Last year, 600 to 700 calls to the Wellfleet Police Dept. resulted in police reports. Of those, half involved mental health or substance abuse issues.
Providing crisis intervention is now something officers prepare for, and in Truro, Wellfleet, and Eastham, they look to the community resource navigator program to provide follow up. (Provincetown no longer participates in the program, choosing to focus on housing and homelessness.) The navigator program appears to be helping, with the percentage of clients judged to be at high risk going down in the last quarter.
Behind the large number of calls, at least in part, is a cultural shift, said Wellfleet Police Chief Michael Hurley, who joined the force 25 years ago. “If you were worried about someone 10 or 15 years ago, you wouldn’t call us to check on them,” Hurley said. “Today, no one hesitates to do it.”
The opioid epidemic and climbing suicide rates have also likely upped the number of calls. In 2016, 78 people in Barnstable County died from opioid overdoses, compared to 12 in 2000. From 2000 to 2016, 512 people died from opioid-related overdoses. The age-adjusted suicide rate on the Cape and Islands doubled from 2000 to 2011, from 6.2 per 100,000 to 12.1 per 100,000, and according to the suicide awareness group SharedKindness, the county’s suicide rate is more than twice the state’s overall.
Providing support to people suffering from mental health crises is now central to police work. “As a department, we’re dealing with it on a daily basis,” Hurley said.
Eastham Officer Josh Adams said that although police are often the first to respond to mental health or substance abuse-related situations, until recently, they were not trained in how to deal with them. “We knew the law and made sure the law was met,” Adams said. “We were never trained as social workers, and we didn’t know what resources were out there.”
Police officers have long conducted “well-being checks” after receiving calls from people concerned about themselves or about a friend or loved one. These days, however, they’re trained in crisis intervention. “Our new guys know how to handle themselves differently,” Adams said. “They’re trained differently — to be less robotic, softer.”
Since July 2017, when Eastham, Wellfleet, and Truro agreed to pool their resources, police in the three towns have relied on community resource navigators to provide follow up. Each town pays Outer Cape Health Services (OCHS) $25,000 annually to maintain the program.
After receiving a call for help, officers can refer the person in need to the navigators — social workers who visit that person in the days following the well-being check.
“We see most folks at home, regardless of insurance,” said Brianne Smith, who runs the program along with Paula Erickson. Meeting people at home offsets barriers, like transportation or the formal setting of an office, which Smith said might discourage people from getting support.
After evaluating the client’s needs, a navigator refers him or her to resources and programs that might help address specific concerns. The navigators meet regularly with Cape Cod Hospital, Bay Cove, and first responders. They also participate in police officers’ crisis intervention trainings and meet with guidance counselors at Nauset middle and high schools.
Police in Wellfleet, Eastham, and Truro say that the navigator program is helping.
Truro Officer Tom Roda worked as an emergency medic for years before joining the force. “You’re bringing the care to them, rather than saying, ‘Hey, there’s this program, if you go to this place, if you call this number….’ ” Roda said. “Almost everyone I’ve spoken with has agreed to meet with them.” He thought the likelihood of follow up with the navigators is high and added that the number of repeat calls coming in about the same individual is going down.
According to its most recent quarterly report, the navigator program received 61 total referrals from the three towns in the last quarter (October to December 2019), up from 43 in the previous quarter. The table below shows which services navigators most frequently referred their clients to over the past two quarters across all three towns:
|Community involvement*||40 %|
|Mental health||30 %|
|Substance abuse||19 %|
|Family / social relationships||18 %|
*The navigators define “community involvement” as services geared toward decreasing isolation.
The navigators track their clients’ progress, and their numbers confirm that the program is working. The percentage of clients deemed “high risk” has dropped from 49.1 to 27.3, while the number of “medium risk” and “low risk” clients has increased. These numbers reflect an assessment of the same people who regularly engaged with the program over a three-month period.
Still, the number of calls coming is high, from a first responder’s point of view. “Some days, it feels like Wellfleet could have its own navigator,” Hurley said.
“It’s unclear if it’s solving the problem,” Hurley added, because the program does not address the root causes of mental illness and substance use disorder.
OCHS has secured funding for a substance use disorder recovery coach, in the hopes that it will lighten the burden on navigators and nurses and will lead to a higher rate of successful recovery. They are currently searching for a suitable candidate.
To close more loops, the navigator program helped form Outer Cape Community Solutions, a group composed of police officers, navigators, and other organizations involved in mental illness and substance use disorder. The group meets monthly.
“It’s really opened up lines of communication,” Adams said. Hurley, too, said collaboration between various groups is cause for optimism. Ensuring that people know about the program’s existence is also important, he said. “It’s working. But there are still steps we can take.”
Navigators’ Drop-in Office Hours
Tuesdays, 11 a.m.-2 p.m., Wellfleet Police Dept.
Wednesdays, 11 a.m.-2 p.m., Truro Council on Aging
Thursdays, 11 a.m.-2 p.m., Eastham Public Library, except second Thursday of the month at the Children’s Place in Eastham.