A program uses staff members with lived experience to de-escalate situations and provide follow-up care

This story is part of Policing the Vulnerable, a package of stories reported and produced in collaboration with Medill Investigative Lab-Chicago, the Invisible Institute and South Side Weekly.

For Manuel Meza, the vice president of clinical operations at a mental health service provider named Thresholds, the need to link crisis response with long-term care is essential.

It’s also part of what makes two programs operated by Thresholds important parts of Chicago’s mental healthcare ecosystem. The Thresholds team responds to crises by offering de-escalation, stabilization and follow-up care. 

Thresholds, a nonprofit organization, carries out this work through two programs: Its mobile crisis response team sends peers to assist people in crisis where they are. In addition, its Living Room program is a peer-led respite center where people can weather a mental health crisis supported by peers who have lived experience with the mental health system.

Chicago’s city-run CARE program also offers non-police response to mental health crises, though it is underfunded and serves only a small portion of people in need, according to a recent analysis by Medill and MindSite News. 

“Everyone knows there’s no treatment in being put behind a police car,” Meza said. “There’s no treatment sitting at the station. What happens tomorrow? What happens tonight?  When those symptoms come back — when the depression, when the loneliness, when the voices come back — what did we leave them with?” 

Thresholds: A Different Approach to Crisis Response

Unlike most Chicago police officers, the Thresholds team tries to give individuals a concrete safety plan. While police may default to hospitalization or arrest, Meza said his team rarely has to take that step. He estimates that 97 percent or 98 percent of all cases that Thresholds responds to end without a hospitalization. 

Meza attributes much of that success to the team’s peer engagement specialists. These are individuals with lived experience of mental health challenges who are trained as certified recovery support specialists. Meza said the use of self-disclosure, where peer responders describe their own experience, is a powerful tool when supporting someone in crisis.

“It just provides the extra level of empathy,” Meza said. “It provides the extra level of understanding. It provides the extra level of ‘I’ve been in your shoes and I know what that feels like.’”

Police do not receive self-disclosure training as part of CIT programming, and it would likely not be appropriate in their role. That’s one reason Meza believes it’s important for crisis response teams to include not just officers, but peer engagement specialists who can draw from lived experience. 

“Not that we can fix their problems, but we can walk the journey with them,” Meza said. “And I think that’s something the CPD doesn’t have.”