The following column is the opinion and analysis of the writer.

I was the clinical director of the Southern Arizona Mental Health Corp. from 1999 through 2011. Until 2014, SAMHC was responsible for providing mobile crisis teams to the community. A family member, law enforcement officer, school, or other entity could call SAMHC if there was a behavioral-health crisis. SAMHC would dispatch a team of two master’s-prepared clinicians to the scene to address the crisis.

The crisis team often worked in tandem with law enforcement. Sometimes the disposition of the crisis was a voluntary or involuntary hospitalization. More often it was a de-escalation of the crisis.

Imagine my amazement to learn today of an individual who called for a crisis team (at the same phone number that is used to reach SAMHC) and was told that a team would not respond because the family member experiencing the crisis would not get on the phone and ask for help. This person was additionally told that the crisis appeared to be exclusively drug-related so there was nothing a crisis team could do.

Since when did behavioral health exclude substance use? Since when could someone on the phone with unknown clinical training determine, sight unseen and with minimal screening questions, that a behavioral-health crisis was exclusively drug-related? We know that a huge number of individuals who have significant mental-health problems also abuse drugs and alcohol.

Because individuals are under the influence of drugs or alcohol does not mean that they do not need or could not benefit from an on-site response by behavioral health professionals. And one thing that I know for sure is that often, people experiencing a behavioral-health crisis, whether or not substances are involved, claim that they do not want help. Sometimes they change their mind when the crisis team arrives.

Sometimes it is clear that the individual is a danger to themself or others and the crisis team (usually working with law enforcement) can facilitate an involuntary hospitalization. And often the crisis clinician can successfully de-escalate a situation so that an involuntary hospitalization can be avoided. These are not options when the agency responsible for dispatching the crisis team refuses to do so.

There’s a lot of talk currently about reallocating some funding currently going to law enforcement to behavioral-health agencies so that behavioral-health professionals can accompany law enforcement or respond independently to situations for which currently people call police. I thought that Tucson was in a good place in this regard. Apparently not.

Law enforcement cannot say that there will be no response. When SAMHC dispatched mobile crisis teams they did not refuse to respond. I invite the agencies currently responsible for local mobile crisis teams to reconsider these policies.


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Laura J. Waterman, Ph.D., LPC, was clinical director for 12 years at SAMHC. She also performed crisis assessments for nine years in Carondelet Emergency Departments. She is currently a behavioral-health consultant working predominantly with private practice clinicians, agencies and attorneys.