When Palo Alto formed its first Psychiatric Emergency Response Team (PERT) in November 2021, city leaders hoped the new program would create a more effective and compassionate approach for assisting individuals going through acute mental health crises.
The PERT program, which pairs up a Santa Clara County clinician with a Palo Alto police officer, showed signs of promise; the team handled 99 calls for service, conducted 68 follow-up visits on past clients and diverted 22 people from what likely would have been psychiatric hospitalization without ever using force or making a single criminal arrest, according to a report from the city. But it came to a sudden end in November 2022, when the clinician stepped down. The county has yet to find a replacement.
Even with these recent staffing challenges, the City Council gave the PERT program an enthusiastic vote of confidence this week when it approved a new contract with the county that would not only extend the program for three years but also add a second team. The council also agreed to foot the bill for the second PERT clinician once that person is hired. The agreement, which the council unanimously approved on Sept. 11, requires the city to reimburse the county up to $183,000 per year for the term of the three-year contract.
Once the county Board of Supervisors approves the contract, the city will begin the process of hiring clinicians to staff the two PERT teams, Palo Alto police Capt. James Reifschneider told this publication.
"We are hopeful that will result in at least one clinician being assigned to Palo Alto in early 2024, with the second clinician to follow," Reifschneider said in an email. "In the interim, the officer who had previously served as part of PERT has retained responsibility for some of PERT's duties in order to make best use of his expertise and training."
According to a report from the Police Department, the original PERT team covered approximately 24% of the weekly shift cycle, which is 24 hours per day, seven days per week. Adding a second team and arranging them in alternative shifts would raise that to 48% of the patrol shift cycle, ensuring that at least one time is on duty nearly half the time.
The PERT program is one of several recent efforts employed by the county and local jurisdictions to address mental health crises and shift responses away from armed officers.
The county also operates the Mobile Community Response Team, which does not include local officers but works closely with law enforcement to respond to events involving mental health. There's also the TRUST (Trusted Response Urgent Support Team) program, which partners mental health professionals with first-aid providers and community members with first-hand experience with mental health issues.
Unlike the other two programs, TRUST does not include law enforcement. As such, it most closely resembles the trailblazing CAHOOTS (Crisis Assistance Helping Out On The Streets) that Eugene, Oregon, pioneered about three decades ago. The TRUST program rolled out in north Santa Clara County last fall.
For Palo Alto, the addition of a second PERT team represents the latest extension of an approach that the council endorsed in 2020 as part of its race and equity initiative, which included an assortment of reforms within the Police Department. During a presentation to the council in fall 2022, Police Chief Andrew Binder made a pitch for expanding PERT, noting that the behavioral clinicians who are part of the team have access to medical records as well as relationships with various agencies and social service organizations in fields such as housing, employment and drug and alcohol rehabilitation. It also helps that unlike patrol officers, PERT members don't have to worry about other types of police calls.
"They're not encumbered by other duties," Binder told the council. "Their whole mission, their whole duty, is mental health response."
While the new contract will require additional expenditures by the city, Binder successfully lobbied the city in May to make the investment. He noted that the city's portion of the cost could come from its development agreement with the Stanford University Medical Center, which includes funding for health programs. The current plan is to use Stanford funds at least for the first year of PERT.
"If the county wants to come forward with funds to support that, great. If not, we took the initiative to earmark those funds from Stanford, and we want to move that ball forward and get it going," Binder said during a May budget hearing.