Mental Health Co-responders are Becoming a Part of Michigan Policing

Mental health co-responders are now a bigger part of Michigan police departments. It’s making a difference in some communities, but there is still work to be done.
Illustration by James Heimer

When Hillary Nusbaum is asked why she wanted to be a co-responder clinician working alongside police officers, she says one of the words that resonated most with her was “reconciliation.”

Her stepdad, someone she admired, was a former public safety director in Coldwater, in southwest Michigan, overseeing both the city’s police and firefighters and inspiring trust between them. The theme of reconciliation followed Nusbaum to Israel, where, for five summers between 2011 and 2016, she worked at a camp bringing Palestinian and Israeli children together to relate and acknowledge and reconcile their differences.

As a trained social worker and certified first responder counselor, Nusbaum wanted to work with police or military officers experiencing trauma. So, when a job opened up to work with police as a co-response clinician in Oakland County — working alongside police on 911 calls related to mental health crises — she took it.

Nusbaum started working in August 2021, when the Co-Response Community Outreach program began under the management of the Oakland County Community Health Network, or OCHN.

Mental health co-responders have been around for some time now, but within a relatively short period, they’ve become one of the state’s biggest policy responses to cries against police violence and abuse.

The Co-Response Community Outreach initiative in Oakland County started among the Auburn Hills, Birmingham, and Bloomfield Hills police departments. But according to Trisha Zizumbo, director of OCHN’s training and justice initiatives, the co-response program quickly expanded.

In October 2022, the Rochester Police Department opted into the program. There’s now a co-responder with the Oakland County Sheriff’s Office and one with the Troy Police Department, “and we are continuing to have conversations with local law enforcement to expand this initiative,” Zizumbo says.

What “co-responder” means can vary from department to department. For OCHN, it’s a position that requires a clinical license, and co-responders undergo six weeks of training
prior to assisting on police calls.

“But there are models where a peer support specialist may also respond, and that is not a clinical position,” Zizumbo says, noting that “in Michigan, there is a certification to be a peer support specialist and/or recovery coach.”

According to Siiri Sikora, OCHN’s justice initiatives manager, all cities working with a co-responder want to fund the program independently after federal grant funding expires next year.

According to data released to Hour Detroit, between October 2021 and September 2022 in Auburn Hills, Birmingham, and Bloomfield Hills, co-responders received 640 referrals. In just over 200 of those times, co-responders were able to leave the client stable, in the care of a family member. In many of the other calls, the client was voluntarily transported to an emergency room (174) or received community-based resources (167). There have been only eight arrests while a co-responder was on scene.

One of the primary goals of co-responders is to divert people from the criminal justice system. Zizumbo says police appear to have accepted their new partners.

“Every time I talk to a chief or a lieutenant or even an officer, they see the benefit of having a co-responder with them or being able to follow up,” she says.

Auburn Hills Police Chief Ryan Gagnon agrees. Police officers in his department call the co- responder to help during calls related to depression, suicide, family troubles, or mental health episodes. He says co-responders have already helped reduce police calls to the same address and resident hospitalizations.

It’s on these calls where Nusbaum often finds herself. She began the job riding along with police officers, building relationships and learning how they respond. During at least 120 hours of ride-alongs, she’s learned where she needs to stand when called to a scene, how to interact with particular officers, and when it’s appropriate to take action. She says it hasn’t always been easy.

Nusbaum says several officers told her they originally didn’t want her on the beat but later changed their minds after seeing the range of services she provides. Since she began, she’s assisted people in the field but also listened to police struggling with trauma.

She’s not allowed to counsel officers due to the conflict of interest but has done trainings for them on suicide, PTSD, and other mental health-related topics and even provided officers with mental health resources. Nusbaum says she focuses on her relationships with officers to improve her work and to help police navigate their own issues.

“I see how they work every day, and I see what they do,” she says. “I think it’s a very challenging job, and I think they’re faced with an excessive amount of traumatic situations weekly, if not daily, and I give them a lot of credit.”

