POLICE AND MENTAL HEALTH CRISES
When an individual is in the midst of a mental health crisis, the only resource people can contact is 911. This will result in the deployment of law enforcement, oftentimes who are not trained to resolve the crisis. For the person in crisis, the mere presence of armed, uniformed officers can often exacerbate feelings of distress. These factors result in unpredictable outcomes.
Sometimes, the individuals in crisis receive jail time rather than treatment in mental health facilities or unnecessary admission into in-patient facilities. Even worse yet, 104 people were killed last year as a result of police response to calls of people “behaving erratically or having a mental health crisis.”
A study of eight cities found that “21 to 38 percent of 911 calls were related to mental health, substance use, homelessness, and other quality of life concerns-all matters that could be better addressed by people other than police.”
Consequently, there has been an uptick in support for alternatives to police response for these kinds of emergencies. Mental Health America (MHA) suggests that “whenever possible, mental health crisis should be treated using medical personnel or, even better, specialized mental health personnel.” In particular, MHA recommends mobile crisis response teams consisting of these professionals or Crisis Intervention Teams (CIT). These teams consist of properly trained law enforcement and mental health professionals (co-responder model) that collaborate to coordinate effective solutions. By composing mobile crisis response teams of professionals, individuals going through a mental health crisis can be better served. When not actively responding to calls, these teams should engage in “wellness checks” for at-risk individuals in their communities.
The CIT Model is all-encompassing and goes beyond response teams. It recommends the implementation of mental health facilities (i.e., psychiatric urgent care centers), research-proven methods, mental health advocacy, and community outreach. The ultimate goal is that these situations can be properly de-escalated, prevent unnecessary arrests, and effectively direct people in crisis to the appropriate services.
From Denver, Colorado, to St. Petersburg, Florida, pilot programs have taken off in cities across the nation. Crisis Assistance Helping Out on the Streets (CAHOOTS) is a program in Eugene, Oregon, that has been around for more than 30 years. Response to a call is performed by a two-person team; a crisis worker and a medic. In 2019, the program responded to 17,000 calls through 911 or a non-emergency line, only requesting police backup for 311 of these calls (1.8 percent).* The program produces extensive fiscal benefits. With a budget of roughly $2 million, CAHOOTS saves the city of Eugene “$14 million annually in ambulance trips and emergency room costs, plus an estimated $8.5 million in public safety costs.”
Support for these programs is also growing at the state level, and New Jersey recently implemented ARRIVE Together (Alternative Responses to Reduce Instances of VIolence & Escalation). This program dispatches a mental health screener with a plainclothes police officer to behavioral and mental health crisis calls. The teams are also responsible for following up with community members who may benefit from outreach. In a press release regarding the program's expansion, NJ Governor Phil Murphy said, “This program is yet another tool for our law enforcement officers to utilize and better assist the communities they serve.”
Critics of CIT point out that in some cities where these programs have been implemented, little has changed. The reality is that these programs fail because police departments fail to properly integrate into a larger mental health care system. Roy Bruno, the Executive Director of Crisis Intervention Team International, explains that departments that view CIT training as just another box to check are not fully grasping what CIT truly is. “If you keep throwing money at training officers, and that’s all you do, and not address the system around mental health care, you'll continue to have nothing but problems.” If we want CIT to be effective and properly aid people in crisis, we must adhere to its guiding research-based principles. Letting departments cherry-pick the way they want reform will never result in a substantial change.