Podcast Summary: "Presenting: The Fifth Branch"
Lost Patients Episode: Presenting: The Fifth Branch
Release Date: September 27, 2024
Produced by: KUOW News and Information in collaboration with Seattle Times and The Marshall Project
Introduction
In the inaugural episode of Lost Patients titled "Presenting: The Fifth Branch," host Will James delves into the intricate and often problematic intersection of mental healthcare and law enforcement in America. Drawing a vivid analogy, James describes the current system as a "sprawling house" with disjointed architectural designs, leading to a maze-like experience for patients navigating mental health crises. This episode focuses on Durham, North Carolina, as a pioneering city attempting to overhaul its emergency response to better serve individuals with severe mental illnesses.
The Problem: Policing and Mental Health Crisis
Will James sets the stage by highlighting the alarming statistics: police in Seattle responded to nearly 10,000 scenes involving individuals in crisis last year, with severe mental illness cases often funneling individuals between the streets, jails, clinics, and courts without receiving adequate care. This system, as James points out, "almost by design, loses patients with psychosis to an endless loop" (00:00).
Durham's Radical Experiment: Introducing HART
The episode introduces Durham's Community Safety Department and its innovative Holistic Empathetic Assistance Response Team (HART). Ryan Smith, the director of HART, spearheads this initiative aimed at disentangling mental health care from policing. Instead of dispatching armed officers to respond to mental health-related 911 calls, Durham sends unarmed social workers and mental health professionals.
Key Quote:
"We can do both. We can have a wonderful professional police department. We can also have amazing public safety partners in Hart." — Ryan Smith (17:03)
Overcoming Initial Skepticism: Gaining Police Buy-In
One of the significant hurdles in implementing HART was overcoming the deep-seated skepticism within the Durham Police Department. Police Chief Patrice Andrews and Ryan Smith faced resistance from rank-and-file officers who were accustomed to traditional policing methods. In early meetings, officers expressed fears about safety and job security, with some declaring, "I thought it was a very bad idea" (20:18).
To address these concerns, Ryan Smith utilized data-driven approaches to demonstrate the efficacy and safety of alternative responses. Chief Andrews played a pivotal role in fostering dialogue, encouraging officers to see HART as a partner rather than a replacement.
Key Quote:
"We're not replacing you. You still have work that you need to do as a law enforcement officer." — Ryan Smith (22:55)
A Turning Point: The Barricaded Man Incident
A pivotal moment in the episode recounts an August night in 2022 when a man with a history of mental illness barricaded himself, making threats to shoot officers if they entered his home. Instead of immediately deploying SWAT, Chief Andrews calls upon Ryan Smith and the HART team.
Notable Moments:
- Intervention Strategy: Abina Beriako, a social worker with HART, engages the man through calm conversation, validating his feelings and de-escalating the situation without force (26:19).
- Outcome: After persistent, empathetic dialogue, the man agrees to seek hospital care voluntarily, successfully avoiding a potentially violent confrontation.
Key Quote:
"He let officers come and search his room. To make sure that, you know, he was okay." — Abina Beriako (27:33)
This incident significantly shifted the perception of HART within the police department, showcasing the practical benefits of an alternative response team.
National Perspectives and Broader Implications
The episode expands its scope to include national insights, featuring interviews with experts like Kristi Thompson from The Marshall Project. It discusses how other cities are adopting similar models and the legal challenges emerging, such as lawsuits alleging that sending armed police to mental health crises violates the Americans with Disabilities Act.
Key Quote:
"Some communities are afraid that if they're sending social workers and others, that someone's going to get hurt and killed." — Abina Beriako (09:03)
Progress and Future Directions
Back in Durham, the success of HART has led to a substantial increase in police officers who now recognize the program's value—from an initial 37% supportive to 66% (30:09). The episode underscores the importance of continuous engagement, data transparency, and building trust between police and alternative responders to sustain and expand such programs.
Key Quote:
"If what we're really doing is about, you know, sending the most appropriate response, then I want that to be available for as many people in as many moments as possible." — Abina Beriako (10:26)
Conclusion
"Presenting: The Fifth Branch" offers a comprehensive exploration of Durham's transformative approach to handling mental health crises, highlighting both the challenges and successes of integrating social workers into the public safety framework. By emphasizing empathy, data-driven strategies, and collaborative efforts between police and mental health professionals, Durham serves as a potential model for other cities grappling with similar issues. The episode leaves listeners contemplating the broader implications of such reforms and the necessary steps to create a more humane and effective emergency response system.
Notable Quotes with Timestamps
- Will James: "Imagine a sprawling house in which every room, doorway, and hall passage was designed by a different architect." (00:00)
- Ryan Smith: "We can have a wonderful professional police department. We can also have amazing public safety partners in Hart." (17:03)
- Abina Beriako: "He let officers come and search his room. To make sure that, you know, he was okay." (27:33)
- Patrice Andrews: "We just needed to make sure that our officers knew that this is not, we're not replacing you." (22:55)
- David Prater: "Police unions can be a limiting factor in the expansion of these programs." (31:22)
Note: For more detailed insights and to listen to the full episode, visit tradeoffs.org/thefifthbranch or find Lost Patients on your preferred podcast platform.