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This column is part of a series of occasional columns regarding mental health in Minnesota, chronicling ongoing struggles, emerging progress and voices of hope.

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A few years ago, when I was a small-town community college teacher in northern Minnesota, a classroom near mine was evacuated. Police cars rolled up. A student cried as a staff person led her through the hall. Others left the building in stunned silence.

Was this another school shooting? Would I have to barricade my room like we did in training? No. This was a young person experiencing a mental health crisis, something that happens every day in Minnesota.

In recent weeks, I talked to sheriffs and police chiefs from across the state about their departmental crisis response protocol. Each told me that their officers respond to mental health and substance abuse calls more than any other type of complaint. While improvements involving mental health crisis response have made substantial advances in recent years, critical training geared to such emergencies varies widely.

More than a decade of research proves that properly trained crisis response teams create better outcomes for people suffering from mental illness — and for responding officers. It's already working in metro areas. The challenge is replicating that success in rural areas, too, where mental health incidents are no less frequent or severe.

"In rural areas, they don't have resources like in cities," said Gordon Ramsay, sheriff of St. Louis County. "In the Ely or Babbitt areas you don't have a social worker who can pop over in five minutes. It's our staff who deal with it. While we have incredible staff, they're not the best to deal with people in crisis. A uniform and a badge can create escalation just with the uniform."

Ramsay said a person might call 911 as many as 40-50 times in an active mental health crisis. This kind of volume drowns out other calls and yet cannot be ignored.

"Law enforcement is designed to respond to a crisis, fix it, and get on to the next one," said Duluth Police Chief Mike Ceynowa. "That's not how it works for people with mental health issues. It's a repetitive cycle."

A seminal 2015 study from the Treatment Advocacy Center found that people with untreated serious mental illness were 16 times more likely to die than other individuals because of law enforcement encounters. After that report, researchers had difficulty acquiring reliable data to update this figure.

In Pocatello, Idaho, a 17-year-old autistic boy, Victor Perez, who had cerebral palsy, was shot nine times when police responded to a call to his family's home on April 5. Perez was holding a knife when officers fatally shot him from the other side of the fence shortly after they arrived. His family intends to sue the city for wrongful death.

Here in Minnesota, a St. Paul woman was shot after pointing a gun at officers during a suicide crisis last year. Ramsey County declined to prosecute the officers, calling their decision justified by the circumstances.

These deadly events are rare, but mental-health-related calls to the police are far too frequent.

Anoka County Sheriff Brad Wise said that from 2016 to 2024, annual mental health calls for his department jumped from 28 to 300, a more than tenfold increase.

Wise said people are often frightened by behavior associated with untreated mental illness. It might not pose an immediate threat, but it still leads to a call. Meantime, people who are caregivers or family members sometimes can no longer physically handle a person in crisis. He said mental health professionals at Mercy Hospital in Coon Rapids often call 911 for help from his department.

"The public has to be realistic that sometimes use of force is absolutely necessary for the safety of everyone involved," said Wise.

Peaceful intervention needs to happen much earlier, when it can produce better results. About ten years ago, Minnesota social services providers and law enforcement agencies started working on potential solutions. One program that proved successful was embedding social workers with police and sheriff's deputies on mental health calls.

The first in Minnesota to try this was St. Louis County in the city of Duluth, but several other cities and counties replicated the idea. None pushed as far with the program as Hennepin County, which recently expanded its Justice Behavioral Health Initiative into more locations throughout the metro area.

When a call is related to mental health, social workers and medical professionals lead the assistance. Personnel are located at several police stations, the Minneapolis-St. Paul International Airport, Hennepin County Courthouse, and especially the Behavioral Health Center at 1800 Chicago Av.

There, people can walk in the door no matter the severity of their symptoms to receive help and referrals. This also provides a place for police and emergency medical services to drop patients instead of jails. The goal at every location is to divert people away from the criminal justice system into the care they need.

Peace officers also receive significant mental health training now. Ramsay said when he became a police officer 32 years ago, new officers received no training in mental health response. Today, they're "de facto mental health workers," he said.

"I watch bodycams and videos all the time," said Ramsay. "Our folks handle these sensitive calls with compassion and empathy and patience. Our residents need to know that the training and people we have are second to none. It shows in how frequently we get these calls and how infrequently you hear about anyone getting hurt. We're trying to decouple public safety from health calls whenever possible."

A study commissioned by the state of Michigan, published in the December 2024 Community Mental Health Journal, showed that mental health mobile response programs work well. They help divert people from the criminal justice system, reduce emergency room visits and improve placement in community-based mental health services, often without law enforcement involvement.

Meantime, families who must call law enforcement for a family member in crisis can help, said Wise. With autism, for instance, he said that alerting officers to triggers like loud noises or lights, uniformed or plainclothes officers, male or female officers can help craft a better response.

"Every law enforcement agency is trying to minimize the risk of a bad outcome," said Wise. "Sometimes it's not possible, but more often it is."

People experiencing a mental health crisis don't need the police any more than they need the fire department.

Leah Kaiser, director of behavioral health for Hennepin County, sees the positive results from earlier intervention in mental health cases.

"We see the resiliency, the dignity, the amazing outcomes that folks in our community have that are living with mental illness and co-occurring conditions when they are received with respect and compassion," said Kaiser.

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