SAN ANTONIO – San Antonio Police Department Chief William McManus said crisis response teams were long overdue to answer mental health calls coming into 911.
“Police officers were never equipped to deal with mental health calls,” McManus said. “We are not the expert.”
These teams are staffed with health officials to address physical and mental needs during crises.
There is no one-size-fits-all model for creating a team well-equipped for this work. It’s up to each city to design its unit fit for each community.
Doug Beach, the executive director of NAMI (National Alliance on Mental Illness) Greater San Antonio, said San Antonio and Denver run different systems with similar goals.
KSAT rode along with the programs in San Antonio and Denver to see how each unit functions.
The story below contains conversations about suicidal thoughts and ideations.
A look behind San Antonio’s SA CORE program
“I have attempted suicide I don’t know how many times in my life,” an unidentified person said to the SA CORE team.
“What do you think brought these thoughts?” Samantha, a crisis response clinician for the unit, responded.
“I have no idea,” the person replied. “I have been depressed most of my life.”
It’s a difficult conversation to have, but it’s one the SA CORE team has had thousands of times.
“I’ve seen a lot of hopelessness,” Samantha said. The unit asked KSAT not to share her last name.
SA CORE stands for San Antonio Community Outreach and Resiliency Effort. This is the city’s main team tasked to respond to mental health 911 calls.
“It’s a game changer,” Isaac Gomez, a San Antonio Fire Department paramedic working for SA CORE, said. “We’re here, we’re here to stay and we’re here to make a difference.”
An SA CORE unit is comprised of three team members: a San Antonio Mental Health Unit police officer, a San Antonio Fire Department paramedic and a Center for Health Care Services crisis response clinician.
This unit was launched for its initial pilot year in 2022. Below is the number of responses the SA CORE team has made each year:
-
2022: 1,177 (April to December)
-
2023: 1,202
-
2024: 2,958 (January to September)
“It’s making a difference in people’s lives and probably saving lives in the process,” San Antonio Mayor Ron Nirenberg said.
Over the last two years, the response team has transformed. It started as a single unit covering the downtown area. Now, it has three teams covering the entire city with 24/7 staffing.
“We’re able to do it all here on this little mobile team,” Gomez said.
Danny Herrera, a SAPD mental health officer with SA CORE, said the unit can self-assign to calls his team discusses and decides are a good fit. They look at history and what’s actively happening.
Herrera said SA CORE avoids calls with weapons or violence.
SAPD assistant chief Karen Falks said SA CORE responds to about 14% of the total mental health calls coming into 911 in our city. Falks spoke to KSAT before her retirement on Nov. 1.
“It’s a lot of work,” Gomez said. “We’re a city over a million in population and you have three teams. You could do the math on that.”
While KSAT rode along with the SA CORE team, a call came in for a person with suicidal ideation. That means they had been preoccupied with thoughts of suicide. After an introduction and a conversation, SA CORE learned this person was struggling with their future housing.
After approximately an hour and a full assessment, SA CORE decided an emergency detention was the best option. The unit transported this person to a hospital for further evaluation and care.
“These are humans,” Samantha said.
In Fiscal Year 2025, the city expects SA CORE to respond to more than 4,000 calls.
A day for Denver’s STAR team
With a growing concern like mental health, the City of Denver rests its hope in the STAR program for mental health crisis response.
“We’ve been pretty limitless in what we can do with people,” Maita Thomas, the WellPower supervisor for clinicians, said. “People should know that when they call in a crisis. They’re going to get the help that they need and that they deserve.”
STAR stands for Support Team Assisted Response. The team falls under the community-response model of care, which means it pairs up a behavioral health clinician with a paramedic to respond to certain 911 mental health calls.
Unlike San Antonio, there is no police officer on Denver’s team.
“We’re giving people hope,” Alan Moreland, the paramedic supervisor at Denver Health Medical Center, said. “This is the gap in the system that needs to be filled.”
STAR responds to low-risk calls where “there are no significant safety concerns.” STAR operates seven days a week between 6 a.m. and 10 p.m.
“What we really want is to be able to support the community in the best way that makes sense,” Tandis Hashemi, STAR’s operations manager, said.
If a situation escalates, STAR calls in law enforcement, but the Denver Police Department said STAR handles most cases independently.
“These are the right people,” Chris Richardson, the director of crisis services at DPD, said. “They’re going to support you.”
STAR’s partners are listed below to serve in unique ways:
-
STAR Community Advisory Committee: oversees STAR’s direction
-
WellPower: provides mental health clinicians
-
Denver Health Paramedic Division: provides paramedics
-
Denver 911: dispatches unit to calls
-
Servicios de la Raza: provides wrap-around services
“Why is it so integral to have continued follow-ups?” KSAT asked Maria Martin, a STAR community services director at Servicios de la Raza.
“So that you’re not putting just a Band-Aid on something,” Martin said. “That their needs can be met in a longer term.”
Denver has yet to make their version of the SA CORE team 24/7. Funding, staffing and ensuring other resources across the city are available during these extended hours is currently holding back expansion.
The city’s goal is to begin expanding the program in 2025.
“You can de-escalate someone, but if you don’t change the environment, they’re still going to be in that environment that caused them to get to that level of distress in the first place,” Evan Thompkins, a STAR program specialist with Denver’s Department of Public Health & Environment, said.
Last year, Thompkins said STAR’s response rate was just under 50% of eligible calls.
“Crisis in Question: Measuring Mental Health in South Texas” will begin airing on Monday, Nov. 11 on The Nightbeat with a new episode each night at 10 p.m., culminating on Friday, Nov. 15 at 10 p.m. All episodes can be seen on KSAT, KSAT+, KSAT’s YouTube channel, and KSAT.com.
If you or someone you know is struggling with mental health or thoughts of suicide, call 988 or text TALK to 741-741.
You can also reach out to the American Foundation for Suicide Prevention (AFSP) or the National Alliance of Mental Illness (NAMI) at 210-223-7233 (SAFE) or 800-316-9241. You can also text NAMI to 741-741.
More Crisis in Question: Measuring Mental Health in South Texas coverage on KSAT: