In first-of-its-kind collaboration, mental health counselor meets people ‘exactly where they are’
For a few tense moments on a recent fall morning, the situation at an RTD bus stop looked complicated.
A woman waiting for a bus was agitated and yelling at anyone who would listen. Other riders appeared bewildered and intimidated. The bus operator wondered whether to choose between declining a rider or inconveniencing all the other passengers. Security personnel thought the woman should cool off away from public transit.
It was a perfect situation to test the skills of the only mental health clinician in the nation assigned full-time to a transit agency – licensed professional counselor Nicholas Runyan, who joined RTD over the summer. Runyan, contracted by RTD through the Mental Health Center of Denver (MHCD), pairs up with a Transit Police officer when he ventures out in RTD’s service area within Denver.
On this day, Runyan asked to have a moment to speak calmly with the agitated woman. He decided the real problem was the obvious one: The woman needed a ride home, and getting one would change her day. Once she learned she would be allowed on the bus she relaxed, and everything turned out fine, Runyan said.
“We see people who are having their worst day,” Runyan noted.
Runyan’s MHCD supervisor, Carleigh Sailon, observed that an individual’s crisis affects not just that person, but also the larger community.
“There’s not really a law enforcement solution to a lot of these crises,” she said. “And it’s wonderful that RTD reached out and saw this as something that really benefits their riders."
The work arrangement RTD has with Runyan follows the “ride-along” model of community mental health that has proven effective with the Denver Police Department, local emergency medical responders and other out-of-the-box situations. RTD sought out the MHCD partnership to help residents in need of extra services and to improve the ridership experience of its customers.
RTD’s passengers display a broad range of human behavior expected in a metro region of nearly 3 million people. Transit can be affected more heavily than other institutions because people with mental health issues, substance abuse histories or legal involvement rely on public transportation. In addition, the metro area’s homeless population uses transit spaces ranging from bus shelters to light rail elevators to waiting areas at high-traffic stops such as Civic Center Station and Union Station.
Runyan starts his days with RTD security officers at 6 a.m. Often their first contacts are with people who are homeless, sleeping on RTD property.
“We meet people exactly where they are,” both physically and mentally, said Runyan, speaking to the MHCD and RTD philosophy of the program. “If they don’t want to talk, we don’t force it. Half the people I already know, from previous encounters.”
Runyan can put them in touch with a variety of community resources, from emergency shelter to food to a mental health intake with MHCD. The mental health agency can send a counselor immediately to a bus stop to make an initial assessment and set up longer-term counseling services.
The teams carry an app with access to MHCD’s records. “I might ask, ‘Are you in our system?’” Runyan said.
He recently met a man living in a bus shelter, who had interacted with security officers nearly every day for weeks. Tickets for trespassing weren’t changing his behavior. Runyan linked him with a long-term counselor, and that connection brought the man into temporary housing just before Colorado’s winter weather hit.
The counselors talk with law enforcement constantly about balancing safety and effective help, short-term versus long-term goals, Runyan said.
“If somebody drinks beer at the same bus stop every day, putting him in jail isn’t going to do anything,” he noted.
When situations are more dangerous, counselors have authority to place people on 72-hour behavioral holds. It’s a rare occurrence – but an important tool when someone poses a clear danger to themselves or others, Runyan said. To this point he has put holds on two people, both of whom were walking out into traffic.
While many days are a “10-hour road trip” without multiple incidents, Runyan said, other days have been quite eventful. In one instance, he and his partner raced to the scene of a shooting near RTD property.
“It’s very different in person than in a book,” Runyan said of his work. “My respect for what police deal with has grown exponentially.”