500-12 Response to Mental Health Incidents

Question 1

Whenever reasonably possible, the department will utilize _____ officers to respond to incidents or calls for service involving persons displaying symptoms of a mental health crisis. For safety purposes, and when resources allow, ___officers shall be dispatched to incidents when available information indicates the involvement of persons who are
exhibiting symptoms of a mental health crisis.

Answer 1

1) Crisis Intervention Trained (CIT)

2) two

Question 2

Crisis Intervention Response Team (CIRT).

Answer 2

A team comprised of a uniformed CIT officer partnered with a licensed mental health professional to respond to persons exhibiting a mental health crisis.

Question 3

Crisis Intervention Trained (CIT) Officer.

Answer 3

An officer who has successfully completed the Texas Commission on Law Enforcement (TCOLE) 40-hour Mental Health Officer or TCOLE 40-hour CIT course.

Question 4

Medical Condition.

Answer 4

For the purposes of this General Order, a medical condition is a physical injury, illness, or condition other than a psychological disorder or mental illness.

Question 5

Mental Health Crisis.

Answer 5

A condition in which a person is a substantial risk of harm to themselves or others due to a mental illness. A substantial risk may be demonstrated by the person’s behavior, or by evidence of severe emotional distress and deterioration of the person’s mental condition.

Question 6

Mental Illness.

Answer 6

An illness, disease, or condition, other than epilepsy, dementia, substance abuse, or intellectual disability, that substantially impairs a person’s thought, perception of reality, emotional process, or judgment, or grossly impairs behavior as demonstrated by recent disturbed behavior. A person with mental illness may not be denied admission or commitment to a mental health facility because the person also suffers from epilepsy, dementia, substance abuse, or intellectual disability.

Question 7

Notification of Emergency Detention (NED).

Answer 7

For the purpose of this General Order, a NED, which is also referred to as an Emergency Detention Order (EDO), is a standard notification form that allows a Texas peace officer to detain a person who is mentally ill for psychological evaluation because the person is an immediate threat to self or another person. This form, which is available on the department’s Intranet Portal, does not require notarization. The NED only guarantees an evaluation will be done; it does not guarantee any form of treatment.

Question 8

AUTHORITY TO APPREHEND

The authority to apprehend a person in a mental health crisis by using the Notification of Emergency Detention (NED) is granted by the Texas Health and Safety Code, Section 573.001. A peace officer, without a warrant, may take a person into custody, regardless of age, if the officer has reason to believe and does believe both of the following apply:

a. The person is a person with mental illness and because of that mental illness there is a substantial risk of ____, and;
b. The officer believes that there is not _____ before taking the person into custody.

Answer 8

a. The person is a person with mental illness and because of that mental illness there is a substantial risk of serious harm to the person or others unless the person is immediately restrained, and;
b. The officer believes that there is not sufficient time to obtain a warrant before taking the person into custody.

Question 9

AUTHORITY TO APPREHEND

A “substantial risk of serious harm to the person or others” may be demonstrated by either of the following:

c. The person’s specific ____, ____, ____, or ____.
d. Evidence of severe emotional distress and deterioration in the person’s mental condition to the extent that ____

Answer 9

c. The person’s specific recent behavior, overt acts, attempts, or threats.
d. Evidence of severe emotional distress and deterioration in the person’s mental condition to the extent that the person cannot remain at liberty.

Question 10

AUTHORITY TO APPREHEND

Officers may form the belief that the person meets the above criteria for apprehension based on either of the following:

e. Information from a _____.
f. Conduct of the person or the_____.

Answer 10

e. Information from a credible person.

f. Conduct of the person or the circumstances under which the person is found.

Question 11

PERSONS EXHIBITING A MENTAL HEALTH CRISIS WITHOUT CRIMINAL CHARGES

Officers who take into custody any person exhibiting a mental health crisis shall follow the procedures outlined in General Order _____.

