COUNCIL OF THE CITY OF PHILADELPHIA JOINT COMMITTEES ON PUBLIC SAFETY AND PUBLIC HEALTH AND HUMAN SERVICES Room 400, City Hall Philadelphia, Pennsylvania Monday, March 17, 2025 10:17 a.m. PRESENT: COUNCILMAN CURTIS JONES, JR., CHAIR COUNCILWOMAN NINA AHMAD, CHAIR COUNCILWOMAN KENDRA BROOKS COUNCILMAN JIM HARRITY COUNCILMAN RUE LANDAU COUNCILWOMAN QUETCY M. LOZADA
There we go. This is a Joint Committee of the Committee on Public Safety and Health and Human Services. I'm your Co-Chair Councilman Curtis Jones, and we are here to review Resolution No. 240703. Ms. Stack, would you read the title of that resolution.
Resolution 15 No. 240703 titled, Authorizing the Joint Committees on Public Safety and Public Health and Human Services to hold hearings to investigate the effectiveness and potential expansion of mobile mental health units administered by the Department of Behavioral Health and Intellectual Disability Services.
Thank you so much. And would you take the role so we can establish a quorum.
Thank you so much. A quorum has been established to review this resolution. I want to open up by saying that this is -- like in public service, if you live long enough and if you watch and pay attention close enough, you see progress that things actually do change sometimes for the better. But it is always important for every now and then for authors of legislation to go back and take a look at well, how are we doing, how can we do it better and to give kudos where appropriate and to give constructive criticism and where there's not. And also, at the end of the day if there is a budget implication, to at least know about that request. So with that, we are taking a look at in my opinion the community response, but also unbeknownst to some of the people testifying here but we tried to work it out in advance, the co-responder response. And my colleague, I didn't mean to traumatize her this morning. I talked about the evolution of this response due to an incident in her District with Walter Wallace. And I'm going to let her speak to that situation. But ironically, we have a 7:00 a.m. every Monday morning roll call with all of the high schools in the western part of my District, meaning West Philly. And we talk about public safety and all of those things that go into making sure our scholars, our babies, get to and from school safely. And sometimes we have to protect them from themselves, from others and even the system. And in this conversation one of my principals, who will not be named, said that he had an incident that week where a 240-ish pound African American man who suffers from some intellectual disabilities found out in class that his parent had died, and in that process had an episode, started tearing up the room. He was distraught. And when he went into the room being called to assist the teacher, he pushed -- the student pushed him. And at that point, I'm on bated breath like what happened next. He said he refused to call the police because that student's grief would not be taken into consideration and possibly be the result of some intervention that wasn't warranted in the continuum of response to a situation. This is very similar to what happened to Walter Wallace or could have happened. But thank God he de-escalated the process to the degree that he was able to cope with the situation peacefully. So with that, that's the purpose of -- so every now and then we want to look back and see, yeah, we had this great idea 50,000 feet in the City Hall. But how is it working on the ground, what can we draw from it to make it better. And with that, I want to recognize my colleague from the 3rd District.
Thank you, Mr. Chair. As you point out, the tragic situation with Walter Wallace, Jr. crystallized for me certainly why we needed mobile crisis units, why we needed to have skilled mental health professionals to respond to people when they're in the midst of a crisis. I'll never forget that day and what happened in watching later on the body camera footage. It stood out to me that that interaction was 41 seconds. I know that it was 41 seconds because I'll never forget. And certainly, Walter Wallace, Jr. had a knife. And certainly, he was behaving erratically. But I will never forget his mom and his neighbors screaming to the police that he wasn't a threat, to have kindness and patience with him. But we know what ultimately happened. And the reason why we need a more compassionate response than what we saw that day is that this was devastating for everyone. It was devastating for the family who will never have their loved one back. It was devastating for the neighbors. It was I believe devastating for the policemen. In watching that video after the shooting happened, there was this sort of what did I do moment. And of course, it was devastating for our community. It was the second time in a matter of months that we had civil unrest in the community in response to that police shooting. So this is very important. It's very important to have a skilled mental health response when we are dealing with a mental health crisis. And I can only imagine if we would have had that on that day, on that October 26th, that we might have had a different situation. And we might have had Walter Wallace, Jr. alive. And so, it's for that reason that I joined with Treatment not Trauma for several budget years to advocate for millions of dollars to the City's Mobile Crisis Unit program. But we have to make sure that it's operating in the way that we need. We can't -- it's not just about allocating the money during budget. It's about making sure that we are implementing this initiative well because as we've seen, it's life or death. And so, thank you so much for having this very important conversation.
Thank you, Chair. And good morning, everyone. And thank you for being here for this really important hearing. As my colleague Councilmember Gauthier just outlined, how do we very carefully decriminalize mental health responses. And I think we have enough examples of how we haven't done that. But I think this pathway, which all of you have worked so hard for, actually makes us very hopeful. And I just echo everything that has been said that it is about transparency, accountability because we have to respond to our community, right. They have to know what's going on. And we have to be able to tell them the resources we invested in this space is bearing fruit. And one of the things I have found in my one year being on Council is our constituents just don't have enough information of all the services we provide, you provide, right. And part of that is being a cheerleader for the resources you are providing for our community and being that conduit to say change is happening. We just said we want to celebrate good, you know, the things that are working. But we can't celebrate them if we don't know them either. So I think making those changes, making sure we have a way to communicate and show that their tax dollars are being used effectively and compassionately. So thank you all for all the work you do. And I look forward to this hearing to give us much more information and see where we can be helpful, as mentioned, in the budget process as well. Thank you.
So I'd like to for the record recognize Member Brooks and Member Landau who are also --
And Member Brooks would like to be recognized. Member Brooks and Member Landau. CWRO: Thank you, Chair Jones, for bringing us together for this hearing on Mobile Crisis Units. When we established this Program in 2022, it was a major step forward for mental health access and violence prevention for families here in Philadelphia. And it has become a model for cities across this country. Three years later I stay confident that this program has been invaluable to people here in Philadelphia. I heard Councilmember Gauthier speak on the incident that we all remember four years ago with Walter Wallace, and I don't want to rehash that, but we realized it was a mental health crisis. And these Mental Health Crisis teams, they grew out of pain and outrage of a tragedy, but also came out of it was hope that this will never happen again. So now, when we have families going through a crisis, we can call 988 to access trained medical health providers instead of involving police. And in most cases, counselors are being provided -- are there to provide care and resources over the phone. But in some cases, the crisis requires an inperson response. And that's where the most Mobile Crisis Teams come in handy. These teams have been bringing care and expertise directly to people's homes and the community and they have been saving lives. I want to share a brief story to highlight how I've seen the Mobile Crisis team at work. Some time after the program was launched, I saw a young man in the midst of a mobile health crisis. He was in public unclothed, and my mind immediately went to Walter Wallace, Jr. Thankfully, someone called 988 and a Mobile Crisis team arrived to provide care and support without involving police. That's one day I can see our city in action when legislation works for the people, and it was a feel good moment. Each day over 200 Philadelphians are reaching out for mental health support. As their awareness of 988 grows, the need will continue to grow and we must be prepared to meet that need with fully-funded, fully-staffed Crisis Response teams. Through the budget process, we need to look at how we can continue to expand this lifesaving program. Just as we commit to supporting firefighters and EMTs, we must commit to supporting mental health first responders who are saving lives, the lives of Philadelphians when they're in a crisis. So thank you so much, Chair Jones, for bringing this together. And I look forward to hear from several witnesses today.
Thank you so much. Member Landau, did you want to speak --
No? Okay. With that, Ms. Stack, can you tell us the first panel to testify.
Interim Commissioner Dr. Marquita Williams from DBHIDS. Also available for questions will be Dr. Tierra Pritchett, Kenny Solanke, and Dr. Lisa Colton.
Thank you so much for what you do. Please come up to the witness table. (Witnesses approached Witness table.)
Thank you so very much. So if you can state your name and begin your testimony, we can begin.
Good morning. I am Dr. Marquita Williams, Interim Commissioner for the Department of Behavioral Health and Intellectual Disability Services. Good morning, Chair Curtis Jones, Chair Nina Ahmad, Vice-Chair Lozada and members of the Joint Committees on Public Safety and Public Health and Human Services. As I said I am Dr. Marquita Williams, Interim Commissioner of the Department of Behavioral Health and Intellectual Disability Services. Joining me today are Kenny Solanke, Senior Director of Crisis Operations; Dr. Lisa Colton, Director of Crisis Related Services; and Dr. Tierra Pritchett, Deputy Commissioner of DBHIDS for Administration, Finance and Quality. Thank you for the opportunity to provide updates on the expansion of Philadelphia's mobile crisis response services under our Crisis 2.0 framework and to address the considerations outlined in Resolution No. 240703, introduced by Chair Curtis Jones. This resolution calls for an evaluation of the effectiveness, challenges and potential expansion of mobile crisis response teams, which have become an essential part of our city's behavioral health Infrastructure. Today I will provide an update on our mobile crisis response efforts. Philadelphia's crisis services system has undergone significant transformation through the implementation of the Crisis 2.0 framework in the past four years. This framework includes several components: One, the expansion of our Community Mobile Crisis Response Teams that now provide services citywide 24/7. The city's first Behavioral Health Urgent Care Center. The addition of a fifth Crisis Response Center in the city that is located in West Philadelphia. And the expansion of the Philadelphia Crisis Line that includes the 988 National Suicide and Crisis Line Initiative, which has received national recognition. Starting with our Crisis Mobile Response Teams, in 2022 we contracted with four providers, Elwyn, PATH, Consortium and JFK that manage up to 29 Community Mobile Crisis Response Teams 8 hours a day, seven days a week 9 across Philadelphia. Each provider 10 is responsible for a geographic 11 region and they can respond and 12 deliver immediate supports in the 13 community for individuals 14 experiencing mental health crises. 15 This critical resource 16 helps to reduce the need for law 17 enforcement involvement when an 18 individual is having a behavioral 19 health-related crisis. Between 20 January 2023 and January 2025, 21 approximately 14,302 dispatches 22 were recorded and that number 23 continues to grow. 24 On September 3, 2024, we established the city's first Adult Behavioral Health Urgent Care located at 3125 North Broad Street --
Yes. On September 3, 2024, we established the City's first Adult Behavioral Health Urgent Care located at 3125 North Broad Street. This urgent care center marks a critical step in providing additional capacity to our city's overall crisis system and is a resource that provides people with same-day crisis services without the need for appointments. In the first five months of operation between September 2004 and January of this year, the Behavioral Health Urgent Care has conducted 1133 service encounters, reducing the need for a more acute crisis intervention. Additionally, DBHIDS opened a fifth Adult Crisis Response Center in West Philadelphia at the Hospital of the University of Pennsylvania, (HUP) Cedar in September 2023 which has increased our capacity to address the growing needs for immediate crisis evaluation services in West Philadelphia. Finally, a significant part of our crisis system capacity building efforts is the expansion of the Philadelphia Crisis Line, also known as PCL, staffing. In 2022 in preparation for the national launch of the 988 Suicide and Crisis Lifeline, our city's crisis response infrastructure significantly expanded to increase capacity to provide access to immediate crisis supports for Philadelphians. Thanks to the funding from City Council, DBHIDS was able to expand PCL staffing to significantly meet the anticipated needs of the callers to 988. PCL now handles over 6000 calls per month, providing telephonic crisis intervention, clinical consultation and seamless dispatch of mobile crisis teams when inperson support is required. Additionally, the collaboration between 988 and 911 which co-locates 988 counselors in the 911 radio room, has led to a 36% increase in warm transfers of behavioral health calls from 911 to 988 during this same period, ensuring that individuals in crisis receive the appropriate mental health Care swiftly and effectively. Our efforts to enhance the crisis system in Philadelphia has been complemented by a comprehensive 988 public awareness campaign, promoting the 988 Suicide and Crisis Lifeline and educating the public on available resources. This campaign is ongoing and it includes partnerships with local media, sports teams and community organizations. This awareness campaign has significantly increased the utilization of crisis services and contribute to a better public understanding of mental health supports. I'd like to now spend a little bit of time sharing with you how we have operationalized and monitored these efforts and where we see that the system and resources put in place are excelling and where there have been challenges that we are actively addressing. The effectiveness of our mobile crisis teams is measured through a set of key performance indicators, including response times, community stabilization and community feedback. I would like to highlight some of our most significant achievements: The primary goal of mobile crisis response teams is to stabilize individuals in the community wherever possible, thus minimizing the need for hospitalization. Mobile crisis disposition data shows that over 50% of dispatches resulted in no 22 need for urgent or emergent services and that these cases were resolved successfully in the community. This means that the crisis was resolved, allowing individuals to remain in their homes and communities with appropriate supports. The rate of involuntary commitments, also known as 302s, has decreased to 17% reflecting a shift towards voluntary community-based care. Additionally, voluntary evaluations at Crisis Response Centers or CRCs are around 6%, reflecting improved crisis resolution at the community level. DBHIDS works to make strides in reducing response times for our Crisis Mobile Community Response Teams through targeted strategic enhancements. The addition of GPS-enabled dispatch technology has allowed the PCL Crisis Line to continuously track and monitor the location of all mobile crisis teams.
