The Deeper Dig is a biweekly podcast from the VTDigger newsroom, hosted and produced by Sam Gale Rosen. Listen below, and subscribe on Apple Podcasts, Google Play, Spotify or anywhere you listen to podcasts.
While an ongoing conversation about police reform plays out both nationally and locally, Covid-19 has led to its own pandemic of mental health issues. In recent months, some central Vermont police departments have been trying a new method of integrating mental health services into law enforcement. Is it working?
Since last summer, Susan Lemere has split her time between the Montpelier and Barre police departments.
Lemere is a mental health liaison. In plainclothes, she responds alongside officers to calls that involve a person that appears to be experiencing a mental health crisis.
“I let them know that I have two connections within the system: one with the mental health world and one with the police department,” she said. The hope is to de-escalate a situation, to avoid violence or arrests and to help connect people with mental health services.
The chiefs of both departments say the model is an improvement. But finding funding to expand it may be a challenge.
On this week’s podcast, VTDigger’s Erin Petenko discusses the program with Lemere, Montpelier Police Chief Brian Peete, Barre Police Chief Tim Bombardier and Dan Towle of the National Association of Mental Illness in Vermont. Below is a partial transcript, edited for length and clarity.
What led you in the first place to look into how police are responding to people in mental health crises? Why now?
Erin Petenko: In 2020, I wrote a story on instances of fatal force in Vermont, where police had killed some Vermonters. Many of those uses had some connection with mental health — the person was in a mental health crisis, maybe they were on drugs, or other reasons like that.
At the time, I looked a little bit into the ways that police were trying to establish a better way of doing things. And one of the things people were discussing as an option, but one that’s rarely used in Vermont at this point, is having an embedded social worker in a police department to help them to respond when someone is in crisis.
When I heard that Montpelier and Barre had actually gotten one of these social workers, I decided to talk to the police chiefs and kind of hear how they were doing — and talk to the embedded social worker, Susan Lemere, to hear her perspective on her work and how she interacts with those people in crisis.
Susan Lemere: Primarily, what I do is go with police when there’s a call with a mental health component and see if I can offer assistance, which might look like making a referral or it might look like emotional support. Or it might look like any number of things depending on what the circumstances end up being.
When you say go, like you actually, physically, are standing next to the officer walking up to the situation?
Susan Lemere: Yes, with the caveat that police are in charge of the safety aspect. And that is one of the reasons that I really value doing the work with them is that when something reaches the level of being a call to police to come at assist, there’s usually a safety component that, you know, they’re attending to the safety and that really frees me to focus on the clinical piece.
Do you wear a uniform?
Susan Lemere: I do not. This is my uniform today. Tomorrow will look like something different.
Erin Petenko: What is kind of going through your head when you’re going for a call with an officer? You’re kind of jumping into an unknown situation. You don’t know exactly what someone’s mental health or mental situation could look like. So how do you deal with that?
Susan Lemere: I mean, very much in line with what officers tell me that they are doing. I’m looking for any clues from the call in, and any information that I may have about what somebody might need: how many people are on the scene, whether there’s more than one person having a crisis, whether we’ve responded to that address before and what that’s been for. So that I can have the mindset, to the extent that any of us can, with what information we have going in about what I might be offering, or how I might be trying to assist.
How is this different from the traditional model? How has this typically been handled by police?
Erin Petenko: The typical interaction that’s been described to me is, a member of the public notices someone in distress. They call 911, because that’s kind of the first place that your mind goes when you want to get help for somebody. The police officer shows up, and maybe this person is committing a crime, technically. Maybe the police officer really doesn’t know how to help this person, because they’re not sufficiently trained or meant to handle someone in a mental health crisis.
So maybe that person, in a dire situation, could end up getting dragged out of that public place to get to the ER against their will, or, in a worst-case scenario, they get arrested and end up in jail when they’re really more meant to get into mental health treatment.
And many of the police officers I spoke to agreed that the goal is hopefully to get someone help, to get someone into mental health treatment or some form of mental health intervention, preferably at a lower level than dragging them to the emergency room against their will.
