After two years, the future of Minneapolis' mental health response program is uncertain

Via Star Tribune, July 2023

As the Behavioral Crisis Response contract nears an end, city officials must decide whether to extend the pilot program or permanently integrate it into emergency services.

It was daylight by the time the overnight team of Minneapolis' emergency mental health response program trudged back to their office in Northeast. A woman with complex hallucinations of dangerous animals in her home had kept the responders an hour past the end of their shift.

As the team debriefed a room full of mental health practitioners, wearing navy T-shirts with "Behavioral Crisis Response" splashed across the back, responders Dane Haverly and Shamso Iman geared up to begin their morning shift. They patrol south Minneapolis in a white van loaded with water bottles, snacks and copies of a homeless resource guide.

"We're just really good listeners," Haverly said. "For a lot of people, that's all it takes. We'll listen for 45 minutes, and then they'll be like, 'OK, I feel safe now.' And that's it, they're good. That's all they needed."

Behavioral Crisis Response (BCR), the newest branch of the city's 911 emergency services, was launched two years ago as a pilot project. Staffed by contractors with Canopy Mental Health and Consulting who have backgrounds in social work, emergency medicine and substance abuse counseling, BCR has freed police officers from thousands of time-consuming calls involving complex issues of psychosis and depression.

Despite commendations from health care providers and recommendations from the Department of Justice for Minneapolis to establish BCR as a permanent emergency program, the pilot project has had a rocky start — and faces an uncertain future.

The program was launched with two old vans that kept breaking down, preventing responders from reaching calls, according to the DOJ. And the office that the city initially offered responders was a "literal storage closet," according to BCR program manager Marisa Stevenson.

Recent hires and new vans added in the past two months have improved the program's ability to respond around the clock in all corners of the city. But as Canopy's contract nears expiration in a few weeks, it's unclear if city officials intend to keep it for the long term.

On Monday, the Minneapolis City Council's Policy and Government Oversight Committee unanimously approved a one-year extension at a cost of $2.9 million. Committee Chair Jeremiah Ellison said he needed more time to consider amending the contract length.

Short and unclear contract lengths can make it harder to work with city and community officials, as well as more difficult to recruit staffers and rent office space, Stevenson told council members. She asked them to extend Canopy's contract at least through 2025.

Some officials "have said openly that they assume the BCR won't be around long, so they don't need to invest the time and energy in cooperating with us," Stevenson said.

Lack of clarity about which city department should oversee BCR has also posed hurdles for the program, said Gina Obiri, the city employee who manages Canopy's contract.

When BCR's budget was transferred from Obiri's Performance Management and Innovation Department to the Office of Community Safety this past year, she said she was left out of public safety meetings that would have helped BCR responders work more effectively within the city's traditional emergency response network — leading to "confusion and inefficiencies, both internally and externally."

The Star Tribune asked city officials how BCR is being evaluated and what is needed to create a permanent mental health crisis responder program. The city's media relations team referred questions about BCR to the Office of Community Safety, which did not respond.

'A lot going on'

Haverly and Iman's first call last Tuesday came from a woman who claimed someone was bound to a fence below her high-rise apartment. The responders found no one there, but Haverly said frightening delusions can feel as visceral to a person as reality.

The pair next rushed to the Nuway addiction treatment center in the Whittier neighborhood, where a despondent client had hinted at harming himself. For the better part of an hour, they listened attentively to the man's business, family and housing troubles, which had compounded to the point where he couldn't stomach being in a group setting.

"Tell me more. It sounds like there's a lot going on," Iman said. "What happened today to lead up to this stress?"

ELIZABETH FLORES, STAR TRIBUNE

Shamso Iman, with the Behavioral Crisis Response team, helped a man who called in with suicidal thoughts last week in Minneapolis. The city’s mental health responder team recently completed its two-year pilot.

They suggested various treatment options based on the man's background, like the exercise-based Twin Cities Wellness Center, and gauged his need to go to the hospital. In the end, with the man feeling calmer, everyone decided that wasn't necessary.

Nuway program manager Tricia Briscoe said she has called 911 for BCR a handful of times over the past two years, to assist when her staffers' de-escalation tactics weren't working and clients needed to go to the hospital.

"I hope they have it every day, 24 hours a day, because a lot of our crises happen off-hours when there's not clinical staff onsite," Briscoe said.

When BCR responders take individuals to the hospital, emergency room clinicians like Melicia Kehneman and her team at Abbott Northwestern are on the receiving end. She said it makes a big difference when responders can provide detailed and pertinent information from a clinical viewpoint, as opposed to when police officers hand off patients.

Officers are "not necessarily mental-health trained," Kehneman said, while BCR responders can establish a baseline: "Is this a typical day for this person, is this new, is this an acute crisis? How can we best help the patient who is essentially a stranger to us in the emergency room?"

BCR responders also make frequent trips to group homes and homeless shelters, such as the Salvation Army Harbor Light Center in downtown Minneapolis. Since the pandemic, program director Ian Brunzell said, Harbor Light has seen "more extreme manifestations of severe and persistent mental illness." A community resource like BCR, which can respond "in a trauma-informed way" to mental health crises, is beneficial, he said.

"What would be wonderful to see would be more of them," Brunzell said. "I think that they're constantly overloaded."

Ellison said the City Council is ready to talk about making sure BCR becomes a permanent part of Minneapolis' emergency response network.

"I don't see this as a service that is something that we should continue plodding along in a pilot phase for many years," he said. "I think that we need to be able to fully integrate this into how our city conducts safety and keeps neighbors safe."