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The Chronic Consumer Stabilization Initiative

In the comments to my previous post about mental illness and the criminal justice system, reader Katherine reminded me of this Houston Press article from last December, about a pilot program between HPD and the Mental Health Mental Retardation Authority of Harris County. Called the Chronic Consumer Stabilization Initiative, it was designed to work closely with the people who interact the most often with the police so as to come up with a treatment regimen for them that would minimize their contact with the police. (The story’s headline, which used the word “crazy” to describe these “chronic consumers”, was harshly criticized in the comments for being derogatory.) By all accounts, the pilot was a success. Here’s the executive summary from the final report, given in February:

The Chronic Consumer Stabilization Initiative is a progressive strategy designed to engage individuals with serious mental illnesses who are in a perpetual state of crisis. These individuals utilize police services and other emergency services on a habitual basis resulting in excessive calls for service and needless law enforcement encounters. The main objective of this pilot program was to reduce and minimize overall police contacts through intensive case management. The long term benefits of this program for the police department would be redirected resources which can be more appropriately utilized by patrol officers. In terms that are meaningful to executive management, this translates to potential savings in operational costs associated with manpower, redirected patrol services to address other criminal activities or calls for service, and possibly reducing the probability of officers being involved in a situation where deadly force may be used.

To identify the variables of this program we researched six months of the top 30 most documented cases and totaled 553 reported events which were identified as calls for service, offense reports, and emergency detention orders (EDO) filed by Houston Police Officers. We then compared the end results of the case managers’ efforts after six months of intensive case management. After intervention there were a total of 169 events which included 65 offense reports, 39 EDOs, and 65 calls for service. Due to the complexity of most CIT calls, it is estimated that it takes an average of one hour for an officer to complete each event. Additionally, department policy requires that two officers respond to every CIT call. Assuming that department policies were followed, this would mean approximately 1106 (553 events doubled) man hours were spent on addressing the needs of these 30 individuals. After the CCSI intervention of the same 30 consumers, 338 manpower hours were spent (169 events doubled). As a result, man power hours were reduced because of intensive case management objectives.

With a proposed expansion of up to four case managers and a full time police officer handling 60 clients, the projected savings in reduced manpower hours would be approximately 3,072 hours during a 12 month period, and 15,360 hours over a five year period. Hence, these potential savings in man power hours would be better utilized within patrol operations.

Actual cost savings, projected to be over $500,000 in the course of a year, are given in this addendum. Defense attorney George Parnham, who was part of the original task force on mental health that was formed in 2008 and which led to this pilot, wrote an op-ed about it in March. This is exactly the sort of thing I had in mind when I wrote that earlier post, and I’m delighted to see that HPD is a national leader in this.

One more thing: The funding for the CCSI pilot came from the city of Houston. Normally, as the Press article noted, the state provides funding for mental health programs. There was a sort-of predecessor to the CCSI called the Assertive Community Treatment Team, which had nothing to do with the police department and was run by the Department of State Health Services. I note that as a way to introduce this:

More than 20,000 Texans who receive state-funded psychiatric care would lose or get fewer services under budget cuts proposed this week by the Department of State Health Services.

The state’s 39 publicly-funded community mental health centers, which provide low cost psychiatric care for poor or uninsured people, would lose $80 million. State hospitals, including Austin State Hospital, would lose $44 million. Psychiatric crisis services would lose $10 million.

[…]

The mental health budget reductions are among $245 million in proposed cuts put forward by the Department of State Health Services. Cuts to mental health services total $134 million of that.

Even though the earlier ACT incarnation of this program wasn’t nearly as successful, this is exactly the kind of short-sighted budget cut that will wind up costing a lot more than it saves. Of course, it’ll be city and county governments that pay the bulk of those costs. The good news is that as I understand it, funding for the CCSI is in the city’s budget for this fiscal year. So at least we’ll be doing something constructive about this problem.

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3 Comments

  1. Ron in Houston says:

    How in the heck did they come up with that name? When I first read the headline I thought the “Chronic Consumer Stabilization” had to do with retailing.

  2. […] Henson got the same information I did about the HPD “Chronic Consumer Stabilization Initiative” pilot program, and as always his take is worth reading. In that post, he pointed to this Malcolm Gladwell article […]

  3. […] wrote about the problems of how we deal with the mentally ill in the criminal justice system, and a pilot program in Houston to handle the “chronic consumers” more efficiently and […]