Skip to Main Content View Text-Only

The City of Portland, Oregon

Police Bureau

Sworn to protect. Dedicated to serve.

Phone: 503-823-0000

Non-Emergency: 503-823-3333

1111 S.W. 2nd Avenue, Portland, OR 97204

More Contact Info

Subscribe to RSS feed

Most Recent

View Less

Behavioral Health Unit - Talking Beat

The Behavioral Health Unit coordinates the Police Bureau's response to people in behavioral crisis, whether it's from a suspected mental illness or a drug and alcohol addiction or both. 

Also we answer the question: "Is the thin blue line a counter to Black Lives Matter?"

 >> Subscription Options

Apple Spotify

StitcherGoogleAndroidRSS

TRANSCRIPT:

Announcer:
Welcome to Talking Beat, the podcast for the Portland Police Bureau. We're focusing on thoughtful conversations that we hope will inform and provide you with a small glimpse of the work performed by Portland police officers, as well as issues affecting public safety in our city.

Announcer:
Here's what's on today's show.

Lt. Hettman:
Law enforcement as a whole is having to reinvent itself and look at ways to maybe address mental health crises, which previously wasn't in or purview. We're rising to the occasion, we're taking it very seriously, and we want to do good work. We've taken it upon ourselves to make sure that the officers that are working daily receive really good training.

Announcer:
Today's spotlight is on Camp Rosenbaum. Each year, Portland police officers partner with Camp Rosenbaum to participate in a free week-long camp for young people in our community. To learn more about Camp Rosenbaum, visit camprosenbaum.org.

Announcer:
Now, onto the show.

Host:
On today's podcast, we're talking to members of our behavioral health unit, which coordinates the police bureau's response to people in behavioral crisis, whether it's from a suspected mental illness or a drug and alcohol addiction or both.

Host:
Lieutenant Casey Hettman oversees a unit. Also, here is Lindsey from Cascadia Project Respond, who works directly alongside officers. Casey, let's start with you. Explain the concept of the behavioral health unit and how it all came about.

Lt. Hettman:
Sure. So, our goal is to really coordinate the response between law enforcement and the greater behavioral health system throughout the city and the region, so we're working with a number of individuals from all walks of life throughout the city that come onto our radar through various police contacts or other means, and so we're really striving to help connect those vulnerable individuals with better services and appropriate services to better meet their needs and maybe limit further police contact or make those police contacts go a little bit better if they do happen.

Host:
So, Casey, I think we've all seen a lot of people on our streets that are suffering from mental health issues. The behavioral health unit actually has a proactive side of the house and then a more reactive. Casey, let's start with the reactive side of the house, which is the enhanced crisis response team. First, tell me about training of all officers, and then tell me about the team.

Lt. Hettman:
The ECIT program is really part of a larger-scaled crisis response model at the Portland Police Bureau and employees, so on the surface level of that, all patrol officers that work patrol, work the streets daily in uniform capacities, they all have 40 hours of crisis intervention training, CIT training, and then there's an additional 129 officers that have the ECIT training, the enhanced crisis intervention training, and that training consists of an additional 40 hours of training on signs and symptoms of mental illness, crisis communication. They have a panel where they talk with persons with lived experience and family members of those individuals to really get the feel of what individuals experience when they're interacting with a law enforcement officer in those crisis events.

Host:
And so on the proactive side, you have the behavioral health response team that pairs an officer and a clinician. Tell me about how you get that caseload.

Lt. Hettman:
So, currently, we have five of those teams, and they're a co-responder model, which is comprised of a patrol officer and a mental health clinician. We currently contract with Cascadia's Project Respond, so we have five clinicians from Cascadia's Project Respond that partner with five patrol officers.

Lt. Hettman:
The BHU gets referrals from all over the bureau from individuals. The officers that are working the street and others that work specialty units all have the ability to make a referral to BHU for individuals that they feel maybe could use some additional assistance or services, so on average, we get about 1,000 referrals per year, and we typically assign about 50% of those.

Lt. Hettman:
A reason why some of those don't actually get assigned for follow-up with one of our teams is the fact that patrol did an excellent job in connecting the person with the appropriate resources on the street, so we will do some work on the backside of that when we actually get the referral and verify and look into it and realize that the person that they contacted was maybe transported to the hospital or reconnected with services that they already are connected to, and so in those situations, our involvement necessarily isn't going to be that much more beneficial.

Host:
So, Lindsey, what does a day look like for you?

Lindsey:
I don't know if there is a typical day because it really depends on who's assigned to us, and everyone that we see is so different that what we're going to really depends on who we're working with at that time. I mean, typically, we come in in the morning and see who's active on our caseload, and then, based on that and what that person's need is at the time, that's how we try to intervene.

