Melissa Perez shooting death points to gaps in San Antonio 911 mental health program

A year-old city program helps people in crisis by sending a mental health clinician and a paramedic — in addition to a police officer — to some mental health 911 calls. It didn't reach Melissa Perez.

• The San Antonio Police Department's Mental Health Unit includes specially trained officers who can better help people in a mental health crisis. It didn't reach Perez either.

Driving the news: The City Council approved an expansion of the city program shortly before three San Antonio police officers were charged with murder in Perez's death. But even the expanded program won't cover all calls like the one to Perez's apartment last month because the call came after the operating hours of 7am-11pm.

What they're saying: District 4 Councilmember Adriana Rocha Garcia, who represents the Southwest San Antonio neighborhood where Perez lived, tells Axios the city should further expand the program.

• "We can no longer treat mental health as something that just happens between the times that are convenient for us to address," Rocha Garcia says.

Why it matters: Police interactions with people in mental health crises can lead to tragedy. At least 111 people were killed nationwide last year after police responded to reports of someone behaving erratically or having a mental health crisis, according to Mapping Police Violence.

• San Antonio police are responding to a growing number of mental health calls. They received 21,496 such calls in 2019, and 32,190 in 2022, per city figures.

Catch up fast: Perez wielded a hammer at one point and was inside her apartment when the officers, standing on her patio, shot and killed her.

• Perez's family filed a wrongful death lawsuit this month against the city and the three officers involved in the shooting, per the San Antonio Report.
• Officers didn't call for the police Mental Health Unit, a policy and training failure, deputy police chief Jesse Salame told Axios last month.

The big picture: San Antonio is among a growing number of cities that have developed alternatives to police response to mental health calls in recent years.

• The changes followed the death of Daniel Prude, who was in mental distress when police detained him in March 2020, and widespread protests against police misconduct after the police killing of George Floyd in May 2020.

Zoom in: The city program, called SA-CORE (Community Outreach and Resiliency Effort) serves downtown and the near North and West sides, the area covered by the police central substation.

• The call dispatching officers to Perez's apartment happened just after midnight and was outside of the central service area.

State of play: The expansion, slated for January, will make SA-CORE citywide. But it will keep the same hours.

• The city chose the operating hours for SA-CORE based on when most 911 mental health calls occur, deputy city manager María Villagómez told Axios.

Details: The Center for Health Care Services, the public mental health services provider for Bexar County, provides SA-CORE with mental health clinicians. They work to de-escalate tense situations and build rapport with a person in crisis, Aimee Hicks, director of crisis response, tells Axios.

• The center then connects people with the services they need. That could be substance use treatment, housing, counseling or medication, Hicks says.
• Clinicians follow up to see whether the person made it to an appointment or needs travel assistance.

By the numbers: SA-CORE responded to 1,465 calls between its launch in April 2022 and March 2023, per figures shared with the City Council in April, the most recent available.

• Fewer than 1% ended in arrest. Another 28% ended in emergency detention after an officer decided the person needed to be taken to a mental health facility. Thirty-five percent of calls were resolved at the scene.
• Mental health clinicians with the Center for Health Care Services followed up with 740 people through SA-CORE from April 2022 to December 2022, the most recent figures available.
• Of those, 56%, or 414 people, received mental health services following the call.
• Another 29%, or 215 people, refused services.
• About 15%, or 111 people, were already connected with the Center for Health Care Services before SA-CORE reached them.

The bottom line: "We don't want to lose any lives, we don't want any more tragedies," Rocha Garcia tells Axios. "So what can we do to be proactive?"