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A wellness check brought Henrico County (Richmond, Va) police to the home of Gay Ellen Plack in September 2019. But an encounter that could have resulted in treatment instead ended in tragedy. After the two officers kicked open a locked bedroom door, Plack, who suffered from bipolar disorder, charged at them with an ax. Police shot and killed Plack, the entire encounter captured on their body cameras.
Despite ample footage of the event, questions remain about whether that evening had to unfold as it did. Did police receive adequate de-escalation training? Could another approach, or another person, have coaxed Plack out without incident? Plack was well-known in the mental health community – could police and human services have collaborated to resolve the crisis?
“Every time we see one of these incidents, involving someone with a history of mental illness, you have to ask whether police are being trained to interact with people in a way that shows compassion,” [1]said Bill Farrar, a spokesman for the Virginia ACLU. “It makes you wonder if proper training and support is being provided.”
Increasingly, cases like Plack’s are highlighting the limits of a siloed approach to policing and human services. While police and human services staff interact with many of the same people, they often do so separately. Critical information is not shared, access to proper supports is limited, and jails become drop-off centers for those with mental health crises, addiction issues, or the homeless. These cycles are draining, ineffective, and costly.
But it does not have to be that way. Some police chiefs and human services heads are implementing a cross-boundary approach, working together to resolve the needs that often entangle individuals with police and keep them unnecessarily engaged with the justice system. These “ecosystems of support” comprise cooperative relationships that identify and treat people who regularly interface with police and human services to get them the treatment they need. Such partnerships are demonstrating positive outcomes for individuals and organizations: Police are reducing use of force rates, recidivism is dropping, and interventions are proving cost-effective.
Crime or other crises are “like an iceberg. The criminal act is just what you see on the surface,” says Hank Stawinski, Chief of Police in Prince George’s County outside of Washington DC., and an adopter of the “ecosystems” approach. “Below that are all the factors in a community – education, health care, housing, human services, jobs – that contribute to it,” he adds.[1] Address those underlying factors, Stawinski says, and you will not only see less criminality, greater stability among the vulnerable, and healthier communities.
“This ecosystem and how we’re working across boundaries to bring outcomes is vitally important work,” LNW Executive Director Antonio Oftelie expressed to global police chiefs at the 2019 Public Safety for the Future Summit. “You should be thinking about how you, as a leader, negotiate across those boundaries, bring people together, create new ideas, and the agreements, metrics, and how you share in outcomes,” he added.
Research at Leadership for a Networked World has posited that the future of outcomes will be based on building vibrant cross-boundary ecosystems – a network of organizations, machines, and services that coproduce new solutions to solve the root causes of individual, family, and community safety, health, and human services challenges.
Ecosystems in organizational theory certainly aren’t new – virtually every organization operates within a complex web of actors and factors. Yet now new digital platforms and management methods enable more intelligent and robust integration of organizations, people, and services. In the broader world, the movement to ecosystem-based business models means we are poised to break through the plateau of outcomes that industrial models of organizing have delivered over the past 100 years.
We need this breakthrough to happen urgently. In fact, when averaged across attendees of the Public Safety Summit and Health and Human Services Summit at Harvard, 73 percent of Summit attendees said they are facing either significant or extreme pressure to improve capacity, service delivery, and outcomes, and 89 percent said building new ecosystems is critical to success.
Yet being poised for a breakthrough and actually achieving results are two different things. To make progress, leaders will have to mobilize stakeholders – including front-line teams and the community – to envision new forms of outcomes and embrace new capabilities, processes, and practice methods.
To help leaders forge a path, the following lessons are synthesized from trailblazers who have embraced the challenge of collaborating across policing and human services and shared their stories at LNW’s Human Services and Public Safety summits at Harvard University. Key takeaways for implementing and sustaining collaboration between police and health and human services organizations include:
To begin the journey towards impactful partnerships, health and human services and public safety leaders must accept and promote that the status quo is no longer an option. Transparency around the lack of suitable options for dealing with people in crisis often highlights the ineffectiveness of a siloed approach to the care of individuals with cross-boundary issues. In Seattle, Sergeant Dan Nelson realized that when police encountered individuals with mental health crises “we could send them to jail or hospital- and that’s not a very good way to deliver services.” Cambridge, Mass. police faced the same frustrations around how to work with runaway youth: “We could arrest or broom them [shoo them away from public spaces],” says psychiatrist and founding partner of the Safety Net Collaborative James Barrett.
