850.20 MENTAL HEALTH CRISIS RESPONSE
ORS 161.336(5) Conditional Release by Psychiatric Security Review Board: Termination or Modification of Conditional Release
ORS 181.530 Commitments
ORS 426.228 Police Officer Taking Person into Custody-Mental Treatment
ORS 430.735-765 Duty of Certain Persons (incl. Peace Officers) to Report Abuse of Persons with Mental Illness or Developmental Disabilities
DIR 850.10 Custody, Civil Holds
DIR 850.30 Juveniles, Custody
Report of Peace Officer Custody of a Person with Alleged Mentally Illness
Report of Peace Officer Custody of a Person with Alleged Mentally Illness as Directed by a Community Mental Health Director
- 1. STATEMENT OF PURPOSE
The purpose of this policy is to establish procedural guidelines for bureau members when responding to persons in mental health crisis.
- 2. DIRECTIVE SPECIFIC DEFINITIONS
2.1. Abuse is:
2.1.1 Any death caused by other than accidental or natural means.
2.1.2 Any physical injury caused by other than accidental means or that appears to be at variance with the explanation given of the injury.
2.1.3 Willful infliction of physical pain or injury.
2.1.4 Sexual harassment or exploitation, including but not limited to any sexual contact between an employee of a facility or community program and an adult with mental illness or a developmental disability who receives services from the community program or facility.
2.1.5 Abandonment, including desertion or willful forsaking of a person with a disability or the withdrawal or neglect of duties or obligations owed a person with a disability by a caregiver or other person.
2.1.7 Verbal abuse of a person with a disability.
2.1.8 Financial exploitation of a person with a disability.
2.1.9 Involuntary seclusion of a person with a disability for the convenience of the caregiver or to discipline the person
2.1.10 A wrongful use of a physical or chemical restraint upon a person with a disability, excluding an act of restraint prescribed by a licensed physician and any treatment activities that are consistent with an approved treatment plan or in connection with a court order.
2.1.11 An act that constitutes a crime under ORS 163.375, 163.405, 163.411, 163.415, 163.427, 163.465, 163,467.
- 3. POLICY
3.1. It is common for members to have contact with persons who, by their actions, indicate that they may have a mental illness. No person shall be taken into custody for mental illness alone. If such a person has demonstrated by his/her actions, as observed by a reliable person, that he/she poses a danger to him/herself or others and is acutely in need of care, a member may take this person into custody for purposes of transportation to a place for receiving care, such as a hospital emergency room or urgent care clinic.
3.2. A person with mental illness, like other citizens, can be taken into custody when he/she has committed an arrestable offense or has a valid detention order against him/her. In such instances, the person’s mental state should be taken into account in considering the appropriate course of action, following guidelines established in Crisis Intervention Training.
- 4. MANDATORY REPORTING REQUIREMENTS
4.1 Members will complete an Investigation Report for allegations of abuse to a person with a mental illness and persons with a developmental disability. A copy of the report will be forwarded to the Multnomah County Mental Health Division or Developmental Disabilities Services Division as appropriate.
4.2 Members will report non-criminal matters to Multnomah County Aging and Disability Services (Gatekeeper Program) as listed in the Problem Solving Guide.
- 5. CRISIS INTERVENTION TRAINING (CIT)
5.1 All sworn members will attend CIT training during DPSST Basic Academy and PPB Advanced Academy. CIT refresher training will be conducted during in-service training. Officers and Sergeants assigned to patrol are expected to use their CIT training when responding to incidents involving persons in crisis due to a mental illness or developmental disability.
- 6. ENHANCED CRISIS INTERVENTION TEAM (ECIT)
6.1 ECIT consists of sworn members who have completed the qualifying ECIT training. ECIT members assigned to patrol will be used for incidents involving persons in behavioral crisis due to a known or suspected mental illness
6.2 BOEC will dispatch ECIT members, when available, to mental health crisis calls. A mental health crisis call is a call with a mental health component AND
6.2.1 The subject is violent
6.2.2 The subject has a weapon
6.2.3 The subject is threatening to jump from a bridge or structure or into vehicular traffic
6.2.4 The call is at a residential mental health facility
6.2.5 Upon request of the responding officer, OR
6.2.6 Upon request of a citizen
6.3 BOEC will dispatch the closest available ECIT officer to mental health crisis calls. ECIT officers will be dispatched to mental health crisis calls in other precincts as required. ECIT officers will notify his/her supervisor when leaving their assigned precinct. BOEC will dispatch cover units as appropriate.
