Sep 14, 2023 - News

San Antonio expands 911 mental health program in wake of police shooting

Photo illustration of two hands reaching out to each other, with abstract shapes and old telephones.

Illustration: Allie Carl/Axios

San Antonio is expanding a program that sends mental health professionals and paramedics alongside police officers to some 911 calls by making staff available 24 hours a day.

Why it matters: Expansion talks accelerated after San Antonio police shot and killed Melissa Perez, who was having a mental health crisis, in June. Mental health clinicians with the program did not reach Perez in part because of the program's limited hours.

  • San Antonio police are increasingly responding to mental health calls, even as the city has developed an alternative response program.

Details: The 24-hour expansion for three teams, approved Thursday as a last-minute amendment to the new city budget, will begin next summer. It will add five clinicians, nine paramedics and 12 police officers.

  • It was requested by seven City Council members and the mayor — the most support amassed behind any of the final-hour budget amendments.
  • Staffing will cost $7.2 million over two years, including $3.5 million in the new fiscal year budget set to take effect Oct. 1.

Catch up fast: Three San Antonio police officers have been charged with murder in Perez's case, which has not yet been presented to a grand jury.

  • The city had planned an expansion of the program, called SA-CORE, about a month before police shot Perez. That expansion covered all corners of the city, but left gaps after the operating hours of 7am-11pm. The call to Perez's apartment came in just after midnight.
  • The San Antonio Police Department's Mental Health Unit, which is separate from SA-CORE, includes specially trained officers who can better help people in a mental health crisis. But officers didn't call for it — a policy and training failure, top police officials have said.

What they're saying: "Mental health crises occur at all hours — not just between 7am and 11pm — and ensuring that we provide 24-hour coverage by the SA-CORE team will enable residents who have an issue overnight to receive assistance," Mayor Ron Nirenberg tells Axios.

  • Nirenberg said his position isn't related to Perez specifically.
  • "The strategies SA-CORE practices are proven significantly more effective than any other response we use officially at the city level, and it's important that they can respond 24/7 with no gap in response," District 2 Councilmember Jalen McKee-Rodriguez, a frequent critic of the police department, tells Axios.

Context: San Antonio police are responding to a growing number of mental health calls, city data shows. They received more than 32,000 such calls last year, up from 21,500 calls in 2019.

  • But 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.

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.

How it works: 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.

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

The bottom line: "Addressing our community's mental health needs is crucial to providing the comprehensive approach that we need to prevent non-violent mental health crises from escalating," Nirenberg says.


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