Answer 11

500-02, Handling and Transporting Prisoners and Other Persons

Question 12

PERSONS EXHIBITING A MENTAL HEALTH CRISIS WITHOUT CRIMINAL CHARGES

If a person who is believed to be in a mental health crisis is in need of emergency mental health treatment and the District Attorney’s Office does not accept Class B or higher charges, then the officer shall_____

When a person is apprehended under a NED, consent of the person is not required. Officers who take a person into custody in this manner shall immediately inform the person in simple, non-technical terms the reason for and location of the detention, that a staff member of the facility shall inform the person of the person’s rights within ____hours after the person is admitted to a facility, and that the detention could result in a longer period of involuntary commitment.

Answer 12

1) take the person into custody without a warrant.

2) 24

Question 13

PERSONS EXHIBITING A MENTAL HEALTH CRISIS WITHOUT CRIMINAL CHARGES

Officers shall first attempt to utilize the Neuropsychiatric Center (NPC) if there are _____.

If the NPC is on diversion, officers may utilize the services of any hospital with a dedicated emergency department, or, if eligible, the VA Medical Center.

A private psychiatric facility may also be utilized if officers have confirmed there is a bed available and _____

Answer 13

1) no co-existing medical conditions

2) the person has an accepted health insurance.

Question 14

PERSONS EXHIBITING A MENTAL HEALTH CRISIS WITHOUT CRIMINAL CHARGES

If a person exhibiting a mental health crisis also has a co-existing medical condition that requires treatment by a medical facility, the person shall be taken directly to a _____.

Answer 14

hospital with a dedicated emergency department

Question 15

PERSONS EXHIBITING A MENTAL HEALTH CRISIS WITHOUT CRIMINAL CHARGES

Upon arrival at the appropriate mental health facility, the officer shall complete the NED and provide it to the medical staff. Once the person has been accepted by facility staff under emergency detention, the officer shall complete an incident report and return to duty.

Officers should be aware that the person shall undergo a preliminary examination by the facility and shall be admitted under emergency detention only if the examining physician believes that the person meets the criteria discussed in Section 1 of this General Order and that emergency detention is the _____

Officers should be aware that the person shall be released by the facility if the above criteria are not met or within ___hours, whichever occurs first. Officers shall not file Class C misdemeanor charges if the person is admitted to a treatment facility.

Answer 15

1) least restrictive means by which the necessary restraint may be accomplished.
2) 48

Question 16

PERSONS EXHIBITING A MENTAL HEALTH CRISIS WITHOUT CRIMINAL CHARGES

If officers have knowledge that the person taken into custody under a NED has been declared a ward by a probate court, the officer shall _____.

Answer 16

notify the applicable probate court as soon as practicable

Question 17

Persons Not in Need of Emergency Mental Health Treatment

If a person undergoes preliminary examination by the facility while the officer is present and it is determined that the person is not eligible for emergency detention, the officer shall…

The officer shall not transport the person if the person objects to the transportation or if the person wants to _____

Any person ___years of age or older may voluntarily request admission for inpatient mental health treatment. The officer shall not transport the person to a second facility for a second mental health examination.

Answer 17

1) transport the person back to the location of the person’s apprehension, the person’s local residence, or another suitable location.
2) voluntarily seek admission for mental health treatment.
3) 16

Question 18

Juveniles Exhibiting Mental Health Crisis

In addition to the requirements above, officer shall contact a ______ for guidance and to coordinate all juvenile dispositions per General Order 500-06, Disposition of Arrested Juveniles when dealing with juveniles exhibiting mental health crisis.

Answer 18

Juvenile Division supervisor

Question 19

Juveniles Exhibiting Mental Health Crisis

When taking a juvenile into custody for emergency detention, officers shall first attempt to utilize the NPC. If the NPC is on diversion, officers may utilize the services of _____

Whenever possible, a parent or guardian should accompany the juvenile to the treatment facility.

