In a first of its kind program, the VA in Long Beach, Cal. is partnering with law enforcement to proactively reach military veterans with mental health issues.
Charlotte Blackwell's Los Angeles living room is tidy and inviting, with a floral couch and pretty antique mirrors. But just a couple months ago, it was piled high with trash.
"I've had this furniture reupholstered now, but this whole room was filled with just junk, junk, junk," she said.
Her 36-year-old son, Jermaine Petit, was in the throes of schizophrenia and drug addiction. Blackwell pleaded with him to stop coming home with garbage.
"Trash off the street," she said. "And you wonder, how in the world could he get it all here? In his backpack?"
Petit is an Air Force veteran. He signed up a few months after September 11, 2001 and worked as an EMT in Germany. His mother said he was diagnosed with PTSD after he got out of the military. He became paranoid and suffered delusions.
Petit had VA care, but often refused to take his medication. Like many veterans with serious mental health conditions, he was falling through the cracks of the system meant to help him.
Now the Department of Veterans Affairs in Long Beach, Cal. is trying a new partnership with law enforcement to proactively reach military veterans in trouble -- even if they aren't connected to VA services.
Blackwell can remember 24 arrests since her son left the military in 2005. The L.A. County Sheriff's Department provided records that indicated Petit's encounters with the law mostly stemmed from bizarre behavior, appearing like he may be a threat to himself or others, and ignoring police orders.
At least one incident involved police use of force. A department report said a deputy tried to stop Petit for jaywalking, but he was unresponsive. The officer saw something in Petit's waistband he thought was a firearm, and when Petit reached for it, the deputy intentionally hit him with his patrol car.
Petit recovered, ran away, and barricaded himself inside a liquor store, before he "fled again on foot acting unresponsive and bizarre," the report said. Several deputies eventually subdued and handcuffed him, and he was charged with resisting arrest and jaywalking.
Recently, the strange behavior escalated. Petit wandered the streets with layers of necklaces, knives, and a hammer on his body. Blackwell worried her son would not survive his next encounter with law enforcement.
"You know you see it on TV all the time: Families calling for help, my son is mentally ill, my son is going through an episode, she said. "And when they get there -- within 5 minutes -- the person is shot to death."
'Brothers on a different level'
L.A. County Sheriff's Lt. John Gannon said he understands that fear. Gannon oversees the agency's Mental Evaluation Teams (MET) that are called in when deputies need help dealing with people in crisis. They arrive in plainclothes without a black-and-white patrol car.
The goal is to establish rapport -- getting the person into treatment instead of a jail cell.
"That is, talk to them differently," Gannon said. "You can't talk to them with command presence like a cop might."
The L.A. County Sheriff's Department first created METs in the early 1990s to respond to 911 calls involving subjects in psychiatric distress. In 2017, county supervisors approved funding to expand the program.
In his first few years with MET, Gannon said he noticed a pattern. "Some of our most difficult calls involve veterans," he said. "Sometimes the reason we were having trouble on these calls was that we didn't relate to them the way a veteran would."
"My people who are not veterans -- it takes them longer to build trust. Whereas the few of the veterans that I have, they much more quickly go into a stage I would call rapport," he said. "They're brothers on a different level that only veterans can understand."
This issue came to a head last January, when the sheriff's department was receiving repeated complaints about a veteran in the Antelope Valley, north of Los Angeles.
The veteran, Jeremy Spencer, 47, fought with neighbors and barricaded himself in his home.
"His behavior was erratic, seemingly he was becoming unstable," Gannon said. "He was perceived to be a threat to his community."
After the third call in a month, Gannon reached out to the Greater Los Angeles VA hospital for help engaging Spencer. According to Gannon, the agency said Spencer hadn't used VA medical services in five or six years, but its hands were tied.
"What I learned is there really wasn't a mechanism here in L.A. County for the VA to proactively get involved," Gannon said.
Two days later, Spencer got into a physical confrontation with deputies and started having trouble breathing during the arrest. He died on the scene. The cause is still under investigation.
Gannon was struck by the feeling that law enforcement and the VA could do more to reach veterans like Spencer in desperate situations.
"I just feel that we may not have put our best foot forward and given him all the resources in a way or a delivery mode that he would accept it," Gannon said.
