Behavioral health expert on the front line of police calls? The study targets co-response teams


Amber McDonald, PhD, LCSW, Assistant Professor at Department of Psychiatry to University of Colorado School of Medicine, has been at the forefront of the cultural shift in public safety for years. She has helped police departments move from a confrontational ‘we take you’ approach to a more nuanced style such as, ‘We want to hear from you and connect you with community resources. “

McDonald, who is deputy director of START-UP Center, serves as clinical supervisor for Longmont’s Crisis Outreach and Engagement (CORE) program.

The innovative joint response team of the Ministry of Public Safety is growing and showing promising results, especially during a pandemic that has caused mental health problems associated with greater barriers to service. Some Longmont officials credit the CORE program, in its fifth year and soon to add a fourth field team, a 50% drop in suicides.

How CORE works

CORE sends a team of three – a behavioral health expert, a police officer and a paramedic – to every call. The goal is to defuse and resolve the incident rather than assign a hasty judgment and simply process the appeal.

McDonald’s provides valuable clinical supervision and, as a former social worker and current researcher, she also brings a passion for research. She received a $ 20,000 grant from the Community Engagement Program of the Colorado Institute of Clinical and Translational Sciences conduct an in-depth study on the effectiveness of CORE.

The multi-month mixed-method study collected quantitative data from police officers – assessing their views on the acceptability of the program – and qualitative data from community members receiving services from CORE. The McDonald’s team asked three questions of those contacted by CORE:

  • Did you think CORE was there to help you rather than to impose punitive measures?
  • CORE was it helpful? Did the team offer helpful resources and work to resolve your issue?
  • Was the team’s follow-up appropriate?

“We’re trying to figure out what components of (co-response) models work, how to keep them sustainable, and how to replicate them in other communities?” McDonald said, noting that the near-completed study will be submitted to academic journals and summarized in fact sheets and reports for city stakeholders. “This (empirical study of the effectiveness of a co-response team) is just not being done anywhere. “

Calls for police reform

Co-response teams are proliferating as calls for police reform have become global in recent years. “Most of the co-response evaluation data comes from Canada or the UK, and the types of interventions offered on the street are unclear. We need to better understand what works here in the United States and what the real interventions look like, ”McDonald said.

McDonald’s interviewed 23 people who came into contact with CORE as part of its study. Respondents often noted the extent to which the co-response team is committed to each person’s unique problem and demonstrates, through probing questions and follow-up contacts, a genuine interest in helping the individual.

One respondent said: “I feel like it makes the community feel more like a community. You’re not alone. ”Another said,“ It sounds like a general human-to-human interaction, not going straight to ‘this individual is causing a disturbance.’ They have to be stopped.

McDonald said programs such as CORE take the community policing movement to another level. “I think they’ve finally hit the head,” she said, as people served no longer feel like they’re being carried on a treadmill. “The CORE team follows you up and makes sure you are connected where you need to be. It makes people feel more like they are in a community, instead of just easing the situation in the moment or deflecting it. And then you are in the same place the next day.

Family stress and pandemic

She said families and children have been hit particularly hard by the public health crisis, which has increased financial and family stress and brought underlying issues to the fore. Before the pandemic, 40% of CORE cases were new and the rest were follow-ups. Today, almost 70% of cases are new.

“Right now, one in five children meets the diagnostic criteria for anxiety, so people are more nervous than they’ve ever been,” McDonald said. During the lockdown at the onset of the pandemic, “CORE was one of the only service offerings that still showed up in person, or still available, when mental health centers closed and people couldn’t do anything. “

With the rise of co-response programs – the International Co-Responder Alliance has been formed and will hold its third annual conference next year – it is imperative to assess whether they are truly effective and whether they need to be scaled to the community, state or national level, according to McDonald’s.

Growing mental health crisis

She hopes that rigorous evaluations, such as the CORE analysis, will determine what each community specifically needs in terms of co-response and how such programs can be applied at broader levels. Because new ideas and in-depth data are essential to tackle the growing mental health crisis in the country, McDonald’s hopes to attract donors to sponsor more research or be able to apply for a larger federal research grant.

“Prisons have become our de facto mental health hospitals,” she said. “Behavioral health will not be attenuated simply by CORE. The point is, we have programming, and we need to know if it works. We know what makes us feel good… but we don’t know without empirical evidence that the program is actually successful.

Meanwhile, she hears about the myriad of daily challenges cops face from her CORE colleagues and her husband – a Longmont police officer.

“My hope is that the patrol divisions get smaller and those kind of co-response divisions get bigger, but there is politics involved, and I have to see small steps in it,” McDonald said. “There is a time and a place for traditional policing and a time and a place where there is none. But it requires a significant culture change.

Photo above: Omar-Fara Norgaisse is a paramedic with the CORE team in Longmont.


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