A mental health crisis is defined as an individual's emotional, physical, mental or behavioral response to an event or experience that results from trauma. A person may experience crisis during times of stress and when normal coping mechanisms are ineffective. Any individual can experience a crisis reaction regardless of previous history of mental illness.

Symptoms may include:

• Emotional reactions such as fear, anger, or excessive giddiness;
• Psychological impairments such as inability to focus, confusion, nightmares, and potentially even psychosis;
• Physical reactions like vomiting/stomach issues, headaches, dizziness, excessive tiredness, or insomnia.
• Behavioral reactions including the trigger of “fight or flight” response.

Behavioral Signs

• Paranoia, guarded body language, talks to self or others who are not present.
• Hears voices from those not present.
• Paces or walks in circles, unable to process simple instructions.
• Unresponsive when spoken to, angry, or irritable.
• Strong and unrelenting fear of persons, places, or things.
• Extremely inappropriate behavior for a given context.
• Frustration in new or unforeseen circumstances.
• Inappropriate or aggressive behavior in dealing with the situation.
• Abnormal memory loss related to such common facts as name or home address, although these may be signs of other physical ailments such as injury or Alzheimer’s disease.
• Delusions, the belief in thoughts or ideas that are false, such as delusions of grandeur (“I am Christ”) or paranoid delusion (“Everyone is out to get me”).
• Hallucinations of any of the five senses (e.g., hearing voices commanding the person to act, feeling one’s skin crawl, smelling strange odors).
• The belief that one suffers from extraordinary physical maladies that are not possible, such as persons who are convinced that their heart has stopped beating for extended periods of time.

Verbal Signs

• Fragmented thoughts or slow or deliberate speech.
• Rapid speech, disjointed sentences, or off topic statements.
• Loud or soft speech, mumbled communication.
• Admissions of wanting to hurt self or others.

19.86% or 66,000,000 adults in the U.S. have experienced a mental health crisis or illness.

4.91% or 16,321,019 Americans have been diagnosed with a serious mental illness (SMI).

232,461 adults diagnosed with serious mental illness in Maricopa County.  

Arizona ranks 18th in the U.S. with 20.06% or 1,100,000 experiencing a mental illness.

The City of Mesa is collaborating with mental health providers to reduce the number of crises related calls requiring a public safety response.

The Mesa Police Department works in collaborative effort with local mental health professionals with the goal of enhancing the quality of life for those who suffer from persistent mental illness and their families.

Resolving situations involving individuals who are affected by mental illness always carries a potential for violence, requires an officer to consider the mental state and intent of the individual and necessitates the use of special skills, techniques and abilities. 

It is the Department's goal to de-escalate the situation safely for all individuals involved when reasonable, practical, and consistent with established safety priorities. Mesa's Public Safety members are guided by Arizona law regarding the detention of persons affected by mental illness or in crisis. Continued training in these methods provide department members guidance, techniques and resources so that the situation may be resolved in as constructive and humane a manner as possible.

Officers utilize these protocols in order to assist them in determining whether a person’s behavior is indicative of mental illness or in crisis and to provide guidance, techniques, and resources so that the situation may be resolved in as constructive and humane a manner as possible.

The graph below shows the progress of the City of Mesa’s implementation of Mental Health strategies from 2014 to 2023. 

• “Suicide” - includes threats, attempts, and committed
• “Mental Health Detainers”-includes voluntary and involuntary petitions for committal
• “Mental Health Related" - includes any call which involves only mental illness
• “Total Calls for Service”- all calls for service involving mental illness

In June of 2021, the Mesa Police Department created a program with Behavioral Health Service Provider Solari. This program provides a Solari clinician to work alongside 911 call takers in our Public Safety Dispatch Center. 911 calls that can be worked by Solari’s crisis network call center are transferred away from Police and Fire dispatch.

Solari is the highest volume crisis call center in Arizona, taking over 25,000 calls per month. As of June 2021, this initiative has transferred an average of 300 calls per month to the Solari crisis call center.

In 2022 there were over 3500 diverted 911 calls for service from Police and Fire to Solari.

