A recent report published by the Brookings Institute focuses on the inadequate and sometimes deadly result of using police as first responders for people in need of immediate mental health response. The report’s authors, Stuart M. Butler and Nehath Sheriff, argue that crisis situations wherein individuals may have behavioral or mental health needs require an approach that shifts police away from leading the response and instead uses mental health professionals and community resources to help individuals secure the care they need.
The Data
The authors cite several high-profile cases wherein police responded with force when encountering individuals with mental health or developmental issues. These include:
- Daniel Prude, who died a week after a violent encounter with police in New York during a mental health crisis;
- Linden Cameron, a 13-year old boy with autism who was shot by police in Utah; and
- Walter Wallace, Jr., who was killed by police in Pennsylvania while experiencing a mental health crisis.
These incidents, the authors suggest, link directly to a steady decrease in the mental health services and facilities available to people in the U.S. since the 1960s, particularly among communities of color. Lack of services coupled with crisis situations leads to more calls to police to provide mental health response for people with untreated mental illness—and data indicates they are 16 times more likely to be killed by police than the average civilian. This has prompted many jurisdictions to consider new models that utilize crisis response teams.
Crisis Response Teams: A Definition
Crisis response teams, also called crisis intervention teams (CITs), combine specially-trained police officers and mental health professionals to become first responders for any crisis situation that may have a mental health, developmental, or substance abuse component. Their key focus is de-escalation, with the goal of connecting the individual in crisis to appropriate community resources for evaluation and care.
CIT Models Currently in Use
- Maryland: Anne Arundel County Crisis Intervention Model
- Resources from the police department and Maryland Behavioral Health Administration have been combined to expand Mobile Crisis Teams and designate specific CITs for cases beyond the expertise of regular mental health counselors.
- A “Warmline” diverts non-emergency calls to trained staff instead of police, and all fire and police stations offer “Safe Stations” that can provide evaluations for mental health cases that need to be referred to a crisis team.
- Mobile Crisis Teams and CITs pair specialized police officers with a licensed clinician, who work together to respond to emergency calls that involve escalated situations.
- All police officers in the county receive mental health first aid and substance abuse crisis training; and CIT officers must also complete a behavioral health course.
- Crisis teams coordinate with emergency departments and criminal justice systems to connect individuals with family and community supports following discharge.
- Oregon: CAHOOTS
- CAHOOTS stands for Crisis Assistance Helping Out on the Streets and is run by a Federally Qualified Health Center in Eugene, OR.
- Local police dispatchers are trained to identify and direct non-violent, behavioral-health related 911 calls to the CAHOOTS team, which consists of a crisis worker in partnership with one of the following: EMT, medic, nurse, or paramedic.
- Two-person teams respond to calls with a police officer present, and call in officers only if necessary. The team works to stabilize the person in crisis and connect them with any medical or mental health supports needed.
- Washington: LEAD Program
- The Law Enforcement Assisted Diversion (LEAD) program in Seattle, WA, was established as a partnership between police and local courts to keep individuals battling substance abuse out of the prison system.
- Police officers help identify people in the community who may benefit from substance abuse treatment, and also work with social services to connect individuals with mental health treatment, assistance with rent, or employment services. Community members who participate in the program do not face criminal charges for drug use or relapses.
- The program will soon be restructured as the Let Everyone Advance with Dignity program, which will put more emphasis on healthcare and remove officers as the main point of contact.
- New Mexico: Albuquerque Community Safety
- Albuquerque, NM, utilizes a Mobile Crisis Team (MCT) composed of unarmed law enforcement officers and master’s-level trained mental health professionals. Six MCTs currently provide behavioral health crisis response for 911 calls.
- In 2020, Albuquerque Community Safety was created, with the goal of restructuring the MCTs to provide a more civilian-driven response team. The new teams will include experts in violence prevention, diversion programs, housing, and social services.
Future Steps
With the scrutiny on law enforcement likely to continue in 2021, jurisdictions will likely need to consider mental health response options that use some form of crisis intervention team or mobile crisis unit. The authors of the report recommend keeping the following in mind:
- The ongoing need to expand access to behavioral health services and treatment;
- Investment in specific mental health and substance abuse training for police so they can handle mental health crises without escalation;
- A way to measure and analyze the impact of CITs on communities;
- Options for connecting CITs across the country in order to share best practices;
- Addressing how to establish a budget for CITs and determining both where funds should come from and how they should be directed;
- Training for dispatchers so they can appropriately direct mental-health related 911 calls to CITs instead of directly to police; and
- Federal assistance and support for these programs, which can help align jurisdictions’ efforts at the state and local levels.
To access the full report, please visit: https://www.brookings.edu/research/innovative-solutions-to-address-the-mental-health-crisis-shifting-away-from-police-as-first-responders/
