How to Get Cops Out of the Mental-Health Business

Police in St. Petersburg, Florida knew full well that Jeffrey Haarsma had mental health issues. Officials had been to the 55-year-old’s home at least 25 times in the year prior to an August 7, 2020 emergency call. But the only officer to respond shot dead the unarmed Haarsma as he attacked her during an attempted arrest for a minor offence. While Pinellas County officials later decided that the shooting was warranted, they also concluded that the call should have been treated as a mental health issue rather than a criminal investigation.

Since that day there have been nearly 2,000 fatal shots by police officers on duty. About 1 in 5 was linked to a police response to someone showing signs of mental illness. It doesn’t have to be like this.

Both the 2020 killing of George Floyd by a Minneapolis police officer responding to an 911 call about an alleged fake bill and the school shooting in Uvalde, Texas have drawn attention to police behavior. But what if they are called to deal with nonviolent emergencies? How we design our first aid systems to deal with urgent mental health and substance abuse incidents deserves similar careful consideration.

At least a third of the 911 calls that police respond to could instead be safely routed to health-focused emergency responders such as psychotherapists, paramedics and social workers. This is clearly humane as it provides proper health care rather than arrest (or worse) to those in need. Psychiatric first responders can reduce the risk of a tragic and violent escalation and mitigate the significant financial cost of returning mentally ill citizens to the criminal justice system.

Redesigning first responder systems to incorporate mental health expertise should also have the enthusiastic support of a broad political coalition. Surveys of police officers show they feel overwhelmed and frustrated when they receive calls about mental health issues, for which they are not adequately trained. Likewise, voices for police reform do not want armed officers to respond to nonviolent calls for help. Reallocating existing police resources to funding mental health first responders will allow police departments to focus on their core role of law enforcement.

A small but growing number of cities have introduced innovative programs that screen emergency calls by type of incident or under the guidance of a specially trained dispatcher. The goal is to identify calls where trained medical professionals can assist the police or act directly as first responders. Boston, Pittsburgh, and Seattle have adopted “co-response” models that allow law enforcement officers to seek advice from or work with mental health specialists in person on field visits.

More ambitious but less common “community response” models dispense with police involvement entirely in carefully screened calls. The pioneering program, which began more than 30 years ago in Eugene, Oregon, has 911 dispatchers who escalate nonviolent behavioral health-related incidents to a two-person team consisting of a paramedic and a mental health crisis specialist. New York City and Washington began piloting similar community response initiatives last year and more recently have expanded the scope of these operations.

We know far too little about the effectiveness of these programs, the relevance of their design details, and how to address the challenges of implementing these programs well. Nonetheless, our recent study of a community response initiative in Denver suggests their promise is compelling and exceptional.

In June 2020, Denver piloted a community response program in the city’s central downtown neighborhoods, dispatching a psychiatrist and paramedic in a equipped van to nonviolent emergency calls related to mental health, substance abuse, and homelessness. These teams responded most frequently to incidents related to trespassing, welfare checks, and requests for assistance. In the first six months, Denver community workers processed 748 911 calls, none of which resulted in an arrest.

Our independent analysis found that the Denver initiative reduced targeted, lower-level crimes such as disorderly conduct, trespassing and substance abuse by 34% in the eight police precincts where the pilot was active. These reductions also occurred during the hours when community workers were unavailable, a finding consistent with evidence that people with untreated mental health crises are likely to offend repeatedly. We also found that the program’s corresponding reduction in police involvement did not result in an unintended increase in more serious crimes.

These results illustrate that the direct cost savings of a community response program can be significant. We estimate Denver’s Community Response program costs just $151 per crime avoided. This amount represents only a quarter of the estimated cost of processing lower-level crimes through the criminal justice system.

We’ll never know for sure if Jeffrey Haarsma would still be alive if his serial engagements with the police included psychological support. But the available evidence of the extraordinary promise and simple common sense of community response programs makes a strong case for investigating this innovation across the country.

Mr. Dee is a professor at Stanford University and faculty director at the John W. Gardner Center for Youth and Their Communities, where Mr. Pyne is a research associate.

Wonderland: Joe Biden prefers to talk about racism and guns than to face the real problem. Images: AFP/Getty Images/Reuters/Shutterstock Composite: Mark Kelly

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Alley Einstein

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