MEMPHIS, TN. — Millions of people across the United States battle mental health issues.
Seeking help is hard enough if you're financially stable, but add living in poverty and it can be nearly impossible to get in touch with the resources needed.
"In our society often we have this idea of pull yourself up by your bootstraps, and if you work hard enough you can make the American Dream come true, and I don't think that's always the case," said Melissa Hirschi, assistant professor of Social Work at the University of Memphis.
"I think that individuals that are living with major and persistent mental illness, especially if it's untreated, and folks that are living in poverty, those are two areas that make it harder for that American Dream to come true."
The University of Memphis reports nearly 19 percent of people in Shelby County live in poverty — that's about 6 percent higher than national numbers.
When it comes to mental health treatment, the Substance Abuse and Mental Health Services Administration says almost 13 percent of people in Shelby County have received services, compared to about 14 percent in the U.S.
Experts say poverty plays a role in the numbers.
"Not having access to mental health services, not having transportation to get to the services that they need, not having insurance," said Michael Sims, program coordinator with Jail Division Services with Alliance Healthcare Services.
"Even though services are limited and sparse its compounded when there isn't access to those services," Hirschi explained.
So what are many doing in crisis when they can't get in touch with the proper care?
Memphis Police Lt. Col. Vincent Beasley said it's often police who have to deal with the situation.
"If somebody is gonna come to the scene you can call the police and we're going to come," Beasley said. "A lot of times we answer calls that are not really police related calls."
Memphis Police trains officers to be part of their CIT — Crisis Intervention Team — led by Beasley, because they are often dealing with people in crisis mode, potentially battling a mental health issue.
"We go out there and de-escalate the situation and get the individual to calm down enough so that we can get them to a place of help," Beasley said.
Right now there are 294 active CIT officers. Last year they responded to more than 21,000 calls, up from the more than 18,000 calls in 2016.
"We only transported 729 people to a penal facility, and that number is way below the national average because the national average is somewhere between 4 and 6 percent," Beasley said.
The city often takes people to Alliance Healthcare, a non-profit behavioral health provider.
"What we found in our work is there is a significant overlap between the people that they're seeing on the streets that have behavioral health issues, and the ones that we're seeing in our EMS system as well as our partners in Alliance Healthcare," said Lt. Kevin Spratlin, Memphis Fire Department's coordinator of the Health Care Navigator program.
So Memphis police, the fire department Alliance Healthcare have partnered together to form Crisis Assessment and Response to Emergencies, known as CARE. A pilot program kicked off in September.
The goal is to move behavioral health patients away from taking an ambulance and get them in touch with the help they really need.
"All three of them arrive at one time, so basically whatever is going on with that individual, you got everything you need," Spratlin said.
Michael Sims, the Program Coordinator at Jail Division Services and Alliance Healthcare Services, says his office helps determine what the person needs and if they need to be taken to a center for treatment.
"Or if that person just really needs a safety plan or an outpatient referral to one of our clinics," Sims said.
For now, the CARE team operates Monday through Friday. Officials say when it comes to mental health, no one is immune.
"When we look at our data on Mental health calls across the city, it is everywhere in the city. There is no one area where it is specific," Sims said.
Memphis is the only one of a few cities trying out the one year pilot. From September when the pilot started until January 9, the care team had been dispatched to 266 incidents.