It’s been three years since a police officer murdered George Floyd. That’s three years since some of the largest subsequent street protests in American history — three years since institutional anti-Black racism, especially pertaining to police departments, became a larger part of public conversation.

In the summer of 2020, with the COVID-19 pandemic killing hundreds of thousands at home and millions around the world, many were confined to their homes and their screens, doom-scrolling through tragedy after tragedy taking place at the hands of police.

Disproportionate police violence against Black and Indigenous communities — and the broader issue of police violence against Americans writ large — is not new. But much of the American public is now paying an unusual amount of attention to the problem of police violence. And since 2020, there have been changes to both police budgets and police work: With the state’s $1 billion investment to fund public safety, Michigan police have more money than in the recent past, especially as politicians attempt to mitigate a slight increase in certain violent crimes (despite a decades-long decline in violent crime). Mental health co-responders are on the scene. And crisis intervention team programming (de-escalation training) has been implemented in some police departments (this has been occurring since long before the summer of 2020).

Co-response work, like that in Oakland County, is widely available across the state. The co-responder is often tasked with helping individuals experiencing mental health crises and domestic disputes and alleviating problems related to wellness checks, suicide attempts, homelessness, family challenges, and more.

Notably, this change is not specific to liberal hubs like Oakland and Washtenaw counties. Co-responders have taken root in places as distant as Ottawa and Ingham and in cities as culturally distinct as Newaygo and Detroit.

But what do these changes mean for Michiganders’ interpretation of safety? What does it say about how we address harm? And do co-responders prevent police violence and create a safer, healthier public?

The World of Police Work

According to the Harvard Law Review, in America, police are often trained to be warriors. This mythos, fostered by politicians, media, and police recruitment videos, supports the idea that police need to enter the streets like they would a battlefield, ready to apprehend “bad guys” and stop violence in its tracks. But addressing violent crime is a small portion of what officers actually do.

A New York Times review of publicly available data demonstrates that police officers address real-time violence only about 4 percent of the time in a given year. Much of the work, instead, includes less-stressful and less-violent tasks, like traffic stops and intervening in neighborly disputes.

This is true in both large cities and small towns.

In Auburn Hills, about 10 percent of calls to police are related to substance use and mental health crises, according to Gagnon. Most policing, in fact, has nothing to do with intervening on knife or gun attacks, Gagnon says, meaning police infrequently need to use force on the job.

Of the 21,892 calls to the Auburn Hills Police Department in 2021, there were 1,714 arrests. During that year, police force was used on 70 occasions — or less than 1 percent of the time.

“The overall majority of calls are not involving violence or threat of violence,” Gagnon says.

The majority of police work, then, is unrelated to the work they are trained for — instead, it includes things like helping those experiencing homelessness, mental health issues, and drug addiction. The same issues, in other words, that social workers are often trained to handle.

That might also help explain why Auburn Hills and several other cities across the state have added clinical co-responders to the beat. It’s also likely why at least 15 jurisdictions across the country implemented co- responder programs between 2020 and 2022. Before that time, 28 jurisdictions already had a co-responder.

But co-responders haven’t always been effective in both aiding the public and preventing police violence.

Last August, an Oakland County sheriff’s deputy was taped repeatedly punching a restrained Black woman (Diressee Wilson) suffering from mental illness in Pontiac (a spokesperson from the department said Wilson was biting an officer and that the co-responder on the scene “told our investigators there was nothing more the deputies could have done to de-escalate the situation before the woman began biting”). And in October, Porter Burks was shot and killed by Detroit police while he was experiencing a mental health episode.

In each of these incidents, co-responders were on the scene. (In response to the August event, OCHN said they were “disappointed” with the outcome in Pontiac.)

The World of Police Alternatives

Public conversations about police violence and police alternatives haven’t only produced co-responders.

There are broadly three models of mental health responses, says Leonard Swanson, a crisis response and stabilization manager at Wayne State University: mobile crisis units including mental health professionals that enter the field independently of police; office-based services where mental health experts receive patients coming to their (often) county door; and co-response models, where mental health professionals team with police officers — a model that is quickly growing in Michigan.