Being transparent about these realities incites pathways for moving forward in ways that are different tactically and philosophically. When homelessness reached epic proportions in Los Angeles, “We said, what can we do differently that we haven’t done before?” Police Chief Todd Chamberlain remembers. Shortly thereafter, he wrote a philosophy to managing homelessness crises that he summarizes in one word: Compassion. Chamberlain knew that human services partners could not only help his officers with outreach, but also in fomenting compassionate relationships between police and the homeless. In Tucson, human services and police teams operate with “compassion and creativity” in helping people in crisis access mental health and addiction supports. There, police have eschewed the “warrior” label in favor of seeing themselves as crucial partners with human services. They support the vulnerable through “a series of warm handoffs,” from police to mental health and addiction case managers, says Maggie Balfour, Chief Clinical Officer of the Crisis Response Center.
Mindfulness around new philosophical approaches often helps to shed light on whom to focus, as well as partnership goals. Almost all of the innovators in policing and human services partnerships narrowed the bulk of their interventions to the “highflyers”: people known to law enforcement and human services due to chronic mental health, addiction, or homelessness issues. These are the individuals who cycle through the system, and different approaches to their care can bring strong outcomes for this population, wield large reductions in use of force and recidivism rates, as well as prove cost- effective. With the targeted demographic in place, partners set clear goals. In Minneapolis, Police Chief Medaria Arradondo and Hennepin County Human Services Deputy County Administrator Jennifer DuCubellis decided two significant goals of their COPE teams would be to “keep those community members in their homes,” Arradondo says, and to bring down the volume of calls to which police, instead of human services staff, respond. In South Carolina, Department of Corrections Director Brian Stirling has a clear vision for supporting the incarcerated: “My vision is reducing recidivism,” he says. “It’s public safety and public safety inside the institutions also.” Clarity around this goal led Stirling and his partners to implement crisis intervention training for staff, integrate employment services at the pre-release center, and provide the newly released intensive supervision, including five straight days of mentoring.
Articulating the need for change and a strong vision might help launch a program, but policing and human services leaders report that specific “success stories” promote long-term support of partnerships.
Stirling, for example, shares skillfully positioned stories that illuminate the benefits of co-locating human services in prisons. Public safety increases, he maintains, when corrections can help inmates get jobs before release. He describes the plight of one inmate who, to the dismay of department officials, would not initially complete a job application. Staff assumed that the prisoner was illiterate. However, following a medical evaluation, they realized that he could not see. Corrections officials gave the man a pair of glasses. As Stirling observed, “There are sometimes simple solutions to hard problems” that are illuminated via partnership work.
Tucson officials tell a powerful story about how collaborating has increased their ability to get even chronically homeless mentally ill persons into proper care. A 67-year old woman had been living in her car for 10 years in a parking lot. “Her world was that car,” says Tucson Chief Chris Magnus. A typical effort to get her into treatment, he says, would have involved officers haggling and assuring her that her car, left in the lot, would remain untouched- an unbelievable story that would likely escalate her resistance. Instead, police and human services worked layers of relationships to get the car towed to the hospital and to provide the woman a room overlooking the car. “This is the kind of approach that’s different and we’re seeing it work,” Magnus says. “This isn’t just a ‘them’ issue anymore. What you have here is a community response to a problem that involves the private and public sector, social work, clinicians, police, psychiatrists, the entire complement of the system working together to not just respond but be problem solvers and proactive as well,” he concludes.
Powerful stories such as those above can inspire stable funding for partnerships that must originate via creative or impermanent funding sources. Human services and policing leaders caution anyone launching such a partnership that for fiscal officers, the prospect of funding a new initiative—particularly one that involves sharing resources with another agency—is a tough sell. Innovators may initially need to re-appropriate existing funds or create a pilot program that’s grant-funded. These and other alternative sources of funding can be critical supports before line items are added to budgets or other stable funds dedicated to the effort.
