The City of Los Angeles is partnering with the county to launch a pilot therapeutic van program, which will send mental health professionals to people experiencing mental health crises, instead of police and firefighters.
On Sept. 21, the Los Angeles City Council unanimously approved the creation of a memorandum of understanding between the Los Angeles Fire Department, or LAFD, and the Department of Mental Health, or DMH, to create the program, which will last for one year. Mayor Eric Garcetti approved the motion on Oct. 4. In addition, the city council approved transferring up to $2,000,000 from an unappropriated balance fund used for mental health services to the LAFD, as the vans will operate out of fire stations. One will be in Station 40, which is on Terminal Island, according to the Chief Legislative Analyst’s report on the project.
The vans will have teams of clinical drivers, peer support specialists and licensed psychiatric technicians, according to the city council’s motion.
The city council began discussing using the program in September 2020, but it still does not have an official start date.
“I wonder why it took them so long to actually start to do something,” said Doug Epperhart, president of the Coastal San Pedro Neighborhood Council.
Epperhart argued that the city’s interaction with homeless people was driving the creation of the program.
“When you have problems with homeless people, you know, addiction, mental health issues, so on and so forth, they seem to call the police first of all,” Epperhart said. “And this is one place where the police are actually … working with social services people, but it’s not even close enough.”
Laurie Jacobs, former vice president of the Northwest San Pedro Neighborhood Council, said she supports the program.
“We need less law enforcement in mental health situations,” Jacobs said.
Councilwoman Monica Rodriguez spoke about the program at the Sept. 1 meeting of the city council’s Public Safety Committee.
“This therapeutic mental health van pilot marks a substantial shift in our partnership with LA County, to deploy the very important and missing mental health resources — trained health professionals — in lieu of fire and police personnel,” Rodriguez said.
LAFD Chief Graham Everett said that the LAFD had been looking for solutions to dealing with mental health emergencies as far back as 2019.
“The problem we were trying to solve was trying to find some alternatives to the 28,000 calls a year we were going on related to mental health patients that may or may not have had a medical issue associated with their call,” Everett said.
The LAFD took about 17,500 patients to the emergency room in 2019 and has had similar numbers in 2020 and 2021. Everett said the LAFD is taking a lot of people to the hospital that don’t necessarily need to go there.
“They have a mental health crisis and they may need to go to a mental health facility, our EMTs and paramedics … it’s not within their scope of practice to do so,” Everett said. “Really we’re limited on the services that we can provide. And this association with the county provides us [with the ability] to have experts in the field of mental health, and to be out there on scene with these patients, provide them with the best possible care, and transport to the most appropriate facility.”
Everett argued that this would help the LAFD as it would allow them to keep their resources available for medical emergencies, and help hospitals as well, as it would prevent their emergency services from being as crowded as they are currently.
Dr. Steve Sanko, interim medical director of the LAFD, said that the program will have five DMH teams strategically placed around the city close to crisis stabilization centers. The Los Angeles County Board of Supervisors proposed the pilot program to DMH, then to the city.
“We would have a checklist for medical clearance to be seen by a psychiatric provider,” Sanko said. “It would be used by either the DMH therapeutic … van providers, or by LAFD members, who could then summon the therapeutic vans.”
Councilmember John Lee said that while the bases for the vans were supposed to be near mental health facilities, they did not do a good job covering his district, Council District 12.
“We still only have one in the valley,” Lee said. “We have nothing in the west valley.”
Lee said he has found another space to place a base for the program and has asked the county for help with funding, but he has not heard a response yet.
Everett said that the city needs more than five vans. He said if the pilot program is successful, it will add more.
“Even though those vans are going to be running 24 [hours per day], there’s only five of them in the city,” Everett said. “So, it’ll be an impact, but it’ll be a small impact at first.”
Rodriguez said she wanted to make sure the therapeutic van program was not duplicating another program the city council is considering — an unarmed crisis response model.
The city council approved this model 13-0 at its Sept. 15 meeting. It is based on the Crisis Assistance Helping Out On The Streets, or CAHOOTS, model used in Eugene, Oregon. That program sends a medic and crisis worker to respond to mental health crises. Neither the medic or crisis worker are cops, and both are unarmed.
Councilman Marqueece Harris-Dawson said that the motion for the unarmed response asks the LAFD and Los Angeles Police Department to analyze similar programs, including the therapeutic vans.
“I understand that there’s overlap,” Harris-Dawson said. “I want overlap. I want the problem that we have two people responding to the same thing thoroughly, because right now what we have is nobody reacting to it, essentially. Or we get from the fire department or the police department, ‘I can’t do anything unless that person harms someone or harms themselves.’ And that’s just an unacceptable solution.”