So how does this model of having a social worker embedded in the police department work differently? How does that lead to better outcomes, according to them?
Erin Petenko: This isn’t a completely new idea. In Washington County, Washington County Mental Health Services has partnered with the police department in the past, to send their clinicians when somebody is in crisis.
But Susan is a little bit different because she’s like working so closely with the police. Often, she’s on the scene or arriving on the scene at the same time that police officers are.
Erin Petenko: This might be kind of a weird question, but how do you actually introduce yourself?
Susan Lemere: I usually go with, “Hi, I’m Susan,” first. Part of what goes into an introduction depends on how much distress somebody is in. I will sometimes say I work alongside police, I’m here to offer our support and assistance. And then sometimes I use the clinician term, I’m often trying to gauge who I’m responding to, and whether they’ll have a framework from what I mean if I say I’m a clinician, or when the time is right for me to do so.
I let them know that I have two connections within the system, one with the mental health world and one with the police department so that they know, you know, who I am, that I’m a civilian, but that I’ve got kind of the foot in each of the worlds and that I’m a liaison sometimes between the two.
Erin Petenko: She tries to talk to the person; she tries to understand what they’re going through. And she has more training to understand what mental health is and how it can shape somebody when they’re in crisis. She tries to connect them with some form of resources — Washington County Mental Health, or maybe they even have a provider, maybe they have a loved one that can help them to navigate that situation. So it’s kind of a form of de-escalating the situation and getting that person out of a crisis without worsening the interaction between them and the police.
Susan Lemere: Really, it could look a thousand ways, but some of the things that I’m looking for: Does somebody seem to have an urgency for just telling someone what’s happening? Sometimes that’s the most important thing right off the bat. Sometimes I’m looking at, what does the person’s breathing look like? Are they physically shaking? Are they breathing?
Sometimes my first intervention with someone is, “Can I get you to take a few deep breaths with me?” A good example of this would be that I sometimes go when there’s been an untimely death. And that might be a situation where the first thing I’m thinking is, is there someone I can call for you? Is there someone that you would like to be here with you? Because that’s a situation where, you know, that’s not a mental health issue, that is a natural response to a tragic event — that somebody likely needs support, and they’re going to better get it from somebody in their natural support system than from a mental health professional, if their response is within the range of what would be a normal response, if they’re aware of what’s going on. And if their emotions are, you know, strong, but not carrying them away, then, you know, oftentimes, they respond best to having the people that they know and feel comfortable with.
Erin Petenko: Now, of course, Susan also says that she appreciates having the police there, or as an option, because if she or somebody else is having a safety risk, there’s still the option of bringing the officers in to protect people.
What do we know so far about how well this system is working?
Erin Petenko: It’s hard to say in definitive numbers. I’m not sure if anyone is currently tracking the number of interventions and what their outcomes are.
Certainly, it seems like the police chief is very happy with it.
Brian Peete: Since I’ve been here, I haven’t heard of any calls for service in which there was a mental health component that we’ve made an arrest on. … I would honestly say, from our department’s standpoint, from how we look at it, the goal — unless there is like a severe criminal nexus to it — we’re not looking to arrest anybody. We’re only looking to try to get somebody treatment and help.
Erin Petenko: I spoke with Chief Brian Peete of the Montpelier Police Department. He started in the position, and moved here from New Mexico, in the middle of 2020. I think he started in June, right after the George Floyd protests started. And what he said coming into the department is that a lot of these officers are expected to handle a large volume of calls, so they don’t have a lot of time to handle a situation if they show up and someone’s in the middle of a mental health crisis.
Brian Peete: What I think that the challenge is, is just the amount of time that it may take to de-escalate somebody, and having a unique understanding and the skill set and actually, emotional intelligence, if you will, to know what you’re looking at. And then like … if you have a smaller department, if you only have a handful of people that are on scene … you’ve got to avoid stacking up calls for service. So there is a rush, or there is a pressure, to try to de-escalate the situation as fast as you can so you can be ready for something else. So there’s that challenge.
