Nashville, TN police-mental health teams de-escalating crises

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NASHVILLE, Tenn. (WKRN) — Almost a year ago people watched as body camera footage showed the moment nine law enforcement officers shot and killed a 37-year-old man on Interstate 65 in Nashville.

The incident began after a Tennessee Highway Patrol trooper saw Landon Eastep sitting on the side of I-65 near Hogan Road and stopped to offer him a ride off the interstate. After a brief interaction, Eastep pulled out a box cutter and the trooper called for assistance.

(Source: WKRN News 2 User video)

Bodycam footage released from deadly I-65 shooting

For 30 minutes, Metro police said officers tried to negotiate with Eastep as he held the box cutter in his left hand and kept his right hand in his pocket.

Officers opened fire when Eastep pulled a “shiny silver cylindrical object” out of his pocket and pointed it toward them. Police later confirmed it was not a gun.

The incident, which garnered national attention, raised many questions about how police respond to mental health-related incidents in a year following several national protests over officer-involved shootings.

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According to multiple protective orders filed against Eastep between September and November of 2021, he had problems with alcoholism, suffered from hallucinations and had been accused of violent domestic abuse.

After Eastep died, his wife said she wished a mental health professional was there to help her late husband through what she described as his battle with mental health issues.

“There were so many options that could have been taken that weren’t, and to me that’s unacceptable,” she said in February 2022.

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While the Metro Nashville Police Department (MNPD) did have mental health clinicians co-responding to calls in some precincts at the time, the program called “Partners in Care” was not yet present in the Midtown Hills precinct where the I-65 shooting occurred.

(Chelsea Beimfohr, WKRN)

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The program, which is a collaboration between the MNPD, Mental Health Cooperative (MHC), and other metro government agencies, has since expanded, with data showing more positive outcomes in mental health emergencies since its launch in June 2021.

By May 2023, Amanda Bracht, Senior Vice President of Public Relations and Community Development and Judicial Services for the MHC said there will be mental health co-responders staffed in the Midtown Hills precinct.

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There are currently 10 mental health clinicians covering four out of eight Metro police precincts, including Hermitage, North, South and Central. Due to its success, the Mental Health Cooperative plans to have the Partners in Care program active in every precinct by 2025.

“We’ve had really good luck in hiring really solid clinicians. Low turnover in those positions,” Bracht said. “I definitely think we’re on target to move forward and have solid clinicians and officers for this program.”

While Bracht said it is impossible to know if a mental health co-responder could have helped Eastep on that particular day, she said the program has helped many people in similar situations.

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“Every situation is unique, and of course the I-65 situation is incredibly tragic with the outcome,” Bracht said. “But we have had similar situations where individuals have been threatening themselves and potentially threatening others and had a weapon, or a weapon close by, and we’ve been able to de-escalate and get those people connected to care.”

Over 2,400 calls answered by officers, clinicians

To date, officers and clinicians have responded to over 2,400 calls for service that met the criteria for crisis response.

Of those, Bracht said only about 4% have ended in an arrest.

The majority are instead being diverted to the mental health care system. Many interactions result in either transport to the ER or referral to resources like the MHC’s crisis treatment center.

“One of the first things we saw that actually surprised us was the volume of cases that were identified, and they were high acuity cases,” Bracht said. “The reason why we say they’re high acuity cases is many of them resulted in that person needing in-patient hospitalization at a much higher percentage than what we had anticipated.”

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In Tennessee, as in most states, Bracht said in-patient hospitalization for psychiatric reasons is typically required when a person has a serious mental illness or serious emotional disturbance and they’re posing an imminent threat to themselves or others.

First responders often determine whether a crisis intervention team (CIT) is needed before they even get to the scene. Bracht said information regarding a history of mental illness, medication and other factors is gathered by 911 dispatchers.

Amanda Bracht, Senior Vice President of Public Relations and Community Development and Judicial Services for the Mental Health Cooperative (WKRN photo)

Officers can also request a co-response team if it becomes apparent that a person has underlying mental health issues during the course of an investigation or interaction.

“It got dispatched as a disorderly person or a trespassing case, but then the officer who gets there based on his or her training goes, ‘Wait a minute there’s underlying mental health issues,’ they can request a co-response team to come and assist,” Bracht said.

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When the program was first launched, only 16 officers had received CIT training. Now, over 200 Metro officers have received training as of Jan. 2023. Eventually, Bracht said the goal is to have all officers trained on crisis intervention.

The most common cases requiring a CIT response are situations in which a person is having suicidal thoughts or where someone is agitated and experiencing what is referred to as “psychotic symptoms,” Bracht said.

“We’ve had situations where individuals have already inflicted stab wounds to themselves when the officers and co-response get there,” she said. “And they’ve been able to de-escalate, get them to drop the knife, stop harming themselves and get them in immediate medical care.”

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Officers take the lead when a weapon is involved. However, once the situation is deemed safe, Bracht said the mental health clinician will get out of the car and start interacting with the person. Meanwhile, the officer will gather additional information from others on scene.

“It’s good to have that collaboration among the two where you can have the clinician hopefully developing that rapport with that individual and trying to de-escalate that situation, and the officer there for safety but also to help gather additional information,” Bracht said.

‘We’re reaching people that if it wasn’t for this program may have fallen through the cracks’

Bracht said she was surprised to learn a large percentage of people in these situations were not previously known to the mental health system. Initially it was thought it would be the other way around, with many callers having a previous mental health history.

However, Bracht said there is a positive outlook based on that data. The program now enables officers and clinicians to work together to connect people with mental health resources they otherwise may not have known existed.

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“So, we’re reaching people that if it wasn’t for this program may have fallen through the cracks, may have not gotten treatment, may have ended up in an unfortunate arrest or any other sort of negative outcome,” Bracht said. “There’s clearly a need out there for this type of program.”

Each week, Bracht said officers and clinicians are responding to a number of “high acuity” cases where if the mental health clinician had not been there or the officer did not have training, “we would have had more negative outcomes.”

“A lot of people will say, ‘Officers shouldn’t be the first responders in mental health emergencies.’ In a perfect, world I would totally agree. It would be mental health clinicians,” Bracht said. “But unfortunately, due to a lot of different factors officers have by default often been the first responder.”

That’s why Bracht said she believes programs like Partners in Care are not only necessary but have proved “effective” in reducing outcomes like that of the I-65 shooting. Officials plan to continue to look at data on the program to see what areas can be improved.

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The Nashville Fire Department and EMS also plan to adopt a co-response program in which clinicians are paired up with paramedics as soon as next month. Bracht said that is a “direct result” of the success of the Partners in Care program.

“I can’t say that a clinician would have been pushed into that scenario just given all the factors that were going on that particular day,” Bracht said of the I-65 shooting. “But, do I firmly believe and know we have cases that we have been able to help and de-escalate that are incredibly acute? Yes, we do have those.”

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