Some successful partnerships began with internal redirection of dollars or utilization of matching funds. To launch the Los Angeles HOPE teams, Chief Chamberlain “pulled all our resources out of patrol cars. So the officers that are working our HOPE teams are not getting anything special. There was not any funds. We just said, ‘Hey, we need to do this,’ and we did it.” Minneapolis COPE teams launched as a pilot program in two out of five precincts, using matching funds from the county to support the pairs of officers and mental health professionals responding to individuals in crisis. “After its first year, all 13 City Council members wanted to expand it,” Chief Arradondo recalls. He says the 1,500 contacts and 332 mental health assessments of vulnerable people- record numbers- helped inspire the Council’s support. “When police departments across this country are being scrutinized for adding additional sworn personnel, we didn’t get any pushback,” he says. Today, COPE teams utilize city and county funds, and leverage welfare funds through federal dollars DeCubellis, the human services head, can access.
Other partnerships launched programs via grants. When Montgomery County, Md., Police Chief Tom Manger and former Human Services Director Uma Ahluwalia began a pre-booking deflection pilot program for people who had overdosed, they needed funding for police, for a validated risk-screening tool, and for human services case managers. They initially utilized grant dollars. Results brought greater security. “The results are so good our city council seems persuaded” to dedicate funds, Ahluwalia says. In Cambridge, Mass., James Barrett—who, as a medical professional, had to adhere to rigid billing requirements, limiting his hours to support police —obtained a small grant from the Bureau of Justice so that he could spend some of his time at the Cambridge Police Department and launch the Safety Net Collaborative. Again, results led the city to provide additional funding to extend the program. Sergeant Nelson and the Seattle Police Department obtained a grant from Code for America to help develop a data-sharing application. The “app” allows officers in real-time to know the triggers of someone they encounter, to learn about that person’s past interactions with police, and auto-engineer best practices. Nelson says it has been key in helping drop Seattle’s use of force investigations involving people in crisis drop from 70 percent down to just 14 percent of cases.
The lesson is that local officials cannot take an initial lack of funds or even rejection from budget officers as a definitive verdict. They need to figure out how to seed their projects and prove their worth. As DeCubellis puts it, “You’ve likely got to make the business case” to obtain secure funding.
A distinct benefit from policing/human services partnerships is an abundance of tools and technology to support new initiatives. Add to that clear tracking of outcomes data, and you have a robust set of interventions that can make the case for long-term implementation.
Sharing data-driven toolkits and unique approaches to problem solving across boundaries can provide new opportunities for diverting the vulnerable from the justice system while also ensuring public accountability. To measure the progress of the HOPE initiative, Chamberlain has introduced a range of stakeholders to a modified version of CompStat, one of the most prevalent crime-tracking tools in law enforcement. In Minneapolis, DuCubellis runs “police roundtables” in the style of human services case management meetings. At the roundtables, “police come in, and say ‘I’m really struggling with this [case].’ This is a multi-disciplinary staffing opportunity to say, ‘How do we change the response?’” she adds. In Cambridge, Dr. Barrett and his colleagues have equipped the police department with a case management tool—a tracking and decision-making technique that is widely used in health and human services—that helps them to monitor participants in the Safety Net Collaborative. “We’re using an empirically validated tool to drive our decisions on what’s happening to kids” who chronically act out at home, who may drink in public spaces, and who upend the very schools in which Cambridge police work, Barrett says. The tool, a strengths and needs assessment, is presented “at the team meeting and we all come up with goals. We front load so it’s less of a crisis response,” he adds. This tool also aids public accountability. “We need something driving these decisions that’s not just gut instinct,” Barrett says. A main outcomes goal of The Safety Net Collaborative is to reduce the number of juvenile arrests. Front loading interventions has helped arrest rates drop by 67 percent in Cambridge, a rate statistically significantly lower than the national, state, or county averages. As the above cases demonstrate, becoming conversant in one another’s tools and data makes it easier to work together and generate results.
