PINELLAS COUNTY — Cheryl Gimenez drives a standard-issue Chevy Tahoe: Lights on top, computer mounted in the cab, plexiglass barrier between front and back seats, “Sheriff Pinellas County” emblazoned on the side. A pair of rubber ducks — one styled as a cop, the other as a firefighter — sits on the dashboard.
The quirk is who’s in the passenger seat. Gimenez’s partner, Brittany DeFiore, is a social worker who joined the agency’s mental health unit after Sheriff Bob Gualtieri decided to expand it last year. Gimenez, who became a deputy after five years as a 911 dispatcher, wears a uniform, a firearm and a body camera. DeFiore, who said she often worked with people with psychosis in her last job, wears plainclothes and a lanyard around her neck.
Most days, they crisscross a chunk of north Pinellas County, carved out for the expanded unit’s pilot period, as they respond to 911 calls related to mental health or substance use, or knock on doors to follow up on cases deputies marked as mental health-related.
A call on this Tuesday was familiar to both of them.
An 11-year-old girl had told her therapist she felt suicidal, and the therapist phoned for help.
Clearwater police were already responding, but Gimenez and DeFiore wanted to cut in. They had helped the same girl through a crisis last week — she hadn’t had to be hospitalized. Gimenez had the therapist’s phone number. They also had a wider set of tools than the patrol officers, and if they did need to take the girl to the hospital, as she was requesting, she would at least know the people with her.
Gimenez called her boss, who was also in the area, to explain the situation and why they would intervene.
“She’s one of ours,” Gimenez said.
The mental health unit has existed in various forms for nearly five years, but the expanded and overhauled version that launched earlier this year coincides with changes in cities and counties across the country. In many places, communities are reckoning with the often ineffective and sometimes deadly results of using law enforcement officers as first responders to mental health crises.
In St. Petersburg, another team established earlier this year comes at similar issues from a different approach: There, unarmed, civilian social workers have begun responding to some calls without police.
The two teams share a core philosophy. Social workers and mental health professionals, equipped with years of education and experience, know how to help people in crisis; law enforcement officers may get 40 hours of training on the subject, but their options in practice often boil down to extremes: arrest, hospitalization or nothing at all.
The St. Petersburg team gets city funding through the Police Department and initially worked alongside officers. Gualtieri, though, doesn’t envision a version of his team in which the social workers — who are Sheriff’s Office employees — respond alone.
“We’re in the mental health business,” Gualtieri said. “Should we be? I don’t know. … But we need to be, and we’re going to be, until somebody else comes in and picks it up.”
The dichotomy puts Pinellas County in an intriguing position: In areas just a few miles apart, residents will be able to see what happens when the role of police in mental health crises is reformed, and what happens when they’re taken out of the equation altogether.
“There’s only so much (law enforcement) can offer,” said Travis Atchison, who runs the St. Petersburg effort. “I tell my team, you’re agents of change.”
The last year marked a turning point in the knotted story of policing and mental health. But in the late 1980s, developments in American cities more than 2,000 miles apart charted separate courses that would ultimately lead to this moment.
In 1987, police fatally shot 27-year-old Joseph Dewayne Robinson outside his mother’s house in Memphis, Tenn. Robinson had a history of mental illness and drug addiction, and his mother told 911 dispatchers that her son had been cutting himself and threatening others. Robinson’s death was no outlier: In the years preceding it, newspapers later reported, Memphis police had killed an average of seven people with mental illnesses every year.
In the aftermath of the killing, police, academics and community organizers collaborated on a crisis intervention team, a group of officers who aimed to reduce the department’s use of force and the rate at which it was jailing people with mental illnesses.
Around the same time, in 1989, the White Bird Clinic in Eugene, Ore., launched a program called Crisis Assistance Helping Out on the Streets. According to the clinic’s website, the program was envisioned as a “community policing initiative,” and it also uses the term “crisis intervention” to describe itself. But it shirked police involvement, instead sending medics and mental health professionals to 911 calls about suicide threats, substance abuse and interpersonal conflicts.
Over the next 30 years, law enforcement agencies across the U.S. adopted the Memphis model. A 2019 research review found that the training improves officers’ satisfaction, reduces stigma around mental illness and may help in diverting people to psychiatric facilities rather than jails.
The evidence doesn’t show that officers with crisis intervention training use force any less often than those without it, though.
The Treatment Advocacy Center, a nonprofit that focuses on mental illnesses such as bipolar disorder and schizophrenia, has estimated that people with untreated serious mental illnesses are 16 times more likely to be killed by law enforcement compared to the general population, and that they’re 10 times more likely to wind up in jail or prison than a hospital. Last year, it gave Florida’s involuntary mental health treatment law, the Baker Act, a “D” grade, one of the worst in the nation.
“Fifty years of failed mental health policy in this country has made law enforcement our de-facto mental health crisis response,” said Jeffrey Melada, the center’s communications director. “We’ve foisted this problem on them because we’ve refused to address it as a society.”
Despite the proliferation of crisis intervention training and an increased awareness of how mental health and policing are tied together, Gualtieri said, significant training on the subject still isn’t baked into the profession.
“What ends up happening,” he said in a recent interview, “is that cops solve the problem by removing the problem from the situation.
“People either get arrested or they get Baker Acted. You shouldn’t be criminalizing mental health issues. But again, at 3 o’clock in the morning, when you don’t have anything else, what do you do?”
While law enforcement struggled to adjust to the challenges of mental illness, the crisis program in Oregon thrived outside the national spotlight. In 2017, according to the White Bird Clinic, the program saved the city of Eugene an estimated $12 million and responded to nearly one of every five 911 calls. Though critics have often raised safety concerns around similar programs, police were called as backup in just 150 of the 24,000 calls the program answered in 2019.