• Mental Health by the Numbers November 2022 Summary

The City of Mesa contracts with two companies in order to provide behavioral health services to Mesa residents. Community Bridges, Inc. (CBI) and La Frontera/EMPACT now provide two mobile crisis teams dedicated to the Mesa Police Department for immediate response to crisis calls. These teams consist of an Emergency Medical Technician (EMT) and a Behavioral Health Clinician. They currently operate 24 hours / 7 days a week responding to mental health calls for service within the Mesa city limits. With an average response time of 20 minutes or less, this new model expedites service/treatment allowing our first responders to be available for the next emergency.

Call requests for mobile teams include any situation in which the person believes they are in crisis and are open to assistance. These requests may include suicidal thoughts absent immediate danger, depression, anxiety, substance abuse, post-traumatic stress (PTSD), child/family issues, social service needs, and dementia/elder issues.

What is C.I.T.?

The Mesa Police Department’s Crisis Intervention Team (CIT) Program is an innovative, first-responder model of police-based crisis intervention with community, health care, and advocacy partnerships at its core.

The CIT model was first developed in Memphis and has spread throughout the country. It is known nationwide as the “Memphis Model”. This is a patrol-based program that provides the foundation necessary to promote community and state-wide solutions to assist individuals with mental illness. The CIT model aspires to reduce the stigma of mental illness and the need for further involvement within the criminal justice system. 

Crisis intervention training (CIT) provides patrol officer-based techniques for contacting individuals with a mental illness with the goal of improving the safety of patrol officers, consumers, family members, and citizens within the community.

CIT provides a forum for effective problem solving regarding the interaction between criminal justice and our mental health care system. Its basic goals are to promote and improve consumer resources and, when possible, safely redirect individuals suffering from mental illness away from the judicial system to the health care system.

CIT members attend quarterly training to learn trends, best practices, and improve proficiency. Mesa Police members receive CIT training in the academy followed up with continued officer education each year. Police department members are trained in recognizing persons affected by mental illness or in crisis. They are not expected to make clinical judgements of mental, physical, or emotional disturbances, but rather to recognize behavior that is potentially dangerous or destructive to the persons affected by mental illness.

Per Arizona Revised Statutes an individual is a:

• Danger to Others, ARS 36-501 if:
  The judgement of a person who has a mental disorder is so impaired that the person is unable to understand the person’s need for treatment and as a result of the person’s mental disorder the person’s continued behavior can reasonably be expected, on the basis of competent medical opinion, to result in serious physical harm.
• Danger to Self, ARS 36-501 if:
  Behavior that, as a result of a mental disorder, constitutes a danger of inflicting serious physical harm upon oneself, including attempted suicide or the serious threat thereof, if the threat is such that, when considered in the light of its context and in light of the individual’s previous acts, it is substantially supportive of an expectation that the threat will be carried out. Behavior that, as a result of a mental disorder, will without hospitalization, result in serious physical harm or serious illness to the person, except that this definition shall not include behavior that establishes only the condition of gravely disabled.

In 2016 the Mental Health Support Team (MHST) was established to assist patrol officer when there were numerous calls for service involving someone with mental illness, or if there was potential harm to the subject or first responders. This unit was originally comprised of detectives from our Hostage Negotiator Team. These detectives were further trained by behavioral health providers. Many of the members of the squad had college level training or degrees in a behavioral health field.

Since the Fall of 2020, the MHST team has utilized licensed clinicians from Crisis Preparation and Recovery (CPR) embedded within the unit to assist in calls for service.

In 2021, the MHST unit had 423 clinician contacts within the community. That year the MHST Unit served over 1030 Mental Health Detainers. Their “take time” approach resulted in only 3 use of force encounters for the year.

Today, MHST detectives are responsible for serving mental health detainers, acting as a liaison with community mental health providers for high volume users, and administering the department’s CIT and mental health education programs. This includes assisting our police academy staff by providing up-to-date police tactics deployed when dealing with mental ill individuals. The MHST unit combines scenarios and in-classroom training for the entire police force as part of our continued officer education (COE) program. This ensures the tactics and information patrol officers utilize on calls are industry-standard best practices.