7 things to know about Denver STAR, a program to send mental health workers and medics to 911 calls

Milwaukee Journal Sentinel

By Ashley Houston

Carleigh Sailon, Mental Health Center of Denver program manager, left, and Dustin Yancy, a Denver Health paramedic, respond to 911 calls involving mental health and substance abuse in Denver.
Carleigh Sailon, Mental Health of Denver program manager, left, and Dustin Yancy, a Denver Health paramedic, respond to 911 calls involving mental health and substance abuse in Denver. City of Denver

The calls for help kept rising in Denver: Welfare checks. Suicidal subjects. An overdose victim.

As 2020 began, even before a global pandemic swept across the country, Denver police data showed mental health-related 911 calls were up 17% from the three-year average.

Last June, the city launched Denver Support Team Assisted Response (STAR), a paramedic and mental health clinician team that headed to 911 calls in a van without police. They treated people with mental health and substance abuse issues and connected them with services.

six-month study of the new pilot program is showing signs of progress. The alternative team responded to 748 calls. None ended with police being called or an arrest.

In the pilot, Denver 911 noted all calls that fit the criteria for STAR, even if calls fell outside the pilot parameters. About 2.8% of the calls — roughly 2,500 of 92,400 — qualified. Denver has an average of 600,000 calls annually, meaning about 16,800 calls could be answered by civilians, not police.

On average, Milwaukee dispatches between 7,000 and 8,000 calls related to mental health annually, about 3% of police call volume, according to police data given to the Common Council.

Denver officials have touted the success of STAR, but there are growing pains as some community partners say they have been cut out of the planned expansion.

Here are seven lessons Milwaukee can take from Denver’s experience.

It took time.

Denver community leaders had advocated for an alternative for at least four years before it became a reality.

It took the city and community three years to put the program together, from researching models to analyzing Denver data and hiring staff.

Denver had a funding source.

In November 2018, Denver voters approved a new 0.25% sales tax increase to generate about $35 million annually. The ballot initiative passed with 70% approval.

At least 10% of the new sales-tax revenue was dedicated to specific public safety services related to mental health and substance abuse. Voters knew this when they cast their ballots. The amount covered the $200,000 cost of the pilot program. The planned $1.4 million expansion is coming from the city’s general fund.

If Milwaukee wanted to put a similar sales tax on the ballot, the city first must get approval from the Republican-controlled state Legislature. Republican leaders in Wisconsin have rejected the city’s earlier pleas to put such a measure before voters.

Denver researched an established program.

Denver leaders went to Eugene, Oregon, to learn more details about the Crisis Assistance Helping Out On The Streets (CAHOOTS) program.

CAHOOTS has gotten widespread attention in the last year as cities rethink public safety after the killing of George Floyd by a Minneapolis police officer and the ensuing protests for racial justice. Milwaukee officials have cited it as an example they may want to model.

CAHOOTS, founded more than 30 years ago, is a partnership with a private counseling clinic and the police department. The clinic runs vans staffed with mental health professionals/crisis responders and a trained medic. CAHOOTS is dispatched from the city’s 911 center to calls involving people who appear intoxicated, disoriented or mentally ill.

It took collaboration.

Denver had a team of government and nonprofit community partners.

The Caring for Denver Foundation (which successfully lobbied for the sales-tax ballot initiative), Denver Police Department, Mental Health Center of Denver, Denver Mental Health Paramedic Division, Denver 911 and community resource providers all joined together.

The Common Council created a task force in March to research and propose a master plan within six months. Although some early conversations have occurred, the task force does not have its full membership roster complete and has not had a formal meeting.

Data drove decisions.

In the past, Denver 911 could only send police or medics in an ambulance. STAR provided a third option. But what calls were appropriate?

The team analyzed 911 data and chose certain call codes to flag for STAR: assist, intoxicated person, suicidal series, welfare check, indecent exposure, trespass unwanted person and syringe disposal.

Most of the calls came from one police district, two precincts within other police districts and one corridor, so that is where the pilot program was based.

Staff from Denver 911 also created an easy-to-understand flow chart and new training on how to dispatch STAR. The program is not designed to respond to violent situations or life-threatening emergencies.

STAR was not the only option.

Many cities, including Denver and Milwaukee, have paired officers with mental health counselors in specialized teams, often referred to as “co-responder” units.

Denver has invested heavily in those units since 2016. The city of about 725,000 people has 25 such teams and is adding seven more to respond at all hours. Milwaukee, with a population of about 600,000, has three teams in the city and is adding three more this year.

If a person is armed or demonstrated violent behavior, the “co-responder” unit should be dispatched, Denver’s police chief said. If a 911 operator is not sure whether to send the co-responder team or the STAR van, then the default is to send a co-responder

Community involvement must be real — or else partnerships faltered.

In Denver, the biggest divide has come with STAR’s planned expansion.

Residents and city representatives led an expansion subcommittee within the larger group that had created STAR.

They proposed an advisory committee and drafted a charter calling for a “trauma-informed and culturally responsive” program with staff “who share lived experiences and identities with Denver’s diverse population.”

Months later, the city health department, which now houses STAR, presented a $1.4 million expansion plan to the city council. That plan included proposals the working group had not agreed to and now some community groups have withdrawn from the process.

The loss of trust could undermine STAR, a program that stemmed, in part, from distrust of the police from residents.