This realtime capacity helps identify the nearest team to the caller, resulting in faster dispatch processes and improved response times. Our goal for CMCRT Teams to arrive on the scene is within 50 minutes of dispatch. This is the benchmark aligned with best practices nationally for crisis intervention. Recent data indicates that with the expanded capacity and our improved technology our median response time has been reduced to 50 minutes citywide. Our four CMCRT providers include Elwyn, PATH, JFK, and the Consortium. And while they have all worked at meeting the 50-minute best practices benchmark, JFK and the Consortium teams have operated consistently within the 50-minute response benchmark. It is important to note that the Consortium CMCRT Team also has provided mental health supports to individuals sheltered in the City's Warming Centers during January. DBHIDS also conducts customer satisfaction surveys for people served by CMCRT. And the surveys conducted between June 2022 and May 2024 found that more than 70% of respondents rated their experiences as highly satisfactory, highlighting the teams' helpfulness, professionalism, ability to de-escalate crises and provide compassionate care. We continue to monitor customer satisfaction closely sharing results with providers to ensure continuous quality improvement. While our mobile crisis response teams have seen notable successes, there are some areas that require ongoing attention. There is high turnover among frontline staff and leadership, and this remains to be a persistent challenge affecting response times and continuity of care. We've observed slower response rates during high call volume periods when a provider is experiencing staffing changes or when dispatches are made outside of a provider's region. To address response time challenges, particularly during peak hours, we have supported providers in adding Bridge Teams. The Bridge Teams increase the number of available teams during the high-volume periods. With a 3 million increase in funding for FY24 from City Council to enhance our crisis system, we have provided increases to provide a budget for the addition of these Bridge Teams which have proven effective in reducing response times during busy periods. These additional shifts have helped to decrease delays in dispatch and arrival times, especially in the busiest regions like West and Southwest Philadelphia. Overall ongoing support will be needed to sustain these efforts and to achieve a stable workforce. There's also a need to continue to ensure standardized trainings across providers. We want to ensure that there's a standardized crisis intervention training program for all mobile crisis team staff to ensure consistent high-quality care across all providers and we will need consistent funding and resources to implement the highest quality of care for the people we serve. We also want to improve the current process and our reliance on law enforcement for transporting individuals under involuntary commitment. Police transports are not ideal, as police officers are not trained behavior health professionals and not equipped to deal with the variety of illnesses they may face. Establishing a dedicated behavioral health transport team would alleviate the burden on law enforcement, streamline the process of involuntary commitment transports and improve the overall experience for individuals in crisis. 0 framework has strengthened our behavior health crisis system providing timely, effective and compassionate care. DBHIDS remains a committed partner in this endeavor, dedicated to providing a trauma-responsive, equity-driven, crisis responses system for the residents of Philadelphia. We look forward to continuing to collaborate with City Council and other stakeholders to further refine these crisis services. Thank you for your continued support and for holding these important hearings.
We look forward to working together to enhance the sustainability and effectiveness of Philadelphia's mobile crisis response services. My colleagues and I are available for your questions.
SO does that mean no one else is testifying at this point?
Okay. So let me first say that a part of my job description, part of all of our job descriptions is to listen for a living. And I listen. It is always good when I'm thinking about questions and you're answering them automatically in your testimony. That is always a good feeling for me and probably many of my colleagues. It says that your preparation and testimony was comprehensive. So kudos to you.
Let me ask you: Where do we stand by way of national models? I don't think we were the first to do a co-responder model, but I'm thinking we were right up there with some of the groundbreaking cities that have done this. Do you have a --
Yes. We weren't the first, but we were certainly early adopters of the model.
And when we talk about 14,000 responses, how do we match up to other cities?
You know, I'm not sure about the call volume for other cities. But I can get that information to you.
Because every now and then it's good to be able to say to our colleagues in other places that good things come from Philadelphia.
Can you describe for us some of the types, general types, of responses and when you get there -- so from the easiest to resolve to some of the more challenging to resolve. Give us a sense of those out of that 14,000.
Absolutely. I'm going to bring in Dr. Lisa Colton and Kenny Solanke.
Hello. Oh, hi. My name is Kenny Solanke. I'm the Senior Director of Crisis Operations for DBHIDS.
I'm Lisa Colton. I'm the Director Of Crisis Related Systems for DBH.
So an example of an easy-to-resolve crisis that a mobile dispatch could respond to would be -- this is actually somebody -- the team gets there and the individual is not there or the individual refuses support. So that's an easy one. It's an easy fix or the team gets there, they provide the evaluation and the assessment and they see that there's a need for this individual to go to the CRC. And there's an agreement that this person will go to the CRC, transported by the mobile team. Those are fairly easy. But then you have instances where in some cases they arrive and people will tell them, I have a gun with me or we have a knife or there is a complicated issue with the family. And I can have Lisa give you more specifics in terms of the kinds of difficult dispatches that could take longer than the median, which is about 30 minutes. This could take maybe an hour.
Oh, sure. For the simple dispatches where perhaps the individual is gone or refuses to speak, the mobile team will still meet with the family or whomever the caller was. So this will be a third-person call probably. So it's not as if they just drive away. There's still an intervention that occurs and ongoing support can be offered to those families. For more complicated situations, we could have someone who is what we call a barricade. Someone who might be in their room 20 with the door closed suggesting that they don't want people to come in. It's unclear what's in the room. If the situation is safe or unsafe, if police support is needed, something like that. I'm trying to think. We have parents who really are frightened of their children, having police intervention and the child is refusing or even an adult, an older child, an adult child. So there could be some negotiation that goes on for some time with the team. It might even include coming back, you know, offering a service. Well, okay, so for now things are settled. We'll wait until morning. We'll come back and re-engage, that kind of thing. So it could be an extended intervention.
So I remember going over to the 911 Center with my colleagues, but one of them was Mayor Parker. And when we went over there and looked at that and saw that kind of difficult kind of balancing act. Help me to understand, usually is it the police that respond first and then the mental health component? How does that work or do they go together?
If the call comes through 911, then it is the police who respond first. Even if the call is transferred over to us, and then a mobile team can also respond. Sometimes police request a mobile team when they are onsite to a call that hasn't come to 988. But if the call goes first to 988 and we do not see any safety concerns, the mobile teams will go first.
So it's also my understanding that there is a log that lists if Member Harrity's -- I live with Member Harrity and I have ongoing crisis problems, that that number is logged in. And so, there's almost an alert that Member Jones might be going through crisis. How does that work?
So, yes, there are frequent callers to 911. We're talking upwards of 200 calls a day. Those go to a particular detective. And we work with that detective to discuss what the caller's saying. We try to engage the caller. The trouble is if the caller refuses to be engaged. So we have had different examples where we've sent teams out to those calls. We've also engaged the co-responder team. Sometimes police sometimes -- I'm sorry. Callers to 911 want police, right. They're frightened. They're calling about something that's scaring them. So the co-responders teams can be incredibly helpful. So we've had that experience. We've also had this detective go out with some of our teams because she often communicates with these people that call multiple times to 911, so she can be a liaison. The goal being to try to engage them in some kind of additional intervention that's not calling police.
You mentioned that there are how many units available? 39, I think.
There are four providers and they each have a team per shift, including the Bridge Teams. So when you add all of those shifts together, there's about 29 teams operating in a 24-hour period.
And usually you are deploying them based on volume of calls. How do you determine that?
Yes, we're deploying them based on whoever is closest to the caller. We have a GPS-enabled capacity to see where the teams are. So if I'm calling from City Hall, whoever the team is that's closest to me which will probably be JFK, will be the team that would dispatch to my call. So even though they are regionalized, we have Elwyn out in the part of Philadelphia and PATH out in the Northeast and JFK is here, we really want to focus on getting to our callers as soon as possible. So whoever's closest to that individual is the team that we're going to dispatch.
Finally, are those teams stationary or are they mobile going around? How to does that work?
That's a very good question. They're stationary. But if there's a let's say Team A and Team B, if she's on a call and I am on another call, when she's done that call, we don't have any calls to dispatch. They may have some downtime so they can go to their office, use the bathroom or have a lunch break or whatever the case may be. But more often than not, we are part of the reason we decided to do mobile GPS-enabled technology is to ensure that as you're wrapping up a call, we're giving you another dispatch close to the vicinity where you are, so you're not running back to your office just to come right back down to where the caller is. We have one of our providers here who can speak a little bit more to how they manage their teams and dispatches.
Okay. All right. They will testify later I take it. Okay. Member Gauthier.
Good morning, Commissioner and Team. Thank you so much for your testimony today and for sharing wonderful information about how you all are implementing the mobile crisis unit model. It's important work, it's groundbreaking work and we appreciate you. But it is work that we want to grow and make even better. And in the spirit of that, I have some questions. First, I think we're all aware that there have been some issues with the contract for the Consortium, which serves a large portion of my District. And in fact, 19143 in my Council District is a zip code that has been utilizing mobile crisis units the most. And so, I want to ask about the plan to ensure continuity of care for all of the patients that have been served or that are being served by the Consortium right now?
Councilwoman, obviously this is a very complex situation. There's a lot of parts involved. And so, we're not at liberty to talk about it here today right now. But the continuity of care for the clients is our number one concern as well.
Okay. Can you talk about the kinds of things that we're considering around the continuity of care?
Absolutely. So we're considering the level of care that the clients are enrolled in and what providers in the event that we needed to move forward we would be able to transfer them to. So making sure, as you said, that clients don't go without services.
Do we feel some level of confidence that there are enough providers and enough teams to serve those patients or do we feel that we would have to grow the network in any way?
At this current time we believe that there are enough providers.
Thank you. I consider these to be emergency services. I consider these to be lifesaving services. I hope that you all do too. Given that, do we feel that a goal of 50 minutes for a response time is adequate?
Well, the national standard is 50 minutes. We are trying to get under that as best we can. We are really proud that we have reached that 50-minute median. We would love to get it even lower, and that's what we're consistently working on.
I seem to believe that we've had conversations with DBHIDS in a prior administration granted where the goal was to get to 30 minutes. Do you have any information on why we've sort of left that goal to the side for a 50-minute goal?
I have to own the 30-minute goal. When we wrote the RFP in 2021, we thought that Philadelphia was small enough. And if we had a provider in each of the different regions that of course they can travel. I don't think what we anticipated was traffic and the distance and some of the things that happened in just in the course of the day that will make it very difficult for providers to travel from one point to another. So 30 minutes is a dream. There's no mobile team within the country that's able to make it to their destination 30 minutes. 45, 50 minutes, an hour, two hours is more the norm. But we're still working on reducing that 50 minutes to let's say 45. If we get to 45, then I'm still trying to go down. And how do we get there? By expanding the teams, by having more boots on the ground.
I want to commend you for being ambitious and having a 30-minute goal, even if nowhere else in the country is reaching that. And I would imagine that with the thousands and thousands of people that we've served is probably a good dream for us to have. Is there a way that you would be able to let our Council know how we would ever reach a 30-minute goal?
So we just had a recent team expansion. Each provider added a Bridge Team just this past fall, summer. And we want to see a whole year what does that look like. I think it's gotten us to 50. So how many more teams would we need, do we need another Bridge Team to layer. So at the busiest times we have not just the day and the evening and the bridge, so each provider will have maybe three at those core hours. Do we need four teams? So maybe that's what's going to do it for us. But mind you, as ambitious as we are real life happens. So you have a provider that has a team member who's sick or they're on vacation or something happens, right away that team is off the grid. We can't use them. So those are the kinds of things that impede our ability to have those core teams functioning seven days a week at that critical mass. So, yes, adding more teams will be the answer to that I think in (inaudible) of sickness, vacation and people leaving the job to go to something else because that's the other problem. There's a huge turnover. This is very difficult work, and we want to recognize them as behavioral health first responders.
Can I ask that this budget cycle you submit to us a plan for how we could get down to 30 minutes and what that would entail?
Also, I know we've been talking about the Consortium sort of offline. I would ask to continue those conversations so that I can understand in more detail what the continuity of care looks like for those patients. And then I have one last question. Could you talk more about the types of calls and scenarios other than suicidal ideation that are being transferred to 988 from 911? And then can you also speak vice versa about what kind of calls are being transferred from 988 to 911?
Sure. So one of the functions that the mobile teams do is that they can go out and facilitate a 302 petition with the family. So those kinds of calls would be transferred from 911. They would come to us. They wouldn't require any kind of a police intervention. Additionally, someone asking for information about the system, questions about what do I do, my husband is not feeling well, I don't know how to negotiate this system or maybe a passerby who sees someone in a wheelchair who looks like they need support. Nothing overtly dangerous, those kinds of questions. More, you know, inquiring for support for assistance. That kind of thing.
Slight follow-up: Is this data that we're tracking? And if so, are you able to provide that to the Committee?
So data from the police -- the police system and our system are not the same. So we have to ask them for that kind of data.
Thank you, Chair. This is extremely informative. I have a few questions. One is the high turnover, right. We know this is an issue in terms of retaining people and it's a high-stress job. So can you speak to, if I'm correct, what are the reasons for this high turnover and what the solutions could be to this high turnover? And how do we compare to other cities where we have this model in terms of their turnover?
I can say that because 988 is across the country there are three requirements for 988. You need to have a 24/7 988 call center. You need to have a 24/7 Mobile Crisis Response Team and 24/7 Crisis Response or Crisis Stabilization Center. So what we're doing in Philadelphia, we're ahead of the game since 2019, 2017. Other states are now trying to catch up. And as we have our national 988, meetings, we're all coming up against the same thing. It's really difficult to get people to do this job, especially when we're looking for Master's level clinicians to be a crisis response specialist and we're paying them barely minimum wage. So I think the problem is, and this has to be from a national to state perspective, we have to elevate these roles as behavioral health First responders. so they can get paid accordingly. Thanks to you we were able to increase the budgets for our providers. They were able to provide salary increases for the existing staff and then bring on board Bridge Teams at a higher salary. But I think we can do all of that. My concern is there's also this idea of safety. It takes a different kind of person to do this job. You have to feel very comfortable and confident in your ability to engage and use your clinical skill set to help people de-escalate crisis. Not everybody is able to do that. And I think after some time some people just burn out and they want to do something else. So a lot of the things that we focus on when we meet with our providers is this idea of wellness, not just from the provider side but also from the crisis call, the 988 counselors that we have that are constantly hearing this calls. So I think it's ensuring wellness providing some value to the job and increasing the salaries of the people that do the work.
So thank you for that. It's clear, obviously, salary is important but the conditions of the job too. It would be very useful to do an economic modeling of saying investing in this space downstream would save us so much money, right. And I think if nothing else moves people, if we could set up some paradigm where we can then allow us to make the argument of why investing here is so important. So I would love to see what you're able to give us. Maybe we can employ all these big institutions who love to do this work because that would be a value add locally, statewide and nationally, right.
