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Jen-Mei Wu was terrified. Her friend was experiencing a mental health crisis late one night recently, but Wu didn’t want to call the police. It started to seem likely that her friend was going to harm herself, and Wu couldn’t find a good alternative, so she made the call.
“Guns rarely make a situation better,” Wu said about why she was afraid to call the police. “When you have people with guns going around looking for a person, you just have to hope for the best.”
The officers who responded did not use force against Wu’s friend, but Wu’s concerns are widely shared by people with mental health issues and their support networks of family and friends. Police usually have very little training in how to deal with someone experiencing a mental health crisis, and can respond with force. According to data collected by The Washington Post, people who had mental illnesses made up 22% of those killed by police over the past 12 months.
On April 18, in a San Leandro Walmart not far from Wu’s East Oakland neighborhood, a San Leandro police officer shot and killed Steven Taylor, a 33-year-old Black man. Taylor had a history of paranoid schizophrenia and bipolar depression, and the police were called because he was walking through the store wielding a metal baseball bat. His family’s lawyer claimed Taylor was having a mental health crisis while the officer shot him.
Wu said her experience of desperately wanting to be able to call a non-police responder made her realize she needed to “step up and work towards those solutions.” She found one organization that is creating this kind of alternative, MH First, and took part in a training the group offered to Oakland residents last month.
Launched by Anti Police-Terror Project Sacramento in January, and led by Asantewaa Boykin, who worked as a psychiatric nurse for over a decade and currently works in emergency healthcare, the goal of MH First is to replace police responders to mental health calls with unarmed volunteers equipped with skills to deescalate situations.
The group has found strong support in Oakland. Hundreds of Oakland residents have expressed interest in learning their model. And Boykin has ties to Oakland. She co-founded the Anti Police-Terror Project in 2014, an Oakland-based organization that, among other things, advocates for shifting community resources away from police and toward alternative models.
Boykin said MH First can help to “prevent police contact” with community members who are in a vulnerable state. “A lot of our folks who are harmed or murdered by police are done so while in the midst of a mental health crisis,” she said.
Daniela Kantorová is helping Boykin expand MH First to Oakland. A clinical psychologist with Berkeley’s Wright Institute, a private graduate school of psychology, and the president of Psychologists for Social Responsibility, Kantorová is also the co-chair of APTP’s First Responder Team, which supports families who have had negative and harmful experiences involving the police. The team also conducts private investigations of police killings. Kantorová said the MH First program is a logical next step.
“We’re working with the families after the tragedy has already happened,” said Kantorová. “I think it is important to try to get ahead of that and see what we can do to prevent police murders.”
Kantorová sees both law enforcement and traditional mental health approaches as relying on “hierarchical relationships.” When dealing with people in fragile mental states, she thinks it’s far more effective and safe to relate to them “primarily as another human being as opposed to a person who needs to be controlled and contained.”
Nikki Jones, a Sacramento-based MH First volunteer counselor, had a personal experience with law enforcement that helped motivate her to become involved. She said police took her to jail and then released her at 3:30 a.m. while she was still experiencing a psychological emergency, which could have put her in an even more dangerous situation.
“Jails are traumatizing places, not places to find healing,” said Jones. “I only made it through because my friends were there waiting outside to take me to the hospital. It’s a model that’s saved my life more than once,” she said.
Focusing on a caller’s needs, not their potential for harm
In Sacramento, Boykin already has MH First up and running with about 50 volunteers. While MH First Sacramento used to dispatch its volunteers to show up for calls in person, its services are currently limited to remote support via telephone in order to prevent the possible spread of COVID-19. They plan to return to in-person response when it’s safe to do so, said Boykin.
Oakland’s City Council recently voted to set aside $1.35 million for a pilot program called Mobile Assistance Community Responders of Oakland, or MACRO, to send out unarmed medical professionals and counselors to deal with mental health crises. It’s a similar program to MH First in some respects, but Kantorová says state-run programs like MACRO largely rely on traditional mental health approaches that tend to be formal and rigid.
Boykin sees a goal of MH First, instead, as providing “socially competent mental health services,” meaning they address not just the symptoms of a mental illness, but also what Boykin views as a wider social context of racism and capitalism that make dealing with those symptoms more difficult and dangerous. MH First’s approach with callers who are struggling with mental health issues includes affirming them and suggesting options for dealing with their conditions. By offering a space to be heard, Boykin said, MH First is “probably preventing folks from spinning all the way out.”
Boykin said she recently had a conversation with a caller dealing with overwhelming feelings about how she “couldn’t take the weight” of racism. “When dealing with traditional mental health approaches, especially as a person of color,” said Boykin, “if you send me to an office to sit across the table from a white person, the power dynamic is such a large gap.”
MH First volunteers are trained to avoid escalating a situation by focusing on the needs of a person experiencing a crisis as opposed to the harm they could potentially cause. And since many volunteers with MH First are mandated reporters like licensed nurses and counselors, who have to call 911 if a person reports being suicidal, they have to be careful about what they ask the person on the other end of the line. Otherwise, they might be forced to call 911, which could lead to police response.
“What we typically ask is, ‘Are you safe?’” said Boykin. “We don’t actually ask someone, ‘Are you feeling suicidal?’”
If a caller says that they don’t want to live anymore or want to kill themselves, Boykin trains volunteers to ask about the person’s plan to assess whether there is an immediate threat.
“If their plan is to jump from the Golden Gate Bridge and they’re currently in Modesto and they don’t have a vehicle,” said Boykin, “that tells us that they’re not in actual imminent danger of hurting themselves.”
MH First volunteers are also taught to identify “conditional suicidal ideation,” suicidal desires that likely won’t be followed through on if a condition can be met. Sometimes meeting that condition can be simple, like helping a person get access to food.
If a caller says they want to hurt someone else, volunteers ask for more details. “There’s a difference between someone saying ‘I want to hurt my husband. I’m in the room with him and I have a gun,” Boykin said, “versus, ‘I want to hurt [the president] because he’s oppressing our people.’”
Boykin said each volunteer’s job is to get to the root of the threat of harm, find out how imminent that threat might be, and to help the caller avoid that harm.
“Police departments don’t ask any of those questions,” said Boykin. Situations can escalate quickly and police can turn to physical violence and incarceration.
Kantorová is currently helping to train a small core team of Oakland volunteers to start practicing the MH First model in Oakland. Several hundred have already signed up to be involved. Kantorová held a virtual meeting over Zoom on June 27 to give Oaklanders an overview of the program. They expected a couple dozen to log on; over 100 ended up attending. Those who are interested in volunteering but did not make last month’s training can contact the organization through APTP.
Although MH First began in Sacramento, Kantorová said she also wants to “learn from people” in Oakland about what they need instead of “coming with a pre-packaged solution” from another city. “I think we need to stay humble, and in relationship with the multiple communities of Oakland,” she said.