president mazzucco, but i also want to thank you, commissioner, and commissioner dejesus because i know you have put a lot of time and energy into this. first of all, i i think it is especially important that before dealing with the issue of teasers, that the police commission chose to grapple with this issue. i think that there is, to some extent, a connection, but that there is, in my view, not a full understanding of how important the mental health piece is, and i think that having a hearing on this before that was a very this -- important discussion on cases was an important statement, and i'm proud of the fact that that statement was made. >> that was a discussion amongst the commission because our first meeting of the year was when the case your discussion was

calendar -- when the taser discussion was calendared. so i'm really glad that we reorganized the way we discussed it at first focused on the mental health issue. supervisor campos: a lot of credit has to be given to you for raising that issue and also to the president who ultimately controls the agenda, and for his willingness to listen and be responsive. one of the things i thought was an unfortunate as the issue of mental health was juxtaposed to the issue of tasers was the statement by former chief gascon where the issue happen in the tragedy happened where there were some mental health issues involved and pointing to that as a justification, in my view, without fully knowing exactly

what transpired in that incident and whether or not it was prudent -- proven with any certainty that one tool or another would have prevented the tragedy. so i think that we have to be very careful about how we talk about mental health, how we talk about tasers, and i think that the commission needs to be given credit for that. with respect to the message model, i wonder, commissioner, the extent to which this remarkable outcome of of raising this very successful model will shape what happens on the discussion of tasers. as i understand the memphis model, in memphis, tasers are not used. i'm wondering if you have any thoughts about that. >> thank you for highlighting that.

it was the president decided to do that, and i appreciate that he did because it led to a healthier discussion. the commission does have an agenda item scheduled for next wednesday at 5:30 at city hall, room 400, regarding the taser discussion. i assume it will be a very lively discussion amongst everybody, and i think it is interesting that memphis does not have tasers. they specifically chose not to because they realized that the effectiveness rate was not high. they did qualify that it was based on their review a while ago because they started implementing them at the memphis small they while ago. instead, they had a different intermediate device they use, a rubber bullet gun, and they said they rarely actually pull the

trigger. i think they are just pulling it out to scare folks. in general, their number one way of responding to a mental health crisis is 3 d escalation techniques that are a lot more successful than any type of weapon. these techniques are often the opposite of what the charter might be used to, so instead of raising your voice and moving in, you lower your voice and move out. you try to buy more time rather than shorten the incident, so those are techniques i think we should discuss, coming up with an effective way of dealing with these intermediate situations compared to other types of devices. supervisor campos: what i would say on this issue is that i think in respect of of where we are on tasers, whether one

supports it not, i hope we have as open a dialogue on the issue and process, that it is as inclusive as possible because i did think that whether you think that they should be used or not, i think if you're going to use them in the end, that is a position where there has to be as much community by as possible. i do think that trying to understand what is happening or not happening in other jurisdictions is really important. to the extent that here we are, saying that we embrace the best practices that memphis has inc., i do think that's we also look at those practices in the context of some of these things, including tasters -- including tasers. i think it is a positive sign, what i have seen, and i hope the dialogue is as robust as possible.

i hope also to include members of the board of supervisors and the public safety committee, certainly, to the extent that there is specific information you are getting about the men this model. i know i certainly would like to learn more about how it works, to learn more about what its implementation will look like in san francisco, and i think that the more that we are involved, the better it will be, and it is certainly something we need to think about as we go forward with the budget process, which is already starting, because it will cost some money to implement as well. >> i appreciate the support from the board on this.