We have to make that value proposition. The second question I had was about de-escalation training for police. Do you work with the police to see -- I recall Dr. Marquita Williams saying that normalizing what the training looks like across the board from the provider side is important. But also, are you the people who are training the police for de-escalation because some calls because of violence, potential violence they get called, who handles that and how do we assess that?
Sure. So the police have a social worker named Erin O'Donnell who does the CIT training to all the officers. We do have different members of DBHIDS who participate in that training. And then we on the Crisis Line specifically have regular clinical conferences with the CERT Teams, with the Co-Responder Teams, to talk about specific cases. We also have a very fluid relationship with them. They will call us onsite if they have a question about something, about how to do something, about what to do, where to go. So we have a very nice relationship with the CERT Team and with the officers on that team. And we also -- we don't have direct training with the with the precincts but we do communicate with them. I'm actually working with the Airport right now around their police and looking for support with their homeless team.
So the reason I ask is, one, for standardizing the response from all the law enforcement. And you mentioned they have one person training a certain group, but this is -- I think our police force would really benefit from the entire force, particularly those on the beat, to get this level of training which could be something your department can offer for a price, right. And that could -- I'm just saying, it's all moving the money around. But this could be something that could be very useful to have a standardized level of training depending on what type of police officer that is. And to have more than one person doing a handful of people, it just seems again this would be reducing police hours, this would be reducing violence on the job. This would do so many things. So another economic model to show your intervention with police can result in long-term stability in our communities. The last thing I wanted to ask was in terms of where you see this work going in terms of improvement, in terms of what data was shared with us, how do we track -- and Councilmember Gauthier sort of asked this question as well, how do we follow people past this encounter that you respond in a mobile crisis way so that the long-term health, mental health of whoever you intervene for has a warm handoff? Now, we have the model for people with substance disorder to have a long-term going to a year at the Wellness Center, right. So it would be lovely to see what we do for others who have mental health issues that cause the crisis team to show up in the first place.
Right. We are in the process of creating our follow-up team within PCL. So individuals that are suicidal that call 988, they get a callback -- depending on the level of severity of the information we get, they can get a callback within hours, 72, 8 48, whatever. And that can 9 continue depending on what that 10 person needs. 11 So that gives us a sense 12 for are they following up with the 13 recommendations, the referrals and 14 the community-based services that 15 we're providing. On the mobile 16 team side, after that crisis 17 intervention there is an 18 expectation for that provider, for 19 the team, to provide follow up 20 within 72 hours just to see how 21 Kenny is doing. I set up that 22 appointment for you, are you going 23 to be able to make it, is 24 everything okay, is there anything else we should be thinking about or doing as we're continuing towards this path of recovery. So those are the two follow-up options we have if we were to take it even further. If these individuals have CBH insurance, we can make sure that, yes, they are connected. This person did show up for that appointment, and we can see the trajectory from that call all the way through disposition. It's a little harder for constituents that don't have insurance. But we can still have a way to figure out where they're going in the system, because with CBH, it's a claims, right. So the provider paid for something so we know they went. But I think we have to continue to work on what would that look like for individuals that are not CBH-eligible, but we're also connecting them to those services.
Those are the people who probably need it the most --
-- who do not have insurance coverage of any kind. So this is great that you're already proactive in this space and you're collecting data, because that's when that was what is going to be really useful for us to say that your follow-up services and you compare that to years past and see the difference in what happens to our communities. Again, a great model for us to use in terms of budget allocation. So I would appreciate that kind of feedback and data to tell us how we can advocate for more of this. So thank you so much for all the hard work. Appreciate it.
Councilwoman, to your questions about crisis intervention training, we have a team member here with us from our Behavior Health and Justice Division who can give you some more information about that. Shaakira Gillette, one of our Associate Directors and Behavioral Health and Justice.
Thank you. Please come up and state your name for the record and respond. (Witness approached Witness table.)
Good morning. Shaakira Gillette, from the Department of Behavioral Health. And I just have some information on our CIT-trained officers. The CIT program has actually been absorbed by the Philadelphia Police Department, but the Department of Behavior Health, we used to spearhead this training. The CIT Program initiated in 2007. And since that time, 4,708 Philadelphia Police Department officers were trained in crisis Intervention services. Class 149 was in February of 2025, so this program has been doing phenomenal. It was doing so well that the Philadelphia Police Department decided to absorb the program from us. We still provide behavioral health support, which means we still partner with the program to be a behavioral health expert in the room.
So Member Ahmad's comment about modeling and measuring is critical because if it ain't measured, it ain't managed. And we can't fight for additional funding if we don't know what our rate of return is. So it's kind of hard to figure out -- it's hard when you prevent things because that's what you do often. You prevent arrests, you prevent hospitalizations. But we have to figure out in that modeling how much is that worth to taxpayers. So with that, I recognize Member Harrity.
Thank you, Chairman Jones. Since I'm the only Irish guy here I'll say Happy St. Patrick's Day everybody. Only Curtis Jones could get this Irish guy here on St. Patrick's Day. I don't know if he knows how much of an accomplishment that is. But first real quick, just a real quick one, what's the starting salary for one of your team members?
And what's the starting salary for those two individuals?
The crisis specialist is anywhere between 55 and 59 and the peer specialist is anywhere between 45 and 49. At least that's what we see in the budgets. We don't get to dictate what the providers pay. We just give them a range for what we think is best.
Okay. All right. That's good. That was a nice quick one. What do you think the success rate has been on decreasing police intervention into behavioral health episodes and situations? Are we kind of getting that away more than -- if you guys did say that already, I apologize.
No, I think we are getting away from having the police involved in behavioral health crisis. There's been really minimal -- I want to say and I don't want to lie because -- but the numbers are low and (inaudible). Thank you. So this is what I was looking for. So for example, in 2024 one provider had only three individuals that were detained by police. And again, that's out of thousands -- I mean, hundreds of dispatches. Another provider had just one. We had another provider that had three. So in total, it was about 10. That's really, really low because if you think about not having these teams.
That's just what I was thinking. That was my follow-up.
So I'm just talking about 2024. So the numbers we gave you was like from 2023 up until January of 2025. But for this police involvement in behavioral health crisis that the mobile teams were involved in, we had about 10 in 2024. So the way I see that is if we didn't have these teams, how much higher would those numbers have been. So 10 had to be the situation was so risky, right, that the teams needed to call law enforcement to support their intervention.
Yeah, I think those numbers are really good. All right. Do you believe as this program expands it will help take the burden away from the police department?
All right. So that's the goal. And then how are we advertising the 988 system because I'm a big -- we as a city do a real bad job of telling people about all the great stuff and great services that we can provide. Just curious of how you're getting that information out to the public?
Well, apparently you are because 14,000 people knew to call 988.
Yeah. So since 2022 we received some SAMHSA grant funds just for 988 Education and Awareness Campaign. So we've had PSAs on television. We've had ads on the radio, iHeart Everywhere, KYW. We have had partnerships with our sports teams, go Eagles, where their playbooks we have an ad in there. We have a partnership with the Sixers where they have Mental Health Awareness Night. It's all about 988. We just had one in January, and we have a lot of resources and cards that we give out. We have partnered with the School Districts to create swag for kids. What I would love to do at some point, if not this year, next year, we still have a little bit of SAMHSA money before they take it away, is to work with the School District to see if they're willing to have 988 on the back of ID cards. A lot of states are doing that. So all of the school IDs have 988 on the back of it. I would love to do that. We go -- our Community Wellness and Engagement Units, they go out into the community and give out information. But you're right, we have to do more. We just don't have enough money for it. But with the little we have, we are spreading and stretching the funds.
SEPTA supports us as well. There's 988 signs in all of the SEPTA stations.
I'm a big supporter also. It's always all over my personal and my government site. Mental health, it affects everybody. So we need to get that stigma away, you know, that is very outdated, you know what I mean. The God's honest truth is most people after speaking with a professional usually are okay.
And we need to make sure that they're available more often. The fact of the matter is that we don't have enough of those professionals. There's a crazy statistic that came out a few years back where we have one child psychiatrist for every 10,000 kids in Pennsylvania. Philadelphia, we're a little better in the numbers because we're a big city, but statewide is one per 10,000. That's just crazy. All right. Thank you.
Thank you, Member Harrity. Before we go to Brooks, Rue Landau and then O'Rourke, that's the order. I'm trying to keep track, quick question: Is your funding in jeopardy based on the new federal administration? How does that trickle-down payment should happen?
So based on the federal administration and /sitiation/, is there any jeopardy to your funding or is it directly from the City of Philadelphia?
it is directly from you. Thank you so much. We are so grateful. But I have to be honest with you, a lot of other states are not so lucky. So the federal government through SAMHSA gave some grants for 988 capacity building. So a lot of states are relying just on that money. We have you and we have Health Choices. So the money they're giving us we're just using for 988 awareness. We're trying to spread the word on 988, because that's part of what you're supposed to use it for. So whatever happens with SAMHSA would not impact us. We just will lose the grant that they've given us through 2026. But other cuts will impact I think Medicaid, which impacts our work. That's where the problem lies.
Okay. So thank you guys so much for this amazing work. I have been following not just our own mobile crisis center, but all over the country. I've been to Portland to see the Portland Response Team and a couple of other programs, and I'm always very proud to see that we're holding our own. And your testimony has been really amazing. And it makes me feel good just to hear that things are going as planned. I have kind of two questions. One, to add, Councilmember Gauthier asked for some more specific information about scaling up. Can you make sure we have some budgetary numbers for that? Because I don't know if she specifically asked for how much is it going to cost. I know she asked how many more staff would you need to do this, but we need to know the cost of that.
Especially in light of what Councilmember Jones just asked. We don't know what's going on. With the federal government everything is on the table, that's how I feel. And the rest of the team that my colleagues have asked so many really good questions. So I have one about DBHIDS. They do support work for people in mental health crisis that that are heavily reliant on the trust in the community, community groups, including groups like Treatment, Not Trauma. So they're here today. Where's the Treatment? (Applause.)
And they have been instrumental in setting up lifesaving programs and expanding funding. They are the ones who kind of put the fire against us and gave us the charge to make this happen. So how many meetings with community groups like Treatment like Trauma have you guys held within the last six months? And what groups have you met with?
So we have a Community Advisory Board for Crisis 2.0 evaluation. That's a quarterly meeting, and TNT is part of that. In the beginning when we were starting this Crisis 2.0, we had a learning collaborative that started in 2021, the end of 2021, 2020, it was about months. They 11 were part of that group. But since 12 we went into implementation, it's 13 really been about ensuring we're 14 getting teams out. We're getting 15 the service rolled out. And we 16 have not had specific meetings with 17 Treatment Not Trauma, but I think 18 they're part of a 911 community.
Right. We have a meeting monthly that Treatment Not Trauma attends, a community meeting, in conjunction with public safety.
And we can only take testimony from the table because it has to be transcribed. So if you shout out who you are, your name, maybe that'll get to our -- what's your name? Your name?
Yeah, but -- all right. Okay. We'll continue our testimony this way.
Yes. Councilwoman, first of all, thank you so much for all of your support. We really appreciate how you have advocated for us. But in addition, we have had some meetings with Treatment Not Trauma. Specifically I've met with them with some of my team members. Whenever there's a need or a request for a meeting, we have that. So we've actually met with them twice over the last six months.
Okay. So I would just like you guys to kind of set up something to more -- in our current era that we're in, I know that advocacy and government goes hand-in-hand. And I think as we move forward if you guys can make sure you kind of meet more regularly to make sure that everyone's on the same page with moving forward to ensure that we can continually fund and support the work that you do, because it's like they were the advocates that got this moving. I would love to make sure that things are continually moving smoothly. So if it's quarterly, can we just or -- because I'm not really clear because I think it could be --
There are a couple of different meetings that are happening, yes.
So if we can have something just like more streamlined so it's clear that everyone's voices are being heard, and we can continue to grow this program, and you guys can continue to do the great work. Thank you.
Thank you so much. I agree. Adding my voice to the chorus appreciate your work so much and appreciate the innovative ways in which you've gone forward to solve a very serious problem here in Philadelphia. I have a few questions for you. First, I might be missing something so I want to dig down on something. We've talked a lot about calls that go from 911 to 988 and from 988 to 911. I've gotten an understanding now a bit more about when calls are going to 911 when they're looping you in for 988. I'm not getting a full understanding of when calls come to 988 when are you looping in 911 and under what circumstances. And also, I believe we heard that you've only had 10 police interventions in about a year or so of interacting with including 911 to 988. But again, I want to get a fuller understanding of when you're calling them and when they're coming out?
So in terms of when we at 988 would call for 911, that would be for an active rescue. So what would happen would be the calltaker from 988 would stay on the line with the caller, and we have a teams chat, right, of all the callers who would ask, I need help, I need someone to call 911, this is the situation. So someone else would call 911 and request immediate police support.
So under what circumstances would you do that? What would the caller have to say to you at 988 for you to use your team's chat to have a colleague call 911?
I'm standing on the bridge, I'm going to jump, I'm on the ledge. That kind of rescue.
Yeah. Or someone who had a weapon, I have the weapon and it's at my head. Now, the calltaker would continue to support the caller and try to get them to take the bullets out of the weapon, put the weapon down, you know, that kind of thing. But you'd also need police to be coming to the home for support.
From your data it seems that you get about 6000 calls a month, a lot. Thank you so much for all that you do. Approximately, how many of those or what percentage of those rise to the level of you including 911?
I don't have an exact number. It is not a regular thankfully, not a regular occurrence, not an unknown occurrence.
Yeah. We actually -- so calls received from January to 2023 through January of 2025, for example, these are the calls to 988. It's 147,375. That's the number of the calls in two years and one month. The warm transfers from 988 -- I mean, from 911 to us is 4,146. Now, from us to them, I think we're going to have to --
We do track how many it is to us because we think that's really important that they're not getting in cases that are behavioral health in nature and doesn't need 911 involvement.
