Why An Embedded Model?

The original idea behind the model created by CC360 actually occurred in 2008/2009 with the implementation by our consulting team of an embedded program to address chronic mentally ill and homeless.  Fast forward twelve years to the “should we send a social worker instead” debate occurring around the country today. 

The first publicly funded, organized police force with officers on duty full-time was created in Boston in 1838 after businesses had started hiring people to protect property and guard the safe transport of goods (https://time.com/4779112/police-history-origins). Thus, the focus to “protect and serve” originated as well.  In February 1968, the first 911 call was made in Alabama.  By the end of the 20th Century, 93% of the United States was covered by a 911 system.  Young children are taught when they need help, call 911.  There is no idea of trying to teach community members to ferret out the type of help that is needed . . . it is just the expectation that if you need help, you call, and help will come.  


So, over time, policing transformed from “protecting and serving” into an expectation to be all things to all people at all times.  Even with the one-day implementation of a 988 system, there will never be a time – repeat, there will never be a time – where law enforcement is not responding to non-criminal crisis events.  Similarly, there will never be a time when our mental health system does not need the assistance of our law enforcement partners – again, never.  We say this with certainty and guarantee.  As such, the need to respond with the appropriate tool for the appropriate situation is imperative. 
So, over time, policing transformed from “protecting and serving” into an expectation to be all things to all people at all times.  Even with the one-day implementation of a 988 system, there will never be a time – repeat, there will never be a time – where law enforcement is not responding to non-criminal crisis events.  Similarly, there will never be a time when our mental health system does not need the assistance of our law enforcement partners – again, never.  We say this with certainty and guarantee.  As such, the need to respond with the appropriate tool for the appropriate situation is imperative. 


This leads to the question we are most frequently asked is, why did we choose to develop and support a fully embedded model.  The answer is not one simple thing; but a variety of factors that influenced our decision.


First, the vast majority of communities have some sort of siloed crisis response program for community members who are experiencing an identified mental health crisis where sometimes mental health professionals take the lead and other times law enforcement is called to respond.  It looks different depending on the region, but typically those community members who are in crisis and are volunteering for services are able to access crisis support services.  It could be through telephone, telehealth, or in-person response depending on the situation and area.  


Recently, while attending the International CIT conference, we were able to attend multiple sessions in which the issue of whether to dispatch a mental health team without law enforcement was discussed.  It was also the consensus of those in attendance, and those presenting on the topic, that this response level is appropriate only in very limited circumstances.  These include when the caller is not displaying any violence, has no weapon, the individual is agreeable to stay safe until the mental health responder can arrive, no crime has been committed, they are voluntarily agreeing to get services, there are no medical needs including overdose and no drugs or alcohol on board.  We agree, under these circumstances, a non-law enforcement response would be appropriate.  However, we think you will agree, this is a very restrictive list and does not, in fact, represent the types of calls that our program advocates an embedded team would respond to.


We are all aware that call categorization is often not inclusive of the underlying reason the call originated.  By integrating a mental health provider with, at times even, officers on patrol assignments, we advocate for teams to prioritize response to calls which are identified as:

  • Suicidal/homicidal subject 
  • Repeat calls to dispatch regarding non emergent content
  • Calls regarding “persons of concern” (i.e. exhibiting psychotic or odd behaviors) or welfare check calls for persons who have been described as having a behavioral health condition.
  • Requests for dispatch regarding individuals in continual crisis who are over-utilizing emergency services or law enforcement
  • Civil disputes
  • Domestic Violence (physical and verbal) and family disputes
  • Victims of Crime
  • Death notifications
  • Calls coded as “mental”
  • Missing/runaway juvenile
  • CPR in progress
  • Homeless 
  • Substance use 
  • Disturbing the peace
  • Trespassing


As you can see, this expanded response definition allows for a response to “crisis” and not just a response to “mental illness.”    This expanded response gives community members the necessary support to meet their needs. 


Our second reason to advocate an embedded model is the significant financial savings in comparison to operating multiple mental health response teams in a geographical area.  Most times, our consultants are able to identify community resources who can pool resources, personnel, and equipment in order to create teams without a significant hit to the budget.  Let’s face it, everyone is trying to do more with less.  The need to work together to face staffing shortages and financial restrictions are more important than ever.


Along the same lines as fiscal responsibility is the ease and speed by which models can be implemented, which is our third reason for developing this program model.  Again, by working with existing programs and using existing policies and procedures; programs can be implemented in a significantly shorter period of time than having to start from scratch.  


Finally, we believe in a shifting culture of law enforcement.  This is a subtle happening in departments who utilize embedded mental health professionals.  It is not quantified.  It is not even easily articulated.  But it is the magic that happens when law enforcement agencies change the lens with which calls are seen.  Different questions are asked.  Different language is used.  Not better, not worse, but different.  


It is our dream that, one day, every patrol officer will be paired with a behavioral health crisis response expert.  A reality?  Not likely.  But it speaks to the value we believe this partnership can bring to policing our communities.  Thus our Mission:  Creating the RIGHT response, at the RIGHT time, by the RIGHT people.

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