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Rebekah Gewirtz and Jon Schnauber: We need to ensure calls to 911 get the best response

memorial for Miguel Estrella (copy) (copy)

A memorial for Miguel Estrella outside of his 279 Onota St. apartment. Estrella was fatally shot by police outside the apartment March 25 while holding a knife. 

Of the many reactions to a Pittsfield Police officer’s fatal shooting of Miguel Estrella, Melissa Helm’s has stuck with us for its simple truth: “No one should have to lose their life because they are experiencing a mental health crisis.” Helm is the executive director of the Berkshire County chapter of the National Alliance on Mental Illness.

And yet, the circumstances of Estrella’s March 25 death are becoming all too familiar. According to news reports, police were summoned to Estrella’s apartment building twice that night because Estrella, a beloved and engaged member of his community who also had a history of mental illness, was intoxicated and cutting himself with a knife. A family member called 911 and told the operator that Estrella needed to be hospitalized. The first encounter that evening between Estrella and police ended peacefully. The police returned shortly after the first encounter to find the 22-year-old again armed with a knife. Police allege that Estrella moved toward the officers, prompting deployment of Tasers. When those failed to incapacitate Estrella, an officer fired two shots, hitting him in the chest. Estrella died at the hospital.

The incident is similar to other recent shootings of people in crisis and holding a knife by police in the commonwealth. In January, Springfield officers killed Orlando Taylor III, a 23-year-old man experiencing a severe mental health crisis. That same month, a middle-aged Burlington man holding in the midst of a mental health crisis was shot and injured by police. In February, Lexington police shot and killed a 35-year-old resident of a group home for people with mental illness.

These tragic incidents exemplify what is wrong with our systems of public health and safety and are testament to the dire need for alternatives to our over-reliance on law enforcement intervention in mental health crises. A 2016 study of police responses to mental health crises published in Police Quarterly noted that more than 90 percent of officers have an average of six encounters with individuals in crisis per month and that seven to 10 percent of all police encounters involve people affected by mental illness. A 2016 Boston Globe investigation found that nearly half of all people fatally shot by police in Massachusetts between 2005 and 2015 were suicidal or living with mental illness.

As we continue to deal with the social, economic and political effects of the COVID-19 pandemic, we must act quickly to meaningfully expand community-based mental health services and ensure comprehensive non-police responses to mental health emergencies to prevent future tragedies.

A new Blue Cross Blue Shield of Massachusetts report starkly detailed the pandemic’s toll on Massachusetts adults: 35 percent of residents aged 19 and older reported needing behavioral health care for themselves or a relative in the past year. The level of need was disproportionately high among those aged 19 to 39, people of color, and those with lower family incomes. And our mental health crisis may not abate any time soon, as 27 percent of adults expected to need behavioral health care over the next six months — about the same level of need reported over the past year. If we’re to make mental health services more widely available, accessible to all, and high quality, we must begin by increasing our investment in them.

Currently, there is a mental health care “workforce crisis” in Massachusetts in which more outpatient clinicians are leaving positions than are being hired, according to the Association for Behavioral Healthcare. Given that, it’s concerning that bills to improve the delivery of behavioral health care in the commonwealth are proceeding slowly if not stalled in the Legislature.

We must also ensure that people experiencing mental health crises get the appropriate response to 911 calls. The Alternatives For Community Emergency Services (ACES) Act would provide grants to communities seeking to provide a mental health response to certain emergencies. Social workers and other allied professionals are highly skilled at building rapport and deescalating emotionally fraught situations, thus freeing police in certain circumstances from responding to emergencies that can be handled by other professionals.

In cities with ACES-type programs in place, 911 dispatchers divert nonemergency, mental health, substance use and other behavioral-related calls to behavioral health specialists. Such a program is being piloted in Lynn and other communities in the commonwealth. Since launching less than two years ago, a pilot program in Denver, Colo., has responded to 2,294 calls for service that would have otherwise been dispatched to police. The paramedics and behavioral health clinicians who respond to behavioral health emergencies in Denver’s program have never had to call for police backup due to a safety issue.

If we agree that a call for help should not result in the loss of life, then we must invest in services to improve and protect the mental health of people in our communities. Therefore, we must ensure the availability of the proper personnel to respond to the range of emergencies involving people in psychological distress.

Rebekah Gewirtz is the executive director of the Massachusetts chapter of the National Association of Social Workers. Jon Schnauber, of North Adams, is a social worker whose practice is based in Pittsfield and the founder of Social Systems Re-imagined LLC.

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