Erin Petenko: These police officers are already feeling overwhelmed or overburdened, and they don’t really feel equipped to handle this problem. And other chiefs seem to agree with him.
Chief [Tim] Bombardier, of the Barre Police Department, said that he feels like police are expected to be a jack of all trades, which means that they’re a master of none. They’re called in to deal with mental health, with domestic violence, with substance use. And they don’t necessarily have the framework to handle those issues.
Tim Bombardier: You can’t look at the police and say you got to be, you’ve got to be everything. You can’t look at a mental health condition and say, you’ve got to be everything. You can’t look at the community outreach person and do the same thing. It needs to be a team approach. And without a team approach, it’s going to fail.
How does each of them feel about the position that Susan is in, and the changes that have come with having a person who’s more thoroughly embedded in the police department?
Erin Petenko: I think that they are very relieved, frankly. I mean, they love her, and they all kept saying they wish they had more of her, because she can’t be 24/7. They are maybe even working on hiring, or hoping to find the funding for, another Susan. Which, considering that a lot of other departments don’t even have one embedded clinician, hopefully, they can get a hold of her.
But it really shows how much it matters to them to have someone who can intervene in these situations and help someone who’s in crisis, who can follow up with that person and make sure that they can get help. Because often, these people, they’re dealing with them again and again — because they go into crisis, they end up in the ER, they’re in the hospital for as long as they can be involuntarily held, and then they just get discharged. And there’s often nothing to stop that person from going back into that cycle again, especially with the general shortage of mental health treatment in the state, [a] long waiting list for therapists, a long waiting list for all kinds of mental health help. It’s hard for people to get more long-term treatment for their issues.
And you can kind of see why someone after having an interaction with the police that may have been dramatic, sitting in the ER for days, maybe even being involuntarily medicated or restrained, and then maybe being discharged — that person is going to not have a lot of trust in the police the next time they encounter them.
That’s a real bad template for those interactions to continually get worse and worse. So if someone like Susan can intervene, if someone like Washington County Mental Health can intervene and kind of get that person treatment in a way that isn’t as dramatic, as chaotic, they’re going to get better, and they’re not going to keep interacting with the police again and again.
Erin Petenko: I spoke to a local advocate from the mental health community: Dan Towle is a peer support outreach coordinator at the Vermont branch of the National Alliance for Mental Illness.
He takes a much more radical perspective. He mentioned that he has a distrust of the mental health system in general, which I can definitely understand — when you’re describing people being forcibly restrained, medicated, feeling like they don’t have control over their lives. But his perspective is that there should be more peer support: people who are in mental health crisis helping each other.
Dan Towle: From our perspective, the ideal scenario is to have peer workers, people who have lived experience and have the training — because I also have training — working with people who have mental health conditions and talking with people who are suicidal, or want to hurt themselves or hurt others.
Erin Petenko: That’s what [the National Alliance On Mental Health] does. They have these peer support groups across the state to try to help people. They run a crisis line to try to help people in crisis as kind of an alternative to calling the police. And he even described an initiative to try to provide one simple number, like 911, that people could call when they witness someone in a mental health crisis, so that there is this automatic bypassing of the police department system in the first place. Or if the police get involved, it’s not, at least, like the first thing that happens in the process.
And he said that he also believed that Susan was an improvement to the system.
Dan Towle: Having the mental health crisis worker be part of the mental health care system is a big step in the right direction, as opposed to part of [the Department of] Public Safety. That was a really positive thing, from our community’s perspective, is that they did it under the umbrella of the mental health community rather than public law enforcement.
So he’s saying this seems to be an improvement. Is it the ultimate solution?
Erin Petenko: I don’t know. It seems, from my conversation with him and from other mental health workers, that the solution is having people not get to that crisis point in the first place. But obviously, that’s very difficult, especially in the middle of a pandemic that’s caused such an uptick in people having mental health conditions, or people with mental health conditions kind of reaching a breaking point in their condition.