Okay. Thank you. I also wanted to ask more about your dashboard. I'm the Chair of the Tech Committee. And so, is there a plan to update the mobile crisis public chat dashboard? It was last updated in May of 2024. And will you include this data that I just asked you about, about the inclusion of 911 and 988?
So the data was taken down from our 988 website from the request of City law because we had monthly data which was violation, so they wanted us to make that annual. That data has been updated. It is now back on the website --
Oh, I'm sorry. I thought I was loud -- oh, big difference. Yes. So the data is back on the website now and it shows annual data. It's no longer by month, and we can definitely ask City law if it's okay for us to share the 911 call transfer data as well.
Okay. Thank you. I think that's it for the moment, and thank you.
Thank you, Mr. Chairman. Most of the questions really have been asked. Let me just begin by saying good morning, Interim Commissioner Williams and team, and thank y'all for being here with us today. I just want to say that your testimony has been, as Councilman Jones lifted up, so comprehensive and thorough at a time that I think that's so important. We are in the midst of budget season. We've heard a lot about the challenges with our federal situation and your ability to provide us with this sort of information as we listen really prepares us and helps us to know where we need to allocate funds in this time. I really appreciated the reference that you made, especially as we hear echoes of this line about strength or peace through strength or force and things like that, making us stronger kind of being a theme throughout the country and our governance. To hear you say that timely, effective, compassionate care has made our system stronger is something I think ought to be emphasized. The idea that compassion makes us stronger is something that I think it should be emphasized and funded through the roof. So again, thank you for making that point --
-- heard loudly. I also want to acknowledge the work that has been done to get us here on this issue over the last five years, by Members Bass and Driscoll and Gauthier and Thomas and others. And just as importantly, I want to echo the shout-out that was lifted up already and thank the advocates and the groups like Treatment Not Trauma for helping lead us in a better direction in the wake of that unfortunate death in the situation with Walter Wallace. Let me just say I do look forward to hearing even more throughout the course of this hearing today. But I just wanted to ask a quick question about data for certain outcomes. What data do you have for outcomes for CERT dispatches? And how many dispatches, if you have it, are actually resulting in involuntary commitments?
So the CERT data is provided by the police. I'm looking at Kurt August, who is the holder of that data, not sure if maybe I can invite him to speak on that.
Oh, I'm sorry. Shaakira might have -- I apologize. BHGD could speak on that. I'm sorry. (Witness approached Witness table.)
And please state your name for the record and respond, please.
Shaakira Gillette. And I'm sorry. Can I have that question again?
Yes. I'm just asking about your what data you have for the outcomes of certain dispatches? And from that data, how many of the dispatches are actually resulting in involuntary commitments?
Okay. Great. So from December 1, 2022, to January 31, 2025, there was a total of 1,775 encounters for CERT and 2192 follow-ups. Out of the 1,775, only of those individuals were arrested. As far as 302, there was 568 involuntary commitments. And then there was also as far as individuals who said that they wanted to go into the hospital, there was 356.
12 What was the date again? You said 13 December 1, 2022 until when? 14
17 January 21, 2025. Okay. Thank you 18 very, very much. 19
Yes. Thank you. Councilmember Lozada had to step out. She had a question about you mentioned the teams are stationary and then you deploy when the call comes in, right. Do they travel in their personal vehicles or is it like your van or some --
They have vans that were included in the budget that they purchased for mobile crisis transport.
And she has a separate bill around an issue about providers in her District which is why she was asking this. And then she had a follow-up question about classifying these folks who are responding as first responders, because that would then exempt them from the law that she was looking at. So I just wondered how are they classified now so I can give her that information?
They're not classified. I think I'm the one that is advocating for calling them behavioral health first responders, and I don't know what that would require to make this not just for Philadelphia but for Pennsylvania as well, so that the staffing, the training and everything is standardized across the state, but particularly across the Commonwealth of Philadelphia.
That's wonderful because that changes how they're viewed in terms of our city, state and the nation, because it elevates the role of needing this service and that mental health is part of health and any crisis in our health spectrum should be addressed.
Okay. I will definitely convey this information to her. Thank you so much.
That's a good point because they're doing the job. They should get the designation. With that, there are no 9 other questions on this panel? (No response.)
One of the colleagues -- one of the things that I heard about this potential hearing is that when we call people to testify we need to be more welcoming because they were kind of apprehensive about what we were coming at them for and what did they do wrong. No. Every now and then we want to acknowledge that you're doing things right. That goes with these hearings as well.
Thank you. Please be seated. Thank you for your patience. Please state your name for the record and begin your testimony. Good morning still.
Okay. I will start. My name is Lindsay Eshelman. I'm the Deputy Director of Crisis and Residential Services for John F. Kennedy Behavioral Health Center.
Good morning. I'm Tenera Styles, the Clinical Supervisor for JFK Crisis Services.
My name is Rebecca Stewart. I am on faculty at the Center for Mental Health at Penn, co-leading the Crisis 2.0 Evaluation.
So first, I'd like to thank the Committee for having us here today to share about the services we provide to citizens of Philadelphia. I'm going to start by discussing how we promote safety and improve client outcomes. I'll then discuss how mobile teams fit into Philadelphia's Crisis Continuum and will conclude by sharing how we ensure staff are appropriately trained and adequately reflect the populations they serve. I'll then turn it over to Tenera, who will provide some real-life examples of dispatches that our teams have handled. Sorry. Just need to make sure I'm close to this. So how we promote safety, how do we do this: So first, by meeting people where they are. So we'll go to wherever the crisis is occurring. So this could be in a home, at a shelter, in a library, on the street. We're never asking someone to come outside and meet us. We're going to them. So this really increases comfort. Second, by prioritizing confidentiality. So teams arrive and we're wearing plain clothes, so we're not dressed in a uniform. And we'll identify ourselves through the use of badges such as this. Some teams might have small insignias on their shirts, but we're not overtly announcing to passersby or to neighbors who we are. We also preserve client confidentiality by asking where the consumer feels comfortable sharing with us. So if we go to a library, we might ask if there's a free room 8 that we can speak to the person in. If we're in the home, we might ask where they feel comfortable sharing with us because they might not speak freely in front of family members. So one team member could speak with the consumer in crisis. One team member could speak with the family. We can make sure that everyone's heard, that we're gathering all the information simultaneously and providing the best outcomes. Lastly, we promote safety by creating safe spaces. So we really want team members to notice nonverbal cues, both their own nonverbal cues and the nonverbal cues of those that they're serving. So this means we want everyone to have open body language. We don't want them crossing their arms. We want them to notice if maybe a consumer is clenching and unclenching their fists. This might indicate to us that we need to disengage, give the person more space or try to redirect them. Lastly, we train them in active listening. So we don't only want to hear what the consumer is telling us. We want to ensure that they feel heard as well. So all of these factors contribute to us creating safety for both the clients, the communities and the teams that are out there. So improving outcomes. We achieve this by providing person-centered approaches. So each of our interventions are tailored specifically to the person we are meeting. So because the City has expanded the number of teams providing services, this allows us to spend time thoroughly gathering information, harnessing natural supports and truly valuing client input. And by doing this, we provide meaningful solutions that reduce reliance on crisis response centers and promote the usage of and linkage to community supports. So now, where do we fit in on Philly's crisis continuum? So we see ourselves as the second layer of support with the Philadelphia Crisis Line being the first layer. And they do an excellent job at providing resources and resolving many of the less-acute crisis situations. But there are occasions that necessitate an inperson intervention. So this might be a health and welfare check. There might be circumstances where a delegate is unsure or unable to determine if the information presented is domestic in nature or mental health-related. There are also instances where they just can't de-escalate someone over the telephone or maybe they don't feel comfortable creating a safety plan without having eyes on the person first. So once the teams receive a dispatch, the primary goal is to get to the scene as quickly as possible to avoid any changes in the circumstances.
So the faster we arrive, the higher the chances are that the person in crisis, A, hasn't left the scene or, B, hasn't changed their mind about receiving services or, C, the situation hasn't changed necessitating some other type of intervention. So as DBHIDS previously said, our new dispatching program, Behavioral Health Link has improved response times by offering geo locating technology. That allows dispatchers to see which team is closest to the crisis. So once teams arrive on scene, they identify themselves and begin the assessment and information- gathering process. So in addition to implementing evidence based- techniques, teams utilize existing health care and community resources that are integrated into the crisis continuum as a means of preventing need for hospitalizations or CRC referrals. So similar to emergency departments, we triage needs based on acuity, allowing us to expedite certain supports. So for instance, a client that's seen by a JFK team can be referred to our Fast Track system. This gets them an intake appointment within 72 hours of service. And in acute cases, it can be same day. So this cuts down the wait time for an intake appointment from potentially months to a mere few days. Additionally, as DBHIDs referred to previously, the new Merakey walk-in clinic can provide great treatment options. So if a team notices that someone's experiencing a crisis because they don't have access to their medication, we might transport them to the Merakey walk-in clinic where they can receive a Bridge script. So if they do have current services, they just don't have an appointment in the near future, they can get a Bridge script for three weeks. Merakey walk-in clinic can also write new prescriptions. They have peer-support specialists, case managers, short-term provider treatment options. And if we do notice that someone needs to go to the Merakey walk-in clinic, we will give them a call in advance to let them know that we're coming. And we also will provide them with a warm handoff so they know what the situation is. In sum, we're kind of a second layer of support. We can provide expedited linkage to needed supports and we also do onsite stabilization plans. So if we don't need to bring anyone anywhere we'll at least create a stabilization plan and then we'll do follow-up to ensure that they're following that stabilization plan. Finally, how do we ensure staff are appropriately trained and adequately represent the populations they serve? So our staff consists of registered nurses, certified peer specialists, licensed mental health clinicians among others. So when screening for appropriate candidates, we not only want to see credentials that look good on paper, but we also look for qualities that translate well into real-life application. We need individuals that function well under pressure, have the ability to multitask and also think outside of the box. Once hired, supervisors will conduct scenario trainings to give staff sort of a broad view of different crises situations. New staff will also shadow teams to gain an understanding of how they function, what they do and who they serve. So all staff also receive onboarding and ongoing training in areas such as suicide prevention, motivational interviewing, trauma- informed therapy, cultural competency, among others. All staff also receive ongoing supervision by a Master's level mental health clinician. Additionally, the ongoing support of this program has allowed us to hire supervisors that are in person nearly 24/7. And so, for those few hours where we don't have an inperson supervisor, there's always someone that's on call. So this allows teams to have extra guidance through complicated situations. Also, if a critical incident occurs, they'll have access to a supervisor for debriefing services. And this is really important because as DBHIDS had mentioned, there is a high degree of burnout in this field.
And so, having that supervisory of support is essential to staff retention and it's also critical to the goal of achieving compassionate care to the communities that we serve. So in terms of diversity, staff provide support by drawing on both lived and clinical experience. So we ensure that staff live within the communities that they serve so that they can draw from that knowledge base when providing assessments and building rapport. JFK ensures that teams know, hear and recognize the communities they serve. And with that, I'm going to turn it over to Tenera to give you some examples of dispatches.
Good morning again and thank you for allowing us to speak in front of the Council.
Tenera Styles. Due to our teams being diverse, well-trained and supported as well as fully integrated into the crisis continuum, they excel at onsite stabilization. An example, for instance, is where a team went out to a personal care home to assess a resident who was agitated and restless. The team was able to de-escalate and redirect the behaviors through brief interventions counseling as well as being able to identify that resident's triggers, which specifically had to deal with family dynamics. The team was also in a place to provide staff with insight as well as support to help them mitigate any future escalation of behaviors in that situation. Also, they were able to make contact with that individual's therapist to move their appointment up to the same day as well as passing off pertinent information to help with that day's session of importance to what that episode incurred. The intervention used by the team was also able to help avoid the use of this crisis response center as well as providing support with personal care staff and then avoiding the possible termination of that resident's agreement with the home. Another occasion the team responded to an individual that was in crisis experiencing a suicidal ideation after they had a very recent serious attempt. The team built rapport with that individual, offering understanding, compassion and was able to identify and let the individual express their unmet needs, fears and anxieties going forward. They worked with the individual to develop a comprehensive safety plan that included natural supports as well as providing follow-up through JFK in connection with our services. Through this interaction, the team once again was able to avoid the use of a crisis response center and allowing the individual to stay home, maintain their autonomy and allow them to willingly agree to benefits and services.
Thanks again for allowing us to share and I'll turn it over to our researcher.