Lindsey:
For example, if we're just starting out with someone, when we first get the referral, we'll usually do some work on the front end because one of the benefits of, I think, our approach and that we're following up after the initial crisis that led to law enforcement involvement occurred is that we get to very thoughtful in our approach, so I might review the record, see if they have any historical contact with the county mental health systems or reach out to family and see what a positive and respectful way we might engage the person could be and see what is contributing to the crisis or their involvement with law enforcement, and then we go out and meet the person and just introduce ourselves and tell them what our role is and how we can help and start building relationship and getting to know them so we can know how we can help.

Host:
Are people receptive?

Lindsey:
Prior to doing this, I wasn't sure of what the reception would be, and I've been continually surprised just how happy people are to see us. I think that there is sometimes a perception that the mental health clinician will be the welcome part of our team, but I would say, sometimes, more frequently, they're much more excited to see my officer partner there and a little bit more reluctant to see me, and I have to do a lot of work to build trust and rapport and make myself as valuable as they view my officer partner being there, but often, they're a lot more excited to see my officer partner than they are me.

Host:
So take me from the beginning, Lindsey. You arrive at someone's home. What happens then?

Lindsey:
We'll go out, we'll build rapport, we'll assess someone. We'll see what their needs are, whether they're just not connected or have never been connected to mental health services.

Lindsey:
So we try to connect that person, whether they're so symptomatic that interacting with an outpatient setting is too difficult for them at that time or they need a higher level of outpatient care where someone will come to their home and see them, whether it's a medical situation that we can help facilitate getting them to a medical provider, whether it's stress due to the living environment, whether they're having trouble paying their bills, whether they're having an interpersonal situation that is causing their symptoms to escalate and law enforcement contact to happen, whether they are responding to some other sort of environmental situation that we can help influence, or whether they really just are not feeling heard or understood.

Lindsey:
And even if the person ultimately declines to seek mental health service, I think that there's something about both a police officer and a mental health clinician showing up, being in their home, listening to them, and treating them with respect that people really respond to, and so even the folks that ultimately decline to let us connect them to any services will still keep calling us and wanting us to come out because, through past encounters with us, felt like when we came out, we could hear them and well, not ever reinforcing non-reality-based beliefs that we might encounter or anything like that, just still treating the person with respect and empathizing with the situation that they're in and doing whatever we can to help address what they believe that the problem is.

Host:
Casey, tell me a little bit about some of the complexities of the system. I don't think a lot of people really know what it takes to have a person seek treatment or get them assistance. I know I have friends who have adult children who have some mental health issues, and once they become an adult and they are faced with wading through this complex system, it's really mind-boggling.

Lt. Hettman:
Yeah. You're right that it's extremely complex, and it's even complex for the professionals involved in the system.

Lt. Hettman:
There are a number of complexities from insurance to transportation is an often thing. Housing a thing that we run into as being a constraint for people, so we have tools in our tool belt, so to speak, to help mitigate and address all of those different concerns, and the luxury of the BHU is the fact that we have time on our side to navigate these complex issues, whereas patrol officers are extremely busy, and they're oftentimes running call to call, and they don't have the benefit of having several hours or days to actually get to the root of an issue with an individual to try to solve problems at the core level.

Lt. Hettman:
Those situations get passed off to BHU, where we have the luxury of time and the expertise of both a clinician and the law enforcement officer to really get to the bottom of it and really start making some headway in solving the underlying root causes.

Host:
Do you see some of the same people over and over?

Lindsey:
We do see re-referrals and actually, pretty frequently, the person who we've worked with in the past will either contact myself or my officer partner directly because they remember that in the past, we were helpful. Our numbers don't change, and so they'll just say that they need additional help.

Lindsey:
We have a lot of flexibility in how we're able to approach, again, because we're following up at a time the person is not actively in crisis, and so we get to work with them on a lot of the things that lead to that crisis, and so when the person no longer needs us anymore, that's always really exciting.

Host:
Lindsey, how is your job different from other mental healthcare providers?

Lindsey:
The ability for an outpatient provider to engage like we engage is pretty limited because they're kind of like patrol. They're going from session to session, and they have the time the person is in front of them to help that person, and they don't get to see what their home life is like, and they don't get to see what the barriers to them getting to that appointment are like, and they don't have access to police reports, necessarily.

Lindsey:
They don't have access to the things that we have access to that kind of help really frame the person's life outside of when the treatment provider is seeing them, and so if there are barriers to accessing...

Lindsey:
We have so much flexibility in the way that we are able to help people, and it's one of the things I love the most about being part of a BHRT is that if it's just that the person is having trouble making their appointments, we get to say, "Great. We'll show up, and we will take you to your appointment, and we'll hang out in the car until you're done with your appointment and then take you home."

