Wellness Division Lets Mass. PD Focus on Community's Mental Health

CHELMSFORD, MA—On a recent afternoon, the resident of a housing complex was facing a crisis.

Police cruisers arrived at his residence, but officers weren't the only ones responding.

In the company of Lt. Todd Ahern, a clinical social worker, Rachel Beers, arrived to help.

The resident struggles with mental health and substance use issues — and wanted help.

After a discussion and several calls, Beers found the resident an in-patient treatment service.

For Ahern and Beers, the call marked the start of their shift together — and one of many efforts on the part of the Police Department's wellness division.

Ahern said Police Chief James Spinney saw the wellness division as a good fit with Ahern's skills and experience.

Ahern works with Beers through the Front Line Initiative — a partnership of mental health professionals working with police in Chelmsford, Tewksbury, Dracut, Billerica, and Tyngsboro.

The wellness division currently consists of Ahern, working in concert with the Front Line Initiative, with an eye toward expansion, amid a growing need for mental health expertise in public safety response.

Ahern might also enlist a clinician specializing in substance abuse.

A clinician attending a call with police is known as co-response.

"Front Line has come up with a co-response policy," Ahern said. "It talks about when you would co-respond. The clinician can go with a cruiser for a few hours...they can meet officers at a scene."

The clinicians and officers can also attend to follow-up calls.

The policy outlines safety protocols. For example, a clinician can wear a protective vest, which also identifies them as a clinician.

"The officer would ensure that it is a safe scene," Ahern said, noting that clinicians do not enter until the officer declares that the scene is safe to do so.

The Front Line Initiative evolved from the Jail Diversion Program through the Greater Lowell Health Alliance.

The initiative began in 2014,with one clinician, and four police departments.

The initiative has expanded through varied grants — with the latest from the Bureau of Justice Systems, for $800,000. This includes funds for a therapy dog.

"One of the things we've done is we have signed on to the International Association of Chiefs of Police's One Mind Campaign," Ahern said. "What you are pledging to do is train all officers in mental health First Aid, which is an eight-hour course."

Ahern said, "You are supposed to train 20% of officers in a crisis-intervention team." This program consists of a 40-hour course.

Half of Chelmsford officers have taken the 40-hour crisis-intervention team training. "We are looking to train 100% of our officers," Ahern said.

In addition to accompanying officers on mental health calls, officers can call clinicians for advice. "A lot of times, they will offer the person, 'Do you want to speak with someone?"" Ahern said.

The Front Line Initiative also allows for phone consultation with a clinician — known as telehealth calls.

The Chelmsford Police Department available cards with a QR code to access help through Credible Mind, which offers mental health resources.

The telehealth model increased during the COVID pandemic, in an effort to provide help but reduce risk, Ahern said.

Ahern said growth of the Front Line Initiative and mental health training for police evolves both from an increased need, and a change in approach.

"Some five, 10, 15, 20 years ago, it was a lot more common for police to send almost anyone with mental health issues for evaluation, be it voluntary or involuntary. What we've learned is that this is not always the best response," Ahern said.

Ahern added, "You are taking away someone's liberty, and they are being compelled to go get an evaluation, to remain there, in a hospital, until cleared, or referred to a long-term facility."

Ahern said, "Our responses are going up dramatically for mental health calls. Even pre-COVID, mental health calls have been going up over the past few years."

In addition to increased need, Ahern said, "It's less stigmatized — 20 years ago, most mental health issues were dealt with inside the family."

Ahern added, "People are more willing to go and get help. Sometimes, it comes in through us, because they are presenting some kind of crisis. It's important for us to have better answers."

Within the need to respond to calls appropriately is a need to incorporate cultural differences. "You have to have a better understanding of how everybody fits into the equation. You have to be aware of implicit biases," Ahern said.

Overlapping problems are common. Ahern said one of those issues is homelessness.

"We work on outreach, and we try to work on placement, which isn't always as easy as you would hope," Ahern said. "People have a naive expectation that if you offer a roof over their head, they would automatically take it. That's not true."

Matthew Page-Shelton, executive director of the Front Line Initiative, said, "The structure is ever-growing." The initiative includes three fulltime clinicians — two fulltime, co-response clinicians, and one full-time recovery support clinician.

The Front Line Initiative's total operating budget is currently slightly over $1 million.

In all, the total of referrals through the initiative total a little over 5,800 between 2018 and October 2021 for all five communities. Page-Shelton attributes some of the increase to the COVID crisis.

"What we have learned...is it that it is so important to have this mutual partnership between the clinical side, and the law-enforcement side," Page-Shelton said. "One struggles to operate without the other."

Page-Shelton said, "From a very early age, we're all indoctrinated that when something is bad, or something is wrong, we call 9-1-1. How do we respond to those calls internally, to make sure of the right response?"

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