Introducing vets to VA care
Cases like Spencer's helped spur the creation of a new Veterans Mental Evaluation Team. The concept mirrored the existing MET program, with a twist: A specially trained VA Police Department officer paired with a VA clinician to join law enforcement on difficult calls involving vets.
After an early 2018 pilot program, the Long Beach VA agreed to officially launch the program in September. The agency says Long Beach's VMET program is the first of its kind in the country.
Marine Corps veteran Shannon Teague, a social worker with the Long Beach VA, is half of the very first VMET.
On a recent afternoon, she ran through training drills on a computer simulation to illustrate how she responds to a veteran named "Lynn" who expressed suicidal thoughts.
"Hi Lynn. They were telling us that you had put some posts on Facebook that you wanted to hurt yourself, is that what's going on today?" Teague said as she went through the computer simulation. She used a measured tone, eventually convincing the woman to leave her apartment to get help.
Teague said her own experience has helped her forge connections with vets in trouble.
"When you're in the military, it's a family," she said. "It really allows you to be able to communicate with them and get them to open up to you."
Her partner, Corp. Tyrone Anderson, was a Long Beach Police Officer for 23 years before retiring and starting work at the Long Beach VA police department.
It's often difficult for veterans to admit they need mental healthcare, Anderson said.
"You don't want to tell anybody because it's a sign of weakness," he said. "Well, a lot of people can't suck it up and deal with it. It's really a call for help. My partner and I, we try to go out there and bring them home."
Teague and Anderson now respond to calls from the Los Angeles Police Department and the L.A. County Sheriff's Department, as well as national VA crisis line calls and walk-ins to the Long Beach VA's Mental Health Urgent Care Center.
VMET runs the name and date of birth, to determine if the subject is a veteran and if they are already in the VA system. They pull up criminal history and military service record.
"Which branch they served in, how much time they did, where they served," Anderson said. "So when we arrive on scene, we kind of know what we're dealing with."
Once the situation is under control, the team's goal is to bring the patient to the VA, where they work with hospital staff and mental health caseworkers. The VMET team can communicate directly with doctors and healthcare workers within the VA, as well as work on other assistance like housing services.
The VMET also follows up during and after treatment -- including home visits.
"And if they don't show up to an appointment, we go up to the house and say, 'hey what are you doing here? You missed your treatment,'" Anderson said.
It's a surprise to many patients.
"We had one guy who started hugging us, crying. He said, 'the VA really cares.'"
A new stance for the VA
Veterans are twice as likely as non-veterans to die by suicide, and the majority of veterans that kill themselves are not connected to VA services. Reducing the number of veteran suicides is the number one clinical priority of VA Secretary Robert Wilkie.
"We need to do a better job of treating veterans' medical and mental health issues," said Dr. Lawrence Albers, Chief of Psychiatry and Mental Health with the Long Beach VA. He said VMET helps engage tough-to-reach patients and fits in with the VA's overall focus on suicide prevention.
In its first four months, the program's results are promising enough that the Long Beach VA plans to add a second team.
"We really feel there's a need to get another team up and running, and we're in the process of putting that in place," Albers said. "The amount of resources is minimal compared to the benefit that we've had."
Albers acknowledged this is a new stance for VA -- to proactively engage veterans who are in crisis but not necessarily connected to VA care.
"We've really been looking not only at what are the needs of the veterans in front of us in our clinics -- but what are the needs of veterans in the community?" Albers said. "We want to make sure that we're doing as much as we're able to do."
Jermaine Petit was one of the first vets helped by the new VMET. They approached him over the course of several days, working hand-in-hand with the sheriff's department and his mother, Charlotte Blackwell, to get him to the Long Beach VA.
"By the grace of God and with the help of this program, Jermaine is a brand new person," Blackwell said.
Now Petit is in a residential drug and alcohol rehab program, and he's taking his schizophrenia medication once a month. His mom says the next step is transitional housing, where she hopes he'll settle into a new life without psychotic episodes, drugs, or encounters with the police.
"You can tell when somebody's changing, and I feel that change," Blackwell said. "It's not what he says, it's the feeling that I get from the things that he's doing out there."
This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans. Funding comes from the Corporation for Public Broadcasting.