Hello. My name is Rebecca Stewart. Thank you for having me and also to DBHIDS for including me --
Closer really? I'm a clinical psychologist and assistant professor at the University of Pennsylvania. Today I'm speaking on behalf of my co-investigator Molly Candon and our team at the Penn Center for Mental Health. 0, which Dr. Williams described so well. It's a citywide initiative aimed at improving the experiences of Philadelphians having a mental health crisis, which includes an expansion of adult mobile health crisis services which is why we are here today. In short, I can report to you that mobile crisis services in Philadelphia are decreasing the need for expensive inpatient care, which results in cost savings to the city. We already know that mobile crisis services work. One way that researchers measure their effectiveness is if mobile crisis services help individuals de-escalate and connect to community-based care while avoiding other costly and potentially traumatizing outcomes. The effectiveness of mobile crisis services, especially in decreasing hospitalization rates, while facilitating access to community-based care has been demonstrated in other cities for many years. For example, a rigorous study in Atlanta from 24 years ago found that mobile crisis services resulted in a statistically significant reduction in psychiatric hospitalizations compared to crises handled by police. A more recent study from Connecticut concluded that mobile crisis services reduced the use of emergency departments, another very expensive level of care. Researchers have also found that most individuals in crisis do not want police involvement and prefer trained mental health teams. Mobile crisis services do just that, by connecting individuals in crisis to the appropriate expertise and minimizing criminal justice involvement. 0 evaluation, we have some exciting preliminary analyses to share with you today. One of the biggest challenges in evaluating programs like mobile crisis services is constructing a comparison group. That has a similar group of individuals who do not receive mobile crisis services, so we can compare their outcomes to a group who did not receive mobile crisis services. Using administrative data from here in Philadelphia, we compared Medicaid-enrolled individuals in crisis who called 988 and received crisis services in '22 and '23 to a group of Medicaid- enrolled individuals in crisis who called 911 and received care from ambulances in 2018 and 2019 before we had these teams. We found that half of individuals who used ambulances ended up in a psychiatric hospital within 30 days of their encounter compared to only one-third of individuals who used mobile crisis services. This amounts to a 34% reduction in inpatient care. And based on our estimates, the decline translates into roughly 5 million in cost savings in the city over two years. Our evaluation team is doing more than just looking at administrative data to understand and improve the delivery of mobile crisis services in Philadelphia. We've convened a community advisory board of experts along the crisis continuum, including Philadelphians with lived experience. We're serving staff, talking to this retention issue of local agencies to better understand the barriers and facilitators of providing high- quality mobile crisis services safely. This year our team will interview Philadelphians who use crisis services, including adult mobile crisis services with the hope of pinpointing areas of strength and opportunities for improvement. We will be thrilled to share the findings with you in the future. To close, I commend the City for providing these much- needed services and I extol the Department of Behavioral Health and Intellectual Disability Services and Community Behavioral Health for pursuing a rigorous evaluation of its rollout and for their commitment to continue to improve mobile crisis services. On a personal note, I'd like to share with her permission that of my co-investigator Molly Candon. A decade ago she had her own mental health crisis.
Like many Americans, she resided in an area without mobile crisis services. Her episode escalated and she was involuntary committed to a psychiatric hospital before being connected to the community- based care that helped her. We are committed to this work in part because we believe she would have had more effective and less-traumatizing care had she been served by mobile crisis services. 0 and I'm happy to take any questions. Thank you.
Thank you all for your testimony. For the record when I cross my arms like this, it's only because I'm cold. Don't want you reading to anything that is not there. But a couple of questions: One, what percentage of the people that you are engaging are senior citizens? I heard that you have actually gone to facilities to have to intervene. What percentage does that represent?
So I don't have an exact number. I can give you one at some point, but I would say it's probably about if I just had to guess maybe 20% of our callers, maybe 25%. It kind of fluctuates depending on the month. So I could also provide you with data that's over a few months' span.
And conversely, what percentage of your respondents are juveniles?
So that's actually a question that I couldn't really answer because we have specific children's mobile crisis teams. So JFK is an adult mobile crisis team. We will handle children calls if there's an influx of those at one time, but we only get about maybe two or three a month in that capacity. But I could certainly pass that along to the child mobile crisis teams to give you some data on that.
Yeah. I think those are important demographics that we need to kind of codify. Your 72-hour referral process, does that pose a problem sometimes where -- when does that kick in versus immediate care?
Right. So we typically will refer someone to an intake within 72 hours if we're able to stabilize the crisis at that time and we feel comfortable with an onsite stabilization plan. And again, we can do same-day referrals in urgent circumstances. So that is a possibility. But we continue to do follow-ups usually within 24 hours, so the person that we do make a referral for will have a follow-up call the next day.
And finally your vans, do you transport people in those vans? And if so, describe for me the interior of the van?
So we do transport individuals in the van. They're really just typical vans. There's nothing that's adjusted inside of them with the exception of one of our vehicles that does have a divider between the front where the team is sitting in the back, but that's just one of the vehicles. And team members kind of can choose which vehicle they feel the most comfortable going out into the field in.
So that's very different than if someone was being restrained or arrested?
Thank you, Mr. Chair. Thank you so much for your testimony and thank you so much for your work. I guess I should have known this, but I was actually really startled by DBH's testimony about the low rate of pay that we were initially offering to people on our mobile crisis teams. And I know that we've made some strides, right, through our joint budget advocacy with Treatment Not Trauma. But I wanted to just get on record what is the actual starting rate and salary for each role on the mobile crisis team? And how does that compare to other jobs that similarly-skilled people might be seeking?
So I'll have to get back to you with the actual numbers on that. And it's also different based on agency. So not each agency pays the same pay rate. JFK maybe being an exception because our staff is unionized, so it's a little different than the other agencies. But a certified peer specialist, the average rate would be between $15 and $20. For a mobile crisis team mem -- and that's per hour. And for a mobile crisis team member, between about $25 to $32 an hour depending on the agency. But again, I can give you precise numbers once I gather them from the different agencies as well.
I would love to -- I think the whole Committee would love that information, particularly as we're headed into budget. And what are just your -- I know you have to get us concrete data and I appreciate that. But do you have an initial sense on how competitive those rates are?
So if we're talking about a Master's level clinician being paid let's go with $30 an hour, it would be about $14 to $15 lower than a comparable job with that clinical background.
Okay. So that's a problem. I think we can note that.
Thank you. And I just wanted to thank Ms. Stewart for the invaluable research that you've been conducting. It'd be great to have a copy of that if we don't already. And I would also say in particular I like that you were able to quantify the specific cos saving. I know that we have a certain number in mind that we're trying to get to for the mobile crisis response in the city. But as a baseline, right, we should at least be or I would argue that we should at least be adding that cost savings into the budget because clearly this is a good return on investment for the city. Did you want to respond to that?
Of course. I'm just really thrilled with your focus on the low salaries. We do not pay for mental health in this country, and that goes all the way up to the low reimbursement rates from Medicaid. And so, this affects everything from the salaries to what our providers can pay for to salaries at Penn Medicine in psychiatry. It all goes back to these terrible reimbursement rates that happen in our country for mental health. The second thing I really wanted to add as part of our evaluation is we're doing a workforce survey. So we've partnered with DBHIDS and we are almost finished collecting data. We have data from over 230 first- line crisis workers. And so, we've asked them about a variety of things, including their psychological safety and also their satisfaction with various factors in their position, including obviously compensation but also the sorts of supports that they receive. We've asked their satisfaction and then also how important they rate these factors in their jobs. I mean, many of these individuals do not go into these jobs for pay. But then we also ask their turnover intentions, and then we're going to try to follow up with them in six months. And then see how they rated these factors and whether they have turned over and where they're leaving. One of our hypotheses is because they are receiving better rates in the private sector, particularly with all these telehealth startups, that many of our workforce in the public behavior health system are moving out into the private sector for better rates of pay and for other reasons. But anyway, stay tuned. The data are going to be almost completely collected in the next week or so. And so, we'd love to be invited back to report some of those findings to you.
We would be highly interested in that. Thank you so much. Thank you, Mr. Chair,
Thank you so much. This was really important testimony from all of you. I have a question for JFK Behavioral Health. You mentioned cultural competency. I just wanted to know, you know, we have diverse communities living here with language access issues. Is there something you are doing -- and I don't know if it's just you as a provider and this is something probably if this is a standard requirement of all providers -- to be able to bring services that could help in the cultural competency of addressing the needs of the client?
So I'll start by saying all of our teams have access to interpretation lines, but we also will work collaboratively with the other agencies. So maybe there might be a team that's more appropriate for the given call than another team. So then we might not prioritize rapid response time. We might prioritize having a more appropriate team go out and respond. So let's say there's a Spanish-speaking team while another agency doesn't have a Spanish- speaking team available. We might prioritize that in a situation. And I'll let Tenera Styles speaks towards training since she conducts the trainings.
Thank you. We try to make sure that all of our team members are aware of the different cultural aspects in our city as well as their traditions so they can assist all of these members within the confines of what works for them versus what they may think work.
Thank you. Yes, I think this would be great, and I'm speaking to the previous panel as well, to have this as a requirement in training for those who provide these services to see what exactly they're doing. The language lines that you mentioned, the interpretation lines, they can be extremely spotty in their quality. I've tested it with speaking a different language and what exactly gets said. And so, I just worry about quality control there and depending on it so much whereas if it was more built in, knowing our city and knowing geographically we have diverse communities, just building that into how we address it would be really helpful and useful.
And I will speak to that because we do have more agencies and because we can spend more time with the consumer, there are instances where we do harness the natural supports. So we might ask a family member who is down the street to come over to help assist us. And that really can make things more familiar and more comfortable. Because, as you did say, I mean using a language service line isn't ideal because it's also strange to have someone on the phone while you're both in person, so I do understand that.
That's right. Well, thank you. Just wanted some more focus on that across the board from everybody. I had a question about your response. You said that you were able to avoid the -- so I'm just trying to understand how you respond for that person from the personal care facility, they called 988 and then you -- how did that happen? How did you get that call versus sending another team? I just wanted to understand that process.
So they called 988, so the service provider at the group home called 988. And then PCL or the Philadelphia Crisis Line fielded the call. And then they dispatched JFK based on geolocation technology.
Because I heard you say you didn't have to use the crisis response team. Aren't you the crisis response team? I was a little confused with terminology maybe.
So the crisis response center, so they didn't have to transported.
SO it didn't go to the crisis response center. It came directly to you?
The team went out and they were able to have a stabilization plan, so there was no need for the team to transport the individual to a crisis response center for high level care.
Okay. But the responses from whoever can respond, it comes through 988 and is just streamed to whoever is available or is appropriate for responding. I just wanted to be clear about that.
And going to the question about salaries, it's a cultural shift in our country not just locally. But we need to keep talking about it so people understand what the value is, of what the service is and why it's important to reimburse at a correct rate, at a better rate. And that's where I think all of us can be involved in being advocates for talking about that. So please feel free to reach out to us, to me specifically because I'm the chair of Public Health and Human Services. And I think it behooves us to really amplify the fact that we need people ready, well, with good salaries, with the state of mind in order to be able to do this work regardless of what training they have, right. It's the work conditions we're talking about. So please use us outside of just budgetary concerns to amplify this and lift this up because we can talk to. Even if the federal government doesn't listen to us right now, we can talk to our state level places, particularly the Governor to say, how do we fill and backfill some holes that might be left and how can we be an example to the rest of the country about what we do for our providers. So we look to that. Thank you.
Thank you, Member. That's very important that we maintain adequate and appropriate salaries so that we don't have this turnover problem. You are trained professionals and all you have to do is -- even in this building when we deal with constituents that in our office sometimes will have a crisis. It lets us know how difficult that can be, how traumatizing it can be for us to have to kind of address that without you. We don't know what we would do and I've had those kinds of situations and I'm thankful, thankful for being able to call upon professionals that can tell us how to intervene. And it resulted in crisis identification for my staff that if somebody is having a problem, how we should approach it. So thank you for what you do. Chair recognizes Member Harrity.
I have just a couple quick questions. First ones are for Penn and then I got a couple for JFK. So, Penn, if, a family needs a mental health intervention team to assist with a 302 of a family member, what options do they have as calling a hotline rather than the 911 system?
And if the family member is a -- so if the family member is hard to manage or difficult? What are the options when it comes to somebody, a child or a son, whatever living at home and the parents are scared, like we've seen, would happen and we had that tragedy, what options are there? Because I'm a firm believer in when it comes to mental health episodes and domestic episodes, the police showing up always escalates everything. So could you just tell me a little bit about how that goes and how you guys interact with the family members to help them to get the other family member into care?
So there are a few options if a family is pursuing a 302. So perhaps if there is an acute crisis happening in the home currently, another family member who has seen the behaviors within the past 30 days could go to the CRC and file for a 302 petition. The other way is of course calling 988, having one of our teams go out. And because we are teams of two, this allows us to maybe separate the family member from the consumer in crisis. So a team member can consult with the consumer in crisis while another team member gathers information for a 302. Other situations we have is sometimes it's difficult if someone goes to a CRC filing for a 302, it's difficult for a delegate to tell if it's truly a mental health crisis because some people don't understand what the criteria for a 302 are. And in those circumstances, they will send out the mobile crisis team to be the eyes on the scene to understand, okay, is this just a situation where someone wants to get someone out of the house or is this a substance use issue, which of course substance use and mental health and a 302 can go hand-in- hand, but sometimes families really want to force treatment upon people by going the 302 route where it's not appropriate. So these are really the options that are available. And of course, the hope is that if someone does call 911 that it'll get patched over to 988 if it's not a circumstance that necessitates a law response.
And since we're on that, just a little follow-up, what is the percentage of -- what's your rate of you getting there and actually having to 302 somebody or getting them to voluntarily go because it's very different?
Yeah. So about 80% of our calls are a result in community stabilization. And I would say anywhere between -- it's probably about 15% that do result in a 302 and what we also do --
Excuse me. For the listening audience that may not know what a 302 is, could you --
Yes. A 302 is an involuntary commitment. It's a warrant for involuntary commitment. So about 15% might result in the 302 and we also do track on our end the amount of 302s that are upheld once they do come go to the CRC. And typically I would say 95% are upheld, and there's about or that are discharged. So it's a pretty high rate in terms of the 302s that are written and the 302s that are appropriate. So about like I said 95%. Does that answer the question? Was there anything --
Yeah, I appreciate that. And while we're on the subject, how do you distinguish with, as you said, somebody who is suffering from substance abuse and somebody is calling about mental health? Knowing from experience, somebody can have a substance abuse problem and still be having a mental health incident rather than it -- it could be caused by the substance abuse, but they're so intertwined, you know.
So the differentiation is really what we would say that the qualifiers are for a 302. So if someone has a substance use issue and they're not caring for themselves, they've lost pounds in the last few weeks. 10 They might have defecated on themselves. They might not be oriented to person, place or time. These would be factors that could add up to an inability to care. But there are people that are using substances that aren't really -- they're not showing signs of mental instability, per se. They're using substances, they don't want treatment, but they're still caring for themselves in some way. They're still oriented to time and place. They're not a harm to anyone else. I mean, certainly using substances can be a harm to yourself, but that's not active suicidality. So those are things we consider when deciding whether it's strictly substance use or substance use with a co-occurring mental health issue.
