Fishman, Ph.D., is a member of the Racial Justice Coalition of San Diego and the North County Equality and Justice Coalition. He lives in El Cajon. Carolino is the brother of Dennis Carolino, who San Diego police killed in 2019 during a mental health crisis call. He is a member of the Racial Justice Coalition of San Diego, and lives in El Cajon.
The commitment that San Diego Mayor Todd Gloria and San Diego County Board of Supervisors Chair Nathan Fletcher have shown to using mental health clinicians, case managers and trained peer support specialists instead of law enforcement to respond to mental health emergencies is impressive to see. We were very pleased they articulated their support for new Mobile Crisis Response Teams in a commentary in The San Diego Union-Tribune in September. The Racial Justice Coalition of San Diego stood with Supervisor Fletcher when he first introduced the county’s Mobile Crisis Response Teams, and we have long advocated for non-law enforcement response to mental health emergencies. We will continue to work with all elected officials to ensure the success of these teams.
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What motivates our work is the death of so many people, including Dennis Carolino, who was in need of professional and competent care during a time of mental health duress but was instead shot and killed outside his home in El Cerrito by San Diego police officers two years ago. There have been many high-profile cases of individuals who desperately needed help with a mental health crisis locally and nationwide, and instead of being provided with professional and appropriate support, they were met with unproductive commands and brutal and excessive force. To be able to address this national epidemic, we have pushed for San Diego County and the city of San Diego to embrace the same programs that other cities and counties have embraced.
The formal description of the program that San Francisco has adopted and implemented should also serve as a model for what we want to establish here in San Diego: “The Street Crisis Response Team is a collaboration between the San Francisco Department of Public Health, the San Francisco Fire Department, and the Department of Emergency Management to provide the most appropriate clinical interventions and care coordination for people who experience behavioral health crises in public spaces in San Francisco. Each team includes one community paramedic, one behavioral health clinician and one behavioral health peer specialist.
To ensure the success of the local Mobile Crisis Response Teams, we highly recommend that more data be made available to the public and that the data be used for the design and implementation of the teams. In particular, we request the release of information on all mental health calls, especially ones labeled as the most serious calls — in law enforcement terminology, the “5150” calls (so named because of a section of California’s Welfare and Institutions Code).
We have questions about these calls. How many were nonviolent and would have been better served by medical and healthcare professionals? How many resulted in death or serious injury at the hands of law enforcement?
This data should serve as the basis for determining the success and the value of the program. If we want to make sure no more families have to live without loved ones who suffered from a mental health crisis and died at the hands of law enforcement, then we need to make sure that we are setting up a program that can provide appropriate and professional mental health care services to those who are in dire need of that type of support.
We specifically want to make sure the local program has a start date for the entire county with its 24/7 service. We also want to ensure that the proper professional staff and physical resources will be in place to serve the intended community. There needs to be clear and credible oversight of everyone that is involved in the program, and the model of public civilian oversight of law enforcement should serve as the model for this oversight.
Proper training for all staff involved in the Mobile Crisis Response Teams program must also be included, and this training should be based on best practices and models that have been developed as national standards. Assessments of this program must be based on the public release of data relating to all mental health calls, and the responses of all agencies must be monitored and evaluated based on successful outcomes and ongoing support.
A large number of law enforcement calls involving mental health result in injury or death. Planning and implementation of the Mobile Crisis Response Teams countywide rollout should ensure that crisis calls from residents in behavioral health distress (including all 5150 calls) receive a response from such a unit every time. This will allow families like ours to know they will receive appropriate professional care and community resources and not suffer a tragic loss of life of a family member. We are all watching.