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Better Together: Changing Public Health Outcomes in Virginia with the Co-Responder Model

  • September 29, 2023
  • Public awareness, Serious mental illness, Suicide and self-harm

The co-responder model is a recent innovation in behavioral health services that employs a mental health professional and a law enforcement official as dual first responders when an individual experiences a mental health crisis. The Marcus-David Peters Act (“Marcus Alert” or “MA”), signed into law in Virginia in late 2020, commemorates Marcus-David Peters, a young Black biology teacher in Richmond, Virginia, who was killed by police while undergoing a mental health crisis.

Kate Garvey, the Director of the Department of Community and Human Services in the City of Alexandria, Virginia, worked with her team and key partners on the development of a co-responder program to support public health and safety ahead of the Marcus Alert taking effect in Alexandria. The APA Foundation sat down with her to discuss the implementation of the model that the city designed.

“Since its inception, the Co-Response Program has shown excellent outcomes: a higher number of crises resolved in the community, fewer restrictive dispositions, diversion from the legal system, and better linkage with behavioral health and substance use disorder services,” said Garvey. “Although the Marcus Alert hasn’t fully taken effect in Alexandria yet, the development of the co-response model required intense collaboration among multiple departments, and even created the appropriate conditions for many other multi-system projects and partnerships to take flight.”

Aside from the increase in safely resolved crisis situations and higher connectivity to substance use disorder services, instances of co-responder models elsewhere in the U.S. have been shown to speed up access to care for struggling individuals and decrease costs for the implementing institutions – as well as decreasing the number of psychiatric hospitalizations. Notably, the co-responder program in Johnson City, Kansas, has been proven to reduce repeat calls for service from the same individual.

All co-responder models include a simultaneous response by mental health and law enforcement professionals, but within that definition, models may vary. In Alexandria, the model implementation began with a small pilot – just one clinician and one officer. The Department of Community and Human Services collaborated with other City of Alexandria departments (including the Office of Performance and Analytics, the Alexandria Police Department, and the Department of Emergency Communications) to engage an external program evaluator. This evaluator oversaw the program implementation, guided data collection, and evaluated outcomes.

“[The external program evaluator] was a critical factor in guiding the development of the program,” said Garvey. “We reviewed the literature on co-response, evaluated programs from other jurisdictions, and incorporated elements from other programs with the necessary adjustments for the specific needs of the City of Alexandria. We created protocols and training standards for both clinicians and police officers. Co-response teams involved the merging of different “cultures” that required often fine tuning and compromises, but based on our positive outcomes, the City Council funded expansion of the model. Two more teams [of officers and clinicians] were created, and coverage was extended to seven days per week.”

The APA Foundation has partnered with the Concerned Citizens Network of Alexandria to form the Mental Health Coalition of Virginia, which scales medically informed, evidence-based mental health initiatives in Northern Virgina. APA Foundation works to increase equitable access to mental health care, which in many cases includes providing resources to those who are detained in the correctional system. Nearly two million people with serious mental illness (SMI) are arrested each year, many for non-violent crimes such as loitering or trespassing. Implementation of the co-responder model is just one example of a systemic change that could decrease that number drastically.

To other cities interested in implementing a co-responder model, Garvey’s advice is: “Like in any other cross-system project, buy-in from critical stakeholders and securing the support of leadership is key. As mentioned, learning from other jurisdictions can save you a few headaches, and in addition, the International Co-Responder Alliance includes helpful resources.”

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Note: This blog was orignially published by the APA Foundation

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