founded three decades earlier. CRU’s team responds to 2,450 calls per year.

During the COVID-19 pandemic, many shelters in Olympia closed, and now only one drop-in shelter, the Olympia Union Gospel Mission, remains open. Providence St. Peter Hospital has always been overwhelmed and frequently at capacity, even pre-pandemic. Many of the social service providers that Buck Williams, who has been at CRU since it started, works with are only open Monday through Friday during normal business hours.

“Mental health crises, substance use—it doesn't work a typical schedule,” Buck said.

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CRU Specialist Buck Williams. Photo by Justin Katigbak.
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Blankets and shoes at CRU’s office in Olympia, Washington. Photo by Justin Katigbak.

Over the last few years, CRU responders have delivered countless shoes and blankets. They have taken people to doctor’s appointments. They have worked with people who have overdosed, people who have been trafficked, and people with mental health conditions.

“Sometimes I get really frustrated because it’s like doing this impossible job,” CRU responder Aana Sundling said. “Day after day of not having a really great solution for a lot of issues that are just like, on this hamster wheel.”

CRU Supervisor Aana Sundling. Photo by Justin Katigbak.

Buck has worked with folks who remind him of family members. He saw firsthand the impact that poverty and substance use had on their lives, and he wants to be able to provide the kind of support he thinks would have been helpful to them.

“I really liked the idea of being able to get out and work in the community—not just when folks ended up in a locked facility,” said Buck, who previously worked in involuntary inpatient psychiatry.

Last November, a man with a mental health condition called 911, and Aana responded to the call. The caller said he was feeling scared and paranoid, and that he just needed to get to his car. Aana met him at his hotel. He was clearly panicking. She walked him to his truck.

“The fact that I could help [him] get to [his] car, that’s a good moment. It’s a small win,” Aana said. “I need to remember it though, because the next 20 losses are going to take me down a notch.”

It’s the little wins that keep these crisis responders going. That could be as simple as a client taking their medication or going to their doctor’s appointment.

“A small win for me is calling us instead of calling the police,” Demetrius said. “They’re utilizing us as a resource and knowing that we can try to help them meet their needs, to keep them safe, to keep them out of jail. It’s building trust and rapport.”

“We have the ability to spend time—days, months even, if we need—to help [an] individual,” said Tianna Audet, CALL’s program director.

More people are calling for their own cities to adopt this crisis response approach, removing police from situations they simply are not trained to handle and where their presence can actually make things worse. The most successful crisis response programs involve residents, community organizations, behavioral health professionals, and police in their creation and implementation. And with broad public support for this crisis response approach, city councils and sheriffs alike are getting behind these efforts to ensure public safety.

“More police departments . . . are picking up on this, and they're starting to use different models. And they're doing that for a reason, right?” Tianna said. “They're doing it because it's needed.”

*Name has been changed to protect identity.