it would be great to have that support. supervisor campos: and the last thing, i have to say that on the mental health complex issue, to end up having the load on that is impressive. having served on the commission, it is impressive to see that level of unity on something as complex and sensitive of that, so i'm very proud to see that. >> thank you. i think we have that unity because we had a room packed of mental health stakeholders were unified in asking for the passage of the resolution as well as support from the chief and director, and that really helped push the commission to say yes, we are all in this commission together. >> adding that is important. the involvement by the director and chief went a long way in making that happen, as a thank-

you to both the director and chief for making that happen. supervisor mirkarimi: some of the stakeholders are here today, and they will speak as well. supervisor cohen? ok, thank you very much. >> i will send you more material about the memphis models of you have it, and i should qualify that my opinion on the taser is my personal opinion, and you will find that the commission's overall opinion next wednesday. supervisor mirkarimi: is inspector dunn here by any chance? andhele -- and helena brook, mental health ward. >> thank you for having this hearing. i'm really excited and pleased by the work that angela and the police commission did to address this issue. i did some squawking, as you know i'm prone to do, in june

when the training that has been going on for 10 years was cut, but it was not just interest to the general public at that time, but i'm really glad to see this happening. but having coordinated the training for 10 years, having worked with almost 1000 police officers who came to the training, a large majority because they wanted to, because they wanted the information about mental illness, and they wanted to learn more because of the time -- you get about eight hours, i think, in your first academy experience. by the time you finish that, you forget most of it. many officers who have been on the force for more than 40 years said it was the best training they have ever had. i want to really salute the police department for having that training for 10 years. i believe, and it is one of

those things you cannot research -- how many times that the police officers who went through that training be escalated the situation before it ever came to any attention or any problem -- de-escalated the situation. because they have had that training. that training was actually based on the mend this model. it is the same actual training that they do in memphis. the difference is only the the community decision 10 years ago was to train the entire police department, since we have such a high number of mentally ill in our city. the highest number of people taken to the hospital as a danger to themselves or others or gravely disabled, and police officers tend to have to respond to more situations where a person is also under the influence of substance abuse, has had a recent incidents of violence.

if i just really think that the training has been very good and very effective in ways that we probably do not even know. i have -- you're just interest in reading over the last 10 years. i would have them right out situations that they had encountered with a person with mental illness. they are very different in the city -- than the situations we encounter in mental health. one of the most graphic was a man in a wheelchair in the middle of traffic, and he had a colostomy bag, and as the police tried to get near him to try to get him out of traffic, he was throwing the contents. that does not happen to us in the mental health building. they have a lot of situations to deal with that are very different. what i hope happens out of this is much more collaboration and more focus and attention on a

24-hour mobile crisis treatment team, on expanding aging care, which is 24 hours, but only has 12 beds. i think we only have 18 beds. in mental health, the resources have been cut in so many ways that police do not have options after they stop a person. a number of stories that we heard of police driving around and around until site emergency went off red alert and with a person in serious crisis in the back seat of the car because they could not take them to sec emergency because it was too full. we really have to collaborate

response from different departments. from reentry, from jail, from mental health, from the full department of public health, the department of human resources. they have all really got to be working together because the police cannot be out there working alone. it is really not fair. supervisor mirkarimi: i very much thank you for that presentation. from my experience when i went to the san francisco police academy, that was not part of our training at all. it was not part of the coast- curriculum, even though there were some modifications to the curriculum here in san francisco to add to more specialized training, and we had that, but on mental health, that was not part of the eight-hour block. so of that was part of the primary, what about the veteran officers? how about the veteran officers who have already established

their habits? been in the departments, and influenced by certain practices? how would the navy influenced after they had become more molded than the academy recruit that was just trying to get through in the launch of their careers? >> a couple of things -- one thing that the chief did while she was here is on basic mental health information and on mental health disorders because we could not move fast enough for the 40-hour training, and she wanted to have all of the officers have some basic training, but a thing -- i think where the 40-hour training did make some changes was the first phase was basically information about mental health. the second day was a visit to clinics and media clients, having clients speak from a panel about what it is to have a mental illness, and the third day was more information.

