How iPads Changed One Police Force’s Response to the Mentally Ill

A pilot project launched by the Harris County Sheriff’s Office in Texas uses “telepsychiatry” software to give police who encounter mentally troubled individuals an alternative to incarceration.

Some sheriff’s deputies in Houston have been using a new tool to respond to calls that involve mentally ill individuals.

An iPad.

In December 2017, the Harris County Sheriff’s Office in Houston, Tx., began equipping deputies with iPads as part of a pilot program aimed at developing new forms of intervention for mentally ill individuals who become involved with law enforcement.

The first phase of the program, involving three deputies, has now been completed, and participants say it’s a success.

“We wanted to make sure the technology works, the software works, and the concept works, and it worked perfectly,” Dr. Avrim Fishkind, CEO of JSA Health Telepsychiatry ,and one of the pilot program’s partners, told The Crime Report.

JSA Health provided the psychiatrists for the program, while Cloud 9, an Austin-based tech company, developed the software, named Cloud911.

Under the program, when deputies equipped with tablets arrive on the scene of a mental health emergency, the person in crisis is offered the option of talking to a psychiatrist through the Cloud 911 app on the deputies’ iPads.

These sessions are called “telepsychiatry appointments,” and they typically last 20 minutes.


A patient uses an iPad for a “telepsychiatry appointment.” Photo courtesy Harris County Sheriff’s Office

By the end of the session, the clinician makes a recommendation. Medication may be prescribed on the spot and picked up by a first responder if deemed necessary. Sometimes, no meds are necessary and a situation is deescalated enough for police to leave the scene.

If the clinician or first responder finds it necessary to take the distressed individual to a psychiatric hospital because de-escalation failed, the Cloud911 app can locate a facility with an available bed. This cuts down on time as officers no longer need to find out which hospital has availability.

The program’s organizers say this enables police to get back to their beat faster, and enables individuals experiencing mental health episodes to avoid arrest.

“One thing we learned very quickly is that people adapt to the technology very fast, the officers and patients,” Dr. Fishkind said. “I’ve done interviews with the patient lying on the ground who held the iPad and talked to me like it was nothing.

“So one of the best parts is the adoption of the technology is nearly 100 percent. We’ve had almost no refusals during the pilot.”

Frank Webb, Harris County’s Mental Health and Jail Diversion Bureau Manager, admitted the program faced initial skepticism among some mental health professionals.

“We did have some who said, ‘oh you know, if you have someone who’s psychotic, they’re not going to use it because they’re going to be freaked out by it,’ and that was not the case at all,” he told The Crime Report.

Dr. Fishkind provided one example of the interactions he witnessed during the course of the pilot program, between officers and a mother whose adolescent daughter was depressed and suicidal.

“She had tried to get in to see a psychiatrist but was told it would be a couple weeks, and here she is in her house talking to a psychiatrist because the deputy had the iPad and she could direct access him right there in her house,” he recalled.

According to statistics provided by Cloud 9, “10 percent of 911 calls are mental health crises, which ought to be handled by clinicians, freeing up police and avoiding tragedies. Fifty percent of jail inmates have mental illness, making jails the largest mental health facilities in the U.S. The cost of incarcerating mentally ill citizens is five times what community health treatment would cost, and this costs emergency rooms and jails annually $2.1 billion.”

Dr. Fishkind noted that the money saved by diverting mentally troubled individuals from jail had helped sell it to county officials concerned about the strains on their budget.

According to Webb, additional money might be forthcoming from the county and even other sources “because they see the value” of the program.

The county’s Center for Mental Health, along with Intellectual Disabilities and Autism Services, the Local Mental Health Authority, together have applied for a grant from the federal Substance Abuse and Mental Health Services Administration (SAMHSA), under its Law Enforcement and Behavioral Health program. The community health organization would provide additional funds for phase two, Webb said, but he added “we’re going to do phase 2 regardless.”

The next phase, expected to last six months, would provide tablets for 25 deputies.

John Ramsey is a TCR news intern. Readers’ comments are welcome.