That model is concerning to many police abolitionists. Many of them say the addition of co- responders is misguided because it doesn’t uproot or appropriately address harm. Angel McKissic, a senior program manager with the Just Cities Lab at the Detroit Justice Center and co-founder of the Metro Detroit Restorative Justice Network, says that for people to be liberated, police departments should not be expanded but rather abolished.

“What we need to do is to completely — even if we’re starting from mental health — divert from the institution of policing and create our own mechanisms of intervention and ongoing support,” she says.

McKissic, also a trained therapist, says harm cannot be disentangled from material conditions like access to housing or capital or immaterial ones like misogyny and racism. Rather than co-responders, she calls for funding projects that financially empower communities to decide what safety is for themselves. In other words, the definition of safety needs to rest, democratically, in the hands of neighborhoods.

But while community-led harm reduction groups are not generally well funded by government dollars, some non-police mental health field intervention programs are.
Swanson says Eugene, Oregon’s Crisis Assistance Helping Out on the Streets (or CAHOOTS) program is, nationally, the most effective field approach to alleviating mental health crises. That response team doesn’t include police.

That program and Denver’s Support Team Assisted Response (or STAR) program, which
also doesn’t include dispatched officers, have seen early success. CAHOOTS saved $22.5 million in public safety and emergency room costs, and STAR expanded by $1.4 million in 2021, in part because health-focused first responders were able to reduce various crimes by 34 percent, according to an independent study.

Alexandria J. Hughes, who worked as a behavioral health therapist and is now a mental health and criminal justice organizer with the group Michigan Liberation, which aims to end mass incarceration, says positive reports for STAR and CAHOOTS should be enough for Michigan lawmakers to adopt them and turn away from law enforcement.

“We’ve always had policing. We’ve always had incarceration. We’ve never taken a chance on a non- police mental health response.”

A Shifting Dynamic

In Michigan, Washtenaw County is doing some of the most innovative work regarding who responds to what public calls for help. A 2019 county mental health millage provided funding for health clinicians to respond to calls independently of police officers as a mobile support unit.

Currently overseen by the Washtenaw County Community Mental Health Department, about 25 of its clinicians can be called 24/7 by police officers or dispatchers to scenes deemed safe enough. In total, Washtenaw mobile health clinicians have called for police backup 12 percent of the time. None have been physically injured on the job, says Executive Director Trish Cortes.

The addition of the CAHOOTS-like and co-response approaches has left Washtenaw with five general responses, which Washtenaw County Sheriff Jerry Clayton considers as existing on a continuum. There are police-only responses, non-police mental health mobile support unit responses, coordinated responses where the police or clinician call each other into the field for support, co-responses in which a clinician and an officer enter the field together, and an unarmed community-based response, which is currently being developed.

The continuum of responses is forcing police and broader community residents to shift how they consider policing, safety, and harm reduction. Police dispatchers themselves, Clayton says, need to ask more specific questions to better understand behavioral health issues and best direct their various resources to a scene. The complexity means that these days, a call is often registered to Washtenaw’s dispatch as one thing but is cleared by the deputy sheriff as another.

“I think what we’re really thinking about is a shifting dynamic across the entire spectrum,” Clayton says. “We’re not only talking about changing culture in the first responder world. We should be thinking about changing the culture from the societal standpoint on who should respond when and also give ourselves some space and time as we start to work this out.”

Back in Oakland County, co-responder clinician Nusbaum continues diving into issues facing police and the broader public and working to reconcile officers and the people who may call for officers to help them. At 21 months in, she’s still doing police ride-alongs when time allows. It’s in these spaces that she’s better able to understand and appreciate police and expand her knowledge of the various needs of the communities she’s serving.

“I do think the addition of mental health working with police, together, is a really great benefit for both of us,” she says.

This story is part of the May 2023 issue of Hour Detroit. Read more in our Digital Edition.