Professionals, Not Police for Mental Health Crises

After wide attention being brought to the issue in 2020, the topic of structural changes to police and prisons seems to have largely faded from the public view. Despite losing mainstream attention, efforts to reduce systematic subjugation of marginalized individuals and communities at the hands of the justice system has continued. A key angle of this issue is protecting those with mental health issues, especially those in crisis. In the United States, an individual experiencing a mental health crisis is more likely to come in contact with law enforcement than to receive support or treatment and over one-third of the population is living in an area with a shortage of mental health providers. This has resulted in jails and prisons becoming the largest behavioral health facilities in the country and at least 20% of police calls being for an individual experiencing a mental health or substance abuse crisis (Dholakia and Gilbert 2021) (Westervelt 2020). Additionally, those with untreated mental illnesses are 16 times more likely to be killed by law enforcement when encountered by them than other people; this number is even higher for Black individuals (Waters 2021). By having no firm mental illness treatment system, the mental health crisis has turned from medical to punitive. It is time for the nation to shift to a system of response that prioritizes helping people rather than arresting them.

From 2015 to 2021, 1,430 people with a history of mental illness were shot and killed by police in the United States. Less fatal, outcomes are even more common and have resulted in prisons and jails being filled with individuals who suffer from mental illness and have been arrested rather than given treatment because, due to a lack of understanding, they are seen as public nuisances (Waters 2021). The best response would be to reduce encounters between law enforcement and individuals with psychiatric diseases. This will not only shrink the already massive prison population of the United States, but also reduce deadly reactions from an untrained and uncaring police force (Carroll).

It is imperative that cities create specially trained, unarmed crisis response teams made of mental health clinicians, medical professionals, and social workers that can exercise empathy and de-escalate situations, helping direct the individual to services rather than arresting them as a threat (Carroll). The belief that those in mental health crises are inherently dangerous and therefore must be “handled” by armed members of the state creates the greatest obstacle to the implementation of these programs (Westervelt 2020). In a nation that so closely links morality with criminality, signs of mental illness are interpreted as inherently immoral, essentially criminalizing mental health issues. If systems of power can shift away from this notion, recognize these situations as emerging due to unmet needs, and shift to an approach focused on empathy, people can get the help they need (Westervelt 2020).

Only a very few cities have created the kind of system needed to handle these situations, where trained professionals rather than police are called to defuse situations. The Crisis Assistance Helping Out on the Streets (CAHOOTS) program founded in Eugene, Oregon in 1989 was one of the first implemented, proving over the past decades that there is an alternative way (Westervelt 2020). The program pairs a medic—nurse, paramedic, or EMT—with a crisis worker to respond to both 911 and non-emergency calls alike for calls involving mental health and substance abuse. They are trained to provide “crisis intervention, counseling, basic emergency medical care, transportation, and referrals to services,” with no armed officer in tow. In 2019, out of the 24,000 calls CAHOOTS responded to, police backup was requested only 150 times (Admin 2020). This goes to show just how unnecessary police involvement is in these situations the vast majority of the time. The CAHOOTS program in Eugene has served as a model for places like Denver, Colorado and Olympia, Washington, with many other cities looking to create their own alternatives (Dholakia and Gilbert 2021).

It is time to move away from punitive and dangerous responses to mental health crises. Over the past years, it has become evident that police forces across the nation are ill-prepared to deal with mental health crises in nearly any capacity. The nation must shift to sending mental health providers in cases of mental health emergencies in order to reduce brutal encounters with an untrained, trigger-happy police force. By switching the way these situations are handled, the nation will see less preventable deaths at the hands of the police and more resources for those experiencing issues with their mental health.

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References

Admin. “What Is Cahoots?” White Bird Clinic, 8 Nov. 2020, https://whitebirdclinic.org/what-is-cahoots/.

Carroll, Heather. “People with Untreated Mental Illness 16 Times More Likely to Be Killed by Law Enforcement.” Treatment Advocacy Center, https://www.treatmentadvocacycenter.org/key-issues/criminalization-of-mental-illness/2976-people-with-untreated-mental-illness-16-times-more-likely-to-be-killed-by-law-enforcement-.

Dholakia , Nazish, and Daniela Gilbert. “What Happens When We Send Mental Health Providers Instead of Police.” Vera Institute of Justice, 27 May 2021, https://www.vera.org/news/what-happens-when-we-send-mental-health-providers-instead-of-police.

Waters, Rob. “Enlisting Mental Health Workers, Not Cops, in Mobile Crisis Response.” Health Affairs, June 2021, https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.00678.

Westervelt, Eric. “Mental Health and Police Violence: How Crisis Intervention Teams Are Failing.” NPR, NPR, 18 Sept. 2020, https://www.npr.org/2020/09/18/913229469/mental-health-and-police-violence-how-crisis-intervention-teams-are-failing.