Police And Mental Health Professionals Collaborate On Telehealth Response Pilot Program

The fraught scenario: a mother and her daughter are having a phone conversation, and the daughter, who lives in Hampton Bays, tells her mom in California that she just can’t go on.

Distraught, the mom calls Southampton Town Police to go check on her. The daughter tells the officer that, yes, she was feeling suicidal but is okay now.

“That would leave the officer in a difficult situation,” Southampton Town Police Chief Steven Skrynecki explained after describing the fictitious scene. Should the officer take the woman’s word? Or take her, perhaps forcibly, to the nearest psychiatric emergency room — all the way in Stony Brook?

Town Police confront some 100 calls for such crisis intervention every year. But, the chief explained, officers have limited training when it comes to psychiatric assessments. Transporting the person to Stony Brook University Hospital Comprehensive Psychiatric Emergency Program, or CPEP, is often the safest choice for an officer untrained in mental illness diagnosis.

The 40-mile, nearly hour-long trip one way, is, the chief said, “not the best situation for anybody. It’s not the best situation for the patient, it’s not the best situation for the officer, and it’s not the best situation for me as a police chief, in terms of liability.” And, he said, only a fraction of those taken to CPEP are actually admitted for treatment.

Enter Dr. Jeffrey Steigman, chief administrative and innovation officer for the Family Service League. Connected to the chief by Assemblyman Fred W. Thiele Jr., who knew him through the successful South Fork Mental Health Initiative, Steigman approached the chief several months ago looking to expand services.

The doctor explained that Thiele asked to convene a group of police departments on the East End to look at innovative ways to meet the need for mental health services. “When we did that, the chief jumped in and was eagerly willing to participate,” the doctor related.

The chief and doctor brainstormed and wondered if telehealth — a remote tool that soared in popularity due to the pandemic — might be of use through Family Service League’s Diagnostic, Assessment, and Stabilization Hub. DASH is a 24-hour crisis stabilization center located in Hauppauge for people experiencing mental health or substance abuse-related crises.

Given geographic barriers, FSL used telehealth interaction even before the pandemic, but it definitely scaled with COVID, Steigman said.

The pair wondered if they could use smartphone technology to connect a person in crisis with DASH on the scene, allowing a clinician to conduct a more in-depth evaluation than a responding police officer ever could. The mental health professional could do on-the-spot triage, then link the patient to treatment and support services.

With access to services and critical time intervention key components of behavioral health care, the question became, Steigman said, “How can you intervene in a way that makes better sense?” How can you harness technology and intervene upstream, he wondered. “This was a unique opportunity to move the needle in a way that would result in better outcomes for all.”

The pair considered a re-engineering of the system. And a pilot program was born.

It began on October 1, 2021, and of 34 calls where a DASH professional was used, 28 were deferred from transport to Stony Brook, with six sent to CPEP. The numbers are revealing “a lot of success,” Chief Skrynecki said.

Eighty-two percent of the calls resulted in avoiding unnecessary hospitalization, Steigman underscored.

“What this is all about is removing barriers and providing access to care where it’s needed,” he said. The same triage and assessment that would happen in Stony Brook can take place right on the scene. Using telehealth re-allocates resources to where they’re truly needed, the doctor said.

Also, there is opportunity for what the doctor called “the right disposition” of a case, such as providing aftercare, links to mental health providers, or bringing the person to DASH. “We don’t want it to be a one and done,” he explained. FLS’s goal is long-term positive outcomes.

A process that could allow the clinician to stay on the line with a patient and let the officer leave to resume other duties was also tested and incorporated. Officers have smart phones, but the clinicians also use the individual’s phone if they have one. An email from the mental health professional to police headquarters would report they are taking over, and allow the officer to be relieved from the site.

The chief acknowledged there are times when the last thing a person in distress wants is police walking through their door. Their very presence can escalate a crisis. He noted the telehealth program allows officers to say, “We can let you talk to a mental health professional right now.”

During the police reform exercises required by then-Governor Andrew Cuomo last year, “a very loud voice representing the broader community” spoke of all the things police do that might be better served by other professionals, the chief said. “I heard that loud and clear,” he asserted, calling the mental health pilot one of the most exciting initiatives he’s been involved with in over 40 years of policing.

“This is very much in keeping with what the community was looking for,” he posited.

It’s what his officers want, too, the chief said. When they have to make decisions and determinations about a person’s mental state during a crisis, “They go home and put their head on the pillow and hope they made the right call.” Police are given “minimal training” when it comes to making mental health evaluations, he underscored. Now, he or she has a professional on scene making that decision — whether to send the person to the hospital or not — for them.

Steigman concurred. “Oftentimes, the front line response shouldn’t be law enforcement, it should be a behavioral health professional,” he said.

The program is, Skrynecki said, “a win-win-win.” It ensures the person in crisis immediate, professional evaluation, allows police officers to stay on the roads in the community, and prevents an unnecessary burden on hospitals. “I love this collaboration,” the chief said. Steigman also praised the pilot as an exemplar in cooperative effort, “using resources effectively and efficiently and right sizing the system. … We’re providing the right service at the right time.”

There’s also a savings derived from not pulling officers off the road for a period of time. The telehealth evaluation takes about a half-hour, compared to the nearly two hours round trip drive to Stony Brook alone for a police officer. The savings is one reason why programs like this are gaining momentum across the country, the doctor said. “It is effective management of resources to the benefit of the client,” the chief agreed.

Southampton Town Police were the first on the East End to pilot the program. Steigman reported that the Southold and Shelter Island police departments are launching similar programs, having seen the results in Southampton. “The chief paved the way and created a lot of excitement,” Steigman said.

The chief predicted further adjustments may be made as time goes on.

“The pilot has been a terrific success,” Thiele said. “There’s a better outcome for those in crisis and a real savings in police resources.”

Speaking of health care in general on the East End, the lawmaker noted the region is historically underserved. When it comes to building on mental health services, he reported that he and his counterpart Senator Anthony Palumbo are looking for capital funding that would bring a DASH center to Riverhead.