Are there any numbers or studies on whether or how many mental health issues we're getting in different areas of the city? Are there hot spots in other words in reference to since we bought it up at the Kensington thing, you know what I mean? Is there areas of the city where you see more of this happening and is that because the substance abuse issues also?
So we do have that data. The data is provided to us by DBH on a monthly basis that we review. So they do have a heat map that shows us the high-volume areas, which one of the high-volume areas is the southwest region, which would be the concern about consortium, the 19143 area code. But we do also get data on what percentages are substance use, what percentage are psychosis, suicidal, homicidal, so we do track all that data. I don't have it with me on hand, but we get it monthly from DBHIDS.
Can you guys see in those numbers any disparities in low-income areas, so mental health, right?
Yes, there's definitely a high degree of disparity. I didn't mean to laugh or anything, but a high degree of disparity between lower-income area areas and higher-income areas. Again, I don't have that exact data with me, but we do have it from DBHIDS which we can be more than happy to send to you after this session.
And does that have anything to do with the amount of care in those areas also? Are they underserved is what I'm trying to get at? Should we have more mental health people in certain areas of the city for different reasons?
Yeah. So access to services is a real hindrance. I mean, as I maybe mentioned earlier wait times for let's say case management could be up to three months. And case management can provide services for employment, transportation, medication management, because a lot of these individuals are experiencing crises because of social determinants of health. They don't have stable housing, they're experiencing food insecurity, any number of these things. And so, this is something that could be resolved if we had more case management access really. So I think that that would be something to consider.
Thank you so much for your testimony and thank you for what you do. One of yous said earlier, which struck me which I always say about different jobs, that people that get into this don't do it for the pay. So I thank you. We have a couple groups like that, police, fire, you know, our emergency responders and also our social workers and mental health professionals. So I thank you.
Thank you, Member. Yeah, those were good questions and stimulated other questions. Member Gauthier.
Quick point just following up on my colleague. I haven't seen the map, but I imagine if there were a map about where you're doing the most service calls, that it's the same map of where the most gun violence happens --
-- it's the same map at where the housing crisis is most impacting people. It's the same map of where we have the most quality-of-life concerns. I'm imagining that all of these things tie together, and maybe assuming research is not dead in the United States of America, maybe that's the next research study or maybe it already exists. Thank you, Mr. Chair.
Yeah, that did spark the connectivity between other social issues and this issue. And so, if you can provide a map, I think it'll be telling to what is happening. And, Member Nina Ahmad.
Just a comment on how to separate what is a mental health crisis because of certain social determinants of health versus somebody who has a mental health disorder that is most likely off a chemical basis, right. So how do you parse that and the data that I know was just asked for in terms of the overlay of where you see this, we have to be careful that we don't conflate these two things, right. So I just wanted to make sure that the response that you all are giving can separate that out.
So in the guidelines or -- yeah, I guess it's the guidelines for crisis teams, they did implement a social determinance of health assessment in June of 2024. So that is one of the assessments that we conduct. So we can see clearly what someone might be lacking in a situation. We also conduct risk assessments and because we have the time to spend with individuals, we also get their information in terms of what their mental health diagnosis might be, what medications they're taking. So we are pretty thorough and being able to understand what is mental health-related, what is substance use-related, what social determinance of health-related and what's a combination of these factors.
I would also for the record like to acknowledge President Kenyatta Johnson is here. Would you like to say anything, Mr. President?
Okay. One other quick question. When you're doing this mapping about poverty, when you're doing the demographic analysis versus young people versus seniors and the like, can you add members with language issues and cultural issues? There's a difference between certain cultures and how they deal with mental health issues, whether it's Islamic, whether it's Asian, there's a different kind of acceptance, if you would. And if you can kind of asterisk that in the map to the degree that you can.
So I will ask DBHIDS to do that because we don't create, generate the reports, but certainly JFK individually we do track that information personally.
This is more geared toward DBHIDS, if that's okay. I know that there will be a transition with the Consortium. The Consortium is the primary organization that has been engaging in mobile therapeutic crisis services throughout the city of Philadelphia. And so, now that there will be a transition I just want you to go on the record and tell me what does it look like in the future if we're not using the Consortium?
Can members please come back to the witness table. (Witness approached Witness table.)
Thank you so much for your testimony. It was in inspiring actually that we can actually move things in the right direction. But we're going to keep it moving by way of supplementing and dealing with the income issue to Member President Johnson's question please.
Dr. Marquita Williams, Interim Commissioner for the Department of Behavioral Health and Intellectual Disability Services. Good afternoon, President Johnson. It has not yet been determined that there will be a transition. But in the case that that would happen, we have been having meetings around looking at providers in the area that we could transfer services to, making sure that there's continuity of care, making sure that the level of services that Consortium provides would be accommodated for all of the clients so that there is no delay or gap in services.
I just wanted to go on the record because I know the work that the Consortium has been doing, and this started when the young man was murdered by the police officer in West Philadelphia, and then we took a proactive approach and worked with the Philadelphia Police Department making sure we have to mobile crisis units are on the scene any time that these types of incidents take place where a person is shot and/or murdered or have an episode, so to speak. Because I have a large constituent base that utilizes the support from the Consortium, and when it comes to this particular topic I just wanted to make sure that whoever the provider will be this still becomes a priority. But most importantly, we're even talking about expanding it and taking it to the next level when it comes to the issue addressing trauma and support for those most in need. So thank you. Hopefully you'll become permanent one day. I appreciate your hard work and your dedication and your leadership, right.
So that you know, Mr. President, we have been on top of that issue and kind of wanted to not do it here --
-- but we are cognizant of what issue is for the only minority provider of these services that we know of. So we're on it, sir.
Absolutely. Your concerns are our concerns as well, so thank you.
Thank you, Mr. President. Without any other -- did you have a --
Without any other questions, thank you all for your inspiring again testimony. Ms. Stack, who is the next panel to testify.
Is that it? Yeah, call up everybody because we have a hard stop at 1:00.
Thank you for your patience. Please be seated and begin your testimony.
I'm glad Council President is here so you can hear the hard work that the City of Philadelphia employees are doing. Good afternoon. My name is Stephanie Bey. I work for the City of Philadelphia. I am a Program Analyst Health -- well, I'm a Health Program Analyst Supervisor for the Department of Behavioral Health. I've been there since '08. So I love my job. I am also a member of District Council 47 Local 2186, which represents white-collar supervisors. (Applause.)
and I represent the Executive board, so I'm an Executive board liaison. Although I work in our Infant and Toddler Early Intervention Unit, I did bring some resources that our Commissioner spoke of that we share in the community, that you can share with your constituents that will help you understand the services we do provide. And I'll make sure I get that to you. Although I am with the union and I work in the Infant and Toddler Early Intervention Division as a liaison for the Executive board, I also meet with our members. So I'm going to present the voice that our members are not being presented with today. And we are the Philadelphia Crisis Line. We are the ones taking it, we are the front line workers. We're the ones receiving the calls. We're the ones dispatching it, and here's what they have to say: Good afternoon, Public Safety and Public Health Joint Committee Members. A special thank you to Councilmember Curtis Jones for providing a space for us to share insight on the mobile crisis team structure and crisis response process for the Department of Behavioral Health Intellectual Disability Services, affectionately known as DBHIDS. The 988 Suicide and Crisis Lifeline offers 24/7 access to compassionate, trained professional callers experiencing suicidal feelings, substance use challenges, mental health crisis or any other emotional distress receiving counseling, guidance and direction for prompt evaluation and treatment services. 988 serves as a universal entry point nationwide, ensuring that no matter where you live in the U.S you can reach out to a trained counselor for support. The Philadelphia Crisis Line has a unique inhouse model. The Philadelphia Crisis Line, affectionately known as PCL, is the only inhouse crisis line in the country. Let me repeat that. We are the only inhouse crisis line in the United States of America. (Applause.)
Unlike other cities where crisis lines are contracted out, having an inhouse system is more efficient and cost- effective. Mobile crisis teams, they're also known as MCTs, each mobile crisis team consists of nurses, Master's level clinicians, Bachelor's level mental health workers, recovery specialists and certified peer specialists in some cases. Team members receive training through their respective organizations along with additional training provided by the Department of Behavioral Health Intellectual Disability Services. These include, but not limited to, 302 training which is involuntary committed process, mental health first aid and dispatch system operations. This is what we do and we continue to do to support those that support our families. All team members are required to complete yearly training and to maintain expertise and effectiveness in crisis response. And, Councilman, I knew you wanted to know the process of what happened when the calls come in. The crisis response process and timeline: An individual in crisis can call 215-685-6440, but that may be too much, or you can dial 988 which is simpler and easier, right. The Philadelphia Crisis Line staff answers calls and communicate with the respectives -- with the representatives to gather details about the person in crisis. This is what we do, your employees, City of Philadelphia. This is what we're doing. A dispatch is sent to the closest mobile crisis team, and you heard that they are broken down by regions. There are separate teams for adults and children. If the team determined that the individual meet the criteria for assistance, they help family or friends draft a petition statement if voluntary intervention is needed. If the individual is willing, they are transported to a crisis response center, and I have that information, our department has it on our cards that I will share with you, and response time vary based on the individual's cooperation and situation-specific. Additional follow-up team and care coordinators help connect individuals and families to person-centered resources for ongoing support. What are some of the opportunities for improvement with our mobile crisis team? We believe the mobile crisis team could benefit from a centralized training program for all team members, including the supervisors and administrators. Mental health workers which are the Bachelor's level, mental health workers often struggle with identifying and diagnosing and should be equipped with border range of options for support for the individual in crisis or the family. Some individuals may not require hospitalization but simply need guidance or someone to talk to. Furthermore, Philadelphia Crisis Line operates with one Health Program Manager. This is a 24-hour shift. We have four supervisors, and 10 to 12 I'll say social workers that are taking these calls. Although our leadership is aware that there is one Health Program Manager, they are working with him to build capacity -- and congratulations to him, his wife just had a baby -- and our supervisors say he does get on calls with them 2 o'clock in the morning during the supervision, but we need to build capacity within -- okay, we want to talk about that -- and overseeing all shifts. This leaves overnight staff with little to no direct support. m. in the morning? We have to reach out to the manager and he has to be back on the following shift. We have four shifts. So as we're looking to build capacity for the mobile crisis team and bring in resources, we want to look at building capacity for the civil servant that -- because he's a civil servant, our Health Program Manager, to build resources to support him. And the union is -- we understand that he needs additional support, but that's a lot to work four shifts and manage all the numbers that you heard shared. That's just a lot for us. Okay. So DBH mobile crisis team provider: We have PATH which is Region 1. That is the Northeast.
We have JFK which is Region 2, North and Center City. We have Elwyn, they are Region 3, North and Northwest. And the Consortium is Region 4, South, West and Southwest Philadelphia. We do have a children crisis mobile team. I didn't hear them spoken of often, but it is called Children Crisis Treatment Center, and we know CCTC. They've been around a very long time. And I want to take this opportunity to thank all of you for your ongoing support and dedication to improving crisis response services in the city of Philadelphia. And that concludes my testimony. Thank you very much.
Of course. Hello, my name is Julia Lyon. I use she/her pronouns, and I'm a licensed clinical social worker and a therapist and I work in Center City Philadelphia. I've worked in community mental health, which means mental health services that are funded by Medicaid or for those who are living in poverty in Philly for years. For the last four years, I have been a member of the Treatment Not Trauma Coalition or TNT, a community-based group which formed after the police killing of Walter Wallace, Jr. in West Philadelphia in 2020. I'm here today to share with you some of the truths that I have come to learn in my work over the last decade. And I'm here to implore you to invest in the expansion of CMCRT, the mobile crisis program which is a commonsense lifesaving solution to mental health crises in Philadelphia. The first truth is that people experiencing mental health emergencies are at their most vulnerable and are in a state of powerlessness. Because of this vulnerability, these folks need a response to their emergency that is safe, timely and clinician-led. The second truth is that when people don't have this kind of response, they suffer. I have seen it. 25% of all fatal police shootings involve a person with mental health problems. The third truth is that that kind of suffering and loss is completely avoidable. On countless occasions, I have seen my clients become endangered by the wrong response arriving on scene. And conversely, I have seen how connection, support and therapeutic intervention can change the course of someone's life or even save it. CMCRT is the best tool we currently have as clinicians, as family members, as neighbors, as Philadelphians to support someone who is at the point of a crisis. CMCRT stands uniquely apart from PPD's CERT or Co-Responder program. CMCRT fulfills an urgent and desperate need that was previously completely unmet in our city. CMCRT is the difference between finding a way out of a crisis and nothing. It is the difference between a hand reaching out for help and a gun being pointed. It is a lifeline. As a clinician, I cannot begin to tell you the value that CMCRT has had for me when helping my clients and their families plan for their safety and well-being. As a neighbor, I cannot begin to tell you the value of having a service to seek out for people who are visibly in need, in distress. As a former school employee, I cannot begin to tell you the value of having a team to call that can give the child in front of me the chance to feel safe and to begin to heal. However, this program is not nearly big enough to meet the current demand of our city. CMCRT needs to be scaled up to meet that need. Average wait times were over an hour for the first three years of the program's existence. This needs to be reduced to 30 minutes or less. CMCRT teams need to be able to get to their clients quickly, efficiently and without traveling across the city. Philadelphians need an easy to remember and clear way to access help in a mental health emergency, not a jumble of numbers, acronyms and departments. I safety plan with my clients all the time, and almost all of them don't know that CMCRT exists. Folks need to be able to navigate these systems without any expertise or insider knowledge or the advocacy help of someone with credentials. Community members need to be made aware of this program, how it works and what decisions are being made about its design and its implementation. Community members need a response that is not police, CERT and programs like it, the Co-responder model, dispatch a police officer and a clinician, and this response boils down to another police response. The presence of police makes people feel unsafe and makes de-escalation, connection to support extremely difficult, if not impossible. I have witnessed this myself many times.
