Most mornings, 28-year-old Rachel Armada accompanies a Providence police officer during a shift, riding along in a cruiser as they answer calls. She’s at the ready when those calls involve someone with a behavioral or mental health problem.
“If [the police] are dispatched to a call where somebody seems to be having a mental health crisis, they will have me respond as well to assess the individual and get them to the level of treatment that they need,” Armada said.
She has been doing so for two years now, as one of the two emergency clinicians working with the Providence Police Department as part of a city-sponsored program that aims to embed mental health professionals with officers to help tackle the increase in behavioral-related calls in recent years.
“For me to be able to respond live in those moments and be able to get people to the level of care that they need and divert them away from the criminal justice system whenever possible, I know that I’m making a long-term, more positive difference in those people’s lives,” Armada said.
The mental health-related calls are not being fielded by the police alone – the city’s other public safety agencies have been dealing with similar situations. And soon, the police will not be the only agency with emergency clinicians riding along on calls.
The city is expanding its Behavioral Health and Social Service Crisis Response Program, preparing to add clinicians such as Armada who will ride along with the Providence Fire Department and the Emergency Medical Service.
“It’s important, particularly for the EMS and fire group, to have clinicians on call due to the influx of mental health calls that have been happening nationally, if you will, but we’ve seen a spike in influx in Providence,” said Laurie Moise Sears, director of the city’s Healthy Communities Office.
City officials point to the data as evidence that the expansion is needed.
In 2021, 6,559 out of 30,796 of the emergency medical services incidents in Providence – or 21.3% – were behavioral health calls, up from 20.1% a year earlier, according to data collected by public safety officials and analyzed by the Healthy Communities Office.
While the overall number of police calls decreased in 2021, the number of incidents related to behavioral health increased, a city spokesperson said.
“Having behavioral health clinicians not only on the ground with our EMS and fire team but also within the 911 dispatch centers will catch those needs earlier,” Moise Sears said.
Starting in July, two new city-funded clinicians will join the program: one will work with the city’s public safety dispatch division to identify behavioral health-related calls, while the other one will respond to behavioral health and social services calls alongside firefighters and rescue workers.
Mayor Jorge O. Elorza announced in May that the city hired The Providence Center to provide the clinicians. The two-year contract will cost the city $371,780, with the possibility of an extension if the program proves successful and funds are available.
Officials say it’s been a success with the police.
When Armada accompanies an officer on calls, she stays in the cruiser while the officer assesses whether an emergency is related to behavioral health, involving mental health or substance use issues. While each assessment is different, Armada said, common identifiable factors include intense emotions such as anger or irritability, symptoms of depression or a threat to hurt themselves or others.
Her role as an emergency clinician includes assessing what resources a person on the scene might need, such as hospital treatment or outpatient providers.
Between the city-funded clinicians and Providence Center volunteers, Armada said, clinicians are able to assist the police seven days a week. But expanding the program will guarantee that other agencies are covered, too.
“Not having a one-size-fits-all to every 911 call or every mental health need is really important,” Moise Sears said. “For the city of Providence, this is big because although we have co-response on the police side of things, increasing co-response efforts on EMS and fire will allow for a wider gap to be closed and being able to connect with folks.”
“There’s a lot of services that are specialized for people who have behavioral health issues that they’re not getting simply because we’ve been overtasking public responders with managing behavioral health emergencies,” said Jacqueline Mancini-Geer, director of acute care at The Providence Center. “They’re not trained or equipped, the system was never designed for them to be able to handle the volume of behavioral health calls that come in.”
Providence emergency medical services respond to an average of 509 behavioral health incidents per month, or 16 per day, according to city data. With an average response of 48.5 minutes, this means that EMS personnel spend 13 hours a day responding to behavioral health incidents.
Officials say the expanded program will alleviate the workload on first responders and ensure that callers receive the help they need when they need it.
Providence Center data shows that the number of people in crisis served by the program’s clinicians in 2021 has more than doubled compared with 2020, from 117 to 303. In 2021, out of the more than 300 interactions, only four resulted in arrests.
“I’ve been able to divert people away from arrest and gotten them inpatient hospital treatment instead of being introduced to the criminal justice system,” Armada said.
Embedding behavioral health specialists in the public safety system, Mancini-Geer said, will help the responders quickly identify mental health-related situations and offer the right treatment options.
“Ultimately, I think, what I hope to find anyway is that we’ll have fewer repeat calls for service for the same individuals because they’ll be getting the right treatment the first time,” Mancini-Geer said.