6.4 ECIT officers will not be dispatched as the primary officer unless the call is in their assigned district. ECIT officers may offer to become the primary officer if they have familiarity with the person in behavioral crisis or they can assist in coordinating a broader system response.
6.5 Members involved in an incident requiring ECIT should request their response. If the member has already taken a person into custody, he/she may still request ECIT for assistance in making appropriate referrals to community resources or Behavioral Health Unit (BHU) follow up.
6.6 Supervisors may use ECIT members, when available, to make initial contact with subject(s) involved in incidents requiring the Crisis Negotiation Team (CNT). ECIT will not be used in place of CNT, but ECIT officers can facilitate an efficient transition when CNT arrives on scene. CNT may use ECIT as a resource when needed.
- 7. DISPOSITIONS
7.1. Members will consider the totality of the circumstances, to include the behavior of the person with a suspected mental illness or developmental disability and the governmental interest, in determining the appropriate resolution for the person in crisis. Members may choose from the following options:
7.1.1. Take the person into custody for a mandatory arrestable offense.
7.1.2. Refer to a mental health agency, crisis hotline or other related service agency. Resource information can be located through the Police Information Line, the Problem Solving Resource Guide, or the BHU Mental Health Community Resource Guide.
7.1.3. Consult with a mental health or medical professional. Members can request, through BOEC, a Project Respond Clinician to call the officer or respond to the scene, if available. Members may contact the person’s health professionals, the Multnomah County crisis line or other appropriate resource agencies.
7.1.4. Transport the person to a mental health or medical facility for voluntary care. Assisted persons should not be dangerous and able to manage their behavior. Members should escort persons into the waiting area and introduce the person to facility staff. Members are not required to standby. Members will complete a Special Report to document the incident and transport.
7.1.5. Take the person into custody (civil) when there is probable cause that the person is a danger to him/herself or another person and is in need of immediate care, custody or treatment for mental illness. Members will transport him/her to the appropriate secure evaluation unit or to the nearest designated hospital for a mental health evaluation.
7.1.6. Delaying custody is a tactic that can be used if the member determines immediately taking the person into custody will result in an undue safety risk to the person and/or members. Members will notify a supervisor and then develop a plan to determine a safer time and method to take the person into custody (civil).
- 8. PROCEDURES: REPORT OF PEACE OFFICER CUSTODY OF A PERSON WITH ALLEGED MENTAL ILLNESS (CIVIL CUSTODY REPORT)
When taking a person with an alleged mental illness into custody (Police Officer Hold) for a mental health evaluation, members will:
8.1 Transport the individual to the appropriate secure evaluation facility or nearest designated hospital emergency department that conducts mental health evaluations.
8.2 Remain at the facility until a physician determines whether the person will be admitted. If not admitted, the member may arrest the person for an offense; transport the person back to the original custody location, or both. In the case where no arrest is made and the person chooses not to return to the location of custody, the person will be released outside the facility.
8.3 Complete an Investigation Report and a Civil Custody Report before leaving the facility.
8.4 Make a copy of the Civil Custody Report. Leave the original Civil Custody Report with the receiving hospital or secure evaluation receiving unit. Turn in the original Investigation Report along with a copy of the Civil Custody Report to a supervisor before the end of shift.
- 9. PROCEDURE: REPORT OF PEACE OFFICER CUSTODY OF A PERSON WITH ALLEGED MENTAL ILLNESS DIRECTED BY A COMMUNITY MENTAL HEALTH DIRECTOR (DIRECTOR’S CUSTODY REPORT)
When assisting a community health and developmental disabilities program director or designee in taking a person with an alleged mental illness into custody (Directors Hold), members will:
9.1. Verify the authority of the person signing the Director’s Custody Report and ordering the custody (civil). Approved Qualified Mental Health Professionals (QMHP) have identification cards issued by Multnomah County.
9.2. Take into custody (civil) the person named on the Director’s Custody Report.
9.3. Obtain the Director’s Custody Report from the director or designee and transport the person to the medical facility as designated by the director. If ambulance transport is deemed necessary due to a medically fragile condition, officers will follow ambulance to the receiving facility. Mental illness alone does not require an ambulance transport.
9.4. Remain at the facility until custody is transferred to facility security or staff members. Members should report their observations to a facility social worker or physician and check with the facility before leaving the premises. In the case where facility security relieved the officer and the person was not admitted, the officer may be requested to return to the facility and must transport the individual back to the original contact location.
9.5. Complete a Special Report documenting the custody (civil) and transport.
9.6. Leave the original Director’s Custody Report and a copy of the Special Report with the receiving hospital or secure evaluation unit.
