Mental Health Special Operations Units

Why MHSO?

As part of my Churchill Fellowship I wanted to look more broadly at how the CJS responds to some of the key risk factors relating to gang involvement. I will be writing in a later post about how gang units in the USA can work effectively with gang involved youth and their communities to support change. In this post I wanted to understand more about the role of Law Enforcement officers and the system to support people experiencing mental health crisis. My reason for this was because many of the young people who I meet who are or have been gang involved have been affected by mental illness. In the UK these two issues are topical and have received recent attention from the Children’s Commissioner: Recognising regional variation in the provision for mental health services for young people and ineffective support for parents whose children are gang involved.

The Process

Harris County Constable’s Office Precinct 1 has one of the largest Mental Health Special Operations Units in the United States. This specialist division operates under Precinct 1 Constable’s Office and is based at the Harris County Psychiatric Center in Houston.  Deputies who work in this division are specially trained and are certified by the State of Texas as Mental Health Officers, and the Division works closely with Harris County Hospitals and Harris County Probate Courts to facilitate the civil process of Mental Health Warrants. 

As part of my fellowship I was interested in two particular aspects of this process. 1. Policing: I had spent the week prior to my time with the Mental Health Division on a Crisis Intervention training course and was interested to see how the dedicated mental health special operations unit functioned. 2. I was interested in the legal processes following the serving of a Mental Health Warrant.

Mental Health Warrants start the process of an involuntary commitment of a person who is suffering from a mental health crisis and is considered to be at risk of harming themselves or others. The application process is described here .

To summarise, once a warrant has been issued by the Mental Health Division of the Harris County Clerk’s Office, Deputies collect the patient and present them for a psychiatric assessment. An assessment is then undertaken within 24 hours of the patient’s admission. With this information, the Court is then able to determine if an Order of Protective Custodyneeds to be issued. At this point the patient has an attorney appointed and has the right to a Probable Cause Hearingwithin 72 hours, during which time a Judge determines whether the patient should be held at a hospital or released until a Mental Health Hearing. 

In addition to representation by an attorney, patients have the right to attend the Mental Health Hearing. Also in attendance, are medical experts, social and support workers, and sometimes the families of the patient. In speaking to the Judges and on the days when I observed the process, it seems that the majority of patients do not contest the warrant, nor do those who wish to oppose it attend the hearing in person. However, a key issue in the process is that they have the legal right to do so.  

Special provisions are made for children and adolescents both in terms of the processes to serve warrants and also their treatment. Psychiatric hospitals have separate wards for both the assessment and treatment of juveniles who are suffering from a mental crisis or illness. 

How might this inform supporting gang involved youth?

My first observation is that the level of training, experience and expertise that the Mental Health Division Supervisors and Deputies have is of an extremely high standard. Not only are they responsible for securely serving warrants and transporting patients, but they are also often interacting with families who are themselves in crisis. This training and experience in both the understanding of mental health, but also how to interact with patients and their families in the most effective manner could be replicated in other areas of police involvement with vulnerable groups. Policing today already requires officers to deal with members of the public who are in crisis. However, not all officers are specially or specifically trained to do so.  

It is recognised that many young people who are at risk of gang involvement and criminal exploitation are coping with adverse childhood experiences and an increased exposure to violence. The impact of historical trauma and consistent exposure to violence are also linked to substance misuse and mental illness. Within the Criminal Justice System, it is the Police who first encounter these young people on the streets committing minor offences. 

Many such young people are in crisis. The system that I was able to observe in Harris County involved specially trained law enforcement officers working with medical experts to support vulnerable people and their families. Having a non-criminal procedure in place that seeks to protect and prevent harm is absolutely the correct way to support people in crisis. As noted, many of the young people who are involved in street level and adult criminal gangs present with mental illness, substance addition, and are at risk of being victims and/or perpetrators of violence on account of their experiences and the situation they find themselves in. My observation of Crisis Intervention and the Mental Health Division has helped me to understand how Police Officers can benefit from specialist training to understand and support young people who are vulnerable to involvement with serious and violent crime. An early indication and immediate referral to a specialist team for assessment and tailored interventions could prevent criminal exploitation and/or support young people away from the Criminal Justice System. 

Acknowledgements

Lieutenant Victor Torres

Deputy Marissa Flores