If a person is under the age of 18 and his or her behavior meets the elements for emergency detention under Chapter ___of the Health and Safety Code, consent of the person or a parent or a guardian is not required.

Nevertheless, officers should obtain parental consent whenever possible before transporting a person under the age of 18 for emergency mental health treatment.

Answer 19

1) Texas Children’s Hospital or any hospital with a dedicated emergency department.
2) 573

Question 20

Juveniles Exhibiting Mental Health Crisis

A parent or guardian may _____ for treatment.

A private psychiatric facility may also be used if officers have confirmed there is a bed available and if _____

Answer 20

1) voluntarily sign the juvenile in

2) the juvenile has an accepted health insurance.

Question 21

Juveniles Not in Need of Emergency Mental Health Treatment

If a person under the age of 18 is transported to NPC or another treatment facility for psychiatric evaluation, but is found not to be in need of immediate mental health treatment, hospital staff will not be able to provide voluntary treatment to juveniles ___ years of age or under without parental consent.

For this reason, the officer shall remain with the juvenile until a parent or guardian is contacted and arrives.

A person ___ years of age or older may consent to voluntary treatment, with or without the consent of a parent or guardian.

Answer 21

1) 15

2) 16

Question 22

Juveniles Not in Need of Emergency Mental Health Treatment

If a parent or guardian of a person under the age of 18 cannot be located, the officer shall contact the Statewide Intake Division of Child Protective Services (CPS) and the _____ for further instructions.

Officers shall list the CPS case number and the name of the person taking the report in the incident report. Because each situation involving a juvenile is different, officers should adhere to the requests of the NPC or other facility staff when releasing custody of a juvenile, with authorization from the _____.

Answer 22

1) Special Victims Division

2) Juvenile Division supervisor

Question 23

PERSONS EXHIBITING A MENTAL HEALTH CRISIS WITH CRIMINAL CHARGES

Officers shall thoroughly investigate all reported crimes, including crimes of family violence, regardless of any history of or reported mental illness. Officers shall be reminded that only a _____ may determine the mental competency of a suspect charged with a criminal offense.

Answer 23

court of proper jurisdiction

Question 24

PERSONS EXHIBITING A MENTAL HEALTH CRISIS WITH CRIMINAL CHARGES

When the District Attorney’s Office accepts charges (Class B misdemeanor or higher) against an adult who is exhibiting a mental health crisis, the officer shall not transport the suspect to the NPC. The officer shall do the following:

a. Follow the procedures outlined in General Order _____and General Order _____
b. Notify the _____.
c. Upon arrival at the jail, inform_____ that the prisoner is exhibiting a mental health crisis and secure the prisoner in accordance with jail procedures. Officers are responsible for the direct care, custody, and control of a prisoner until the prisoner is accepted by jail personnel.
d. Complete the _____ required by the jail facility as outlined in General Order 500-08, Required Booking Information and Procedures.

Answer 24

a. Follow the procedures outlined in General Order 500-07, Filing Proper Charges and General Order 500-02, Handling and Transporting Prisoners and Other Persons.
b. Notify the concerned division.
c. Upon arrival at the jail, inform jail personnel that the prisoner is exhibiting a mental health crisis and secure the prisoner in accordance with jail procedures. Officers are responsible for the direct care, custody, and control of a prisoner until the prisoner is accepted by jail personnel.
d. Complete the jail booking process required by the jail facility as outlined in General Order 500-08, Required Booking Information and Procedures.

Question 25

Charges Filed Against Juveniles Exhibiting Mental Health Crisis

When the District Attorney’s Office accepts charges (Class B misdemeanor or higher) against a juvenile who is exhibiting a mental health crisis, the officer shall transport the juvenile suspect to the _____for expedited processing. The transporting officer shall then transport the juvenile to the NPC for a mental health evaluation.