There’s a big debate going on in Montpelier over whether they should even be allowing homeless people to camp outdoors, and what are they going to do about the rise in people who are on the street? So obviously, this is a situation where outreach workers and mental health workers are going to really be needed, from what I’m hearing.
And the more people that are on the street, the more likely there are to be these initial encounters with law enforcement that could escalate, if there’s not an effort made to de-escalate?
Erin Petenko: Obviously, not everyone who’s unhoused is in the middle of a mental health crisis. But being on the street can obviously exacerbate any problems that you have. And because they’re already in public, obviously, the public is more likely to see them, to interact with them, to call 911 on them. So the police have to show up in that situation.
If you’re on the street, you’re also a little less likely to be able to seek mental health treatment — you don’t have an address, you don’t have steady access to transportation, you can go off your meds in that situation. People do seem to be concerned about the rise in homelessness and whether it could lead to a rise in people being in mental health crisis.
Are there other reasons that this is a particularly acute concern right now?
Erin Petenko: Another issue is just the rise in kids going into mental health crises. The media talk a lot about the delay in kids in the ER getting into psychiatric hospitals. They would spend days in the ER. That’s not a great environment for someone to be in for a long period of time when they’re in a mental health crisis.
What Chief Peete said was that, with kids not going into school as often, they’re not interacting with their guidance counselors, and the school resource officer — who is kind of a law enforcement officer for the school — doesn’t interact with them either. So it’s harder for them to notice and intervene when a kid is having a mental health issue. There’s kind of this pattern of people getting worse and worse before they actually get into mental health treatment.
The other big, timely aspect of this is that we’re in this moment right now, when we’re about a year from the protests over George Floyd’s killing by police in Minneapolis, and this much broader conversation about police reform, defunding police departments, potentially shifting funding from police departments more into social services. Where does a solution like this — positions that are straddling social services and law enforcement — fit into that conversation?
Erin Petenko: Well, neither of the police chiefs I spoke to were advocating for cutting their own budgets. I will say that. But they both certainly spoke in favor of increasing the budget of Washington County [Mental Health.] Peete even mentioned, we’re having all these conversations about helping people with mental health issues, but Washington County’s budget didn’t magically get doubled overnight. They’re constantly dealing with all these things.
But at the same time, I do think the police departments feel like they’re already working under budget. They describe how little time police officers have to deal with calls. Certainly the Barre police department is understaffed. So that’s even more work for fewer officers. So in general, I don’t know if the police would agree that they need to be defunded. But I think they just believe that there should be more resources in general in the whole system to help people — from police, to mental health services, to maybe getting people into housing at the very end of that system.
But to them, it seems like the idea that you would just dedicate social workers to some of these calls and take away the law enforcement response — that, to them, is a non-starter.
Erin Petenko: Yeah. I will say that that does happen in other states in the CAHOOTS model. In Oregon, social workers and emergency services like EMTs arrive at the scene, and there’s no police officer involved. I think that in Montpelier they talked about that option, but decided they wanted to still include the police because of the safety issues.
Certainly Susan described, there are some instances where she feels more comfortable approaching somebody because she has the backup of the police officers if she needs them. So, no, I don’t think that any of them would agree that they need to get out of the system entirely.
You came to this by having researched and studied the progression of fatal police shootings over the past few decades. Is there a sense that this new model might help address that absolute worst case consequence in more of these incidents?
Erin Petenko: I think that there are really two two frames that you could see it in. One is whether the police can de-escalate someone who’s in an a crisis situation to the point where they have a gun and they might be threatening to shoot someone, or if they’re in extreme distress — versus the ability of police officers to intervene with someone before they even reach that level, like the very first time that they ever have a mental health crisis, the beginnings of their feelings of suicidality, or violence, or whatever they’re going through.
I certainly get the perspective that police officers would rather do that latter option if they can. Whether you can de-escalate someone who already has a gun, that’s just a more challenging, much more charged environment to be in.
So, hopefully the answer is yes, better mental health treatment, better ways for police to handle someone in that situation will prevent future deaths. But the headlines will probably still keep happening, unfortunately.