9.7. Turn in the original Special Report along with a copy of the Director’s Custody Report to a supervisor before the end of shift.
- 10. PSYCHIATRIC SECURITY REVIEW BOARD (PSRB) ORDERS OF REVOCATION
10.1. PSRB will direct members to take PSRB supervised persons into custody on Revocation Orders, which are comparable to arrest warrants. When a member is notified of a PSRB Revocation Order, typically through a PSRB LEDS message reading: “No Criminal Warrant, PSRB order for mandatory return to Oregon State Hospital” members will:
10.1.1. Take the person named in the Revocation Order into custody and notify a supervisor.
10.1.2. Ensure the Oregon State Hospital Communications Center is notified. The phone number can be found in the PSRB LEDS message or the Problem Solving Resource Guide.
10.1.3. Transport, with one other member, the person to the Oregon State Hospital Communication Center. If additional verification of Revocation Order is needed, the PSRB Executive Director may be contacted. The phone number can be found in the PSRB LEDS message or the Problem Solving Resource Guide.
10.1.4. Document the incident on a Police Custody Report and submit to a supervisor before the end of shift.
- 11. PATIENTS ELOPED FROM MENTAL HEALTH FACILITIES
11.1. Members may be requested to take patients that elope from facilities into custody. This will be done only when.
11.1.1. A patient who eloped from a state hospital was committed under ORS 181.530 due to a conviction of a crime or committed as sexually dangerous. Notice can be in writing or by teletype.
11.1.2. A civilly committed person unlawfully elopes from a residential facility and the facility produces the order of commitment.
11.1.3. An eloped patient is deemed to be a danger to him/herself or others.
11.1.4. If the eloped patient meets one or more of the above criteria, members should;
18.104.22.168. Take the eloped patient into custody (civil) and transport him/her back to the facility they eloped from, if stable enough to return, or transport to the nearest designated hospital.
22.214.171.124. Complete a Special Report documenting the incident and transport, including the name of the person and notification to the affected facility. Submit the report to a supervisor before the end of shift.
126.96.36.199. Criteria for court ordered civil commitments are dictated by individual state laws. If a patient has eloped from a mental health facility in another state, members should assess the person and take action in accordance with paragraph 7. Members should contact the reporting facility and notify them of the disposition.
- 12. WARRANTS OF DETENTION/TRIAL VISITATION
12.1 During pre-trial civil commitment processes, a person with an alleged mental illness may be released into the community and be monitored by a civil commitment investigator. A civil warrant of detention may also be issued by a judge to take a person with mental illness into custody. Members should not become involved in these activities unless called to an incident to assist a civil commitment investigator or civil deputy in fulfilling his/her mission.
12.2 The statutory authority to serve a warrant of detention rests with the county sheriff.
- 13. ASSISTING HOSPITALS WITH PATIENTS WITH MENTAL ILLNESS AND WALK-AWAYS
13.1 Members will not become involved in incidents within a secure evaluation unit or an emergency care hospital, unless the facility cannot give appropriate care or a person becomes violent, resistive or refuses to go with facility arranged transportation to an appropriate facility.
13.2 Secure evaluation units and hospitals are responsible for transports to the other care facilities.
13.3 Members will not take into custody voluntarily admitted patients who have walked away from a hospital or facility, unless their actions at the time indicate they are a danger to themselves or others and are in need of immediate care, custody and treatment for mental illness.
- 14. CUSTODY OF JUVENILES
14.1 Juveniles may be taken into custody for a mental health evaluation under the same circumstances as an adult.
14.2 The parent/guardian of the juvenile should call the destination hospital to make arrangements for the completion of any needed consent for treatment forms. If a member is unable to gain consent from a parent or guardian, he/she will contact DHS Child Abuse 24-hour Hotline and follow the protective custody guidelines outlined in DIR 850.30
- 15. RECORDS DIVISION RESPONSIBILITIES
15.1 Records will flag persons taken into civil custody with “Mental Illness” and forward copies of all mental health related reports to the Behavioral Health Unit (BHU). Persons flagged with “Mental Illness” will automatically be purged ten (10) years after the last known reported law enforcement contact.
- 16. SUPERVISORS RESPONSIBILITIES
16.1 Supervisors will ensure the appropriate dispatch and use of ECIT officers are followed.
16.2 Supervisors will ensure their members follow the investigations and reporting requirements for mental health crisis response.
- 17. BHU REPSONSIBILITIES
17.1 The Behavioral Health Unit will review all mental health crisis response reports forwarded by Records.
17.2 The BHU will be the Bureau liaison with the mental health community and follow up on any response concerns.