Answer 25

Juvenile Division

Question 26

Charges Filed Against Juveniles Exhibiting Mental Health Crisis

If the NPC determines that the juvenile does not require emergency mental health treatment, the officer will receive a Brief Psychiatric Assessment Form completed by the NPC personnel documenting any treatment and the release of the juvenile. The officer shall then inform the Juvenile Division of the NPC’s mental health determination and transport the juvenile to _____.

Answer 26

Harris County Juvenile Probation (HCJP)

Question 27

Charges Filed Against Juveniles Exhibiting Mental Health Crisis

If the NPC determines the juvenile requires emergency mental health treatment, the officer shall complete a NED for the juvenile suspect, inform the NPC personnel that the juvenile suspect has pending charges, and advise the Juvenile Division. Juvenile Division personnel will contact _____and confirm if the juvenile should be transported to HCJP after the juvenile has received treatment or be released to a parent or guardian. Juvenile Division personnel shall advise the officer so that the officer can inform the NPC that the juvenile will be released to a parent, guardian, or be held and taken to HCJP when released from the NPC.

Answer 27

HCJP

Harris County Juvenile Probation

Question 28

Charges Filed Against Juveniles Exhibiting Mental Health Crisis

In either circumstance, the arresting officer shall complete the incident report and charges. If the juvenile is to be left in the custody of the NPC, then the first line in the charges shall state “_____”

Answer 28

Juvenile is at the NPC under a NED for mental health treatment.

Question 29

CRISIS INTERVENTION RESPONSE TEAM (CIRT}

Officers requiring the assistance of a GIRT unit at a scene shall follow the procedures described in General Order 600-01, Response Management. GIRT units are not to be utilized as “wagon units” for mental health crisis calls. CIT patrol officers shall continue to _____ when possible.

Answer 29

be the first responders to mental health crisis calls

Question 30

JAIL DIVERSION

Officers may consider jail diversion services through the Mental Health Diversion Center when an officer believes that _____ and the _____.

Officers may divert_____ offenders who are not in crisis and not a danger to themselves or others to the Mental Health Diversion Center instead of filing charges or writing a citation.

Answer 30

1) symptoms of mental illness are a contributing factor to the offense
2) individual does not pose a public safety threat
3) non-violent, low-level misdemeanor

Question 31

JAIL DIVERSION

To be eligible for jail diversion, the suspect must be 18 years of age or older and must agree to go to the Diversion Center. Driving while intoxicated (DWI), assault (including domestic violence), and weapons offenses are not eligible for consideration for jail diversion. The officer shall determine, based on the totality of the facts, whether or not the suspect would be appropriate for jail diversion. The officer shall consider the following when determining the totality of the facts:

a. The complainant’s _____ on the suspect or utilize jail diversion services.
b. The _____ on the suspect or utilize jail diversion services.
c. The suspect does not have a _____.
d. The suspect is not a _____, does not have _____, or a _____ from Immigration and Customs Enforcement.
e. Whether the suspect has previously participated in the jail diversion program without a _____

If an officer needs additional information (e.g., mental health history, diagnosis) to help determine if jail diversion is appropriate, they may consult with the Joint Processing Center (JPC) Triage Diversion Desk to inquire about the person’s mental health history, if available.

Answer 31

a. The complainant’s decision to press charges on the suspect or utilize jail diversion services.

b. The District Attorney’s decision to press charges on the suspect or utilize jail diversion
services.

c. The suspect does not have a violent criminal history.
d. The suspect is not a sex offender, does not have open warrants, or a pending detainer from Immigration and Customs Enforcement.
e. Whether the suspect has previously participated in the jail diversion program without a good faith effort to seek voluntary assistance.

Question 32

DOCUMENTATION

Incident Report

Officers shall complete an original incident report for any incident in which a person is _____. Officers shall articulate in the narrative of their incident report why they believe the person is mentally ill and why the person is a substantial risk of serious harm to self or others.

Substantial risk shall be supported based on…

Additionally, evidence of severe emotional distress and deterioration should be thoroughly documented, if used as a basis for determining substantial risk.