Lindsey:
Through that process, maybe see what were some of the barriers that were preventing them from making the appointment when they were offered a cab by their outpatient treatment provider. Maybe it was that they were just having trouble with timeliness. Maybe it was that there was a family member who would accidentally be a barrier to them making it out the door on time, or just kind of address in that situation what the barrier is, as opposed to trying to manage it from an outpatient clinic.

Lindsey:
I think we have a certain amount of privilege, too by being able to go out to the community and have an officer that comes with, particularly for folks who maybe don't see their mental health systems as the primary cause of what's initiating their law enforcement contact.

Lindsey:
For example, if someone is experiencing psychotic symptoms and they believe that there are people projecting voices into their home, and so they're frequently calling law enforcement because someone is sending these transmissions or communications their home and they want it to stop, and maybe those communications are not things that are reality-based, but we can go out, and we can explore that together with them in the situation. If they're only hearing it in their home, we can say, "Okay, well, that's not something we're hearing, but we're going to try to look for what some of the causes might be," and just kind of supportively let them know what we're experiencing, which I think is something that patrol will often do when they're out in the situation too, but we get to form trust over time where we can kind of get to a place where they might be able to explore that it may be mental health symptoms in addition to just their experience of it.

Lt. Hettman:
We also have an ability to connect folks in other ways. So, I know that there's been a number of times where we will coordinate for food boxes and other personal needs for individuals that are maybe having some difficulties meeting their personal needs.

Lt. Hettman:
It really runs a gamut of things that we are doing, and we're getting very creative behind the scenes to try to make sure that we're meeting these folks where they're at but then also meeting their basic needs because what we find is it's really hard to address these larger issues, especially surrounding mental health, if someone's most basic needs aren't being met.

Lt. Hettman:
So one of the ways we do that is we have access to supportive transitions and stabilization, STS beds. We currently have nine beds online, and those beds are reserved strictly for our BHRT teams to utilize for the individuals that they're working with, so we're very fortunate to have that money to aid us in helping these individuals with housing because we find that one of the largest barriers to helping these folks oftentimes is the fact that they're unsheltered or they're living out on the streets.

Lt. Hettman:
It's hard enough to survive on the streets, let alone try to remember that you have a mental health appointment or an appointment with your counselor in two weeks and you don't know what day it is or what time it is, how you're going to get there. You're just trying to survive.

Lt. Hettman:
So when we take that out of the equation and can get somebody into a bed and get them sheltered, very low-barrier housing, they have wraparound services there, 24-hour staff, and we find that that's immensely helpful for us to then start the process of getting them connected in other ways so that they can start the healing process and getting them back on track to being well again.

Host:

I'm glad you mentioned that, Casey, because I think that when people look at what you do and providing services, they're thinking about mental health services, but there's so much more. You just mentioned housing, food boxes, we'll give Sunshine Division a plug, all the other things that people need to survive, and then mental health issues.

Lt. Hettman:
Yes.

Host:
Also, on the proactive side, we have the service coordination team. Can you just tell me a little bit about what they do? I think that's a whole other podcast because it's so fascinating, but tell me a little bit about the program.

Lt. Hettman:
Sure. It's a city-funded program that really works to connect individuals to housing that are affected by substance use issues that also have been touching our criminal justice system somewhat frequently. So the idea is to get those individuals into low-barrier housing and access to wraparound services to start addressing the underlying issues involving the substance use, and then it starts addressing the criminality and the other behaviors that are a result of that use.

Lt. Hettman:
PSU audits it every year, and they find that it's a highly successful program, as far as the money goes.

Host:
Is the behavioral health unit and some of the things that we do, is that unique to Portland, or do other cities have similar models?

Lt. Hettman:
So yeah, it's taken off, and honestly, the co-responder model is becoming best practice throughout the nation, and we've hosted a number of site visits for agencies from all over the country and some international partners that have come to see the model that we are employing here and how we're working towards better serving these individuals.

Host:
Lindsey, you technically work for Cascadia Project Respond. Some people may not know what that is. Why don't you tell me a little bit about what Project Respond does.

Lindsey:
So, Project Respond is a 24-hour mobile mental health crisis team, and they receive referrals through the crisis line, and we'll triage those calls and, if indicated, try to go out to the person in the community and see them to help provide support around the crisis and provide crisis assessment and intervention.

Lt. Hettman:
But I also want to add that patrol officers routinely call upon Project Respond to assist them, so that's also a highly utilized resource that patrol is frequently using to assist, navigate some of these more complex calls that have a mental health nexus within them.

