Dustin Pigeon, 29, was standing in his front yard, covered in lighter fluid, holding a lighter in one hand and a bottle of accelerant when two Oklahoma City police officers arrived. Pigeon suffered from bipolar disorder, anxiety, depression, and substance abuse. The officers begged Pigeon to reconsider. Before he could, another officer, Sgt. Keith Sweeney, arrived clutching his gun.
“I will fucking shoot you,” Sweeney yelled. “Get on the ground.”
Sweeney fired five shots at Pigeon. He died.
Bennie Edwards, 60, suffered from bipolar disorder and schizophrenia. He went to a strip mall holding a knife. Oklahoma City police Master Sgt. Keith Duroy and Sgt. Clifford Holman arrived, pepper sprayed and fired a Taser at him. Moments later, they shot Edwards. He died.
Ernest Antwine, 42, suffered from schizophrenia and substance abuse. Oklahoma City police arrested him at least 15 times before his mother, Shirley Antwine, called for help again. During previous interactions with Antwine, officers used a Taser on him for resisting arrest. In many cases, they then drove him to a nearby hospital and then took him to jail. This time, however, Oklahoma City Police Sgt. Robert Burton dropped him outside of Oklahoma City limits, on the side of Sooner Road. Burton stepped in front of a silver Nissan pickup truck. He died.
Those mental health emergencies were reported by Oklahoma Watch over the last four years. In each case, Oklahoma City police officers responded without the guidance of a mental health professional.
While the majority of mental-health-related calls do not end so tragically, stories such as these sparked a Department of Justice investigation into the state of Oklahoma, Oklahoma City and the Oklahoma City Police Department in 2022. Federal investigators are looking at whether the state, city and police department comply with the Americans with Disabilities Act, which prohibits discrimination against those with disabilities.
On July 3, the city council released a 20-page report titled “Transformational Progress, Oklahoma City’s Mental Health Services, Challenges, Innovation, and Solutions.” The report was largely the product of the Law Enforcement Task Force and the Community Policing Working Group, which started in 2020. The two groups, with the help of 21CPSolutions, a company that specializes in public safety services, collected information to present 39 mental health response recommendations to the city council.
Implementation
Two programs launched in 2019 to address the plethora of mental-health-related 911 calls dispatchers receive annually: the Community Advocacy Program through the Oklahoma City Fire Department and the police department’s Triaged Resources Urgent Support Team, known as TRUST.
In 2023, 18,614 of the 438,785 calls the Oklahoma City Police Department received were mental health-related. The city council’s report discussed how the two programs have changed the role of 911 for those who routinely call by connecting them to services that reduce their need to call again.
“They were overutilizing 911,” Oklahoma City Fire Department Chief of Operations Mike Walker said. “I don’t say that in the sense that they were abusing, it’s just that’s who they knew would answer the phone.”
The Community Advocacy Program takes fire department referrals and connects people to agencies that provide services ranging from food and housing to mental health care.
Firefighter Lieutenant Bill Downs and Oklahoma Department of Human Services Family Services Specialist Jenna Cox visit clients regularly to assess their needs. The two-person team can only keep a caseload of about 70, and Walker said they check on some clients only once per month.
The Fire Department will add two case managers but is struggling to find qualified applicants.
Downs said that so far, the program has saved the Fire Department an estimated $600,000 in costs from 911 overuse.
“A little bit of prevention, a little bit of coordination and everybody wins,” Downs said.
TRUST is a similar program. Police officers dispatched to mental health emergencies can refer callers to members of the Crisis Intervention Team, who can then connect them to appropriate services.
The Crisis Intervention Team, launched in 2002, is a voluntary 40-hour mental health response training program. It comprises 172 Oklahoma City police officers, which was 35% of active patrol officers as of June, although 460 have completed the training.
Valerie Littlejohn, the Oklahoma City Police Department’s public information officer, said the disparity can be explained by the additional criteria required to join the Crisis Intervention Team; an officer must be a lieutenant or below in rank and the majority are on patrol, not in other departments such as investigations or administration.
Kathy Walker’s daughter struggles with mental health and interacted with Crisis Intervention Team officers on two occasions, most recently in May 2023.
“They were very good at talking to her and convincing her that she needed to go to a hospital to be evaluated,” Kathy Walker said.
Collaboration is Critical
Mental health response frequently overlaps with homelessness and overdoses, so mental health responders have to collaborate with other providers, such as those assisting the unhoused and those who have overdosed.
The city started the Homeless Outreach Team in 2014. Police officers can report cases involving unsheltered individuals to the Oklahoma City Action Center, which notifies 40 non-profit organizations affiliated with the city’s Key to Home Partnership.
Shelah Farley oversees the Street Outreach and Community Response team at Mental Health Association Oklahoma, part of the Key to Home Partnership.
