In addition to the police, fire, medical and other personnel who are trained to respond to different kinds of emergencies, Boulder employs another, less common type of first responder.
Enter the city's Crisis Intervention Response Team, or CIRT -- a team of licensed clinicians and case managers that co-responds with the Boulder police to situations where people are experiencing behavioral health crises.
A recently released report shows CIRT's services have been in high demand, and there are also signs that the team's work is having a positive impact in the community. From 2022 to 2023, the most recent years for which data is available, the team had 4,119 interactions with community members -- an average of between five and six interactions every day -- and in more than two-thirds of those cases, those community members were stabilized.
Most of CIRT's clients during that time (60%) were people who weren't already engaged in behavioral health services. Although some clients were engaged in services prior to CIRT, most of them needed help beyond what they were receiving.
Because the CIRT team responds alongside police, there were some CIRT responses where arrests occurred or where police used force. There were arrests in 2.5% of CIRT responses, and 0.3% of responses involved police use of force.
For Wendy Schwartz, senior manager of human services for the city, the data from the report highlights "just how needed and used" these services are.
"The amount of work that the team is doing in-person, in follow-ups, in case management work, is really a lot in a city of a little more than 100,000 people. This is a very busy team," Schwartz said.
CIRT is a relatively new program for the city. It was established in early 2021, when the city brought an existing co-response team called Edge into its fold. Edge originally contracted through the nonprofit Mental Health Partners. Case management services, which were not originally part of the CIRT program, started in 2023.
Now, the crisis response team has 14 members. Licensed behavioral health clinicians respond to calls that come via the emergency dispatch system, and case managers work with clients who need ongoing support beyond the initial contact. The most common types of calls CIRT responds to involve suicidal ideation and substance use issues.
The case management system allows clinicians to follow up with clients and connect them with other services and resources. These clients often have acute needs and may not be served adequately by other systems, according to Lucy Larbalestier, behavioral health crisis response manager for CIRT.
"It's one thing to go and do a crisis intervention and talk to somebody in the moment and kind of help them stabilize that day. And folks often have real structural barriers, things that are going on in their lives, that you're not going to be able to solve in an hour of talking to them, no matter how great that intervention is," said Larbalestier.
Keeley Warren is one of those case managers. She and Kristi Phifer, her supervisor, recall one client who had started calling 911 multiple times a week after experiencing severe anxiety due to life changes. This person was having serious concerns about health and quality of life as well as suicidal thoughts.
Over several months, Warren worked with the client, asking about the person's goals and asked how she could support the person. It took time to forge a relationship with the client, but eventually, Warren became part of the person's support network.
"I'm able to use the trust and rapport that I'm building with her to help find more appropriate connections with longer-term providers to bridge the gap," Warren said. "This person had had some providers in the past but was not engaging with them in the way that would be useful for her needs that she still (has)."
The people doing this work can encounter a significant amount of trauma, and that can be "a lot to take on," Phifer said. But both Phifer and Warren agreed the work feels very rewarding.
Larbalestier also said she's seen some "incredible successes" from CIRT's case management services, especially, since they help fill a gap between emergency response services and the longer-term care that many people need but aren't getting.
Community members have also been overwhelmingly supportive of the CIRT program and its services, according to Schwartz, the city human services manager.
"The community really likes this program and will often call asking for assistance with CIRT. I think that's really a plus, that the community finds it to be a helpful resource," Schwartz said.
There is strong demand in Boulder for this type of social safety-net program, especially as housing and daily necessities grow ever more expensive. However, many of these programs are struggling to keep up with the level of demand, and some are in a financially vulnerable spot right now due to funding cuts and tight city and county budgets.
"A lot of our safety net organizations have some limitations going on right now. Across the whole spectrum of healthcare, I think we all know that it's just a tough time in our landscape. Although we might be able to meet one unmet need, I'm sure there are many others," Schwartz said.