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'We see them at their worst': How L.A. County's mental health team is working to end a stigma

Daily News - 11/13/2017

Nov. 13--Long after he has helped them, the teenagers and the elder adults who want to take their lives tend to linger in the mind of Los Angeles Sheriff Deputy Rene Gonzalez.

After he's able to link them to services, the 10-year veteran of the department rarely sees them again. Yet, he often wonders what happens to them.

"I wanted something different," Gonzalez said of why he asked to be moved from patrol to the LASD's Mental Evaluation Team. "It's very different. I'm different because of it. I want to help people, but we can only do so much."

When he signed up to join the Mental Evaluation Team more than a year ago, he wanted to learn more about spotting the signs of mental illness. It's a new tool he appreciates, he said, to minimize confrontations and to help link people to services. But there's always more to learn, he acknowledged.

On any given day, he and other members of the MET units could be called anywhere across Los Angeles County, at all hours. They could be pulled into the West Hollywood station, to help calm down an inmate in the jails during a psychotic episode. They could be called to Temple City, where a young woman has threatened suicide. They are spat on and cursed with racial slurs. But the deputies' job is to be calm, to be unoffended, to understand when to step back and let a mental health specialist step in, or another deputy that has more rapport with a person.

"In the Antelope Valley, I've seen 7th-graders who are suicidal, because of something posted on social media," he said. "They're depressed because they're bullied and that's the frustrating thing. On social media kids are so cruel that other kids want to take their own life. That's hard to see."

He's also seen how loneliness and abandonment affects older adults.

"I once went all the way to Avalon, to help an elderly woman who was very depressed, and suicidal" Gonzalez said. "It's tough and sad," he said.

But it's a growing reality for an undermanned sheriff's department, its deputies struggling to work their beats in the face of an increasing number of mental health calls for service. At the same time, law enforcement officers find themselves in an ever more crucial role in the broad, network of care for people in need of mental health services.

From 2010 to 2015, calls for service to the LASD involving mental health issues increased from 11,660 calls in 2010 to 18,061 calls or a 55 percent increase.

In the 2015/2016 fiscal, members of MET placed 3,768 on psychiatric holds. That increased by almost 14 percent in the last fiscal year, to 4,515 holds.

The need for more teams has become the focus of activists, a Sheriff's civilian oversight committee and members of the Board of Supervisors. In the last year especially, some actions have been taken to expand the teams and the services they need.

Next spring, there will be 23 Mental Health Evaluation teams -- a complement of social workers and clinicians with the Los Angeles County Department of Mental Health that accompany law enforcement personnel on calls.

In the case of the elderly woman, a MET team brought her to a hospital by boat. But seeing her was unsettling, Gonzalez admitted.

'At their worst'

MET teams often patrol an area of more than 4,700 square miles. On a recent morning, Gonzalez began at the South El Monte Sheriff's Patrol Station to fill in for another MET unit that had been called to help with an inmate at Men's Central Jail, in downtown Los Angeles.

Gonzalez had no mental health professional with him, when he responded to a scene in Norwalk, where a 34-year-old man had locked himself in his truck. The man had used a baseball bat to smash the windows of his neighbor's home, then the headlights and taillights of his own spray-painted black truck before speeding away. His mother called 911, and told them her son had been diagnosed as bipolar, and he had not taken his meds in a while.

Another lone deputy had been able to cuff the man, and put him in his patrol SUV. But deputies decided he needed to be placed in a special patrol car and taken to a psychiatric hospital. As they worked to transfer the man from one car to another, he body slammed Gonzalez and other deputies, then tried to break the patrol car's passenger window with his head. He squirmed and cursed as deputies held him still. More deputies arrived along with the fire department and paramedics.

"Why's this happening!" he shouted into the asphalt. "What did I do?! Mom! Mom!"

His mother, 54, watched as deputies later strapped her agitated son to a stretcher to be taken to a hospital.

"He had a job, he brought us Christmas presents," his mother said as she wiped away a tear.

"I didn't want him to hurt anyone," she added.

"We see them at their worst," Sgt. Annadennise Briz, said of the sons and daughters, mothers and fathers who break down, become violent, or whose moods either dip or escalate because they stop taking medication, or else they medicate with street drugs.

Briz, who oversees the MET teams in the San Gabriel Valley, had first been a social worker, joined the Sheriff's Department specifically so she could work with people who display signs of mental illness.

"It's very near and dear to my heart," she said. "I was always dealing with a crisis. I believe in (the work). I see the efforts of how law enforcement is changing the stigma."

One of the misconceptions people have about the program is that MET members only work with homeless people who have mental illness. Though Briz said it's true, many homeless people have mental health needs, she said families suffer.

"It's a societal problem," Briz said of the stigma that exists, of the shame families feel, and the lack of services and help. "It's very sad. It's always a lot of types."

But the members of MET still work to link those they meet with as many services as they can.

"We're not just patting them on the hand and making like we want to help," said Sanjay Shah, a social worker and supervisor with the county's Department of Mental Health. "We want to implement services."

Others see the need

But the system designed to treat people is still ill-equipped to work with them. County officials say there aren't enough beds to help people referred by MET, nor enough teams. And critics contend that law enforcement personnel need more training to deal with such situations. California law requires each law enforcement officer receive 15 hours of training. In Philadelphia, officers receive 40 hours.

