Crystal Deramus’ teenage daughter recently climbed out onto the family’s roof in St. Paul after an argument over picking up her clothes. She refused to get down, shouting that she hoped her mother would die.

Like many people struggling with a loved one’s mental illness, Deramus turned to the first logical place for help.

“I didn’t know what to do, so I called the police,” said Deramus, who reported that her daughter had stopped taking medication for mental health issues because of negative reactions from other teens.

Mental health calls to St. Paul police more than doubled between 2004 and 2016.

In response, St. Paul police debuted a mental health unit in March. It was comprised of three officers, a supervisor and a licensed clinical social worker, Amber Ruth. A second licensed clinical social worker, Kara Haroldson, joined the unit in early September.

The increased staffing allows the team to respond to calls of people in crisis, not just follow up afterward.

“Officers are empowered by law to take a person to a hospital for a mental health evaluation,” said Sgt. Jamie Sipes, who oversees the unit. “But we have limited expertise in this area. This gives us an opportunity to bring the expertise out into the field with us on a call to make a more informed decision.”

The unit has handled about 1,003 adult cases and 130 juvenile cases. Of those, six resulted in arrests, according to St. Paul police. About 428, or 37 percent, of the people involved reported having a mental health diagnosis.

Another hope of the program is to reduce potentially fatal encounters between police and people experiencing a mental health crisis.

Of 169 fatal police shootings across Minnesota since 2000, 71 of those shot had a history of mental illness or were in the throes of a mental health crisis at the time of the shooting, according to a Star Tribune analysis.

Some police departments work with county crisis teams and social workers, but St. Paul is unusual because it has a dedicated unit, said Sue Abderholden, executive director of the National Alliance on Mental Illness (NAMI) Minnesota.

St. Paul’s social workers, Ruth and Haroldson, are paid by People Incorporated and Regions Hospital.

“It’s pretty unusual,” Abderholden said, “To just have a special unit to follow up on people … kind of checking up on people, connecting with people.”

Andy Skoogman, executive director of the Minnesota Chiefs of Police Association, said St. Paul’s unit is rare in the state.

“More agencies are looking at collaborative efforts with county-based mental health crisis systems, particularly in smaller agencies,” he said, “but even that is still in the developing stage.”

Numbers from St. Paul police show that while many 911 calls come in to dispatch with a known mental health issue, officers often later identify more cases where it’s a factor. In 2016, St. Paul received 8,704 calls designated as mental health calls. But officers identified a total of 12,345 calls that year involving mental health issues — up from 5,269 cases in 2004.

Sipes believes the jump is due to increased awareness among police and the public. A key goal of the unit is to decrease such calls by connecting people with appropriate medical care and other resources.

‘Through the cracks’

Unit officers Justin Tiffany and Marshall Titus, along with Ruth and Haroldson, visited Deramus on a recent Tuesday morning; the initial incident with her daughter occurred several days earlier and was handled by patrol officers.

The unit arrived in two minivans largely unmarked with the exception of a small police badge on the door. The officers wore dark navy shirts and khakis instead of traditional uniforms — all conscious choices aimed at reducing the anxiety some have about police.

They were following up on Deramus’ daughter, but also making sure Deramus is in contact with resources she needs.

Deramus, who uses a wheelchair and has other children, was facing eviction after her daughter broke some windows.

“They slip through the cracks,” Ruth said of people like Deramus. “They focus on their kids and not their own self-care.”

Deramus said it was the first time she felt heard after struggling with her daughter’s issues since late 2017.

“It was really good to talk to them, and for someone to listen to my side of the story,” she said.

On another day, unit officers Lori Goulet and Titus arrived at a public housing high-rise to check on a woman whose case manager had contacted them with concerns that she had stopped taking medication.

“Oh, there’s been some commotion in the middle of the night here,” said a tenant as the officers and Haroldson approached the woman’s unit.

The trio spoke with the woman privately, and determined that she wasn’t in crisis, or a threat to herself or others.

They then stopped at the home of a woman whose grown son had recently jumped from a bridge in a suicide attempt, badly injuring himself. Haroldson said they wanted to make sure she was connected to services that could help her and her son when he’s released from the hospital.

Next: Iris Park. Several people had called 911 throughout the day reporting that a woman was acting disruptive and aggressive. Titus placed a hold on the call so the mental health unit could respond instead of patrol officers.

The woman told police and Haroldson she had been living in the park for weeks, but was receiving services and expected to find housing soon. The officers didn’t arrest or hospitalize her.

“When we approached her she was quiet, she was calm,” Haroldson said.

Sipes said the unit will evolve as it learns from the past few months, but hope for even better results with the addition of Haroldson. People are often more likely to accept help when they’re reached during a crisis instead of a follow-up a few days later, Ruth and Haroldson said.

“Reaching people in the moment is just key,” Ruth said. “So many things can happen beyond that 24 hours, be it family involvement, friend involvement.”