Dealing with mental health crisis one Zoom call at a time

The sergeant had so little use for the tablet that she did not bother to grab it from the seat of her squad car when she ran into the house where a suicidal man was screaming and slamming his head against the floor.

But when she saw the man might harm himself, his family or her officers with knives he was threatening to use, she sent an officer to retrieve the tablet. She turned it on, handed it to the man and told him to talk to the woman whose face appeared on the screen. And then she watched as the man immediately calmed down.

"When I saw how this tool pacified him, I was like, holy smokes, this is incredible,” said Cook County Sheriff's Police Sgt. Bonnie Busching.

The scene marked the first time the department took the idea of the Zoom call that has become so common during the COVID-19 pandemic and inserted it into one of the most dangerous things a police officer can do: answer a domestic disturbance call.

Law enforcement agencies are struggling nationwide with increasing violent crime as calls mount for changing how police interact with citizens, especially those with mental health issues. Police are still most often the first called to the scene, and the sheriff's department's Treatment Response Team is a novel approach to managing such calls.

Started two years ago, the effort was designed to help the sheriff's department's 300-member police force deal with a skyrocketing number of drug overdose calls during a national opioid crisis.

Then, as the pandemic left more people isolated in their homes, either unable to connect to services or unwilling to step outside and risk getting sick, the department was faced with an explosion of 911 calls linked to threats of suicide and other mental health crises.

The sheriff, who made national headlines for putting in place programs at his jail dealing with the growing number of inmates with mental health problems, now saw the same kind of issues playing out for his officers on the street.

“We were being asked more and more to be the first responders for mental health cases and they were being asked to do things they don’t have training for or minimal training for,” said Tom Dart, whose department is the second largest sheriff's office in the nation and patrols unincorporated parts of Cook County and many of its smaller communities. It has seen the number of 911 calls involving mental health issues increase by nearly 60% this year.

There are other programs around the country, but most involved mental health professionals riding around with police officers or in ambulances, Dart said. That's fine for smaller communities but wasn't practical for Cook County, where getting from one end to the other — without traffic — takes well over an hour.

“How many ambulances would we have to buy and how many would we have to hire to man them all?” Dart asked

Enter the tablets.

“We wanted a tool for the officers to get that mental health expert on the scene immediately,” said Elli Petaque-Montgomery, the team director.

Thus far, the department has 70 tablets — 35 purchased with grant money when the program began and 35 more when it became clear that the number of Zoom calls, which has now climbed past the 50 mark, would increase.

Also, with a program that the department is using throughout the county as well as the west side of Chicago there have been times Zoom calls have been impossible, due to spotty service or other reasons. In nearly 20 instances, officers set up a phone call between the people in crisis and mental health professionals.

At the same time, four clinicians and other mental health professionals already working for the department have been joined by four more to answer calls. Dart said the price of the clinicians and the tablets — a couple hundred dollars each — is a fraction of what it would cost to send out a small army of mental health professionals ready to hit the streets.

“We're not asking anyone to work an 8-hour shift, but we're just asking them to be available," said Dart, whose office announced last week that one suburb, Oak Lawn, has joined the program. The hope is others will follow.

Still, such a program cannot work unless police officers, particularly those who have been around for a while and have a certain way of doing things, embrace the idea of handing over at least some control of situations to someone — and something — else.

“I don't play video games and I wasn't brought up in an era where you FaceTime and text instead of dealing face to face,” Busching said. And she didn't like the idea of someone on a video screen looking over her shoulder and telling her what to do.

But on that night in December, she quickly concluded she had no choice, and borrowing a famous line from a game show, told the man she was going to “phone a friend."

“I looked at the guy and said, 'This lady is going to help you, she's not the police, she's a therapist,'” Busching said.

Busching may be one of those not all that comfortable with Zoom calls and text messages, but she quickly learned what anyone with teenage kids already knows.

“People spend a lot of time on electronic devices, they're comfortable with them and they feel safer talking face to face with a person,” said Petaque-Montgomery, who was on the other end of the call. And, she said, by handing the man the tablet, Busching signaled a level of trust.

That signaled something to the officers themselves.

“They've seen they could go into (situations ) that historically meant hours and hours and tons of paperwork and potentially the use of force and hand the tablet over to the clinician and let the clinician do their job so they could do theirs,” Petaque-Montgomery said.

“We can even slide a tablet under a door so they don't even have to see a cop,” Dart added.

One mother of a troubled 12-year-old boy who kept running away and needed mental health assistance a few weeks ago could see the change in her agitated son's demeanor when the officer handed him the tablet. It changed even more when the conversation with the clinician started.

“The way he (the clinician) talked, my son could see he was understanding,” said the woman, who spoke on condition of anonymity because she does not want her son identified. “He likes it because somebody is talking to him and seeing the human behind the voice helps.”

For Busching, the questions she had about the tablets and the worries about what might happen if she was forced to try to restrain a man who had threatened to kill himself vanished when what looked like a situation that might easily turn into a physical confrontation ended quietly.

“He gave me his hand and walked to the ambulance with me,” she said.