Rethinking the Police Response to Mental Health-Related Calls Promising Models

By The Police Executive Research Forum

  This report addresses one of the most critical issues in policing today: the role of police in responding to calls for service involving people in mental or behavioral health (MBH) crisis. This has been a serious challenge for policing for decades, ever since mental health institutions were closed, people were discharged without adequate provision of help to live in the community, and many of them landed on the streets. Police found themselves responding to incidents involving people in crisis and doing the best they could. It has been more than 30 years since then-Commissioner of the NYPD, Lee Brown, said that “this country’s social problems are well beyond the ability of the police to deal with on their own.”  Yet that is what they are often called upon to do. The issue has come into sharper focus in debates about policing reform, especially since the murder of George Floyd. While many calls to reallocate funds from police to social services were not well thought out, many police agree that responsibility for responding to MBH calls for  service should not fall to the police alone, and in some instances not at all. The scope of the problem is enormous. The American Psychological Association reports that 60 percent of psychologists currently have no openings for new patients.  Emergency room visits by children and young adults surged by almost 60 percent between 2011 and 2020, and suiciderelated visits increased five-fold. In 2021 more than 100,000 people in the U.S. died from drug overdoses, more than twice as many as in 2015.  Nearly 600,000 people in the U.S. experience homelessness on a given night.  All these individuals risk falling victim to crimes, and some pose risks to the safety of themselves or others. Whether or not there is a threat to safety, police are likely to be called to MBH incidents, which can account for anywhere from 1 to 10 percent of all 911 calls. There are several reasons why calls come to police even when there is no immediate threat to safety. As a deployed service, patrolling the streets 24/7, police are usually in a position to respond quickly. Many people call 911 for help without thinking about whether another service provider may be more appropriate. And often, no one else is available to call; few mental health and social service providers have rapid response capabilities and even fewer operate during nights and weekends. MBH calls are resource intensive. They can be time consuming both on-scene and during the follow-up, which can include transporting subjects to the hospital and writing reports. Often, the subject is arrested; about 2 million times  annually, people with serious mental illness are booked into U.S. jails. MBH incidents can also be fraught with risk. The great majority of encounters are handled safely but some end tragically. According to the Treatment Advocacy Center, the risk of being killed is 16 times higher for people with untreated serious mental illness than for others approached or stopped by police. The issue therefore touches on three significant aspects of our current policing crisis, which is the worst in a generation: • First, a crisis of public trust in policing, driven in large part by high-profile incidents of police shootings and fatalities in police custody. • Second, a workforce crisis. Recruiting shortfalls in many departments — and budget tightening — have made patrol officers’ time more precious than ever. • Third, gun crime rates appear to have risen since 2019 (though early data from 2023 suggest they may be subsiding), and violent    crime clearance rates have been declining for decades. This third point also affects public trust in the police. If the role of police officers in mental health-related calls can be focused on instances where the potential risk of the encounter necessitates an armed presence or police powers, police departments should be able to divert their limited resources toward actions that require immediate police response, as well as toward crime prevention and investigation. We have made significant progress over the years in preparing police for MBH encounters. Mental health awareness training has been widely implemented. Thousands of agencies have conducted Crisis Intervention Training (CIT), which has been shown to increase understanding and empathy for individuals in crisis. Yet police often have to deal with MBH incidents with inadequate mental health resources. And tragically, some of those encounters end in a fatality

Washington, DC: Police Executive Research Forum, 2023. 59p.