San Antonio police mental health unit

Officer Ernie Stevens, shown in a video presented to the Lewisville City Council, is an officer in the mental health unit at the San Antonio Police Department.

For about five minutes on a Saturday morning last month, Lewisville Police Chief Kevin Deaver showed the City Council a video of what police officers deal with when they respond to a mental health-related call.

The video from the San Antonio Police Department included body cam footage from various police encounters. In some cases officers are seen talking with someone who has a mental health issue.

But it also showed what happens when officers don’t have the mental health training. In one case a police officer responded to a call involving a mentally ill person, and as the situation escalated the officer fatally shot the man.

“No one with mental illness deserves to die,” one woman said on the video. “Because they’re already dying inside. Suffering.”

Lewisville is taking steps to ensure the same doesn’t happen here.

Deaver and Fire Chief Mark McNeal presented plans during a council planning session for a mobile crisis outreach team called CoCare where first responders trained in mental health would arrive on the scene when a mental health crisis is suspected.

He said based on the statistics it’s a critical program to have in place.

“In the United States about one in 10 of all police calls involves a person with mental illness,” Deaver said.

Deaver said those suffering from severe mental illness account for one quarter of all fatalities involving law enforcement.

“The people who don’t have insurance to be able to get the care, those are the ones we see on a daily basis,” Deaver said.

Firefighter/EMS personnel receive the same types of calls. McNeal cited a study conducted by the Colorado Department of Public Health that indicated that between 2011 and 2015 behavior/psychiatric was the second-most used primary impression for EMS providers in the U.S., trailing only traumatic injuries.

The study stated that in 2015 approximately 15 percent of EMS patient contacts were related to substance abuse, overdoses and behavior/psychiatric cases.

Locally, McNeal said 10 percent of the calls the Lewisville Fire Department responded to in 2020, or 912 calls, were related to mental health issues.

The problem, Deaver said, is the first responders who arrive on scene may not always have the training to handle someone dealing with a mental health crisis.


Deaver said CoCare would focus on mental health, behavioral disorders, substance abuse, the aging population, arson investigations and homelessness.

He said CoCare would be a team composed of two police officers, three firefighter/paramedics and a mental health clinician.

“When you look at these calls they are truly medical in nature,” Deaver said.

Deaver said the program would partner with Denton County Mental Health Mental Retardation (MHMR), which would provide the mental health clinician. The clinician would perform a virtual assessment through iPads that have been provided to first responders before making a recommendation on next steps.

North Central Texas Area Agency on Aging and the North Central Texas Aging and Disability Resource Center would be partner agencies as well. 

The officers in the program would receive crisis intervention training and trauma affected veteran training. They must have two years as a certified officer and they must pass the mental health officer training. They will go through 40 hours of training.

Deaver said he plans on training more officers in case they’re needed.

McNeal said the paramedics would help determine if the symptoms the individual is experiencing are related to mental health or another medical emergency.

Other programs

Deaver said the police department in Memphis, Tennessee was one of the first departments to have a crisis intervention program. He said 20 percent of its officers were trained in crisis intervention and would respond to mental health related calls.

Last year Denton County created a Mental Health Unit that is made up of mental health police officers and a mental health clinician. The team responds to mental illness and behavior health issues.

The Dallas Rapid Integrated Group Healthcare Team (RIGHT) responds to the same types of calls but also includes firefighter/paramedics.

Irving has a similar program but includes substance abuse disorders as well.

Deaver said 11 of Lewisville’s 17 comparison cities have some sort of officer to respond to these calls.

In addition to helping residents with mental health issues and protecting the first responders, Lewisville officials said this program would help with workload.

McNeal said that in 2018 police spent an average of 86.1 minutes (per employee) on mental health related calls, and EMS spent 42.4 minutes.

Deaver said currently multiple first responders will arrive at the scene of a call, and if it’s determined there is a mental health issue then the individual is transported to the mental health facility in Denton. An officer stays there until the mental health deputy arrives.

“All that time we’re on the call that we’re not doing something else,” Deaver said. “That has a domino effect on the calls we’re able to respond to in a timely manner.”

Moving forward

McNeal said the initial cost of the program, which includes the officers, paramedics, a vehicle and training, is expected to cost $742,142. He said ongoing costs are expected to be $603,562.

“It provides the right care, the right treatment and the right approach,” McNeal said.

City officials said they’ll have to get creative in finding ways to fund the program. Deaver, for example, said he would delay the hiring of two detective positions that are expected to pay for these CoCare officers.

Despite the high price tag, council members supported the program.

“To me it’s incredibly expensive not to,” Mayor Pro Tem Neil Ferguson said. “Expense in this sense isn’t always money. It’s people’s lives, it’s the toll it takes on officers.”

The police and fire departments plan to start training selected staff so the program can begin at the beginning of the 2021-22 fiscal year in the fall.

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