Ultimately, without enough beds in county hospitals or clinics, jails become a de-facto treatment center for those diagnosed with a mental illness.

In 2010, inmates with mental illness in the county jails totaled 2,475. As of 2016 that number more than doubled and exceeded 4,000, according to the Sheriff's Department.

Other police agencies have seen the need for similar teams.

--In Orange County, a 2015 grand jury report examined the Sheriff's Department there and found that at any given time, at least 20 percent of inmates were diagnosed with a mental illness. The report concluded the department would benefit if deputies each received 40 hours of crisis training. The department responded by saying 40 hours was too much.

Instead, the department expanded two different units, including their Crisis Assessment Team or CAT, which provides 24-hour mobile response services to adults with a psychiatric emergency, Landquist said. The Psychiatric Evaluation and Response Team, or PERT units, include a behavioral health clinician who rides along with a police officer to provide a prompt response to individuals in need, said Tricia Landquist, a spokeswoman for the Orange County Health Care Agency.

--The Pasadena Police Department began utilizing one team, known as HOPE in 2002 to reach out to people who are homeless, said Lt. Mark Goodman. Since then, two more teams were added and a recent grant will help pay for more training and teams, he added.

But it's the Los Angeles Police Department's SMART units that have emerged as a model replicated by other law enforcement agencies.

The LAPD deploys 17 teams per day, 7-days per week, said the agency's spokesman Josh Rubenstein. In August, 72 percent of the persons placed on mental health holds by LAPD SMART were placed in private facilities, which means there was less recidivism, Rubenstein added.

In the department's recent use-of-force report, four of the 41 total suspects, or 10 percent, were perceived to be experiencing a mental health crisis. This accounted for a 21 percent decrease compared to 31 percent in 2015.

But in vast Los Angeles County, the funding can't catch up with the growing need. A recent report by the newly formed Los Angeles County Sheriff's Civilian oversight Commission praised the potential of such teams and efforts made, but also expressed concern with the county's jail population. Nearly a third of all inmates are diagnosed with symptoms related to mental illness.

"Although the current expansion plan's proposed 23 teams may be a start, significantly more, 40 to 80 may be ideal and even necessary in the future to ensure effective coverage of Los Angeles County and to be adequate for use as a de-escalation tactic and diversion to resources accompanying first responders," according to the report.

Stakes are high

There is an increased public outcry over officer- and deputy-involved shootings and use of force, especially when incidents involve people diagnosed with schizophrenia, for example. The consequences of not knowing how to interact with someone whose words or actions seem threatening can be deadly -and costly.

--In 2012, a woman diagnosed with schizophrenia named Jazmyne Eng, of Rosemead, was shot and killed by deputies when they found her wielding a hammer in the lobby of the Asian Pacific Family Center. The 40-year-old woman's family was awarded a $1.8 million dollar wrongful death settlement.

--In April, the Los Angeles County Board of Supervisors awarded a family $3.3 million to settle a lawsuit brought by the family of a 31-year-old Lakewood man who was fatally shot by sheriff's deputies in 2015 in front of his home. In a memorandum released last year by the Los Angeles County District Attorney's office, LASD deputies said John Berry became combative and could not be subdued with pepper spray or a Taser. They said he used his car as a weapon by ramming a patrol vehicle while in reverse, pinning a deputy. Deputies' fired 31 rounds toward Berry, according to the district attorney's report.

Christopher Berry told reporters his brother had not accelerated and crashed into the police car. The district attorney's report said Christopher Berry had contacted a MET team, but he did not respond when the team called him, according to the report.

None of the officers were charged in the shooting.

--This year, Dennis Todd Rogers was killed by officers in the parking lot of 24-hour fitness in Ladera Heights. Rogers reportedly had become agitated when he was told to leave by the gym's manager. Deputies called MET, according to reports, but the team wasn't immediately available. In July, the family filed a wrongful death lawsuit.

Those kinds of confrontations are why organizations such as the National Alliance of Mental Illness have called for more such MET teams, said Brittney Weissman, executive director of NAMI's Los Angeles County Council. "We want to prevent 5150s from going bad."

"I believe in (the work). I see the efforts of how law enforcement is changing the stigma."

-- Sgt. Annadennise Briz, Los Angeles County Sheriff's Department

The onus to help people in need of mental health services should not fall squarely on law enforcement, Weissman added, because they are there to provide public safety.

"We need everyone, the entire system and public to participate in helping our fellow community members out," Weissman said. "We need family member engagement, school personnel engagement, law enforcement, department of mental health outreach teams, mental heath providers and street outreach workers, etc. We can all play a role in helping people to the support they need to feel better in life."

Such teams are in demand at police departments across California and nationwide, said Toby Ewing, the executive director of the Mental Health Services Oversight and Accountability Commission. The commission develops strategies to help people overcome stigma but also advises the governor and legislator on mental health policy.

"In working with counties, we began to hear more concerns within the law enforcement community and mental health community that there is more work to be done," Ewing said. "There's been increased efforts in California and nationally as well. The time is right."

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(c)2017 the Daily News (Los Angeles)

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