We've all seen it, and some of us even know someone: a person who, despite the best efforts of families, social service agencies and law enforcement seem beyond reach. Today, a special program called Head's Up is gathering together representatives from a variety of agencies and organizations to identify and support folks who need assistance but for whatever reason are not receiving the type of help they require.
It all started in 2019 with a single person- an individual who was frequenting the downtown Ukiah area and upsetting individuals and businesses. Megan Van Sant, Senior Program Manager, Special Projects Team for the County of Mendocino, who is the project's facilitator noted that everyone was frustrated.
"This person was in and out of jail, and not making progress. Law Enforcement was frustrated. My team started meeting with the county Probation department and the Ukiah Police Department specifically about this individual." Though the outcome was not as successful with this person as they would have hoped, the process of meeting together to focus on a specific individual continued.
"Another woman was having similar behaviors," Van Sant continues. "She ended up in jail, but we tried to focus on her. She was open to support, which led to her becoming permanently housed. This is what got us working together."
The current active partners in the Head's Up program include the Ukiah Police Department, Mendocino County Probation Department, Mendocino County Sheriff's Office, Mendocino County Department of Social Services, and the Mendocino County Behavioral Health Department. To date, the project has responded to over 250 unique situations. At full capacity and with full participation, the team estimates that the demand and need is likely three or four times the current volume.
According to Van Sant, Heads Up provides a pathway for law enforcement agencies in Mendocino County to alert the Behavioral Health and Social Services departments about individuals who have repeated and unproductive interactions with law enforcement, the jail, the social services system, and the behavioral health system.
After receiving a referral, the Heads Up team identifies the most appropriate human services worker and/or organization to respond and follow-up. The goals of the project include providing early identification and diversion of individuals in need of behavioral health and social services support, and identifying the right person to respond to community members needing assistance. Other community-based organizations are providing additional support through the acceptance of secondary referrals.
To get to this point, team members all agreed to check their assumptions and egos at the door.
"Between law enforcement and mental health, we make tons of assumptions about each other. And we don't speak the same professional language. Some of my preconceived ideas were completely wrong. This has been an important educational process for me- simply understanding the organizations, systems and the individuals that work within them amidst serious staffing shortages. We have developed mutual respect. We're getting there.".
The program is not grant funded, which enables the team to work together with fewer funding-related constraints. "It's definitely a team effort. We're all trying to do our jobs, but it's taken years for us to develop trust and understanding, and we didn't want to announce the program until we'd developed a communications system and had successes under our belt. We're all showing up and we're very proud of the work we've accomplished."
Van Sant assumed that most of their referrals would consist of "frequent fliers" and other folks seen wandering the streets.
"It turns out we've had quite a number of clients who were totally off the radar. There's way more of a variety than we thought. Not all the folks we've worked with are well-known by the community."
The group has assisted with number of elderly people who are aging in place. "Sometimes they're estranged from family. Sometimes they're just not ok. We've responded to situations where family members at wit's end with their teen or young adult, so they call 911 out of desperation. These situations are way outside the scope of and expertise of law enforcement, and generally, not what they signed up for," Van Sant continues.
One issue that arises are the inherent freedoms that adults possess. "The public might evaluate an individual at home or on the street and think, 'Why hasn't someone done something? How could someone not scoop up this person?' It's not always that people haven't done their job," says Van Sant.
To be placed on a 5150 psychiatric hold, there are specific criteria that must be met, as the person being held is temporarily losing their freedoms. "The 5150 criteria- 'danger to self, danger to others or grave disability' is complicated. Say someone is detained for 14 days or longer. They receive medication. Once released, they may stop taking their medication, the prior behaviors slip right back and as an adult, there is little agencies can do to intervene. The pathways to getting help are definitely not straightforward and there are multiple ways to fall off those paths. And in America, we place a lot of value on free will."
Other times, a person will agree to psychiatric or substance abuse treatment. But, notes Van Sant, if there are no treatment beds available immediately available, where does that person go until a slot opens up? For many, jail has been a stopgap solution, which is clearly inappropriate for the individual, the other inmates and most importantly, the employees in the criminal justice system who are obliged to care for them.
"If we don't put a person in jail, what do we do if there's no infrastructure to replace jail? That's what we haven't figured out in California. We know the public is losing patience. They want this issue solved. But to do that, we need a lot of things including enough beds for psychiatric treatment and truly supportive housing."
The key players on the team meet quarterly.
"Communication is ongoing. I generate a weekly report with a running tally of very basic outcome notes and a quick view of what's going on with a person. My commitment to the group is communication- that you will never send an email to nowhere. We're committed to doing our best, but if we're not making progress, we'll report that."
The Chief of the Ukiah Police Department, the Chief of Probation, and a Sheriff's lieutenant attend the meetings, along with Van Sant and others. "I make sure people in the field are also involved. Responders also come to our quarterly meetings."
One important feature of the project is that no person or agency is in charge. "In keeping with our common understanding that complex community problems require complex and creative solutions, Heads Up project members recognize that no single agency or administrator is responsible for solving societal problems with multiple causes," says Van Sant.
Those taking the referrals meet more frequently.
"We have an 'air traffic controller' who gets the referrals. Then, in collaboration with the team, they figure out the right home for that person. Then we follow up. Our field team is pretty intrepid. They have a way of locating folks, even if they are unhoused and without a phone."
There are still some systemic issues that Van Sant hopes will improve.
"Because of way communication works, we're probably not getting all the calls we could get. If a Deputy that works nights makes a referral, he may not be on call for another 5 days, so we may not get to talk to that deputy. That's just how the structure is."
She has also noticed that many people seem to be expecting their call.
"When we follow up after someone has a law enforcement interaction, they're usually glad that we called and in general, thank us for reaching out."
Referrals are classified using a color-coding system.
"Green means the person is on a better pathway. Blue indicates they are incarcerated. Red is for red flags- were acknowledging the person is not making progress, meaning we're familiar with the person, we've done research, we're trying and we're going to have to continue to find strategies. That all gets communicated back to law enforcement. This is the system we're using to communicate throughout the participating agencies. Half of the referrals get to green. Some people we're just not able to locate, so they get coded black. It's a good type of shorthand. We still have a lot of people that are 'square pegs,' but we have a platform to communicate."
Initial response to a Heads Up referral may take up to a week. This project is not designed to provide immediate, real-time, responses.
Heads Up referrals may only be initiated by first responder agencies in Mendocino County. They do not accept referrals from parents, friends or community members.
"I worry about people struggling mightily who are not on the streets. I wish we had an alternative to 911 that could address nonviolent crimes, particularly for issues like parenting challenges, youth or young person challenges. We would like to have more partners in that arena."
"Even though it's super hard to see individuals we're not making progress with, we have to keep trying. People I thought would never come around- and then they do. I don't think that we can ever state it's hopeless. Hope itself is so powerful for the individual. If we continue to helpful and people feel hopeful, change is always possible," Van Sant concludes.
More information about the project can be found at www.headsupmendocino.org.
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