‘Crisis Cop’ shares story of San Antonio outreach that saves resources, rescues lives

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San Antonio Police Officer Joe Smarro discussed how his city diverts the mentally ill and/or addicted from jails or emergency rooms by connecting them directly to counselors, medical care or other needed services. Photo/Pat Grossmith

MANCHESTER, NH —  The San Antonio Police Department’s approach to dealing with those suffering from mental illness and/or addiction is not to arrest them and put them in jail but to connect them with medical or other services they need.

Their approach and the wrap-around services provided in the Texan city were explained as part of “Developing a Safety Net for Manchester with G.R.I.T.” presentation Thursday at the Derryfield Country Club.  G.R.I.T stands for Growth, Resilience, Integrity and Tenacity.

Karla Ramirez, managing partner for Behealthle in San Antonio, said the programs have saved Bexar County, Texas, $96 million over eight years.

She said people suffering from mental illness and/or addiction who go to emergency rooms cost about $2,000 per visit but when brought to a clinic the cost drops to about $200.

The city hired Ramirez’s consulting firm to develop a plan for the city concerning homelessness.  Joe Smarro of the San Antonio Police Department, appeared at the event on behalf of his private company, SolutionPoint+, working with national consulting firm Behealthle.

Smarro, co-star in the HBO documentary “Ernie and Joe: Crisis Cops,”  was the featured speaker at the Derryfield presentation. The film follows Smarro and his partner, Ernie Stevens, members of the department’s Mental Health Unit, as they respond to crisis calls.  In one incident, they talk a woman out of jumping off a bridge.  Voices, she said, told her to “Jump. Jump. Jump.”

The two officers strike up a conversation with the woman and, winning her trust, they are able to take her to a clinic for medical care. They follow up with her six weeks later and find that she is no longer on drugs and is working.  Later, however, she is no longer at that residence.  She and her boyfriend were evicted because he repeatedly beat her, causing disruption to other residents.

Eventually, the woman gets treatment, a new boyfriend and a job at a restaurant.

Smarro said the film took three years to make and involved 300 hours of filming that was boiled down to the 96-minute documentary.

About 100 people came out to the Derryfield Country Club to hear the ‘Crisis Cops’ talk about what success has looked like on the beat in San Antonio. Photo/Pat Grossmith

In his talk, Smarro said one program that is very successful in San Antonio involves a team of two mental health officers, a full-time clinician and a paramedic who visits people identified as the top 100 users of emergency services each costing the public about $1 million a year.

“We are going to show up at your door a lot,” he said.  Some of them have complex conditions while others are isolated from their families and are lonely so they go to the emergency room because it is a social event for them, Smarro said.  He said these are people are in the emergency rooms four to five times a week.

Now, they have weekly visits with a psychiatrist, are given money, if needed, for monthly medication or provided food if needed.  Some don’t know that they qualify for Social Security Disability, Social Security or veterans programs and they don’t know how to apply for those programs.

“Sometimes it is just holding their hand and taking them through the process,” he said.  In the first three months, 47 people were tracked; 911 calls dropped 67 percent.

Housing is a necessity to ensure health care, according to Ramirez. She and her team are in Manchester gathering data to come up with a housing plan.

The idea is to create a systemic response to homelessness by strategically allocating and using resources.  According to the Manchester Health Department, 33 percent of homeless people battle mental illness which often leads to drug and alcohol abuse.

The program, hosted by the city’s health department, drew more than 100 people, including state and local officials as well as representatives from police departments including Manchester, Nashua, Concord and others.

Anna Thomas, director of the Manchester Health Department, opened the program by providing comparisons among San Antonio, Manchester, Nashua, Concord and Rochester.

San Antonio, the seventh most populated in the U.S. with 1.7 million people, has a crime rate of 649 per 100,000 people;  Manchester, 592 per 100,000; Nashua, 140 per 100,000; Concord, 239 per 100,000; Rochester, 378 per 100,000.

The greatest disparity, she said, is when it comes to overdose deaths.  Manchester’s rate is 68 per 100,000 while San Antonio’s is 6.8 per 100,000.  “That’s incredibly dramatic,” she said.

In Manchester, AMR (American Medical Response) has gone on 3,682 overdose calls with 355 deaths.  Narcan, to revive those who overdose, has been administered about 10,000 times.

Thousands have come to the city’s Safe Station, with half of them coming from outside the city.   It is a program being replicated across the country, she said.

In the city, 600 students, half of them in elementary school, are displaced or homeless.  Every night, the homeless shelter is filled to capacity — 130 people, with 30 of them sleeping on mats on the floor every night.  Warming stations have been set up in the city to help another 10 to 30 people to prevent loss of life in the cold, she said.

“This is our every day,” she said.  Thomas said she knows other communities are struggling with the same problems.

“This is all in our future work,” she said.


Officer Joe Smarro of the San Antonio Police Department was here on behalf of his private company, SolutionPoint+, working with National consulting firm – Behealthle. He is not appearing on behalf of the San Antonio Police Department.