Technology that enables real-time decision-making is also crucial to reaching outcomes goals and provides another layer of accountability, partners say. Minneapolis and Tucson have both implemented crisis lines that serve as an alternative to 9-11 calls, reducing the number of times officers are first responders to people who ought to be served by human services staff. In Tucson, Balfour, the crisis center director, reports that mobile units of mental health experts dispatched from rerouted 9-11 calls are required to respond within the hour. If police respond to the rerouted call, they are required to respond in 30 minutes. Response rates are tracked via the technology. The Regional Behavioral Health Authority manages the funding. “Since they’re the ones managing the money, they also put out performance metrics,” she adds. Many partners report implementing mobile apps that deliver critical information to police as they encounter individuals in crisis. Cross-boundary information sharing is at the heart of the technology’s success. In Minneapolis, mobile apps have been key to reducing the number of arrests. DeCubellis provides just one example of the mobile app capability: COPE teams of police and human services staff can, in real time, pull up welfare data on a person in crisis, and know that this person “is already assigned to a service community treatment team, they’ve got a targeted case manager in the community,” she says, adding that the individual can get reconnected with their case manager and “the officer doesn’t need to keep doing follow up, but the clinical team is.” Diversions, DeCubellis reports, have not only proven successful in keeping people out of jail, but are also subsidized. DeCubellis can cover up to 50 percent of costs by using welfare funds for direct services. “So if we’ve got a position that’s being shared between the two of us,” DeCubellis says, “I can draw 50 percent of that down from the federal government and you just cut your costs.”
Partnerships between health and human services and public safety benefit from having governance structures that allow for input from a range of stakeholders while still enabling nimble decision making. In Seattle, the CIC has approximately 90 members, a format that allows dozens of interests to provide input. At the same time, the CIC has small workgroups (10-12 people) that can synthesize feedback and expedite decision-making for specific topics. Minneapolis’ Arradondo and DeCubellis share leadership over a behavioral health steering committee comprising their “strongest leaders.” This group reviews the data collected from other partnership committees and “looks for alternatives to booking in the first place. How do we treat people who go to court? How do we embed some staff in the jail to identify needs and better connect folks?” DeCubellis says. She and Arradondo meet monthly to synthesize plans authorized by the group.
Arradondo stresses the importance of prioritizing governance before delving into the work. “We need to be in partnership over how we respond, how we align and do the work together,” he says. “We built our governance structure a few years ago, not during a crisis, not in the heat of a 200-person encampment but in advance of that, looking at our data.” Manger and Ahluwalia of Montgomery County say they wrote up a memorandum of understanding (MOU) around decision-making and meeting frequency (every 60 days) in a joint task force on elder abuse. The MOU clarified questions about the project, which had raised some eyebrows over the plan to co-locate police and human services. “I think the MOU helped us get funding,” Manger said, “because it’s right in black and white what we are trying to accomplish.” In some partnerships, governance by philosophy is the playbook. Before launching HOPE, the LAPD focused on developing a policy framework. Notably, it does not include a lengthy set of rules or bylaws; instead, it describes the compassionate philosophy that LAPD and its partner organizations want to employ. This emphasis on philosophical norms—rather than, as Chamberlain says, a more “mechanical” set of rules—stems in part from the partners’ desire to preserve the ability to modify the specifics of their approach as the partnership develops.
Partnership leaders mention how important diverse partners are. They also share that to maintain momentum, deepening those relationships must remain a priority.
In Seattle, Sergeant Nelson was initially able to build a broad coalition to participate in the CIC; over time, however, enthusiasm waned and partners backed off. “People were like, ‘Ah, you guys have got it,’” recalls Nelson, who explains that some partners felt that SPD was well positioned to spearhead the initiative once it started to generate results. Nelson has therefore communicated to the CIC’s members that it is imperative that they continue attending meetings and rededicate themselves to the initiative.