the fourth day was a full day with a person from the academy and a person from mental health and doing role-playing and very specific techniques for de- escalating. what we heard so much from officers was in the first part, not having information -- in other words, if they come upon a scene and start with the usual command and control response to any person does not respond at all as predicted. in other words, if a police officer comes up to me and says, "standstill, touch your toes, jump," i'm going to do all of those things. of the that a police officer and respond in whatever i asked to do, but a person in a serious mental health crisis might not even be aware that as a police officer. they might be hearing voices saying that that is someone out to hurt them. a lot of that training provides information, just a different

tool to evaluate a situation. if a person, for infants, is not appearing to see that you are a police officer and as perhaps looking up to the left or right like they are listening to something, tell them that it is okay to ask the person -- if they are hearing voices and ask a person with the voices are saying. if a person appears suicidal, ask them if they are thinking of killing themselves. people are very hesitant, police officers included, if they are planning it, whether they will give them an idea. and that is not true. they shared with us that having the information and then meeting to people -- meeting people with mental illness -- many officers if they do not have a person with mental illness in their home do not know that mentally ill people can be very intelligent. that they are meeting in person at their very worst moment.

but that in recovery, people hold jobs, contribute to the community, so seeing the full range of what this person is capable of was very helpful to them. supervisor mirkarimi: it's psych emergency at san francisco general is reducing down to 18 beds, and as you said earlier, police will be somewhat disabled from not being able to -- if in fact they are at or beyond capacity for both beds and what other services, what do you anticipate happening then? >> pretty much what has been happening. the 18 beds is in sight emergency. i did not know what their full capacity is. but they will make decisions based on, you know, what they can do with a person.

supervisor mirkarimi: but the police department has the mandatory power to commit somebody for up to 72 hours. isn't that correct? >> that is correct. >> yet, if they reduce that level of access or resources for the police to be able to bring somebody, then, it is to one of the non-profits, i believe. is that not correct, too? >> if they decide that someone needs to be 5150ed, other than dole urgent care, there is nowhere else to bring them. let me correct that -- they can bring them to st. francis. they can bring them to some of the other hospitals. what we are hearing is back the other hospitals are not very responsive to our clients coming, and often, they will not

necessarily refuse them, but make it very difficult. then, an hour or two we will later, an officer will be called again for the same person because the other hospitals have actually put them out. supervisor mirkarimi: do you have any specifics on the 5150 population? >> yes. we did -- we have done a couple of research studies. one in 2005 in which we look at all the 5150's over a three- month time and were comparing them and found that the police officers were more often people who were also under the influence of substance abuse who had recently within two weeks had a violent incident. in terms of the overall calls per month, as a look at my notes

here, i do not have the memorized. the san francisco police informant has from 1 to 20 interactions per share with people with mental illness with an average of four contacts. a lot of that depends on different areas of the city. supervisor mirkarimi: what was the first statistic? >> one to 20 interactions per shift. it hundred 5911 calls per year or 30 per day. with approximately 8 per day resulting in a 5150 -- supervisor mirkarimi: do what we have any idea of the repeat offenders? >> i do not have an update, but

-- actually, i do, i do not have that in front of me. we did this from a different perspective. we did a study over three years in 2009 of 5150's intensely looking at what the cases were about, what the person was complaining of, and such, and to determine how many of those could have gone to dual urgent care instead of psychiatric emergency, and we came up with about 2/3 of those could have gone to build urgent care. within that study, which i'm happy to forward to your office, it does detail how many of the people were repeat calls and what specifically the numbers from each supervisory district as well. supervisor mirkarimi: maybe you can provide that to our offices. >> i would be happy to. supervisor mirkarimi: thank you. appreciate it. supervisor campos: i do not have

any questions. i simply want to make the point that, as is the case with anything dealing with public safety, whether you are dealing with mental health issues or something else, there's the policing peace, which i'm glad we are addressing the fact that we are following a model that will incorporate best practices and will, among other things, provide better training to police officers, but i also think that there has to be a prevention piece, and that is where mental health services comes in. you can do everything right on the police enforcement peace, but if you are not providing those services and protecting those services, you are going to have a problem. i hope that is something we keep in mind as we move forward with our budget. we have to make sure that we

move on parallel tracks because of the services are as important as the other pieces. supervisor mirkarimi: thank you. we are quite agree. thank you very much. >> thank you. [inaudible] supervisor mirkarimi: yes, please. lisa hoffman? thank you for your patience and for being here. >> thank you for inviting me. good afternoon. i just wanted to talk a little bit about the 911 communications because that is my field of expertise. ordinarily, 911 dispatchers in the state of california for debate in the peace officers standards and training program. that training is reimbursed by the state of california. our dispatchers go on to receive about 32 weeks of on-the-job training, working one-on-one with a public safety dispatcher

