This, in part, is because law enforcement are inappropriately expected to respond to situations that could be better handled by health professionals. Individuals with mental illness are especially at risk when it comes to police violence. According to the Washington Post, nearly 20% of all fatal police shootings in 2020 involved a person experiencing mental health issues. How did we get here? Inadequate investment in community-based support and shifts in policing like greater militarization of law enforcement and higher responsibility of crisis response have placed police in the path to care for nearly one-third of people with mental illness in the United States. In order to improve crisis intervention and prioritize the safety of individuals with mental health issues, that responsibility must be shifted away from law enforcement. But this requires ample resources, support and manpower at a national level. Calls for reform have long rung out, so what has the response looked like thus far?
Is Progress Being Made?
It’s important to note that advocacy for police reform around mental health crisis intervention has existed well before it became national mainstream conversation. LEAD, a program created in 2011 in Seattle, Washington, was formed to disrupt the typical criminal justice system cycle that accompanied the war on drugs paradigm. Police, prosecutors, housing providers, public defenders, civil rights activists, political leaders and mental health and drug treatment providers joined forces to find new solutions for individuals who frequently fell victim to a broken system. According to LEAD’s website, participants in the Seattle program were 58% less likely to be arrested after enrollment compared to those who went through the “system as usual” criminal justice processing. As a shining example of a diversion program, LEAD is now advancing criminal justice reform in communities across the country. Vincent Atchity, president and CEO of Mental Health Colorado, leads the organization’s Care Not Cuffs initiative, a campaign focused on providing health care for health needs rather than relying on criminalization and incarceration. “In the advocacy work I do at the intersection of mental health and this criminal system, I often say that law enforcement folks are some of our chief allies in disentangling mental health and criminal justice,” Atchity says. Atchity explains that while crisis management has not historically been the dominant police culture, it has become the “scrappy upcoming subculture” focused on de-escalation, reducing arrests, and improving health outcomes for individuals and communities. Research has shown that de-escalation training can be incredibly effective in reducing harm. A 2020 study found that after sixteen hours of training, officers logged 36% fewer injuries, reported 28% fewer use-of-force accidents, and received 26% fewer citizen complaints. Despite its success, not all states require officers to receive de-escalation training. According to the Washington Post, most of the progress being made is in larger metropolitan areas. Larger police departments with bigger budgets have been more likely to implement the training and commit resources to refresher training while working with local mental health professionals. The International Association of Chiefs of Police launched its One Mind campaign to improve interactions between law enforcement and individuals with mental health conditions. It asks police departments to cultivate partnerships with local mental health professionals while training officers in mental health awareness courses. According to the IACP website, over 600 agencies have taken the pledge. But considering that there are more than 12,000 police departments in the U.S, this number is just a drop in the bucket. But there are some points of progress. For example, the state of Virginia passed legislation that implements co-responder models in which police officers are paired with better-equipped experts like social workers and mental health professionals when responding to a behavioral or mental health crisis in order to reduce harm. And in a completely police-free move, New York City’s B-Heard program responds to mental health crises with mental health professionals and paramedics rather than law enforcement. Similar programs now exist in Washington and Colorado. Another area that could prove promising is a new crisis hotline that’s on the way.
988: A New Crisis Response
It’s one of the first phone numbers we memorize: call 911 in an emergency. But 911 operators have extremely limited options when it comes to helping the person on the other line. The operator can send police, emergency medical services or both. And many times, once the call is identified as a mental health-related issue, police are dispatched regardless of whether safety or criminality are in question. More often than not, police response to a mental health crisis does more harm than good. Countless tragic accounts exemplifying this have made the news in recent years. Next summer, another 3-digit emergency phone number will be available. In 2020, 988 was announced as a new crisis response hotline to be rolled out in summer 2022. This number will be dedicated to connecting individuals in a mental health crisis with the support and resources they need. The implementation of this new emergency number should, in theory, take some of the burden off law enforcement as first responders and provide better solutions for people in crisis. However, as we’re just seven months from the number going live, experts say the supporting systems are not ready. Benjamin Miller, PsyD, a clinical psychologist and president of the national foundation Well Being Trust, has served as an advisor to presidential campaigns, states and health systems regarding mental health solutions. He views the hotline as a point of progress but can’t ignore the heavy lifting required in rethinking the full continuum of crisis response. For the hotline to see success, Miller says, the system must offer accessible and timely crisis response, as well as the ability to hire, train, and retain experienced clinicians. More trained operators and mobile crisis units will be necessary to handle an inevitably heavier call volume thanks to a more easily accessible hotline. “We’re getting close," Miller says. “We’re having the right conversations, but we’re not going to be prepared.” The reality is that even after the hotline goes live, it’s possible that law enforcement will still end up serving as first responders because other resources aren’t yet available. And to Miller’s knowledge, while police departments are aware of the new hotline, there’s no new training specific to its implementation. This is the issue inhibiting mental health crisis intervention progress: The infrastructure still needs to be fully fleshed out in order to support people in need. “There’s an opportunity for us to really get this right,” Miller says. “But there’s a lot of work to be done so that we don’t betray the trust we’re asking of the public when they think they’re going to get something different when they call this new number and they get the same old response.”