Commander Chamberlain faced a different challenge when building the relationships that underpin the HOPE initiative in Los Angeles. One of the key partners for the program is the Los Angeles Housing Services Authority (LAHSA), an agency that, as Chamberlain explains, has staff members who used to be homeless and, in some cases, committed crimes and developed a poor impression of LAPD. LAPD has therefore gone to great lengths to build trust with LAHSA. “It took a lot of time to build that relationship,” Chamberlain says. “It took a lot of time to break down barriers. It took a lot of time to establish what our goals are and how we need to get there together.” Yet the HOPE example demonstrates precisely how such relationships can be the linchpins in facilitating relationships with the vulnerable, a key goal of most policing/human services partnerships. LAHSA staff are “the subject matter experts” in knowing what many homeless individuals want or need, which is critical for HOPE police who initially “don’t have the comfort level in dealing with somebody who is homeless,” Chamberlain says, adding that previously, police would often clear encampments and send residents to jail. With facilitated introductions overseen by LAHSA, now police have a “luxury most of our officers don’t have. And that is to truly build relationships, to truly engage with the homeless, which allows the officers to provide services and referrals” they never previously could, Chamberlain says. In the first year of operations, HOPE teams fostered 70 secure placements of homeless people, and 1,554 referrals for services, “something that has not been done before,” Chamberlain says.
From Cambridge to Tucson to Montgomery County and other partnership sites, leaders say that the police and staff drawn to such work – typically those who want to break down silos or come from families that have navigated mental illness – lend credibility to the project and are keenly interested in deepening ties in the community. DeCubellis of Minneapolis says she moves human services staff into partnering with police on mobile crisis units who are “passionate about saying ‘I love the connection with law enforcement and don’t see law enforcement as the bad guy – I really want to partner,’” she says. Tucson’s first police officers to participate in their partnership work had family members touched by “serious mental illness and it was a deliberate choice to pick those first two,” Balfour says. “We’re talking people who have real credibility in the agency.”
The implication is that successful partnerships require a foundation of trust and that the bonds and commitment that undergird them must be repeatedly renewed. Soliciting partners who appreciate the cross-boundary nature of the work or who have a vested interest in positive outcomes for the vulnerable may lend the work credibility and ensure longer- term commitment of staff and other partners.
As the above examples illustrate, ecosystem-enabled approaches take considerable planning and resources, but pay off in outcomes. These collaborations have sustained in large part because they demonstrate significant reductions in use of force, better service to vulnerable people, improved community relations, and fiscal savings to both fields.
Can more be done?
Leadership for a Networked World, while applauding current partnerships, is also pushing policing and human services leaders to ideate and enact deeper ecosystems of support. But what would that comprise? Is there a role for collaboration between policing and human services in more substantive preventative care before an individual has a mental health crisis, before a teen becomes a dropout, before a family becomes homeless?
Hank Stawinski, Prince George’s County, Md. Chief of Police, may illuminate some steps forward. At the opening of this report, Stawinski argues that crime is like an iceberg: all we see is the surface- the criminal act. Many of the factors that foster criminality remain unchanged in siloed policing and human services work. We “need to interrupt all the conditions to either mitigate or prevent” criminality, Stawinski says.
Stawinski’s Transforming Neighborhoods Initiative (TNI), a project between police and the County Executive, sought to first inspire trust between police and the community. Stawinski worked to shift the lens through which many interact with police mistrust due to historical trauma and foster relationships. He built a mobile policing unit that moves monthly, so police can meet the community in malls, clinics, and parks, instead of during arrests or crises.
Next, Stawinski and the county executive focused on six high-need communities. Cross-disciplinary teams inventoried each neighborhood, asking the community their challenges, the assets they currently had in place, and what they needed on a wide spectrum of issues, including education, social services, and employment. The programs implemented were wide-ranging, from school attendance interventions and celebrations, to environmental advocacy work, summer jobs programs and other economic initiatives. Teams comprising a range of stakeholders (including the community) are dedicated to improving these “growth” areas and set priorities around delivery of services to the vulnerable. A recent report by the Prince George’s County Social Innovation Fund recommended continued resources be devoted to TNI neighborhoods as drivers of economic growth[1].
The TNI is one example of an approach that utilizes the best of current technological advances to humanize policing and drive further engagement between police, human services, and the communities in which both groups live and work. What can other policing and human services leaders do? As models develop that continue to enhance predictive policing and forecast human services needs, so too can our capacity to pre-empt criminality and crisis. Who will be the innovators who insist that such technology work for the common good as defined by the flourishing of all communities, but especially the vulnerable ones? What will those interventions comprise, and how do we need to prepare police and human services staff - perhaps in tandem - to implement them?
The challenge to do so is upon us.