A mental health crisis and the limits of police response

A call for help put a Des Moines woman and her family on a tragic one-way track.

Dawn Saunders on balcony

Dawn Saunders at her home in Des Moines on Sept. 30, 2020. Saunders’ family struggles to find resources other than police for her daughter in crisis. Her daughter, who has severe mental health challenges, has been arrested multiple times. (Jovelle Tamayo for Crosscut)

No one wanted Rose to go to jail, not in the state she was in — convinced she had gone deaf, hand-signing a made-up language, communicating with her dead relatives.

Her husband, who had called 911 in the first place, didn't want it; her mother, who had seen before how this could end, didn't want it. Even the police who came to her home seemed to understand that this was not a crime scene, but an unraveling of Rose’s long-fragile mental health.

And yet, to jail she went, for the second time since May. In her frantic state, she had hit her husband, and it would be a liability for the Des Moines police to not take her in, her mother, Dawn Saunders, was told, almost apologetically. So Rose once again went tumbling through a system that seemed unwilling at every turn to acknowledge how ill she really was.

"It didn't matter that she was in a mental health crisis or anything," said Saunders.

The idea of substituting for police where they may not be needed has begun to find broader favor in the wake of summerlong protests, particularly when it comes to mental illness. The loudest voices for defunding the police support it; centrist candidate Joe Biden raised the idea in the first presidential debate. A recent Crosscut/Elway Poll found a majority of voters in King County support funneling some money away from police for alternatives. 

For her part, Saunders doesn't blame the police who arrived that day, but she wishes someone else had responded instead. Her daughter, whom Crosscut is identifying by her middle name, Rose, is bipolar with PTSD and borderline personality disorder. She is not intentionally violent, but is sometimes confused when not taking her medication. She has had traumatic encounters with police in the past. How could someone in law enforcement, even with the right training and intentions, conceivably help her?

Political debates aside, what Saunders knows is that what she and her daughter experienced wasn't what they needed in that moment. In some cities, like Eugene, Oregon, or Denver, there are off ramps away from a police response and toward behavioral health specialists. But alternatives available in King County are mostly separate from the 911 system and stretched thin. For Saunders, even with the help from a friend of hers, Lauren Simonds, executive director of the Washington chapter of the National Alliance on Mental Illness, it seemed that all roads led to the cops and the criminal justice system.

“You never send the police when you call 911 for any other health issue,” said Simonds. “That being the first step is the problem.”

Over the past six months, there has been no shortage of opportunities for the system to intervene on Rose’s behalf.

She went into the hospital last May for nine days of treatment. When she left, however, she was still not doing well. Two days after she was released, she experienced a psychotic episode and was arrested for the first time in her life on the lowest level domestic violence charge. The charge was later dropped.

Saunders thought the system might have learned something about her daughter after that first failed interaction with the jails, the hospital and the cops. Two months later, she was proved wrong.

On Sunday, July 19, Rose experienced another crisis. As she flailed her arms, she hit her husband. He called 911. When the police arrived, they said they had no choice but to arrest her.

For her family, though, they knew it was not what she needed. "It was not in the best interest of her health, it wass not in the best interest of her child to see her mother put in the back of a police car," said Simonds. "The man who called didn’t want her arrested."

But despite everyone's opposition, Rose spent the night in jail.

The next morning, she was released with nothing but orders to take her medication and not contact her husband. While in jail, she did not take her medicine and her mental state had continued to devolve.

The day after she was released, Rose disappeared. Over the next 24 hours, she would be picked up twice more, brought to two separate hospitals and twice released, each time with little help on the way out the door. Through all of this, Rose was still deeply unstable, claiming to be talking to tree spirits as she wandered an abandoned street in Black Diamond in the middle of the night.

By midweek, Saunders and Simonds  had managed to get Rose to her sister's apartment. But she was still not doing well, in a state of psychosis and acting frantically, and her family felt they needed outside help.

Hoping to avoid another run-in with the police, Simonds first called the King County designated crisis response team, which has the authority to commit someone to a hospital against their will if necessary. But the team told her that it would take them two to three weeks before they could respond — unless they could get Rose to an emergency room.

And so the family called 911, thinking they could get an ambulance to take her to the hospital to be evaluated. Instead, it was the police who showed up again. They said they could not take her to a hospital unless Rose was violent, which she was not.

"This is the primary reason that mental health is stigmatized," said Simonds. "Whether it's somebody who's homeless or who has a mental illness and somebody calls 911 for them or if it's me calling 911 for my child or loved one, it's the police, no matter what."

There are cities in which a call for a similar mental health emergency could lead to someone other than police to arrive. Eugene and its CAHOOTS program — which deploys mental health professionals instead of police when appropriate — has received widespread attention in recent months, despite its founding in the 1980s.

Since her daughter was arrested, Saunders has been reading up on Denver's Support Team Assisted Response program, a similar program in its earliest stages. "Just the fact that they insist on sending police when it’s a mental health issue and the problems that causes," she said, reflecting on the local response. "The police come and they do nothing."

The Puget Sound region is blanketed with service providers and nonprofit organizations, but none is currently positioned to take a meaningful number of calls away from police. In Seattle, the Downtown Emergency Services Center has a mobile crisis response team, but it's stretched thin and isn't intended to be a first response.

In the suburbs, the closest alternatives are the county's designated crisis responders. They have more legal authority than most service providers to commit people to a hospital against their will and, unlike police officers, they do not carry weapons. But the program is small — just 40 staff members, on call 24/7 — which explains why they were not immediately available for Rose.

"There needs to be someone you can call to get assistance with mental health in less than two to three weeks," said Saunders.

Leo Flor, director of the King County Department of Community and Human Services, said in a recent interview that the county could certainly use more resources for the designated crisis responders, although he said such dollars might be better spent focusing on nonemergency responses, like improved mental health care services.

Eventually, Saunders persuaded Rose to drive with them to the hospital. When they arrived, they waited for hours for an evaluation. The person who finally saw her recommended a 14-day commitment to a hospital — an imperfect but preferable response that they had wanted from the start.

Since the end of that stay, Rose has remained on her medication and is seeing her counselor, Saunders said. For now, she's stable. In the meantime, her husband fought for a month and a half to have the no-contact order lifted. A judge agreed early last month.

The whole experience was harrowing, and Saunders wonders if it needed to unfold as it did. Rose is kind and caring, not a criminal, said Saunders. For now, she's OK, but what if she had run from the police or acted out against them?

Simonds, the NAMI Washington executive director, said she doesn't use the language of defunding the police. At the same, she said, time the whole experience with Rose gives credence to some of the protesters’ underlying logic. 

“When you hear the language of defund the police, what you're talking about is reallocation of funding into things like mobile crisis response units,” she said. “That's really what we're talking about."

About the Authors & Contributors