Los Angeles: Mental Evaluation Unit (MEU)

Location

• City: Los Angeles, CA
• Population Size: 3,979,576
• Jurisdiction Size: 488.67 square miles

Intercept

• 0 – Didi Hirsch 911 Triage Diversion Program
• 1 – MHIT, Senior Lead Officers (SLOs), Triage Desk, SMART
• All – CAMP, Threat Management Unit

CIT (Crisis Intervention Training) Requirements

• MHIT (40 hour POST-approved) course that is offered 25x/year (every other week) to all patrol personnel, Los Angeles County co-responder teams (officers, clinicians), and other outside agencies (i.e., LAFD, outside law enforcement)
• Mental Evaluation Unit (MEU), Training Unit, officers are responsible for conducting the 40-hour training
• MHIT is required for all patrol officers

Model Components

• Staffing Structure
  • Entire unit/division is 90 sworn officers and 46 BH staff
  • MHIT – MEU Training Unit Officers
  • SLOs – one officer per Police Bureau
  • Triage Desk – rotating with SMART unit members; one officer and one BH clinician
  • SMART – rotating pairing (one officer and one BH clinician)
  • CAMP – one BH staff (psychologist, nurse, social worker, etc.) and one detective/investigator
  • Threat Management Unit – Detectives
• Staff Training/Qualifications
  • All officers receive MHIT
  • BH staff for CAMP is various levels (psychologist, nurse, social work, etc.); degree qualifications unclear for the BH staff on SMART units
• Dispatch Structure
  • All dispatchers receive 8 hours of training (“Persons with Mental Illness”); MH calls get special codes; dispatchers will alert patrol with the code if it involves a person with MI; if crime code as well, crime code takes precedence
  • Responding patrol officer responsible for stabilizing scene and conducting preliminary investigation, and then contacting MEU Triage Desk
  • Triage Desk assists patrol via phone or will dispatch SMART unit to assist
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Operating Structure

• • Operations
    • SLOs
      • One assigned to each Police Bureau; liaison between LAPD, community, and service providers; manage MH-related issues or concerns (organizes and provides community meetings, addresses COMP-STAT-related concerns, develops response strategies)
    • MEU Training Unit
      • Deliver MHIT training (40 hours) every other week (25 times annually)
    • Triage Desk
      • 24/7; take MH calls from field officers responding to MH-related situations; staffed by officer and BH clinician; will talk through situation with officer or dispatch a SMART team; required to enter information into MEU Incident Tracking System (protected from outside access); can also make a referral to CAMP if individual has had repeated contact with police or demonstrated high risk behaviors; manages radio calls as well; may facilitate hospitalization
    • SMART
      • 24/7 teams of one officer and one BH clinician; dispatched by Triage Desk or responds via radio call; assist field officers and provide intervention, referral, or placement for a person with MH issues; may assist at disaster scenes or critical incident follow-up; MEU Supervisor will respond if no SMART unit is available; SMART officer secures and stabilizes situation; person is handcuffed/detained while clinician does the interview; SMART clinician looks up person’s MH history in database prior to arrival; SMART officer and clinician can complete 5150 app on the person (involuntary commitment) and often do o February 2021- modified SMART’s response model from a secondary responder to a co-responder.
      • The SMART units are now dispatched to mental illness calls meeting specific criteria (higher priority calls) at the same time as the patrol unit assigned the call. Previously, the patrol unit arrived at scene, then requested SMART support.
    • CAMP
      • Case management approach and primary goal is to reduce violent outcomes between police and person with MI
      • Pairs detectives with BH staff (psychologists, nurses, social workers) to coordinate and facilitate treatment for individuals with repeat encounters with emergency first responders, individuals who are at risk of violent encounters with police (suicide by cop, veterans with PTSD, school violence, jumpers), individuals with MI who are at risk of committing mass violence (PATHE strategy)
      • Manages seized firearms
    • Threat Management Unit
      • Handles aggravated stalking, threats to elected City officials and workplace violence cases
      • Can pull in BH when needed because of co-location
      • Might work with some CAMP cases
    • Didi Hirsch 911 Triage Diversion Program
      • February 2021 – Non-imminent suicide and BH related calls are diverted to a dedicated line at the Didi Hirsch Mental Health Crisis Call Center; pilot program became 24/7 as of July 2021
  • Funding Mechanism: City funded from Consent Decree 20+ years ago
  • MOUs/Contracting
    • MOA between LAPD and LA Dept of MH
    • MOUs with local universities
    • MOA with LA Fire Dept.
  • Management Structure
    • BH clinicians embedded at the Mental Evaluation Unit of LAPD
    • BH clinicians are LA County Dept of Mental Health employees

Data Systems & Collection

• Data Systems:
  • Triage desk’s MEU Incident Tracking System – in-house, Access-based database where all MH-suspected calls from patrol officers are recorded with various types of information (both BH and arrest info); documents ALL department contacts with persons who suffer from a MI
  • SMART, CAMP – have access to the shared Triage Desk database; BH staff have access to treatment history and records via their database; police have access to arrest history/CAD; share info during crisis
  • Threat Management Unit – separate databases but co-located
• Data Collection:
  • Triage desk – collects BH information, call and arrest history, risk assessment and enters into the shared database
  • Monthly stats – how many SMART calls received, SMART calls handled, referrals by SMART, CAMP cases, MHIT trainings (# of presentations, hours, attendees, roll calls), Community outreach (# of presentations and # of attendees); # of involuntary holds by SMART, patrol, weapons seized, attempted suicide with ambulance dispatch
  • Review Use of Force reports with mental illness indicators
• Highlighted Statistics/Outcomes:
  • In 2020, Triage desk received over 19,226 calls
  • CAMP averages 30 new referrals per week for follow-up
  • 12-14 SMART teams are deployed 24/7
  • Patrol officers are trained in MHIT (40 hours)
  • In 2020, a SMART unit response resulted in a monthly average of 469 dispositions of 5150 hold (involuntary commitment)

Key Takeaways

• BH embedded in the MEU within LAPD; located in same building, on same floor; shared space
• SMART team co-responds with patrol on certain high risk MH-related calls; SMART can still be requested as a secondary responder
• CAMP teams pair detectives with BH staff to do follow up/case management with “high risk” individuals with BH issues
• Also has Threat Management Unit (focus on stalking, workplace violence and threats to City officials)
• SLOs in each Police Bureau act as community/mental health liaison
• BH-related calls to go through Triage Desk is part of PD Dept policy
• Review Use of Force reports with mental illness indicators
• Weapon confiscation after 5150 (involuntary commitment)