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In an imperfect system, two different groups with often alternate perspectives have come together. Through regular conversations, meetings, and a collaborative Crisis Intervention training, Homeless Health Services and the police department serve people experiencing chronic homelessness in Fargo, North Dakota. Kim Seeb, Director of Homeless Health Services, has worked with the Fargo Police Department to build bridges between the mental health perspectives and law enforcement perspectives when it comes to serving people who are struggling with homelessness, mental illness, and substance use.


In Fargo, North Dakota, a man who is living on the streets is confronted by police officers. He is turned around and held up against a car because he is holding a rock. The officer takes the rock and throws it into the street. What the officer does not know is that the rock has meaning; this man had been collecting things for the shelter. “What people have in their pockets is all they may have and you have to respect that. You have to treat people with respect and dignity,” explained Kim Seeb, Director of Homeless Health Services. Some officers argued that they don’t have time to worry about the rock in a pocket. Conversations like this one are central to the evolving relationship between Fargo’s police department and Homeless Health Services, which has recently seen a dramatic increase in the number of people who are experiencing homelessness and who have traveled to North Dakota from other states.

Homeless Health Services in Fargo opened in 1989 at a Salvation Army. When the program opened, there were significant efforts by the police to rid the area of anyone who was intoxicated. At the time there were 15 to 20 individuals experiencing chronic homelessness who accessed a significant number of resources. In response, a group was formed for police officers to talk with case managers and mental health professionals once a month. The group discussed how to come up with plans for safety, housing, and health. The group achieved some success with this model and one of the officers wrote a grant to be a police homelessness liaison. “He had become so involved and was committed to keeping people who had been through detoxification out of jail,” says Kim. Now, when the police encounter someone new they connect them with the services of the clinic.

The Homeless Health Services Clinic offers primary care, case management, and outreach. They have a government drug program that exists to make necessary medications available and affordable. For the most part, the average prescription costs only two dollars; there is an emergency fund on hand for rare cases where prescriptions run at a higher cost. Patients have access to labs, X-rays, exercise, pain reduction, mental health services, an expanding vision program, and a limited dental program. The clinic board of directors has made the clinic a charitable program. Patients are always asked to pay, but, if they cannot, they never leave without their medication. Collaboration with regional mental health centers provides access to substance use programs. Kim works with 15 Shelter Plus Care clients and the program provides a 42-bed Housing First facility and conducts outreach on the streets and under bridges. “We do what we can here to keep people safe and to explore housing options. There are many barriers, including landlords who are unwilling to rent, and limited apartments within the payment standards,” says Kim.

The process of relationship building over the past 11 years has been challenging as well as rewarding. There are inherently different attitudes that police officers and social workers bring to the streets. They resolve differences by meeting with each other to discuss their differences; they address issues as soon as they arise.

“One day, in a detox group, a man did not want to take his coat off and one of the officers assaulted him. What the man who had been assaulted remembers is that he was being treated for facial wounds. The officer admitted that he used excessive force,” says Kim. It is not a perfect system.

One of the most successful collaborations has come out of a shared training effort. The Fargo Police Department Highway Patrol, County Patrol, and Fargo mental health providers all participated in a national best practice training, the Crisis Intervention Training. This training has been used throughout the Midwest. Kim explains that this training has given law officers an important perspective on what mental health care providers do and why they do it. Conversely, the mental health providers have learned about the importance of police procedures, law, and safety, and how they can participate. “My relationships with officers improved one hundred percent after this training and now we know that we have the same hope for the same outcome as a result of this training,” says Kim.

Earlier in her career Kim worked on a crisis team focused on people who lived with serious mental illness and substance use disorders. She received a call from a father who told her that his son was suicidal and drinking in a hotel room. She went on the call and the young man was not there. He had gone out the window. When they returned to the hotel, he was curled up on the bed and in very bad shape. In that moment she thought, “Oh my God, this is someone’s grandson, someone’s son. I have to make sure that someone loves him. I have to make sure that he is ok.” This, she said, was a pivotal moment that shifted her perspective from looking at people as clients to looking at people as human beings, as individuals with precious lives and precious families. The Crisis Intervention Training seemed to be a pivotal moment for both officers and mental health workers as they learned to have respect for each other’s point of view, just as service providers strive to have respect for the people they meet every day in their work.

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SAMHSA
2013
Rockville, MD
617-467-6014