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Response Alternatives to Mental Health Crises

Posted by Sara Cooper | Jun 15, 2023 | 0 Comments

You can visit social media for a short period of time and eventually find someone talking about 988 on their account story or recommending the number to a person in the comments without even knowing them. We all know what 911 is in the United States, and the popularization of 988 has skyrocketed for the past year to address mental health. Passing in Congress in 2020 under the National Suicide Hotline Designation Act, a nationwide alternative of mental health response. This number connects to a variety of mental health services, and it's in hopes of disarraying from the tragedies of law enforcement corresponding as mental health aides with little to no training.

We have seen a mental health crisis of a vulnerable individual turn into an outcome of great injury or death of the hands of a police officer. There are many grand examples of non-white Americans and predominantly Black Americans, who are misunderstood and violated by law enforcement, without proper assessment and de-escalation techniques that are utilized in order to discover mental health illnesses. According to the National Alliance on Mental Illness, about 2 million times per year, people with mental illnesses are booked into our nation's jails, with around 20% of fatal encounters with the police involved a person with mental health difficulties.

Differing opinions on who should be the forefront of responding to crises regarding mental health are continuous, as the demand is uprising for departments both of law enforcement and community-based services. With the establishment of 988 and mental health collectives working together and are funded by local governments to assist in situations that utilize non-violent resolutions, bringing in professional that work directly with the mentally disabled community and their loved ones centers the destigmatization of mental health or at least a first step as a country. This makes a life-changing impact on mental health systems and how they approach crises that are not within their physical proximity, saving lives and incorporating legal remedy as a guarantee.

Typically in the past years, several police departments across the United States have partaken in de-escalation trainings facilitated by clinicians and the programs they head. Some trainings and programs can range from 40 hours a year to a few weeks of concentrated time to be educated on mental illness and how to prevent unnecessary arrests and shootings. This was in following of the profound precedence of CAHOOTS (Crisis Assistance Hanging Out on the Streets) that started in 1989 in Eugene, Oregon as a compassionate agency that includes medics, crisis counselors, and social workers, and operate independently from law enforcement. It's important to note that advocacy for police reform around mental health crisis intervention has existed well before it became national mainstream conversation. Still, law enforcement after these trainings would hold weapons and are not equipped for medical issues unlike these clinics that specialize in crisis situations.

There is also interference with how each county prioritizes these trainings for law enforcement and funding for mental health systems. Despite its success, not all states require officers to receive de-escalation training mentions Very Well Mind. As of currently, 21 states do not require de-escalation trainings to help prevent the usage of excessive force. The placement of police that has been highly militarized into being as a form of care for millions of Americans with mental illness should not be taken lightly or the responsibility cannot be solely relied on them. It has a lot to due with where the funding goes for these systems and how expansive these systems are.

According to the Washington Post, most of the progress being made is in larger metropolitan areas.4 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.

In a NPR article: The biggest breakdown, Bruno and others say, is that cities and counties too often fail to carefully integrate the program into the wider behavioral mental health care system and route calls away from police. "If you keep throwing money at training officers, and that's all you do, and not address the system around mental health care, you'll continue to have nothing but problems." Many police departments take the training for the label of interacting with mental health protocol and indirect support but are still enforced to be the problem-solver without active change for this national issue.

There are mental health specialists and counselors in police departments and that is eventually expanding. However, crisis teams that do not involve law enforcement and allow variations of model programs take into effect that deal with situations that police were originally intended to control.

Here is a great layout of a community-based system that focuses on crisis response, thanks to the Appeal:

Key Elements of Model Programs

model crisis response program should follow these principles: 

Be separate from law enforcement: A crisis response program should be entirely separated from law enforcement. This includes team members, managers, and anyone in an oversight position. One of the common ways teams are dispatched is through 911 calls that are routed to the crisis response team, but a city or county could also create a number that routes directly to the crisis response team. 

Include on-site, on-demand emergency and preventative services: Crisis response programs should provide both emergency and preventive services. This means meeting people where they are and referring people to necessary services and treatment. Ideal crisis response teams include both a medic and a crisis worker who can provide “immediate stabilization in case of urgent medical need or psychological crisis, assessment, information, referral, advocacy and (in some cases) transportation to the next step in treatment.”

Be fully funded through law enforcement budget reallocation: Funding must be provided to both create and operate a crisis response team. As cities and counties grapple with budget shortfalls due to the COVID-19 pandemic, shifting money out of police budgets and to these more effective programs makes sense and makes the development of this alternative to policing feasible.

Resources to check out for more involvement with community-based emergency systems:

Current Developments:

Supporting Documents:

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