In Spokane and across the country, first responders are getting more and more calls for behavioral health crises—sometimes drug-induced, sometimes not.
To address the shift, Spokane now deploys eight co-response teams, pairing mental health experts with officers from the fire department, police department, and sheriff’s office.
These teams offer certain advantages for the public and the vulnerable populations they serve, but they're a small part of a system peppered with gaps.
Officer Josh Zuray is responding to his first call one Thursday morning. He’s an officer with Spokane Police Department’s Behavioral Health Unit, or BHU. A Frontier Behavioral Health clinician is with him, too.
They’ve gotten a call from someone in an apartment in north Spokane, who says their neighbor has been screaming all night.
Once the co-responder team is at the apartment complex, the screaming is confirmed by another neighbor. It’s a woman, they say, and they point to her truck in the parking lot.
Zuray runs the license plate and gets a name.
The clinician runs that name through Frontier’s records. “Yep, she’s in the system,” she says.
Zuray runs the name through police records. He sees an arrest he was a part of. “Yep, I remember this woman,” he says.
With the records side by side, the co-responders get a clearer picture of the woman who’s been screaming. She’s been arrested and gone through treatment multiple times. She’s likely fallen off her management plan.
“The biggest thing the co-response gives the community...is it gives the responding teams a holistic look at the individual they're dealing with," says Captain Kurtis Reese with the Spokane Police Department.
“Frontier can't see what the police history is, and this person might have been contacted 50 times in the last three days. And we can't see the mental health side of it or their charts or anything that's going on," he says. "So when you have the two different entities coming together and looking at the holistic person, you can kind of see, ‘Oh, this isn't a police issue. This is definitely a crisis issue with mental health. Or, ‘Maybe this isn’t a mental health issue. Maybe we have some criminal stuff we have to deal with.’ Or whatever that may be.”
Zuray goes up to the woman’s apartment and knocks. Nothing. He tries again. He talks to property management. He spends at least an hour trying to get ahold of someone who isn’t actually doing anything criminal.
“Having teams that are designated to handling these situations definitely relieves the pressure from patrol having to go to them," says Austin Skinner, a deputy with the behavioral health unit in the Spokane County Sheriff’s Office. "A lot of crisis calls end up being pretty time consuming calls.”
Zuray goes back to the woman’s door one more time. After a few more attempts, he hears something. She’s mimicking his knocks on an inside wall.
“She’s banging back,” he says. “That’s contact right there.”
Then, suddenly, she’s at the front door, screaming at him without opening it. She tells him to leave, then runs further into the apartment and slams an inside door.
That’s it. Zuray doesn’t have the authority to force his way in. So he and the clinician head back to the car to fill out paperwork. They tell property management to call 9-8-8 if she starts screaming again.
If the team could get her to talk to a designated crisis responder, they might be able to ITA her.
ITA stands for Involuntary Treatment Act. That state law says if someone meets a high threshold of danger to themselves or others, or presents a grave disability, their civil liberties can be taken away and they can be forced into treatment.
The thing is, there’s a lot of time between being ITA’d and being put in a secured facility—because there are almost no secure beds in Eastern Washington.
Eastern State Hospital is the only psychiatric hospital on this side of the state that can take ITAs for long-term care. After recent policy changes, it doesn’t take very many. Two Frontier Behavioral Health Evaluation and Treatment facilities in Spokane do take involuntary treatment patients, but the length of inpatient care is typically six to eight days.
So even if the team could get this woman into a local hospital, and a designated crisis responder ITA’s her, the woman can decide she doesn’t want to go to Eastern, walk out of the local hospital that can’t legally detain her, and go back home.
Such are many days in the life of the Behavioral Health Unit.
Or, she could decide that she wants to get back on her treatment regime and go through a voluntary treatment program, like the one run by Pioneer at the county’s crisis and stabilization center. Officers say it has a great track record for people who stick with the program.
Rayanne Paget is a Program Administrator at Frontier Behavioral Health. She says the road to recovery is long.
“I think working in the crisis field, success can be varied depending on the day," she says. "So a lot of it is whether or not it was a good contact and we planted a seed in that individual's brain to call sooner or to call 9-8-8 to get support, reach out for help.”
Anne Raven is an administrative Battalion Chief for the Spokane Fire Department. Fire has similar co-responder teams that partner paramedics with mental health clinicians.
"Trying to get [people] the actual help they need for long term success is hugely important," she says. "That is success, even though unfortunately it doesn't necessarily equate to them going to treatment right in that moment."
Mental health issues and drug use are almost always intertwined, officers say. Fentanyl use is decreasing in Spokane, but meth is back on the rise—and with it, the chicken-and-the-egg question of whether schizophrenia or meth comes first.
In lieu of enough involuntary treatment beds, some people start thinking of jail as the only alternative secure detox facility.
Officer Casey Jones has worked the downtown Spokane precinct for over a decade. On a different Thursday morning, Jones is driving his typical route along the outskirts of downtown.
When he cruises by the 7/11 gas station on Second and Division, he recognizes someone. Well, Jones recognizes most of the people he passes. But he recognizes this guy because Jones is pretty sure he has a few warrants out.
He checks his records. He’s right—the most recent one is for harassment at the library. By now, the guy has seen Jones and takes off on his bike. Jones swings around to cut the biker off as he crosses the street.
There’s no struggle. The guy is mainly disappointed that he’s gonna lose all his stuff.
As Jones searches, he finds an eyeglass case with two glass pipes and two meth crystals in it. Each rock is about the size of an acorn.
Illegal possession—that’s a new charge, Jones says.
Jones drives over to the jail, which already has a handful of cars in the booking line. As he waits, Jones talks to the man he just arrested.
“Do you want to get clean off of meth?" Jones says. "So this is the thing that I see. People try to keep their feet in both worlds. I understand you want housing, but you don't think your meth addiction has any influence on your being on the streets. And it does.”
Their conversation about addiction lasts nearly the hour it takes to get the man booked.
“You're going to jail today—you have to take care of your warrants," Jones says. "This is a can you keep kicking down the road. You gotta take care of this first. Jeremy, Jeremy. This is not a hindrance to you getting clean. In fact, this is probably the best way to do it. Listen, over there, you could walk right out the door. In fact, that’s why I quit taking people there in lieu of jail. ‘Diverting’ people. Because I would get a call five minutes later, ‘Yeah, he just ran out the door.’”
Most officers agree that adding entry points to services and warm handoffs between resources is a good idea. But they often feel like a lot of people just don’t want help.
“I want you to start seeing value in you getting clean," Jones says to the arrested man in his car. "I wish I could make people want it. But I can't.”
Officers say they often feel like they’re a small part of a huge system that isn’t delivering.
“You know, I see the ins and outs, how the system is broken," Jones says to me. "But I have no control over that. What I do have control over is that I do my best. I kinda joke with the jailers sometimes—I go in there so often, I bring so many people in there, that it makes them work, and they kinda razz me. But I let them know, taxpayers deserve my best. So I just do my best in this big machine. If Jeremy has a change of heart eventually, it’s worth it.”
Editor's Note: This story has been updated to give more context for what options are available for involuntary treatment.