Mobile crisis funding and resources should go to clinician-led programs like CMCRT that result in better outcomes like fewer 302s and cost less. Finally, the most important truth that I know, the one that has been shown to me over and over again is that humanity is fragile. Humans can only thrive and indeed survive when another person with some expertise or some compassion is available to help. We would consider it barbaric and strange to expect a person having a heart attack or a person whose home is on fire to somehow find a way to change their situation on their own. We would find it strange or barbaric to say, oh, I'm sorry, we don't have enough funding for the program, the program that dispatches someone to support you if you have a heart attack or your home is on fire. We have all seen people suffering but thought it would be too hard or too uncomfortable to help. Recently we have seen dehumanization and cruelty everywhere in our country and at the federal level. Today I ask you to put the necessary resources, money and attention into a program that works, that people can rely on when things are too hard and when people are in desperate crisis. We are beyond the exploratory phase of mobile crisis planning in Philadelphia. A clear picture has formed of what works and what doesn't. A clinician-led response works and a police-led response does not and risks violence. There is a need to take action now to save lives. I ask you to fully fund an expansion of CMCRT, to keep your attention and eyes on the program and its growth and to offer your support to those who implement it. I ask you to do all of these things so that when one of your neighbors or someone you love is utterly alone, there is someone to call to come to their aid, to your aid. Thank you. )
Yeah, I'm just here to help support. My name is Robert Harris. I'm the Vice- president of AFSCME District Council to support with any questions, but we put everything that we needed to say in our members' testimony here. And next time we will have call center folks. They are very hard to come by. They are working many hours, so we will have them for you next time.
So for me as I turn it over to my colleagues, one suggestion -- and I heard several, but one suggestion you would emphasize to make it better for people in Philadelphia?
Many things. Number one, I would say to just push DBHIDS and city infrastructure to expand as quickly as possible. I know that last year for our budget demands, TNT's recommendation was an immediate doubling from roughly around $10 million to $20 million in order to just immediately give those four provider agencies more money to hire more folks just to meet demand. So that would be to me the immediate and the most important thing. I think people like this program when they utilize it. I think it is a much, much better option than people calling 911. I think also just bumping up awareness of the program as much as possible. I cannot tell you how many times people have told me that they endured unnecessary suffering or risked losing themselves or someone they love to suicide because they were too afraid to call 911 and have police officers respond. And I want people to -- I know that that CMCRT and PCL are not perfect, but I don't want people to be in that kind of anguished decision any more than they have to be. So I would say for me those are the two biggest things, just rapidly expanding as fast as is feasible with the four agencies that already have contracts, and then to just consider scaling up the program. Additionally, long-term I think it would make sense for people who staff CMCRT to be city workers, to have even more of the infrastructure housed within city in addition to how the PCL is. I think this makes sense, and I think that it would provide a more stable long-term structure to avoid sort of rapidly changing funding streams and kind of shifts in policy choices based on political administrations.
Good response. But I did say one thing. You mission creeped all the way to all things. Thank you.
It would be -- I don't know if my mic is off. Is it on -- okay. We would say a cross-system training. One thing about DBH, Department of Behavioral Health Intellectual Disability Services, we are a heavy community- based department. We work in collaboration with many community partners and we do a lot of community outreach. We do a lot of educational training and involvement. We even open ourselves to train the community. So we can continue to do training of cross-systems and also with our community partners and with the community. What better is to train a parent of the child that's presenting with the issue. And this was previous Dr. Evans -- I don't know if you remember Dr. Arthur Evans.
His vision was treat the neighborhood. You can't just treat the individual. You have to treat the community, and that's when we opened up to do training everywhere. So my Commissioner, my leadership is right there. We go everywhere. We don't care. We're in every emergency and transitional housing. We don't say shelters anymore. That's not a nice word, but we're there every day. We're in our drug and alcohol programs every day. We were in the warming systems. We are everywhere disseminating information about the Department of Behavioral Health Intellectual Disability Services, because we provide mental health, substance abuse, intellectual disabilities, and don't forget the baby's birth to born with medical diagnoses 3 and developmental delays, and that's who I serve.
Thank you. I know you didn't testify. But would you like to give a --
Robert Harris, Vice-president of AFSCME District Council 47. I agree that we should be bringing these programs into civil service positions, that we've invested into the program. We see that it has done positive things for our city. We see that we are spending our city-earned dollars as citizens of Philadelphia. We should make sure that we're getting Philadelphians strong union jobs, that they are working for the City of Philadelphia and doing these services for the members of our community. So we should be working this program not only out into these other aids and contracting them out, we have people to do that here in Philadelphia, so we should be doing that work.
Just for the record, I want to thank you all for educating us because we learn by having these hearings on how to be helpful. So thank you. Member Gauthier.
Thanks to all of you for your testimony and for your work as well. My questions are about PCL first. Thank you so much, Ms. Bey, for just describing so comprehensively what the staff are taking on and how great of an effort they're making. You all are helping to save lives and helping people, I'm sure helping people to feel not so alone when they feel very alone. I also really loved your idea around the cross-training and really getting out more into the community. I honestly predict that as the City starts to feel more of the impacts of what's happening at the federal level to our economy we're going to need that type of training and support for people even more. I wanted to ask, you know, you talked about sort of the current staff complement and how that is difficult with the amount of calls in the situations you all are taking on. Can you talk more about the staff complement that is more desirable? And I'm sorry if I missed that in the testimony.
I don't know if I could talk to that degree because they're our members and there -- actually our members are the supervisors overseeing the staff. So just to answer your question and I just want to highlight because there's only one supervisor in 10 to staff 12 person, it's sometimes very difficult for us to take leave of absence and take vacations. These things have to be in consideration. So some of the things that they may be discussing or additional support, is that what you're asking?
Well, you so eloquently outlined why it's difficult to have so few supervisors because you're getting calls 24 hours a day. I wanted to know -- and if this is something that the union wants to get back to us about, then that's fine. What would be more ideal with the volume that you have?
Oh, yeah. So we would say we need maybe 6 to 7 supervisors, and for the staff that are handling the calls I see about or because of the volume of 11 the calls. And what would happen 12 it will allow them -- because 13 sometimes they call in and our 14 members, our staff, will have to 15 reach out to their supervisors 16 because the calls coming in from 17 the mobile crisis team may not -- 18 it's like, oh, this doesn't qualify 19 for 302. So they have to follow up 20 with their supervisors before they deny anything. We have an internal -- and I think she's -- process in place. We just can't deny 302s. It's a process. And they have to go to their supervisors to seek guidance, right, so that may extend a phone call. So if we have sufficient staff on each shift, it would allow us to prioritize, right. Move it over to the next delegate so Robert could deal with that while I'm working with the supervisor because I'm not getting the correct information from the mobile worker that's calling in for this 302. So if we could get additional staff, for me I would say I would love for us to have three to four more supervisors. I would love for us to have maybe five to six more clinicians that are taking these calls or social workers that are processing these calls. I know we're short-staffed. We have our labor management meetings with them. We know that we are short in our positions. It's hard, it's hard to find staff to backfill these positions, but we have an interim supervisor that was taken away that's acting in a role as a manager -- I mean, a supervisor acting as an interim manager, but she's a supervisor but we need help. And our HR is working with them to build the capacity. We also have Deputy Commissioner Amanda Davis that's working closely with the leadership in that unit. I mean, they're working with us. So we don't want to present they're not, right.
They're definitely working with us the best they can to help build the capacity. But it's finding the staff, right. It's finding the staff.
Thank you so much. That's helpful. I see DBH chomping at the bit so I think they want to add into this question. But I want to put one more question that maybe someone could expound upon. I know that we do a pretty good job of tracking sort of what happens when people call 911, right, when someone calls 911 how long it takes for them to get an actual answer. Beyond talking about the staff complement at PCL, if anyone can give information on how long does it take if I call 988 for someone to pick up the phone and answer my call?
That would be leadership. I'm not familiar with how long it takes.
All right. So we've got 15 minutes. I got my other members and --
Thank you all. I have palm cards for you. Am I allowed to give that to you? Can we approach or no? It's like we're in a court. Thank you all.
We had -- why don't you get your question on the record.
Okay. Thank you. I actually had a question for Ms. Stephanie Bey because she mentioned mental health workers sometimes struggle with identifying diagnosis and should be equipped with broader range of options for support. So this means you're talking about Master's level clinicians who should be addressing this? I just wanted to understand the flow --
Those are the Bachelor's level mental health workers. I believe the Master's level clinicians are the supervisors. I'm not familiar with how they meet up. But I believe it's the Bachelor's level mental health workers that are calling in when they're reporting to a scene where there's a possible crisis.
So they're having -- so that's what you said. Mental health workers sometimes struggle with identifying. So what would be useful in this --
The individuals that work in that unit, our members are saying they need additional training on how to identify diagnoses. Is it something that we could provide resources for, is this something where they should get a 302. Sometimes when they're calling them, they're just saying they're presenting with, oh, they're being defiant, they're not being respectful. This is the younger ones, right. They're cursing. They're being -- they're giving us a hard way to go. Do we have to 302 this person because the mother wants the person out of the home, the mother's afraid of them, they're scared. So they're calling with these diagnoses, right. And I guess sometimes it has our mental health workers struggling, and they have to follow up with their -- it has us follow up with our supervisor for clarity and guidance and support in the decisions that we may make. So we feel they need additional training that are going out to these sites and doing these evaluations and making a determination on what should happen with Philadelphians when they're presenting with a crisis.
So additional training. And would it be useful to have the people there asking these questions with them as part of the team?
So in addition to additional training for those who are responding, would it be useful to actually have onsite with them people who do have the ability to answer these questions? Meaning, have a broader team address it rather than people with --
And I think it's what he was also saying it's the language, right. We're Philadelphia. We have different cultures. We have from what we've learned over 99 or 100 different languages spoken in the city of Philadelphia and we represent things differently. Me working with infants and toddlers, the state mandate is we use family-friendly language, family-friendly language. We can be very clinician, we can use clinician language but we're dealing with a family that don't know clinician language, right. We have to meet our families where they are and speak a certain dialect so we all can be on the same page. So that's what we mean by, you know, going out there having more than one person, you're right, and I believe it's more than one person that goes out, not familiar. But I think it's more than one person that goes out when it's a crisis. And we want to note that City of Philadelphia employees do not go out. Only one that may go out is a manager or a supervisor, but it would be an extreme reason for us to go out. Typically, we don't go out.
So it would be the team, the providers who are responding?
I'm just trying to understand where the level of additional information is. So the team who's responding, the providers who are responding should have access to somebody who can help them make the diagnosis better --
Just trying to clarify that. So would that support come from Department of Behavioral Health and Intellectual Disability Services?
Thank you, Member. Commissioner, you wanted to interject something for the record?
Interim Commissioner. I wanted to add some additional information and to address Councilwoman Gautheir's question. Kenny Solanke is going to talk a bit more about our staffing complement as a follow-up to Ms. Bey. But I also wanted to let you know, Councilwoman, that from January 2023 to January '25 we had 147,375 calls. The average call length is 7 minutes and the average call speed, what you asked for, is 11 seconds.
My name is Kenny Solanke and I'm the Senior Director of Crisis Operations. And with regards with those numbers, we have approximately -- our staffing pattern is set up to have 43 people. So we have nine supervisors, we have two program managers and the rest are crisis counselors. We have six current vacancies that we're actively working to fill, so we are adequately staffed for now. As we continue to grow the program, our expectation is as we start with chat and text and we do follow-up, we're going to see an increase in demand for staff. So the plan is to use the current vacancies. And then if we need more, obviously we're going to be speaking with our Commissioner to see if we can include that in our budget.
Wait. When you say you're adequately staffed, do you mean --
We are at 1 o'clock. I'm going to just put that on the record. Member Harrity.
I'm good. Most of mine were answered. Just the one, what type of budget number are we talking to fully fund your program?
What was the budget number to fully fund your program? You said 5 million? 6
So last 7 spring -- I don't have the most 8 updated numbers. Last spring our 9 demand at TNT was just automatic 10 doubling. That would take it 11 roughly from 10 million to 20 12 million. 13
Okay. 17 Thank you so very much for your 18 testimony. 19 Ms. Stack, where are 20 we -- is that good?
All right. Thank you. Thank you so very much. This was informative and that is the precursor to our budget so that we know how to be helpful. Thank you so very much. Ms. Stack, would you please name the individuals that want to testify.
For those who have written testimony, please allow the Sergeant-at-Arms to take it. If you can summarize that testimony, that would be helpful because we do have a hard stop, which we are already beyond. But that's all right. When you're getting good information --
Yeah, let's do a minute. And if they have it in writing, please submit it. (Witnesses approached Witness table.)
Thank you so much for your patience. Please be seated. And in the order the clerk said, would you state your name for the record and begin your testimony.
