Partners in Care is a co-responder program between the Metro Nashville Police Department (MNPD) and the Mental Health Cooperative that serves to divert people who experience a mental health crisis from the criminal justice system.
In early December, Cpt. Anthony Brooks who oversees MNPD’s Office of Alternative Policing Strategies together with Michael Randolph, director of Emergency Psychiatric Services-Co-Response at the Mental Health Cooperative, presented an update of the Partners in Care Program to the Metro Council Public Health and Safety Committee.
The Office of Alternative Policing Strategies was created in 2021, Brooks reported, and the first project was to develop and implement the Partners in Care co-response program with the Mental Health Cooperative to protect vulnerable populations as an alternative to traditional policing.
“A lot of this came about in order to simply address mental health crisis calls out in the public with first responders,” Brooks said. “There are a lot of opinions about how those [calls] should be handled. There are a lot of opinions [of people who think] that those in my profession should not be interacting in some of those incidents as much as we do. And certain times I would actually agree with it.”
When people see an incident out in public, they generally do not recognize it as a mental health crisis and call 911, Brooks explained.
“And when a 911 call comes in, law enforcement and/or fire is going to have to respond,” he said. “So, whether we like it or not, we’re going to be involved in these interactions.”
The program started as a pilot in 2021 in the North Nashville and the Hermitage police precincts. By May of 2024, it had expanded to all eight precincts. It has proven successful with only about 4.5 percent of the mental health crisis interactions that the Partners in Care teams respond to end up in arrests.
Since the program’s start, co-responder teams have answered 41,000 overall calls for service. Of those, 8,300 turned out to be mental health crisis calls.
“We are going through a lot of things that are not necessarily mental health related,” Brooks said. “But there are benefits there as well.”
He used the example of the Covenant School shooting where teams of the Partners in Care program were able to help with the reunification process of parents and their children immediately after the shooting. In other instances, it was helpful to have a mental health clinician present to talk to the victim of a violent crime.
Every officer assigned to one of the Partners in Care patrol units receives 40 hours of crisis intervention training. A Crisis Intervention Team (CIT) training coordinator from the Mental Health Cooperative is embedded in the police training academy. The 40-hour CIT training is offered once a month and teaches officers how to recognize signs of mental illness, how to perform de-escalation training, and connecting a person in crisis to proper resources.
Mental Health Cooperative’s counselors also receive 16 hours of police policy training to understand better what officers are required to do when responding to a call. Brooks said when a clinician and a police officer look at the same situation from different perspectives, things sometimes may not add up. Providing some baseline understanding helps with the success of the program and avoid friction on the same team.
Randolph explained that there is a trained counselor (which Brooks referred to as clinician) assigned to each precinct with a supervisor, who is also a counselor, covering two precincts. Supervisors provide clinical supervision for the counselors, perform note reviews and build partnerships with the precincts’ police leadership to resolve operational issues on a day-to-day basis. They also work with community resources located within those two precincts to build ongoing collaboration and get people connected with needed services in the areas they live.
The teams currently go out Monday through Friday during the day and evening shifts, which leaves the Midnight shift not covered by a Partners in Care team yet. That’s why Brooks said he believes that it’s important that eventually every officer assigned to MNPD’s patrol division receives the extra 40 hours of crisis intervention training to help guide them through a situation where they encounter someone experiencing a mental health crisis, even if no clinician is present. While clinicians take part in full-time ride-alongs, they are kept from harm’s way, as officers are instructed to stabilize a situation before a counselor gets involved, meaning police will never allow a counselor to engage with an individual who is armed.
The program shows a very low use-of-force rate. Only in 2 percent of situations was force used, which may sound worse than it often is. Brooks gave examples of restraining a person to administer life saving medication or keeping a person physically from jumping off a bridge. The rate of use of force is less than half of the arrest rate of 4.5 percent. And of those arrested, about three quarters of charges are dropped eventually due to the mental health care programs arrested people may be connected with through the jail system, which offers additional diversion strategies.
Overall, 364 officers have received the CTI training. Of those, 258 are still assigned to patrol. Others have meanwhile transferred to investigations, and some were trained because their specialized units have seen the benefits and asked for the crisis intervention training. In addition, 108 supervisors have been trained with 82 of those still in patrol.
Randolph provided more details of the calls received during the first 11 months of 2024. About 3,400 mental health calls were answered and about 20,000 other calls for service citywide.
Out of the 3,400 mental health calls, 55.5 percent received a full mental health crisis assessment, which Randolph explained means that an individual had a suicide ideation or suicide attempt, homicidal ideation, or some type of psychosis, or a combination of all three. Of these calls:
- More than half were able to be resolved in a person’s home with a safety plan and follow-up plan in place.
- About 34 percent went to an emergency department either for medical clearance, for inpatient hospitalization, or for a medical concern such as a suicide attempt or acute intoxication.
- About 6 percent went straight to the Mental Health Cooperative’s crisis treatment center, which is located in Metro Center, where they were able to begin their mental health treatment.
- And another 5.5 percent went directly to a psychiatric hospital to receive treatment.
Randolph further reported that of those 55 percent mental health crisis calls, about half were actively suicidal at the time, 10 percent had homicidal ideation, and 45 percent had some form of delusions or hallucinations going on. Some of those were also a combination.
Data shows that 75 to 80 percent of the people served live in an apartment, house or a group home.
“We thought there would be a higher number of unhoused,” Randoph said. But only Central Precinct, which covers the Downtown area, shows a significantly higher rate of service for people who are unhoused than those in housing.
Consequently, the Central Precinct’s Partners in Care team functions a little differently from other teams. The Mental Health Cooperative counselor is embedded in the Central Precinct’s Quality of Life Team, which is a special team of officers who have a heart to work with the unhoused population, Brooks explained. They check on encampments, give out food alongside The Salvation Army and build relationships with unhoused individuals. In partnership with the Salvation Army and the Office of Homeless Services, that team has been able to find housing for more than one hundred people who were staying in the Downtown area. Having a relationship with people in encampments often helps officers to learn if another person is not doing well in a tent, and they consequently reach out with the counselor to do a wellness check.
Once individuals have received help through Partners in Care, they will get up to three follow-up calls within the first 24 hours. Furthermore, follow up coordinators will check on people within a week and in some instances provide short-term case management to ensure people are linked with the resources and services they need. Tennessee law permits the initial crisis intervention to happen without signed consent, but counselors obtain consent before they are able to follow up with calls.
In 2025, the Partners in Care program will expand to include School Resource Officers (SROs) in the training and embed a counselor to MNPD’s School Safety Division. The program will partner with Metro Nashville Public Schools counselors to avoid redundancy yet support SROs with de-escalation and trauma-informed interventions in schools.
Co-responder programs across the nation have shown promise. So far, research of these programs has found enhanced crisis de-escalation, increased connection to services, reduced pressure on the criminal justice system and the health care system, and cost-effectiveness.
Partners in Care is not the only co-responder program in Nashville. The Fire Department/EMS paramedics also pair a crisis counselor from the Mental Health Cooperative to respond to mental health calls that do not require a full ambulance response. That program is called Responders Engaged and Committed to Help (REACH) and was launched in February of 2023.
For those interested in more detailed program data of Partners in Care, they can visit MNPD’s Website, which currently lists full data sets for the first two years of the program.