San Mateo County, California
Below is series of videos demonstrating the continuum of team responses to individuals in crisis in San Mateo County, California. The videos feature the San Mateo County Mental Health Assessment and Referral Team (“SMART”) Program; Field Crisis and Consultation Committee; and Pathways Program, including the Mental Health Court.
1. San Mateo County Mental Health Assessment and Referral Team (“SMART”) [7:20]
The SMART Program is a collaboration of the San Mateo County Health Department, American Medical Response, San Mateo County Human Services Agency, and law enforcement agencies in San Mateo County. The goal of the program is to best manage individuals who are experiencing behavioral emergencies—in other words, getting the individual to the services he or she needs.
The video demonstrates how the SMART staff works with police officers who are responding to behavioral emergencies. In the first demonstration, the SMART staff and officers are conducting a “5150”, which is the procedure under California law to place an involuntary psychiatric hold on an individual who is a danger to himself/herself or others due to a mental disorder. Pursuant to Section 5150 of the California Welfare and Institutions Code, the officers may transport to a designated psychiatric emergency services facility. The facility may detain the individual for 72 hours for evaluation and treatment. If the individual is not in need of emergency psychiatric services, the officers can take an individual to other resources in the community.
- 2. Field Crisis and Consultation Committee [8:06]
The Field Crisis and Consultation Committee brings the city and county stakeholders together once a month to discuss the cases of individuals brought before them, and to devise a plan to assist each individual with a plan for recovery. The committee is composed of the following agencies: San Mateo County Behavioral Health & Recovery Services, San Mateo County’s National Alliance on Mental Illness, San Mateo County District Attorney’s Office, San Mateo Mental Health Association, San Mateo County Aging & Adult Services and Probate Investigations, San Mateo County Conservatorship Investigations, San Mateo County Sheriff’s Office, City of Belmont Police Department, City of Pacifica Police Department, City of San Mateo Police Department, City of Daly Police Department, San Mateo County Probation Department, San Mateo County Emergency Medical Services, San Mateo County Mental Health Assessment and Referral Team (“SMART”), American Medical Response, and Mobile Support Team.
The video demonstrates a meeting of the Field Crisis and Consultation Committee. To be eligible to participate in the Pathways Program discussed at this meeting, an individual must meet four criteria: (1) be statutorily eligible for probation; (2) a San Mateo County resident; (3) diagnosed with a serious mental illness and functional impairments but mentally competent to stand trial/plead; and (4) voluntarily agree to participate. The Pathways Program is discussed in more detail below.
- 3. Pathways Mental Health Court—In-Chambers Meeting [2:22]
As set forth on their website, the Pathways Program is a partnership among the San Mateo County Courts, the Probation Department, the District Attorney’s Office, the Private Defender Program, the Sheriff’s Office, Correctional Health, and the Behavioral Health and Recovery Services Division. The program is designed to serve people with a serious mental illness and functional impairments who are competent to stand trial/plead.
Also as set forth on their website, the program has three paths to treatment: (1) diversion from the criminal justice system; (2) post-adjudication intensive supervision; and (3) post-adjudication alternatives to incarceration. The goal of each path is to achieve better outcomes for individuals with a serious mental illness and functional impairments. The program achieves these goals by integrating criminal justice sanctions and treatment approaches so that the clients’ underlying behavioral health problems are addressed.
This is a video of an in-chambers, pre-court meeting of the Mental Health Court. In addition to the participation by the judge, the meetings are staffed by the district attorney, private defender, Pathways clinicians, probation officer, and chair of the Field Crisis and Consultation Committee/clinical services manager of San Mateo County Behavioral Health & Recovery Services.
- 4. Pathways Mental Health Court—The Honorable Mark Forcum, Judge, Presiding [3:19]
This video demonstrates the approach and protocol of the Pathways Mental Health Court with an individual who is eligible and chosen to participate in the program.
- 5. Conclusion [3:22]
Some of the leaders involved in this comprehensive approach in San Mateo County comment on the benefits to the individuals and community they have observed as a result of these programs, including a decrease in recidivism. Providing observations and perspective are Greg Munks, Sheriff of San Mateo County; the Honorable Mark R. Forcum, Judge of the Pathways Mental Health Court; Myra Weiher, Assistant Chief Private Defender; Steve Wagstaffe, San Mateo County District Attorney; Brad White, General Manager, American Medical Response; Sharon Roth, Co-Vice President, San Mateo County-National Alliance on Mental Illness; Louise Rogers, Director, San Mateo County Behavioral Health & Recovery Services; and Don Mattei, Chief of Belmont Police Department.
We wish to thank Chief Don Mattei of the Belmont Police Department for providing these videos to demonstrate the team approach in San Mateo County, California; we also wish to thank all of the professionals who participated in the mock proceedings and videos.