“When you’re living outside with untreated mental illness or substance abuse issues you’re in what we call survival mode,” Farley said. “You’re only worried about the here and now. You’re not worried about talking to someone about your mental health because you don’t have time for that, so if we’re bringing that to people, it’s a lot easier to obtain.”
The city also launched the Overdose Response Team in July 2023 to follow up with people who suffered an overdose and connect them with food, water, housing, and/or mental health care.
The team consists of Lance Jones, a major in operations at the Oklahoma City Fire Department, and Stephanie Pfitzenmeyer, a peer recovery support specialist at Hope Community Services.
“They know where we need to go and we know what we need to say when we get there,” Pfitzenmeyer said, speaking of the collaboration between law enforcement and mental health professionals.
Jones said they have spoken with about 600 people, both overdose victims and their companions.
Walker said the city’s efforts will focus on expanding programs like these and creating others that allow mental health professionals to play a larger role in responding to 911 calls.
Mobile Integrated Health Care
The city is hiring five clinicians, five paramedics, nine case managers, and one physician for its Mobile Integrated Health Care program, which aims to embed mental health professionals who work directly for the city into law enforcement response.
Mobile Integrated Health Care will consist of four units, two of which are already in operation: Crisis Call Diversion, Crisis Response Teams, a Community Advocacy Program, and an Overdose Response Team.
Crisis Call Diversion will provide a localized alternative to 988, a national suicide and crisis lifeline. It gives those experiencing a mental health emergency an option other than 911 by allowing callers to interact with mental health crisis specialists over the phone. Crisis specialists can dispatch Oklahoma Department of Mental Health and Substance Abuse-contracted professional mobile crisis teams if needed.
Due to its high call volume, Oklahoma 988 sends its high-risk calls to 911 emergency dispatchers. Walker said that last year, there were about 18,000 of those.
In order to manage this and provide residents with a localized alternative to 988, the city will implement Crisis Call Diversion to embed a clinician and a certified case manager who is qualified to assess needs with Oklahoma City 911 dispatchers. The program will ensure more streamlined coordination between mental health professionals and law enforcement.
If mental health professionals decide that a person requires a high level of care, they will be able to send a crisis response team.
Crisis response teams will consist of a paramedic and a case manager who, if necessary, will take people to crisis and urgent recovery centers operated by certified community behavioral health clinics. Less critical cases will be handled by an alternative response team operated by an external agency and will be on the streets by January.
Staffing Problems
The city’s largest obstacle is staffing. The only position filled so far is the physician posting.
According to a November 2023 report by the Tulsa-based Healthy Minds Policy Initiative, the federal government has designated all 77 Oklahoma counties as mental health professional shortage areas.
“The fact is, we can throw money at a problem all day long,” Depression and Bipolar Support Alliance of Oklahoma Executive Director Jeff Dismukes said. “But if we don’t have a workforce, we’ll never be able to deliver what it is that we need to deliver.”
A separate report by the Healthy Minds Policy Initiative found that a significant reason for this is the lack of in-state educational opportunities for those interested in mental health careers.
The likely caseloads also might be an obstacle. Steve Norwood, chief operations officer for specialized services at RedRock Behavioral Health Services, said their crisis stabilization units are normally at 85%- 90% of capacity.
RedRock Behavioral Health Services Chief Executive Officer Verna Foust said community mental health jobs aren’t the most desirable.
“It’s a tough job, there’s more paperwork because we’re billing government forces,” she said. “Sometimes, it’s easier not to work in the community sector.”
Statewide Reforms
Tulsa has operated its Community Response Team, similar to Oklahoma City’s Mobile Integrated Health Care, since 2017 through a collaboration between law enforcement and Family & Children’s Services, a certified community behavioral health clinic.
Through its Community Outreach Psychiatric Emergency Services, known as COPES, Family & Children’s Services works with Tulsa police and fire departments to dispatch a mental health professional with law enforcement when needed.
Amanda Bradley, vice president of COPES, said that when the Community Response Team was formed, it was imperative that every collaborator agreed on a set of definitions for terms such as “divert.” She said that because law enforcement and mental health professionals have different backgrounds in mental health response, it is important to make sure everyone is on the same page.
Tulsa’s program didn’t struggle with recruitment because mental health professionals from Family & Children’s Services were able to fill those roles immediately.
Pfitzenmeyer said working for Hope Community Services, not Oklahoma City, has made her job on the Overdose Response Team easier because she completes client intake forms for admission to Hope while she is checking on them with Jones, expediting treatment center admission.
“Behavioral health issues don’t belong to just one entity,” Dismukes said. “It’s going to take multiple organizations working together to find real and lasting solutions.”
Ed. note: This story was updated on July 11, 2024 to clarify that most, but not all, of Oklahoma city’s Crisis Intervention Team officers work on patrol.
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Oklahoma Watch, at oklahomawatch.org, is a nonprofit, nonpartisan news organization that covers public-policy issues facing the state.