Lt. Hettman:
So, officers can request through dispatch that Project Respond come to the scene to assist, and oftentimes, they're there within minutes to do an assessment right there on the scene and to help those officers plan the next steps for the individual.

Host:
A lot of times, the headlines are about some of the failures, and what would you want people to know about your day or what you work on?

Lt. Hettman:
I think one thing that folks kind of lose sight of sometimes are the fact that underneath our uniforms are human beings that are actually very caring and empathetic individuals that are really trying to serve their community and make the community a better place and actually care for the people that we're interacting with.

Lt. Hettman:
So, on the surface, I think that sometimes, right or wrong, folks just kind of see the uniform and don't realize maybe there's more to the story there, and then, as far as Portland goes, we are very lucky to have just a huge amount of amazing individuals and people that work with the police bureau that are doing this really challenging work, and it's becoming more and more clear that obviously, that there are some constraints and issues throughout the wider mental health system that we've kind of touched on that really start falling onto law enforcement, and kind of, that's been happening nationwide and throughout the world, unfortunately, where other systems start to break down, it kind of falls down to the lowest common denominator, and folks don't know how to call. They call for help, and the police usually are the first ones to show up to fill that need.

Lt. Hettman:
Law enforcement as a whole is having to reinvent itself and look at ways to maybe address mental health crises, which previously wasn't in our purview to be responsible for, but we're rising to the occasion. We're taking it very seriously, and we want to do good work. We want to really help the individuals that we come into contact with, and so we've taken it upon ourselves to make sure that the officers that are working daily receive adequate and really good training, as far as mental health procedures and identifying mental health crises and symptoms of mental health issues and really, are trying to support the work that's being done and making sure that we are actually having a positive influence and a lasting impact in a positive way on these individuals that are having these mental health issues.

Host:
We always ask our guests one last important question. We embrace our stereotypes at the Portland Police Bureau, so Casey, what is your favorite donut?

Lt. Hettman:
Anything made by Coco's. I'll plug them. Coco Donuts.

Host:
And Lindsey?

Lindsey:
I really like a good Boston crème.

Host:
Okay. Thanks, guys.

Announcer:
Did you know you can report some crimes online? Remember, if it's an emergency, always call 911, but if you want to report a non-emergency crime, such as a non-injury hit and run, theft, or other crimes, or need to report lost property or graffiti, go to portlandpolice.com to learn more on how to submit an online police report.

Announcer:
Now it's time for Tough Questions, our segment where we answer your toughest questions regarding policing or public safety.

Sgt. Simpson:
Today's question is, "Is the thin blue line a counter to Black Lives Matter?"

Sgt. Simpson:
The thin blue line really has a lot of different meanings, but generally, it means that police officers stand as the thin blue line that protects society from evil and chaos, and it's really several decades old. It was used as a terminology in both TV and film and in some literature.

Sgt. Simpson:
More recently, you've seen a flag, a black and white American flag with a blue line through it that has become often symbolic with law enforcement and officers killed in the line of duty, and there's been some controversy around it as, to the point of this question, that it's been promoted to counter the Black Lives Matter movement or the #BlackLivesMatter.

Sgt. Simpson:
The two things have nothing to do with each other. Black Lives Matter, to me, really goes back to the discussion of, for many, many years and in many communities, black lives, when they were lost, they didn't seem to count, and whether it be through drugs or gang violence or police-involved shootings, that somehow, they were less important than other lives.

Sgt. Simpson:
My recollection is that two women started it after Trayvon Martin was killed in Florida, and it became a rallying cry for a lot of police-involved shootings of African Americans around the country, and then sometimes, as a response to that, there's been the use of the thin blue line flag, often inappropriately, that these two things are opposed, and they're really not.

Sgt. Simpson:
The thin blue line and the thin blue line flag really should be used a symbol of support for law enforcement, not as an anti-message to anyone else, and it should be used appropriately. It's a symbol representing support of law enforcement, but it's also a bit about a somber, a message that an officer or officers have lost their lives in the line of duty, and it's a reminder that there are officers across this country that go to work every day, working to protect society and their communities and doing the best job that they can, and in the course of doing that duty, they lose their lives.

Sgt. Simpson:
It shouldn't be viewed as a symbol of hate, and unfortunately, it's been used that way by people who maybe purport themselves as supporters of law enforcement, and they're using it as an anti-something else message, and it's fairly disheartening for law enforcement officers to see that because that is not the intent of the words or the message.

Announcer:
Thanks for listening to the Talking Beat. Do you have a question for us? You can call and leave a message on our dedicated voicemail line at 971-339-8868, or send us an email to talkingbeat@portlandoregon.gov. If you enjoyed this episode, please share it with your friends. More episodes can be found at our website, portlandoregan.gov/police/podcast.