Call for Backup

During a mental health crisis, police officers on the scene can now enlist a cadre of mental health specialists and data — through Cloud 9.

StartUp Health
StartUp Health

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This story first appeared in StartUp Health Magazine Issue 2, which hits mailboxes this September. Sign up for your free subscription here.

By Cole Stryker

Dwayne Jeune was mostly okay as long as he took his medication. One of the estimated 10 million Americans with a serious mental health disorder, Jeune had schizophrenia. On the last day of July 2017, during the humid days of the New York City summer, Jeune couldn’t remember if he had taken his medication. And he started acting strange. His mother, Dulcina, began worrying about him and called 911 for help, telling the operator that her son had schizophrenia and was not violent. Officers arriving on the scene said that Jeune approached them with a knife, and they initially tazed him. When he continued to move toward them, one officer fired four shots at Jeune, killing him in his own home.

While some 7,000+ officers in the NYPD have trained in Crisis Intervention Training, which helps officers understand how to handle emotionally disturbed individuals, the officer who shot Jeune had not. In January, his mother filed a wrongful-death lawsuit against the City for $20 million, alleging that the officer did not understand how to intervene in situations involving mental illness.

Around the country, police officers are increasingly enlisted to encounter individuals who have mental health disorders. While some interventions resolve peacefully, others end with a fatality. According to a study by the Treatment Advocacy Center, people with untreated mental illness are 16 times more likely to be killed during an encounter with law enforcement.

Cloud 9, a startup based in Austin, Texas, has built a mobile communication platform that aims to address this problem. Co-founders J.C. Adams, an entrepreneur, and Dr. Elizabeth Truong, a psychiatrist, have intimate experience with mental illness, having lost friends and loved ones. Both have dedicated their lives to “provide healthcare to those who need it most,” as Adams says, echoing the company’s tag line.

The startup initially sought to realize this mission with the company’s flagship product, designed to promote ongoing treatment for those managing a mental health concern. The platform enables clients to video chat with a therapist, track their progress via questionnaires, and facilitates behavioral self-reporting.

As Adams and Truong considered the numerous dimensions of mental health intervention, they realized that there were other players who could benefit from better access to expertise, information, and protocols for helping individuals with mental illness. While law enforcement officers may not have significant mental health training, they are increasingly the ones who are enlisted to contend with the unpredictable realities of our modern mental health crisis. Sometimes these situations resolve with police helping someone to get professional help or admitting her to a psychiatric ward. In other cases, untrained police and other emergency response workers aren’t able to respond appropriately to distress calls, and the situation escalates into violence or a fatality — as it did with Dwayne Jeune.

Adams and Truong’s new product, called Cloud 911, is a communication platform poised to drastically reduce the financial toll of the modern mental health crisis while simultaneously offering a humane and compassionate resource for officers. The partners see the platform as the complement to the company’s namesake product geared to those with mental health disorders.

“It’s a dual-treatment solution, so they work together in different parts of the healthcare ecosystem in order to prevent a crisis situation from occurring, and also intervening at the correct time when a crisis situation has occurred,” says Truong.

Cloud 911 equips emergency response teams with mobile technology, so that a police officer can quickly access data about the person gathered from previous encounters with the broader mental health system. For example, once an officer knows the person’s name, they might learn that they don’t have a history of violence, that they have a tendency to go off their medication, that they have had prior suicidal ideations, or that they have a sister who can assist with de-escalation. All of this information is stored securely on Cloud network, and maintained with compliance to HIPAA and CJIS (Criminal Justice Information Services) regulations.

The platform gives officers access to experts, too. When on the scene, they can connect a struggling person with a mental health professional via on-demand video chat at the point of the crisis. Some cities have acknowledged the value of this approach by augmenting patrols with trained mental health professionals who “ride-along” with police in areas like homeless tent cities, where mental health crises are likely to flare up. But maintaining such a fleet is costly. And police officers don’t necessarily need the added pressure of a third-party looking over their shoulder on every call. Cloud 911’s on-demand intervention facilitates the presence of mental health professionals without imposing the cost of in-person ride-alongs.

Mental illness is not a crime, but when the people tasked with handling a mental health crisis are people who fight crime for a living, the line blurs. This leads to unnecessary ER visits or incarcerations, followed by legal proceedings and probations, all of which is expensive for city and county governments, and some of which is unnecessary or actively counterproductive for the person struggling with mental health problems. A recent estimate by Cloud 9 puts the annual cost of jail and ER treatment for the mentally ill in the United States at over $32 billion. Adams describes this system as “a failed cycle.”

“When a crisis occurs, law enforcement arrive — hopefully we avoid a tragedy — but typically the dumping ground is the emergency room or county jail, where mental healthcare services are not provided,” says Adams. “People get kicked out, and they keep coming back. It’s a revolving door that we can no longer afford.”

Cloud 911 aims to provide emergency response workers with a tool belt that will enable them to respond to mental health crises so they can make good decisions under intense circumstances, compassionately, and cost-effectively. Police officers called to respond to a mental health crisis would have instant access to therapists, unique behavioral data, and best practices.

In addition to providing help to those with mental illness, Cloud 911 promises to ease the legal and emotional pressure on police and other emergency response teams. The technology is designed to walk them through a situation in order to mitigate risks. And beyond: because even when crises are successfully de-escalated, the path forward is not always obvious. For instance, does the person who is suffering need immediate medical care in an ER? Or perhaps a safe ride to a pharmacy or home? In addition to providing responders with data and therapy access for dealing with a crisis, the app can also suggest options for what to do next. The app, with its real-time database of availabilities at psychiatric facilities, can point emergency responders to a nearby hospital that has appropriate facilities for a person in crisis. This could enable responders to skip the ER and go straight to a psych ward, significantly cutting costs and expediting the necessary intervention.

The Cloud 911 platform has been tested through a pilot program in Houston. Preliminary data from the company’s own analysis, conducted in partnership with the University of Texas, indicates that 97% of Cloud 911 consults were considered by users to be superior to clinician ride-alongs, and that the platform saved municipalities $847 per 911 crisis call, amounting to a 798% return on investment. The results of the pilot are giving Adams and Truong the case studies and statistics they need to build the business, and they are now fundraising and looking to partner with more city and county governments to launch additional programs. Adams envisions a future where the app is used to call in a drone delivery of emergency medication to the site of a crisis. Considering the very real-world repercussions of mental health issues, such futuristic propositions, like Cloud 911 itself, represent interventions based on treatment and knowledge, not force.

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