I wanted to start by saying really appreciated hearing all the testimony today, and I wanted to share that at Amistad Law Project where I'm the Co-Executive Director we have a documentary that follows workers from the Consortium doing their mobile crisis work. It is almost done and we would love to have members of Council screen that documentary. It's about 4 minutes. 5 I actually am here 6 today. I wanted to read the 7 testimony of a TNT member who was 8 actually going to testify back when 9 this was scheduled earlier last 10 year but wanted to have her words 11 in this space today. 12 My name is Clarice 13 McCant and I'm a resident and 14 native of Philadelphia. I'm a 15 mother, wife, help lead a nonprofit here in the city and I'm also the primary care support for my sister who was in recent years diagnosed with severe mental illness. Over the past four years since her diagnosis, I have come to learn more intimately than ever that derelict and soul-crushing conditions of Philadelphia mental health services. What we've experienced while accessing care at every single level from mobile crisis to crisis response centers, inpatient Behavioral health and outpatient care has been truly horrifying and traumatizing to my sister. Out of pure and honest desperation and rage, I started going to Treatment Not Trauma meetings wanting to understand what is going wrong. I want to give you a glimpse into what people are experiencing and implore this body to do everything in its power to make radical improvements to these programs. We need to make sure that the reality that my sister and so many others are facing is no 21 longer the norm and that people can get the care that they need without hassle or fear for their safety and their dignity intact. Public mental health care is one of the most important ways to ensure a safe and thriving community, and these services need more investment, not less and that investment needs to come with clear standards of care and improve the mental health outcomes of people who need them. There have been multiple times that my sister was in mental health crisis and I needed urgent support for her care. None of those times did who and what showed up for my sister help my sister feel safe and cared for. In October 2023, I got a call from my sister while I was at work. She had taken some pills and attempted to take her life and was now feeling lightheaded and collapsed on the floor while she was on the phone with me. My heart started pounding. I was so afraid. I did not want to call 911 but I knew she needed to get to the hospital immediately. I called 911 and asked them to send an ambulance. They said that since she was experiencing a mental health crisis, they had to also send police even though I asked them not to since she was not a threat to anyone because she was literally collapsed on the floor. She needed medical help, not police. What crime was taking place. So now, I'm zooming through traffic to get to her place before the police does because who knows what's going to happen once they get there. I arrive and they're kicking the door of the apartment trying to bust in. It's already very escalated. I asked the neighbor if he will let us up. I'm trying to answer them calmly and let them know I'm on the phone and she's not a threat. Once we get in there, they start yelling and rifling through things, and I'm just trying to keep myself calm and seeing my sister on the bed, laid out and unresponsive. Thankfully we got her to the hospital safe without incident. She survived. The police did absolutely nothing but make an already stressful situation more stressful. I think it's important to know that a few weeks before that, she was in an inpatient facility trying to become stable during a manic episode. And the experience of that city's mental health system left her traumatized, depressed and hopeless about her condition.
Had she gotten the right kind of care then she may not have even been in that situation. So Clarice goes on and has like more stories about her sister and her experience. She didn't call mobile crisis and that situation did not actually go very well, so they waited over an hour for help. And then ended up going to a CRC. But I just wanted to share her words just because these situations are very chaotic. And so, we need the system to be as structured as possible so people who are in crisis can get the help they need without the police and so on. So that's all I want to share today. Thank you.
Thank you so much for sharing her testimony. And we shouldn't have to struggle between getting help and endangering the people needing help. And that is a difficult thing to manage and one that needs classically-trained people to be able to do it. Thank you. Next person to testify.
My name is Steven Strauss. I'm an urban policy analyst now retired having worked for cities, counties, unions and nonprofits. I'm a member of course of TNT. When people experience a behavioral health crisis, they need special care grounded in dignity and compassion. Sadly, police have become the default responders for handling the needs of people suffering under the weight of social issues from mental illness to lacking housing to substance use, domestic violence and more. Typical behaviors linked to the behavioral health struggles like loitering and minor public disturbances suck people into the system. And for some, it becomes an endless circle of trauma between jail and the streets. Police presence feeds the criminalization of social marginality. Although officers may have some de-escalation skills, their presence alone heightens tensions, especially in poor Black and Brown neighborhoods. Research points to the staggering estimates of 25% to 50% of those killed by police having histories of mental instability. When the default response is the police, it not only threatens those in need, it undermines public safety by diverting resources from violent crime. Although the PPD does not disclose 911 call data, which should be public and anonymized, national studies find that most calls sending police have nothing to do with serious crime or violence. But one sector in this depressing story that is a standout is civilian behavioral crisis response units that send care workers only. There are now more than 100 programs across the country and they're showing great promise. They rarely need police involvement and they're doing the job at lower cost and more effectively with fewer involuntary commitments and drop-offs at the ER. If there's a central driver, it's probably the focus on relationship-building, especially through staff with direct life experience. Philadelphia is very much a part of this new world, as we've heard, even if some may say or favor a carceral approach in this area. CMCRTs are clearly up and running. Yes, there are also friction points. Philadelphians are unclear about who's coming. Will it be CMCRT or police with weapons and barking orders? Clear decision criteria for triaging at 911, if it exists, have not been disclosed. CMCRT remains starved of funds and in need of structural changes, stability and community oversight. Most of its caseload is through 988. And according to DBHIDs, as we've heard, few responses require police on the scene. More clarity, however, on the police role is needed. So those are my prepared remarks. And I know it's been a long day. I was wondering if I could briefly answer Chairman Jones' question about what might you recommend. So it's really a kind of a wonky data question, in that we haven't yet really found the full universe of behavioral health crisis responses in Philadelphia. We don't know what that is because we're missing 911 data. We have reason to believe that those are the bulk of the calls, certainly more than any other single categorization, right. It's police who are answering those calls. They may be trained in some sort of intervention procedures, but we have no idea really the numbers, although we got a hint of it for I think 2021 and the numbers were quite astonishing, something like 1500 calls per week. Now, we need an update on those numbers. I'm not even positive that that was the figure, but it was astonishingly high. So to understand the mental health situation in Philadelphia, we need to figure out what those are. Thank you.
Thank you for your testimony. I heard nods of approval and appreciation of what you said. So thank you.
Good afternoon. My name is Audrey Hausig. I live in 19143 and I've been a music therapist here in Philly for years. Been 16 extremely privileged to have 17 thousands of people tell me about 18 themselves, about their worst 19 times, about their stories. And 20 I've worked residential, outpatient 21 and inpatient. 22 And something I wanted 23 to share about inpatient is that 24 when we do our treatment groups, I can't tell you how many times that instead of talking about our goals and objectives about gaining coping skills and figuring out triggers that we're stuck on people being activated by the guilt, the shame, the fear and the trauma they experienced being handcuffed and brought into treatment in a police vehicle. So we never even get to the symptoms or what's really going on that brought them there. We spend most of the time just providing support to help people stabilize and start to work through their experience of the transport into the hospital. At the hospital when there is a psychiatric emergency, they generally don't allow security to be involved, right, because that scares people. If you think of your most fearful, awful moment, do you want flashing lights and handcuffs and someone with a gun, right, or do you want a clinician or a peer specialist who understands what you've been through. So even with my Master's degree and everything I've learned in my presence, if I came in a police vehicle with that uniform and a gun, I'm not going to be effective in de-escalating people. So I just want to implore you to increase mobile crisis so that it's available to everybody of all ages, including youth, to adults so that people can feel safe and people feel confident reaching out. Because right now a lot of folks won't call because they're afraid that police will come and they'll have more harm done than good. Thank you.
Thank you for your testimony. For those people, can we transition them to the table. And thank you again for your brevity and thank you again for your patience. We appreciate it. (Witnesses approached Witness table.)
So why don't we go your left to my right I guess, yeah. State your name for the record and begin testimony.
Hi. My name is Kaitlin Orner and I'm a business owner in Germantown and a member of the Treatment Not Trauma Coalition. As a business owner on a prominent commercial corridor, I've encountered a number of public health mental health crisis situations ranging in intensity and outcomes with a variety of responses from both PPD and other providers. I got involved with TNT after a number of failed responses from PPD, most notably when I viewed on my surveillance footage a woman in crisis encountering two Philadelphia police officers. And after a few moments of dialogue between the three of them, the officers got back into their vehicle as she laid down in the intersection in front of my shop. The officers drove away as she lay in the street blocking traffic. She was struck and killed in the same position a minute and 30 seconds later. Her death could have been preventable had the officers taken the necessary precautions to assist her in that moment. Her death could have been preventable if there had been access to a timely mental health response. Her situation deserved an immediate response from specifically trained mental health professionals, not law enforcement who may have given more of a response to a fallen tree limb blocking the intersection than they did to a literal human life in the same position. High-stakes situations such as these deserve immediate response times 7 days a week, 24 hours a day, including midnight on a Saturday night in the middle of the holiday weekend. As a business owner, I continue to witness additional crisis moments and have struggled to find appropriate nonpolice responses to those situations in the moment which has sometimes led to police being just dispatched anyway or more commonly, nothing at all. Recently our business neighbors attended a small business roundtable with Councilmember Landau and they echoed the similar sentiment and its effects on small businesses. We are often the institutions interacting firsthand with community members in need of assistance on a daily basis but lack resources to provide safe alternatives to their circumstances. As we continue to see a rise in mental health crisis, I'm hopeful our city can adapt to respond to the growing need in a safe and dignified way that decreases law enforcement response and increases skilled professional interactions and nontraumatic interventions that result in fewer deaths and a more positive outcome for all. Thanks.
Good afternoon. My name is Jenny Zhang. I am a Philadelphia organizer with Asian Pacific Islander Political Alliance. We're a statewide Asian American advocacy organization. I'm speaking today in support of fully funding our mobile mental mobile crisis units here in Philadelphia. Today I wanted to share the story of Christian Hall. Christian was a Chinese American teenager and he was experiencing a mental health crisis in Monroe County in Pennsylvania on December 30, 2020. He called the police because he needed help. The Pennsylvania State Police responded by shooting him seven times. Video evidence shows that Christian had his hands up when the police opened fire. A call to 988 and access to mobile crisis units would have saved his life if his mental health crisis was met with a mental health response and professionals. Christian might still be with us today. This is not the first time you all have heard his story. Last year City Council passed a resolution honoring the life of Christian Hall and advocating for full funding of 988 at the state level. So hearing everything today and knowing Christian's story, you all know how important mental health response is to mental health crisis. And mobile crisis units could have saved Christian's life. Mobile crisis units could have saved Walter Wallace's life. And mobile crisis units have saved lives already. And if fully funded can save many more lives. And especially as Council considers the budget and as we face potential federal cuts, we cannot afford to skimp on lifesaving resources and services. It is now more important than ever that we fully fund culturally-competent and linguistically-accessible mental health services that protect the health and safety of Philadelphians. We need and deserve compassionate, professional mental health response to mental health crisis. Thank you.
Thank you. I remember that resolution 17 and the sadness in which we submitted it. I think we have two other people to testify; is that right, Ms. Stack?
Thank you so much for your patience. Please be seated. State your name for the record and begin your testimony. (Witnesses approached Witness table.)
Hi. My name is Max Osborn. I am Assistant Professor of Sociology and Criminology at Villanova University. I'm also a member of Treatment Not Trauma, and I also am a resident of the 19143 zip code in Southwest Philadelphia, which as we've already discussed, is the zip code that is currently utilizing mobile crisis services at the highest rates. So I'll be brief and I don't want to recap too much of what people have already said, but I'm also asking that the City invest further in CMCRT as the most effective commonsense solutions to crisis response. We know again that about a quarter of all police shootings involve civilians with mental health conditions and that about two-thirds of police shootings of people in crisis are fatal. We also know that these harms are not distributed equally and that people who are disproportionately likely to be killed or harmed by police include Black and Brown people, disabled people and queer and transgender people. These disparate impacts mean that comprehensive nonpolice response options are especially important for protecting our most vulnerable community members. I also know from my own research, which deals with service access and crisis response for marginalized populations, that when people have negative experiences accessing these services, it really deters them from accessing them in the future. I have spoken with people who have had nonconsensual police involvement in response to crisis situations, who have had involuntary hospitalization experiences and who have told me point blank, I am never going to feel comfortable asking for help again, like I am never calling a service, I'm not calling a hotline, I'm not calling 911, I'm not calling 988, I do not feel comfortable because the experience that I had was so traumatizing. And so, I do want to just note that this is a compounded problem, right. It's not just the response in the moment. What its message is sending to people about what is likely to happen to them if they ask for help from these services. When I've asked people in research interviews what would you in an ideal world imagine happening to you in a crisis situation, what resources do you want to be available. The number one most consistent response that I have heard is that people want some sort of middle ground between calling 911 and doing nothing, right. They want help. They want services, but they also want to be assured that police are not going to show up unexpectedly because people are very, very concerned about that. And people who are experiencing crisis themselves or witnessing someone else in crisis are forced, as other people have mentioned, to decide between potentially calling 988 or 911 and having police show up and harm their loved one or doing nothing and having the loved one harm themselves or someone else. So it is really an impossible choice, and too many people are forced into that situation. So as other folks have said, CMCRT seems to be the best tool that we currently have to support people in times of crisis without involving police, without involving coercive responses that cause people further trauma and victimization. So I like the other Treatment Not Trauma members, I am asking that you commit to protecting our most vulnerable community members by expanding and fully funding CMCRT. Thank you.
Thank you for your testimony. And I sense that this process is evolving, that with your testimony, with other testimony today, we're hearing it and seeing how we can tweak it for the better. So thank you for your testimony.
They weren't here, oh, okay. Well, I'll tell you this, and thank you, members, for sticking it out. I do appreciate it. But what we heard was encouraging. What we heard was and imagine this because I've been around a minute, actual public policy that is actually improving things. That is refreshing to me to see that, no, it is not perfect but, yes, it is moving us in the right direction. And with that input that we received today, we might be able to tweak it, make it better, whether it's how we compensate those individuals, those highly-trained individuals that provide this service to designating them as first responders, to being able to increase the amount of responsiveness, meaning cutting it down to 30-minute response as opposed to what is 50-minute response. All those are worthwhile goals. And the only reason we know these things is because we listened to the people who have to do it. So I applaud you all for caring. And with that my, Co-Chair, would you like to say something or anyone else?
I just wanted to thank Councilmember Curtis Jones. This is a joint hearing, but he's the impetus for this so I'm very grateful to him for bringing all of you here so we could learn from you, we could see what the progress has been made and where we need to improve. And I know there's going to be more follow-up and follow-through. I want to thank all colleagues here who are members of either both or one of the committees. And as Councilmember Jones said, if we don't do this, if we don't listen, we're not really serving our constituents. And this is why this is so valuable and worth sitting through it. And thank you all for coming and participating.
Okay. With that, this concludes the business of the Joint Committee on Public Safety and Health and Human Services to review Resolution No. 8 240703. Thank you all for attending.
Thank you, Mr. Chair. (Joint Committees on Public Safety and Public Health and Human Services concluded at 1:34 p.m.) C E R T I F I C A T I O N I, hereby certify that the proceedings and evidence noted are contained fully and accurately in the stenographic notes taken by me in the foregoing matter, and that this is a correct transcript of the same. __________________________________ TANEHA CARROLL