Officers should avoid using only generic or vague statements such as “consumer was a danger to self and others” or “consumer needed psychiatric treatment.” Such statements do not adequately detail the justification for the apprehension by an officer without a warrant, as required by the _____

Answer 32

1) exhibiting a mental health crisis (A condition in which a person is a substantial risk of harm to themselves or others due to a mental illness.)
2) specific recent behaviors, overt acts of self-harm, attempts to harm others, severe emotional distress and deterioration in the person’s mental health condition, or threats observed by the officer or reliably reported from a credible person.
3) Texas Health and Safety Code, Chapter 573.

Question 33

DOCUMENTATION

Incident Report

The title of the incident report shall always be listed by the _____and _____shall be listed as a secondary title. If a criminal offense was not reported, the incident report shall be titled “Investigation - Mental Illness.”

Answer 33

1) highest criminal offense

2) “Investigation - Mental Illness”

Question 34

DOCUMENTATION

Incident Report

If a person is reported to have committed a criminal offense, regardless of whether or not charges are filed, the person shall be _____ and the offense shall be thoroughly investigated per _____. If the person is not reported to have committed an offense and is being handled for only mental health purposes, the individual shall be listed as a complainant.

Answer 34

1) listed as a suspect

2) General Order 600-27, Preliminary and Follow-Up Investigations

Question 35

DOCUMENTATION

Incident Report

Officers shall document all license information pertaining to individuals who hold a _____, _____, or _____.

Officers shall include the LTC license number, Private Security license number, or Peace Officer Personal Identification Number (PIO) in the report narrative. This documentation should also list the company or employing agency of the individual.

Answer 35

1) License to Carry (LTC)
2) Private Security Armed Registration
3) Peace Officer License

Question 36

DOCUMENTATION

Incident Report

Officers shall properly document items (e.g., knives, rope, pill bottles) located at a mental health scene within the narrative of the incident report and contact the appropriate concerned division for guidance, but shall not…

If the incident involves a completed suicide or an attempted suicide that may cause the death of an individual, officers shall contact the _____ for guidance and authorization to tag the items.

Officers are reminded to follow the guidelines of General Order 700-01, Property and Evidence Control Regulations, and consult with the concerned investigative division to receive their authorization to tag firearms or property that may have evidentiary value due to involvement in a criminal investigation.

Answer 36

1) tag the items as evidence under the Mental Health Division (MHD).
2) Homicide Division

Question 37

DOCUMENTATION

Notification of Emergency Detention (NED)

In accordance with the Texas Health and Safety Code, Section 573.002, the NED must contain specific and detailed information that shows that the substantial risk of harm is imminent unless the person is immediately restrained. The NED must contain:

a. A statement that the officer has reason to believe and does believe that the person shows signs of ______;
b. A description of the _____;
c. A statement that the officer has reason to believe and does believe that the risk of harm is _____;

d. A description of the person’s recent behavior, acts, attempts, or threats observed by the
officer or reported by a _____; and

e. If applicable, the name of the credible person, address, and relationship to the apprehended person, who _____.

For any incident resulting in a NED, officers shall document the name of the mental health facility or hospital where the person is to be evaluated, the name of the person who accepted the NED, and, if applicable, the Medical Record Number (MRN) in the incident report. Officers shall request a copy of the NED from facility personnel, then scan and upload the copy of the NED into the incident report via lntellinetics.

Answer 37

a. A statement that the officer has reason to believe and does believe that the person shows signs of mental illness and is a substantial risk of serious harm to self or others;
b. A description of the risk of harm;
c. A statement that the officer has reason to believe and does believe that the risk of harm is imminent unless the person is immediately restrained;

d. A description of the person’s recent behavior, acts, attempts, or threats observed by the
officer or reported by a credible person to the officer; and

e. If applicable, the name of the credible person, address, and relationship to the apprehended person, who reported or observed the behavior, acts, attempts, or threats.

