Prince William County’s community services board has been selected as one of five in Virginia that will be the first to implement the commonwealth’s MARCUS Alert mental health crisis response system with the goal of partial implementation by December, according to county officials.
The "mental health awareness response and community understanding services," or MARCUS Alert, was signed by Gov. Ralph Northam in November 2020. It requires localities to establish regional crisis call centers to work alongside 911 dispatchers to send mental health clinicians, law enforcement officers, or both depending on the situation, to respond to mental health and substance abuse-related emergency calls.
The law is named for Marcus-David Peters, a 24-year-old, African American high school teacher who was shot and killed by a Richmond police officer in 2017 while suffering a severe mental health crisis.
Police officers in the United States fatally shoot hundreds of people experiencing a mental health crisis every year, according to a Washington Post database. Since 2015, police officers have fatally shot more than 1,400 people with mental illnesses.
The state selected five community service boards, or CSBs, in different regions of Virginia to be the first to implement the system. They include CSBs covering the City of Richmond; the City of Virginia Beach; Prince William County, Manassas and Manassas Park; the City of Bristol and Washington County; and Orange, Madison, Culpeper, Fauquier and Rappahannock counties.
Prince William County was chosen in part because the county has already implemented a local police co-responder program, which is one of the requirements of the MARCUS Alert Act, according to Heather Baxter, the county’s behavioral health program manager who is leading the local effort to implement the program.
“We were chosen because we were already ahead of the game in this,” Baxter said at a May 24 meeting of the county’s Racial and Social Justice Commission policing subcommittee.
Prince William’s co-responder program sends mental health clinicians alongside local police officers trained in crisis intervention to respond to people experiencing a mental health emergency. It began as a pilot in August 2019 with one team consisting of a mental health clinician and a crisis-trained police officer. It was expanded to three teams in December 2020. Another three teams will be added beginning in July.
County officials have said the program has so far resulted in time and money saved for the police department, which often sends officers to accompany those experiencing a mental health emergency to hospitals or takes individuals into temporary custody until mental health clinicians arrive.
Between Jan. 1 and March 31, the co-responder teams were dispatched to 240 mental health calls or nearly three per day, Baxter said.
Prince William County police and community members have so far reacted positively to the changes, Baxter said.
“We have received letters from family, from people that have interacted with them. We get emails from sergeants and police on the street constantly. I think the reason that they're giving us so much praise is because they just really were surprised,” Baxter said. “They had no idea that it could help so much.”
Some mental health response calls won't include police
But the co-responder units are only one of the requirements of the MARCUS Alert Act. Under the new law, many no- or low-risk mental health-related calls will require a response from mental health clinicians without police. The county is preparing to implement those response teams by December.
Prince William County’s MARCUS Alert Implementation committee, which consists of local police and representatives from fire and rescue and local hospitals, is still discussing the best way to move forward, according to Baxter.
The current plan is to dispatch in-person mental health workers from two existing Northern Virginia crisis call centers – the Children Regional Crisis Response, or CR2, a rapid mental health crisis response service for people under the age of 21, and REACH, a crisis response service for individuals with intellectual or developmental disabilities – in addition to a team of local mental health clinicians.
“The expectation is that [911 dispatchers] would be able to call one of those teams to respond. We don't have the logistics yet of how that's going to work. We really want to make that as seamless as possible because in an emergency, the last thing you want is multiple phone calls or people not answering,” Baxter said.
All Virginia localities will eventually need to set up regional crisis call centers to field mental health emergency calls under the new law. But because Prince William is among the first to begin implementing the new law, no such call center exists. Until the call centers are established, likely sometime in 2022, mental health clinicians will be working within the county’s 911 dispatch to assess mental health calls and provided the appropriate response, Baxter said.
Counselors, police or both?
Dispatchers will be using four different triage levels, still under review by Virginia’s MARCUS Alert stakeholder group, to decide whether to dispatch mental health clinicians, police or both to mental health emergencies, Baxter said.
A level one emergency response would be for “no risk, no harm” situations best handled over the phone by a mental health clinician or a 911 responder, Baxter said. Level two responses would likely require an in-person response from mental health clinicians for an urgent mental health crisis, such as a person experiencing suicidal thoughts but who does not have the intent to harm themselves. Police would not respond in a level-two situation, but dispatchers may notify police of the response in case the situation escalates.
A level three emergency would require a dispatch from the co-responder unit in which a person is a threat to themselves or others and there is a high level of risk.
A level four response would be for very high risk, dangerous situations requiring a police-only response.
The triage levels and associated responses are not yet final and will need to be approved by the Virginia legislature before December, Baxter said.
Currently, police departments throughout Virginia are the only agencies responding to all mental health emergency calls.
The Virginia General Assembly created the MARCUS Alert Act in December 2020 following a summer of unrest both locally and nationally as protesters took to the street to advocate for police reform following several high-profile police shootings. The bill was one of several police reforms passed, including a ban on no-knock warrants.
Several cities throughout the U.S. already have programs similar to the MARCUS Alert that changed how police respond to mental health crises, including in Eugene, Oregon, San Francisco and Denver.
In Virginia, police will not be taken out of the equation entirely when it comes to mental health first response.
“If there is a belief that police will be taken out of this 100%, that is not an appropriate expectation. It’s not going to happen. We can’t take them out 100% because they’re safety. Sometimes there’s weapons involved. Sometimes there’s a very high-risk situation,” Baxter said.
“… But there’s a lot of situations that police are responding to right now that maybe [they] don’t.”
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