The San Ramon City Council has endorsed a plan that would make fire personnel the first responders on non-violent mental health calls instead of police.

The council didn’t take any official action May 11 concerning the Public Safety for Mental Health pilot project, but members are clearly on board.

“It’s indicative that we learn sometimes from hard lessons; but we learn, we adjust and we adapt,” Councilmember Mark Armstrong said. “I think that’s what’s going on here. So I applaud the fact that we’re changing this whole paradigm.”

It is a joint pilot project from the San Ramon Valley Fire Protection District — about half of which is inside the city of San Ramon — local law enforcement and Contra Costa Health Services.

The idea involves better training for emergency personnel responding to mental health emergencies, treating them the same way EMTs and fire personnel treat other medical emergencies.

“Historically, mental health issues haven’t been looked at as medical issues,” Paige Meyer, chief of San Ramon Valley Fire Protection District, told the council. “That’s just the fact of the matter. When I got into this business almost 30 years ago, nobody said ‘Hey, we’re going to go on mental health calls.’ That wasn’t something we did. We knew we’d go with the law enforcement folks when they went, but other than that, we didn’t have a lot of training in it. And didn’t look at it as a medical call.”

“We have to change that way of thinking. That’s no longer acceptable, based on what we’re dealing with and what we’re seeing.”

“People don’t want to wait 30 minutes when they’re having a crisis. They’re calling because they need us now.”

Paige Meyer, San Ramon Valley Fire Protection District

Many municipalities around the country are re-examining the way they respond to 911 calls related to people in mental distress.

The idea is getting those with the right training in a position to de-escalate situations that sometimes lead to tragedy when police get involved. One of the goals of the SRVFPD program is reducing avoidable law enforcement response to non-violent mental health complaints.

Instead of police responding to do an initial assessment while EMTs stage a block or two away from the call’s location, the initial roles would be flipped, with fire personnel taking the lead and police standing by.

Meyer said the county is looking at programs that would get health professionals to the scene of a mental health crisis within 30 minutes. He wants his department to be trained and ready to respond in seven minutes — the district’s existing goal when responding to medical calls.

“People don’t want to wait 30 minutes when they’re having a crisis,” Meyer said. “They’re calling because they need us now.”

Fewer hospital visits

The faster, more-thorough approach could also involve mental health professionals assessing patients on scene, which could lead to fewer hospital admissions. Nearly 60 percent of mental health calls result in first responders transporting someone to Contra Costa Regional Medical Center in Martinez.

“We only have so many ambulances in the district,” Meyer said. “When we go to county health, that ambulance can be out of service for three hours.”

A city staff report said there has been a “consistent 20 percent annual increase in (mental health) calls” since 2015. San Ramon accounts for nearly 50 percent of the mental health-related calls in the San Ramon Valley Fire Protection District.

The new procedure would involve more integrated and specialized mental health education for all emergency personnel, initially and on an ongoing basis. They would also receive specialized crisis management and de-escalation training. There would also be increased community outreach and a continuous quality improvement program.

Ambulances would be equipped for videoconferencing and real-time triage, assessment and de-escalation. A specific, step by step “model of care” would be put in place, based on whether the person in distress was violent or not. The plan would also include more oversight and communication between agencies, including individual evaluations of each incident and training effectiveness.

San Ramon Mayor Dave Hudson lauded the speed with which the plan came together and asked the district to come back to the council if funding becomes a problem.

“People are really interested in making this work,” he said.