By Anna Cook, Jon Lloyd, Fablina Sharara, Jennifer Key,
When someone is in a crisis, a police response can lead to help — or harm. Across the country, communities are trying something new: sending mental health specialists, peer specialists or other trained professionals to crisis calls instead of police through alternative response programs (ARPs). Research on ARPs has focused on case studies and standout programs like CAHOOTS in Oregon and Denver STAR, but we know relatively little about the broader trends in this growing field. Comprehensive information about where and how jurisdictions are implementing ARPs is crucial so that policymakers, funders and advocates can make better informed strategic decisions regarding public safety innovation. To address this gap, we created a novel database of 216 ARPs established since the early 1970s and operational as of 2024 to produce one of the first overviews of these programs throughout the United States. By summarizing the design, scale and geographic distribution of ARPs, we provide a broad look at the field to help inform and empower community leaders to build stronger public safety systems while reducing dependence on traditional policing. Our findings underscore critical choices in how ARPs are implemented and raise important questions about their scope, accessibility and long-term potential. As policymakers, practitioners and advocates continue to explore alternatives to police response, this report provides a foundation for understanding the current landscape and identifying paths for growth. Given current gaps in ARP implementation, future research and innovation are needed to explore how these programs can evolve to handle a higher volume and wider range of calls, understand the benefits and limitations of different call lines, and expand to meet the needs of smaller or underserved communities.
Key findings: • Recent proliferation: Public officials and other decisionmakers established nearly 120 ARPs from 2020 through 2024, reflecting a surge in interest and political willpower following national Black Lives Matter protests. • Limited scale: Most programs serving large populations respond to fewer than five calls per 1,000 residents per year. • Narrow scope: Mental and behavioral health are a stated focus for 94% of programs; far fewer are designed to address issues like traffic safety, interpersonal conflict or homelessness. • 911 reliance: Despite their focus on mental crisis calls, only 18% of ARPs use the 988 national mental health crisis line, while 50% use 911 for dispatch. • Urban concentration: Programs are concentrated in large, racially diverse, urban areas.
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