A Massive Step Forward for Mental Health Access

My community just announced an initiative allocating nearly $1M in Federal Covid Rescue Funding to set up a "Living Room" to provide immediate care to people experiencing mental health crises.

In 2014, I was home with my three kids when a woman experiencing mental instability walked into my kitchen and refused to leave. Terrified and wanting to protect my children and their friends, I did the only thing I knew to do at the time: I dialed 911.

Using audio from that 911 recording, I created this short audio summary to illustrate what happened next.

Looking back, I wish I’d had another resource to contact besides the police that day. I didn’t know who else to call.

Fortunately, as you can see, the Evanston Police Department officers who’d been dispatched to the scene were well-trained and prepared to manage a scenario like this. They diffused the situation. They recognized this woman as someone in our community who often wandered into homes. And they avoided further agitation and provocation by keeping an eye on her as she made her way back to her home. Granted, their “shepherding” took them away from their other responsibilities, but it’s reasonable to say that their training prevented further harm.

However, this scenario is not the norm, as not all police personnel are trained to manage mental health crises. As we all know, concerned (and even well-meaning) citizens regularly contact 911, but the responses can often turn non-crisis situations into tragedies

One only has to remember 23-year-old Elijah McClain. In August 2019, he’d been wearing a ski mask while walking home from a convenience store when someone reported a suspicious person to 911. Three officers attempted to arrest the unarmed McClain, and after tackling him to the ground and using a chokehold, Aurora Colorado Fire Department personnel injected him with ketamine. McClain suffered a heart attack. Days later, he was removed from life support.

To be sure, one might argue that the two scenarios above are apples and oranges — that only the woman in my kitchen was, indeed, experiencing a mental disturbance, and that McClain had simply been minding his own business.

Yes.

And.

Evanston Police *could have* been more aggressive with the panicked woman at my house, thereby escalating the situation (as with McClain) to the point of tragedy. Fortunately, the Evanston police officers were well-trained, and everyone walked away safely from the scene. Fortunately, the police demonstrated awareness and sensitivity toward someone in a mental health crisis.

Aurora Police *could have* de-escalated the McClain scene by better recognizing the signs of neurodiversity, anxiety, and panic. Everyone at the scene *could have* benefitted by immediate access to and involvement of community mental health professionals. Elija McClain *could have* lived if Aurora police explained they would immediately contact neutral, trained professionals to help understand and diffuse the uncertainty of this chaotic situation. That didn’t happen, and McClain is dead.

For too long, there’s been too much discussion and too little action around “the need for mental health resources,” but today’s announcement by Evanston, Illinois’ Mayor Daniel Biss demonstrates critical, forward momentum in prioritizing mental health in one of many communities around the country.

Here’s Mayor Biss’s announcement, shared via email on 4/14/22 to the Evanston, Illinois community:

A Big Step in Mental Health Access

Something exciting happened at the March 28 City Council meeting.

In a unanimous vote, Council approved the allocation of $900,000 of federal COVID rescue funding to set up a "Living Room" to provide immediate care to people experiencing mental health crises. Here's what that means and why it matters.

Our community, like many others, is experiencing a mental health crisis. It's been going on for a long time, and the pandemic both demonstrated this crisis and severely worsened it, as countless people were separated from support networks and resources and put in truly devastating situations.

As we seek to address this, it is clear that Evanston, like almost the whole country, has major gaps in mental health services.

One acute gap is in appropriate places to bring individuals experiencing psychiatric crises. Because of this lack of services, two of the most common responses to these crises are dialing 911 or doing nothing at all. Certainly doing nothing guarantees that the individual in crisis gets no care. But calling 911 may not ultimately provide them with the care they need either. Often it results in police arriving—putting our officers in a completely impossible position of being asked to solve a massively difficult problem without the necessary tools and resources. Eventually the individual might be taken to an emergency room, which also isn’t properly equipped to solve most mental health crises, leading to a deeply painful experience for the person in crisis and a discharge back into the community with the problems exacerbated rather than solved.

This is a terrible cycle that benefits nobody, doing a disservice both to the individuals who need and are not receiving care, their families, loved ones, and friends, and the broader community. Whether you look at this from the point of view of justice, health care, public safety, or even cost-effectiveness, it's a bad situation all around.

That's where the Living Room comes in. It's a free alternative to hospital emergency rooms whose staff include therapists, peer supporters, and more—helping people in crisis rest, relax, regulate, and ultimately access the suite of services they actually need. Whether individuals and their families hear about the Living Room and show up without prompting, or whether a guest arrives as a result of a deflected 911 call, this crisis response is designed to address root causes and establish a path to recovery.

There isn't yet a Living Room in Evanston, but there exist a number across the state, including one that's been operated in Skokie for a decade by a provider called Turning Point. Their record is frankly astonishing—they have hundreds of visits per year, and more than 98% of visitors are consistently diverted from requiring emergency room services. In addition to much-needed health care, the Living Room connects visitors to resources including shelter, transportation, food, employment, housing, legal assistance, and more, based on an understanding that these needs can be inextricable from mental health challenges.

The Evanston plan that's moving forward is to open a Living Room near Saint Francis Hospital. Turning Point will be the primary operator, but we'll be building a version of this program that's designed specifically for Evanston, in partnership with numerous other providers and local institutions, including PEER Services, Impact Behavioral Health, and more.

This project will take continued work to come to fruition, and it will not end or completely resolve our mental health crisis. But it's one critical step in closing the gap and making our community the just, compassionate, safe, and welcoming place we aspire to be. I’m truly grateful to all the community partners, City staff, and Council members who are doing the work to make this happen.

Daniel Biss
Mayor, City of Evanston
dbiss@cityofevanston.org

I’m thrilled to see this proactive step, and eager to hear more about its implementation.

And while this may feel like a small and uncertain effort, it’s also a brave and critical step in the right direction.