Honolulu Police Department psychologist Michael Christopher, his black motorcycle jacket slung on a chair, had just begun an interview in his office when his cellphone rang.

“So, what’s going on?” he quickly asked the caller. “Do you know what medications he took? We don’t? Are there indications that he’s hearing voices?”

The call was one of a growing number — about 60 a week — coming in at all hours from police officers on the front lines, dealing with emotionally disturbed or mentally ill people in crisis on Oahu. More than a quarter of these troubled people are homeless.

Christopher coordinates the Honolulu Emergency Psychological Services and Jail Diversion Program. Launched in 2007, it aims to get mental health treatment to people who need it, rather than arresting and locking them up for minor infractions, a costly approach that often makes things worse. The program is a collaboration among the Honolulu Police Department, the state Health Department, Honolulu Emergency Medical Services, the Institute for Human Services and several hospitals.

Despite pervasive fear of the mentally ill, the person in crisis usually poses a threat to himself or herself — not others. The call that Christopher handled that morning, for example, involved a man who was threatening to kill himself and had burned his beard with a lighter.

The jail diversion program has helped more than 10,000 people get immediate mental health care since it began. Last year, Honolulu police psychologists logged 3,090 calls, involving 2,106 people in crisis. That’s a big jump from 2,100 calls in 2010, and nearly three times as many as the 1,200 in the first year of the program. The rise reflects the growing need for help as well as training of officers to spot signs of mental illness.

“In District 1, which stretches from Chinatown to Ala Moana, we have as many calls to check on people as we do for crimes,” said Lt. Dee Ann Koanui, a 28-year veteran of the police force who works that area. “The public will typically report that an individual is acting out in public, passed out, loitering, etc. Most of them need help or some type of medical or psychological intervention, so being able to call the psychologist is a huge help.”

The two police psychologists, on call 24 hours a day, help determine the appropriate steps, whether deploying a crisis worker, arranging help with a family member or sending the individual to the hospital for an involuntary mental health evaluation. Less than 2 percent of last year’s calls resulted in an arrest.

Judging by one basic measure, the Emergency Psychological Services program is working for most people. The vast majority of people – More than eight out of 10 people who trigger a call to the police psychologists do not prompt another crisis call in the same calendar year.

“It is a much more enlightened way of addressing the needs of the community than just putting people in jail,” said Loraine Fleming, a psychiatric nurse practitioner and past president of the American Psychiatric Nurses Association’s Hawaii division. “Many times people with mental illness don’t recognize they have an illness and don’t want to follow up with treatment. The value of the program is tremendous because it provides an interface with the emergency room and the community.”

Calls to the Emergency Psychological Services program reflect in part the upswing in Hawaii’s homeless population, which now is higher per capita than in any other state, according to the State of Homelessness in America 2015 report. Almost 28 percent of the 2,106 individuals referred to Honolulu police psychologists last year for mental health crises were homeless, up from 21 percent three years earlier.

People who live on the street and show symptoms of mental illness, such as visual or auditory hallucinations, tend to alarm onlookers and trigger 911 calls.

“It’s one thing to be hearing and seeing things at home,” said Christopher. “It’s another to be sitting on the sidewalk. No one’s going to call the police, most of the time, if you or I are at home. Problems that would have been manageable in a home become unmanageable when people don’t have homes.”

At the same time, homelessness can push otherwise stable people over the edge.

“You can take a perfectly healthy person and leave them on the street long enough, and they will develop mental illness,” said Christopher, who has two doctorates, one in sociology and one in clinical psychology with a specialty in police psychology. “If you take someone who has mental illness and leave them on the street, they will just get worse. Housing is a basic medical need for everybody.”

Just a few blocks from his office, a middle-aged woman wearing a baby-blue top and pants, the disposable kind given to patients, lolled on a lush patch of lawn in front of the Queen’s Medical Center on a recent afternoon. She was clutching a clear plastic bag.

Inside were her discharge papers from the emergency room, which she pulled out to show a passing bicyclist who stopped to check on her. They indicated a diagnosis of schizoaffective disorder, which involves hallucinations or delusions and mood disorders such as depression.

Asked if she had been helped at the hospital, she shrugged. “Not really,” she said. “They didn’t find me a place to live.”

A fly landed on her tawny cheek and she left it there, her gaze remaining steady. “You know why the flies are coming?” she asked. “They’re here in case I end the world.”

There are many others like her, finding what shelter they can on the streets of Honolulu, seeing and hearing things that others do not. cannot The police effort to refer people for emergency psychological help goes only so far.

“The inpatient services we can provide in the hospital are really only one part of what’s necessary,” Fleming said. “You really have to have a robust community treatment system, and you know that costs money. And our patients are not at the front of the list of getting things — they are not a strong political block.”

Every call to the police psychologists is documented, yielding a trove of data. Over the last two calendar years, police reported that 64 percent of the folks who triggered calls to police psychologists posed a danger to themselves. About 39 percent appeared dangerous to others. Nearly two-thirds showed signs of severe mental illness, such as hearing voices. More than a third were intoxicated with alcohol or drugs. Two percent tried to kill someone.had made a homicidal attempt.

Police officers are trained to identify people suffering from mental illness as well as healthy people who may be in an emotional crisis. The officers learn to use alternative tactics to minimize the use of force and de-escalate tense situations.

“We try to train them to … use the neocortex and emotional part of the brain to override the ancient ‘us vs. them’ impulses,” Christopher said. “We’re asking police officers to do something which goes against a significant part of human nature. We’re asking them to use the complex problem-solving, compassionate side, to override the instinctual part of the brain, which is in all of us and comes out under stress.”

The intervention seems to be making a difference for many unstable folks who come to the attention of police psychologists … but not all of them. Last year, 83 percent of the 1,867 people who were referred by police for an involuntary mental health evaluation at a hospital appeared only once in the program’s database.

“Most of those people are getting adequate help,” Christopher said. “But a minority of them we are seeing over and over. It’s clear that the system doesn’t work for them. They are not getting the right kind of treatment or they are not getting adequate treatment.”

During the last six months of 2014, for example, the two most frequent users triggered 13 separate calls to police psychologists. In the previous six-month period, one person prompted 19 crisis calls. Thirteen people, on average, had more than five crisis calls in each six-month period.

It has been difficult to track what treatment people receive after they are sent to the hospital, partly due to medical privacy restrictions. But the police department is now focusing on individuals who trigger repeated calls, bouncing from the street to the hospital or jail and back to the street.

The Institute for Human Services, the state’s oldest and largest homeless agency, handles many people with mental illness, often receiving referrals from Queen’s Kekela psychiatric facility. To ease that transition and help other residents with mental troubles, in May the shelter began sharing a psychiatrist with Queen’s. She works 10 to 15 hours a week at the shelter, providing continuity as patients try to piece their lives back together.

“It mitigates the extent to which those people would go back to Queen’s,” said Jerry Coffee, clinical director of the Institute for Human Services.

Dr. Virginia Pressler, the director of the state Health Department, considers behavioral health one of her top priorities at the department. Her hope is to rebuild mental health services that were sliced in 2009.

“It’s an area that’s been neglected for many years,” she said in a recent interview with the Honolulu Star-Advertiser. “And I think with all the budget cuts a number of years ago, cutting community-based programs and things like that, we’re paying the price big-time now. Because that’s part of the homeless problem.”