County Urges El Cajon PD to Change Mental Health Call Policy

A few months after El Cajon police quietly halted automatic responses to some mental health calls, the county is urging the city to change course. 

A top county bureaucrat detailed the county government’s concerns with the El Cajon policy shift including challenges for county-contracted clinicians who can’t always respond without police backup – in a letter to the city manager last week. She asked the city to consider changes. 

El Cajon’s police chief told Voice of San Diego he’s not going to.  

“We don’t have any intentions on shifting back to what we were doing before,” Police Chief Jeremiah Larson said. “I think it’s working how it should be.” 

The police department no longer automatically sends out officers to calls where  someone threatens to harm themselves but there’s no apparent crime or danger to others. That has sometimes meant that two county-contracted  teams of mental health clinicians that aid people in crisis are unable to respond due to safety concerns or can’t get police support when they seek it. 

The county’s Mobile Crisis Response Teams can only respond to calls where there aren’t safety concerns such as weapons or violent threats and its Psychiatric Emergency Response Teams accompany police officers to calls – meaning they can’t respond without officers. 

Larson and other El Cajon officials have argued that clinicians are better equipped to handle those calls than police, whose responses can increase tensions and liability. Larson has also emphasized that El Cajon police are still responding to most mental health crisis calls. 

But the county’s teams require a police response in some situations.  

 In the letter obtained by Voice after a public records request, county Assistant Chief Administrative Officer Caroline Smith argued that El Cajon’s policy shift has “created significant gaps in our behavioral health crisis response system” and led to “immediate and concerning impacts on vulnerable residents.”  

Among them, according to Smith: residents in crisis were left without help when police declined to respond and clinicians decided they couldn’t go without their support, police referrals that didn’t take into account county contractors’ safety limitations and calls transferred from agency to agency  that “only exacerbate (callers’) distress and increase their risk of harm.” 

Smith also shared a breakdown of 22 incidents since mid-May where the county and its contractors reported that El Cajon police at least initially declined to intervene. Smith wrote that some of these situations didn’t jibe with the county’s Mobile Crisis Response memorandum of understanding with El Cajon police and other agencies across the region. 

“We would respectfully request that ECPD leadership consider modifications to your current policy, that were agreed to by law enforcement entities countywide, that would restore appropriate law enforcement support for all high-risk mental health crises, ensure seamless communication between all crisis response teams and protect our most vulnerable community members,” Smith wrote in the letter sent Sept. 11 to El Cajon City Manager Graham Mitchell. 

Smith’s letter noted that the county would continue to talk to the city and other stakeholders to try to identify solutions and to regularly share details on incidents flagged by county contractors.  

Mitchell confirmed Thursday he had yet to respond to the county’s letter and expected to review it more closely that day, a week after receiving it. He declined to comment further. 

Smith’s letter to Mitchell came a month after a City Council discussion of the policy where officials also questioned the county and its approach to mental health responses. At the Aug. 12 meeting, El Cajon officials asked why police needed to respond to county-contracted PERT calls and why the county – rather than the city – isn’t providing security for those calls itself. No county officials attended the meeting to answer those questions. 

The county notes it budgeted $37.7 million for the PERT and MCRT programs this fiscal year and that existing agreements dictate that the civilian teams can’t respond alone to crisis calls when there are safety issues such as weapons or threats of immediate violence. 

PERT Director Mark Marvin said Thursday that the policy shift drove a significant drop in PERT responses in El Cajon that has continued in the four months since the initial change. 

Marvin and county officials noted that they likely aren’t aware of all the 9-1-1 or other calls coming in that may be impacted by the El Cajon policy shift. 

Larson stood by his policy call and his department’s response to incidents the county flagged.  

“Ultimately, I think at the end of the day, even with the list of calls they sent over, they’re calls I believe our supervisors are making the right decisions on,” Larson said. 

On July 28, per a county incident log, a resident of a board-and-care facility called police to report another resident was screaming and threatening to kill others and that she was “afraid for her life.” The log states that El Cajon police declined to respond after calling the facility. 

Larson told Voice a dispatcher followed the department’s usual protocol to call the facility before responding if it’s not considered an immediate emergency. Larson said an employee at the facility told a dispatcher the person was leaving. Police invited the facility to call back if they did – and police never got another call. 

In two other instances, the log described calls about people who threatened to run into traffic.   

On July 15 at 6:20 p.m., the county log says El Cajon police referred a call to MCRT that the county-contracted team decided clashed with its safety requirements.  

“Client had attempted to run into traffic, and a third party was on scene holding client down,” the log states. “The call was diverted back to law enforcement due to safety.” 

Larson said El Cajon police initially referred the call to MCRT with initial information they received and then learned the woman’s mother had pinned her down after she attempted to run into the street. 

“We immediately responded and actually took the person into custody with a mental health hold,” said Larson, who said officers responded to the scene within 38 minutes of the initial call. 

Mental health holds – often deemed 5150s – allow police to detain a person and take them to a hospital or other mental health facility for evaluation. 

Then, on Aug. 26, the county log states that El Cajon police twice referred a person with suicidal ideation who described a plan to walk onto a freeway to MCRT, first at 1:55 a.m. In both instances, MCRT decided it couldn’t respond due to safety concerns though it had deemed the person who was experiencing hallucinations at imminent risk and able to carry out their plan. The contractor told ECPD they could not respond due to safety concerns. Ninety minutes after the initial call, El Cajon police called for MCRT again when the person was walking along the freeway. 

“ECPD declined to respond both times due to no danger to others or crime being committed,” the log states.  

Larson said he wished MCRT had responded to the calls, though he was reluctant to second-guess the team’s protocols. 

“He was not making any threats to anybody. He was referring to harming himself only and he wanted help,” Larson said. “I think a mental health professional would have been a great response.” 

Larson said police did contact California Highway Patrol after MCRT declined to respond and never got another call about the situation. 

He emphasized that El Cajon police aren’t trying to shirk responsibility but don’t think they are the best responders to help people in crisis. 

“We care deeply about people,” Larson said. “We care deeply about their situations but very often when law enforcement shows up and we’re not mental health professionals, we’re trained in law enforcement, it often makes things worse.” 

Smith argued that El Cajon police often need to be part of the solution. 

“Both MCRT and PERT are specifically trained to de-escalate behavioral health crises, but there are situations where law enforcement support is essential for these programs to operate safely and effectively,” Smith wrote. 

The post County Urges El Cajon PD to Change Mental Health Call Policy appeared first on Voice of San Diego.