When some of San Mateo County’s most volatile 911 calls come in, the first responder stepping out is not always in uniform and certainly not in a roaring cruiser. Instead, it is Briana Fair, a licensed clinician climbing out of a white Toyota Prius, quietly walking into situations that could otherwise end in handcuffs or a hospital hold.
Fair is the county’s first street-level mental health clinician, riding alongside officers to calm situations, build safety plans and connect people to treatment. She keeps a rarely used bulletproof vest in the trunk, but most of her work is far less dramatic: follow-up calls, detailed safety planning and quick links to services that can keep people stable. It is a lower-key alternative to arrests or involuntary hospitalizations, and a recent evaluation suggests that wherever this model shows up, forced psychiatric detentions and repeat crisis calls start to drop.
Study Finds Fewer Involuntary Psychiatric Detentions
A formal evaluation of San Mateo County’s “co-responder” teams - a pairing of a police officer with a mental health clinician - found that the program cut involuntary psychiatric detentions by roughly 16.5% and reduced mental-health-related 911 calls by about 17%. According to Nature Human Behaviour, that translated into about 370 fewer involuntary holds over two years and an estimated $300,000 to $800,000 in health-care savings each year.
The Stanford-based John W. Gardner Center, which led the pilot evaluation highlighted in the same analysis, reported similar results in its impact report and noted that the effect appears to stem from both on-the-spot decisions during crises and fewer repeat emergencies in neighborhoods where the teams regularly respond.
What It Looks Like On The Street
On a Dec. 15 ride-along in San Mateo, Fair waited until officers secured an apartment scene, then stepped in and spent several minutes working with family members to build a safety plan instead of initiating an involuntary hospital hold. “I fill in the gaps,” Fair told reporters during that shift, according to CalMatters.
Her job does not end when the patrol car pulls away. Fair follows up by phone, connects people with community partners and walks clients through benefits and medical paperwork. Officers say those practical touches lower the odds that a shaky situation turns into an arrest or an emergency detention. That is exactly the sort of replacement the program’s designers wanted for blunt, expensive tactics like automatic hospitalizations.
Countywide Rollout And Nonprofit Role
The co-responder pilot launched in December 2021 in Daly City, Redwood City, San Mateo and South San Francisco. Since then, versions of the model have spread across more of the county. StarVista, the nonprofit that trains and supervises clinicians, recently announced that its Community Wellness and Crisis Response Team has expanded to additional police departments.
Local law enforcement agencies say the pairing lets officers zero in on immediate safety while clinicians carry the weight of mental health assessments and longer-term care planning. In practice, that can free up patrol resources and deepen working relationships with hospitals and community providers that are often left scrambling after a crisis call.
Costs, Outcomes And The Case For Change
The two-year pilot cost about $1.5 million, with expenses split between San Mateo County and the four participating cities. Most of those jurisdictions have managed to keep the work going after the seed funding dried up, CalMatters reports.
Researchers say the drop in involuntary detentions and the related decline in repeat crisis calls likely explain the program’s modest but real financial savings. The Stanford analysis put those savings at roughly $300,000 to $800,000 a year, according to Nature Human Behaviour. Mariela Ruiz-Angel of Georgetown Law has praised co-responder teams as “fantastic” but cautioned that they are not a full replacement for non-police responses to mental health emergencies.
How A ‘5150’ Hold Fits In The Response
California’s involuntary psychiatric detention law, widely known as a “5150,” allows hospitals to hold someone for up to 72 hours for evaluation if they present an immediate danger to themselves or others, or are deemed gravely disabled. The Gardner Center’s impact report explains that clinicians on co-responder teams are typically the ones who complete the required 5150 paperwork and then steer cases toward outpatient or community supports when possible.
That approach can reduce the paperwork load for officers and improve continuity of care for the person in crisis. Even so, researchers stress that co-responder models are only one part of a much larger mental health system and that they work best when paired with careful planning around 911 dispatch, staffing and training.
San Mateo’s low-key, Prius-based approach offers a concrete playbook for counties looking to revamp 911 responses without walking away from public safety. If the early results hold, the region will need more clinicians, smarter dispatch triage tools and stronger long-term treatment options - the unglamorous but necessary investments that turn promising pilots into everyday practice.