Question 38

SEIZURE OF FIREARMS FROM PERSONS EXHIBITING MENTAL HEAL TH CRISIS

No Criminal Charges

Pursuant to Texas Health and Safety Code, Section 573.001 (h), officers are authorized to seize firearms only when the following criteria are established:

a. The person is exhibiting a mental health crisis, taken into custody for a ____as specified in section 1, Authority to Apprehend;
b. Upon detention the person is _____; and
c. A criminal offense involving the use of the firearm has _____.

Firearms that were not within the person’s immediate possession at the time of the person’s
detention cannot be legally seized (e.g., firearms stored in a bedroom closet). The MHD shall not authorize the seizure of firearms that do not meet the above criteria.

Answer 38

a. The person is exhibiting a mental health crisis, taken into custody for a NED as specified in section 1, Authority to Apprehend;
b. Upon detention the person is in possession of the firearm; and
c. A criminal offense involving the use of the firearm has not been committed.

Question 39

SEIZURE OF FIREARMS FROM PERSONS EXHIBITING MENTAL HEAL TH CRISIS

No Criminal Charges

Firearms that were not within the person’s immediate possession at the time of the person’s
detention cannot be _____. The MHD shall not authorize the seizure of firearms that do not meet the above criteria.

Officers shall obtain authorization to tag such firearms from an _____.

If unable to contact an MHD GIRT supervisor, officers shall contact a _____ for authorization.

Officers shall tag the seized firearm in the Property Division. Seized firearms and other firearm components (e.g., magazines, ammunition) shall be entered into the property tab in ARS utilizing the involvement code “MHF.” The required forms can be accessed on the department’s Intranet Portal.

Answer 39

1) legally seized (e.g., firearms stored in a bedroom closet)
2) MHD GIRT supervisor
3) jail HPD supervisor

Question 40

SEIZURE OF FIREARMS FROM PERSONS EXHIBITING MENTAL HEAL TH CRISIS

No Criminal Charges

Officers who seize a firearm from a person taken into custody shall comply with the requirements of the CCP, Article 18.191, and immediately provide the person with the following:

d. A written copy of the receipt for the firearm (_____).
e. A written notice of the procedure for the_____

Officers shall upload copies of the seizure forms along with a copy of the NED into the incident report via lntellinetics. Officers shall put the original Receipt and the Notice of Rights for Seized Firearms form, along with a copy of the NED, in the MHD Drop Box at the Property Division. The seized firearms shall be tagged in the Property Room following the procedures outlined in General Order 700-01, Property and Evidence Control Regulations.

Answer 40

d. A written copy of the receipt for the firearm (Receipt and Notice of Rights for Seized
Firearms).

e. A written notice of the procedure for the return of a firearm.

Question 41

SEIZURE OF FIREARMS FROM PERSONS EXHIBITING MENTAL HEAL TH CRISIS

No Criminal Charges

Firearms Related to a Criminal Offense

Firearms used in the commission of a crime (e.g., Aggravated Assault with a Deadly Weapon, Deadly Conduct, Places Weapons Prohibited, Unlawful Possession of Firearm) shall be treated as evidence and shall not be seized under the CCP, Article 18.191. Instead, officers shall follow the guidelines of General Order _____, and consult with the concerned investigative division to tag firearms with evidentiary value.

Answer 41

700-01, Property and Evidence Control Regulations

Question 42

PREMISE HISTORY PROCEDURES

If there is reason to believe that the mental health related information indicates a possible
risk to the safety of responding officers, the mentally ill person, or another person at the
location, then a _____ shall be completed.

Premise histories shall not be placed on a location solely because a person who resides at that location suffers from mental illness.

Officers can access the Premise History Request form on the department’s Intranet Portal and email it to HPD.CIT@Houstonpolice.org. Officers and supervisors shall not _____ to request that a mental health premise history be placed on a location. The MHD shall authorize, enter, and maintain all mental health related premise history entries.

Answer 42

1) premise history request

2) contact the Emergency Communications Division (ECO)