that his experience and a communications training officer. unfortunately, there is not a lot for widespread embrace men of looking into enhancing the mental health training for dispatchers on an ongoing program. we can solicit that. they reimburse, and they also reimbursed through the peace officers using the men this model. santa clara county uses the memphis model, and they have a reimbursement program. imagistic in the commission hopefully seeking dispatchers' inclusion in the program because oftentimes, we are considered an agile, and many times, we do not find out about the programs until it comes to somebody's attention or alertness reviewing meeting minutes, and that is why ask to be here today. supervisor mirkarimi: in many ways, you really are the first responders. you are right. people sort of do not include that calculation in these normal discussions, but dispatchers

really are. >> our dispatchers are very much affected by this program. the reason i say that is because they are not just police dispatchers. many times, they are giving medical instruction to somebody who is trying to aid somebody who is having a mental health crisis and also a medical condition from that crisis. it could be drug or alcohol- related, our dispatchers are very much emotionally tied to the issue, and they want to get more training. like every other department, ours is suffering from budget concerns, but that does not eliminate my desire to make sure my dispatchers get the best training possible and that we consistently work hand-in-hand with the police commission and fire department to make sure we are getting the best training for our staff. supervisor mirkarimi: what would you say in terms of trend? might be static, increasing, or decrease in, in terms of the dispatcher interface with people will call in about somebody in a

mental health crisis. >> unfortunately, i cannot give you a trend because they do not know the statistics. supervisor mirkarimi: anecdotally is fine. >> one officer on the street has wanted 20 contacts per shift with a mental health patient, there are only 10 dispatchers answering the phone, so you can imagine that volume. you have 75 or 100 officers on the street at any time, the dispatcher is taking that and considerably expanding their contact with mental health patients, whether it be someone who is calling in because their child is out of control of di to some type of medical condition that is enhanced by the mental health problem, or there is an elderly person who has -- over time, their mental health abilities have digressed, and the care giver of a child is trying to deal with their elderly parents, who they are responsible for periods of our staffers have been given

instructions to keep them alive while we get to patient care, and many times, they are combative, said the dispatcher has to play a dual role. they are asking as an emergency dispatch instructor and try to get the correct resources for the patient here not only that, but we have to keep track of the psychiatric emergency system, and we have to let officers know when they are in the red zone, meaning they cannot take any more patients, or they are at a level where there are very few patients they can take, because we do have a large complement of people that need that assistance. supervisor mirkarimi: any idea how many times we may have reached that ceiling in a year? i would love to see that. >> i'm not sure if we keep that statistic. we do have a sign up on the wall that tells us what the status is so any dispatcher in the room can see that. supervisor mirkarimi: when i was

at the police commission hearing, that did not come out. >> i can find out where i can get the statistics if i do not personally have them. i think we logged in, but i want to make sure that they are empirical and not anecdotal. supervisor mirkarimi: that would be helpful. 120 hours post-training, is that combined? in a consecutive three-week process? >> yes, we do a three-week academy. we call it an academy, and it is 120 hours. we have to agree that we will follow the guidelines and mandates. we do that training at our facility in our training room. once they successfully complete the process, they migrate out on the floor where they work one- on-one, and it takes about three rotations of four weeks in each rotation to where they are qualified to answer phones, but we do not allow them to answer phones on their own, and and then migrate into a time where

we monitor them one-on-one to make sure they are capable of understanding the process. once that are successful, we allow them to answer phones on their own while we bring back into the room here at all in all, it takes about 11 months to fully train a 911 dispatcher. supervisor mirkarimi: the funding needs you were referencing as the commission was contemplating how they would be able to assume the memphis model for dispatchers, what with that funding piece look like? >> depending on the amount of training that is involved, normally, i send my dispatchers to 24 hours of training every tip will years, and that is mandated to make sure that they keep current in their continuing educational professionalism. if we were to include, asking if we could expand that to include the mental health component, i'm sure they wo