by Judith Evans
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In a year marked by reports of police brutality, two names stood out for mental health advocates in 2020: Daniel Prude and Cameron Linden. In Rochester, New York, Prude was asphyxiated to death by police after he was seen naked and babbling in the street. In Salt Lake City, Utah, 13-year-old Linden — who lives with autism spectrum disorder — was shot and seriously injured by police while experiencing a mental health crisis.
Across the country, mental health advocates, social service agencies, and police departments are working to prevent police violence toward people with mental illness.
Grim Statistics
In the United States, 1 in 20 people live with severe mental illness. This group is disproportionately represented in the number of fatal police encounters. In 2015, the Treatment Advocacy Center released a landmark study on the subject that revealed some grim statistics:
When being stopped or approached by police, the risk of being killed is 16 times greater for people with untreated mental illness than for other civilians
25% to 50% of all fatal police incidents involve a person with severe mental illness
1 in 10 police responses involve people with severe mental illness
How Communities are Responding
From police crisis intervention teams to medical mobile units, a wide range of crisis response programs have been established.
Crisis Intervention Team Model
Since the late 1980s, crisis intervention teams (CIT) have become a common law enforcement response system for mental health emergencies. Before serving on a CIT, police must undergo 40 hours of training to learn de-escalation skills such as tone of voice, body language and eye contact. Other topics include mental health diagnoses and medications.
This model originated in Memphis, Tennessee, after police shot and killed a 27-year-old man who was suffering from a mental health crisis. With comprehensive training and ongoing support from mental health experts, CIT programs can help de-escalate crisis situations.
Medical University of South Carolina: A Holistic CIT Program
An effective CIT program exists at the Medical University of South Carolina (MUSC) in Charleston. MUSC’s public safety officers undergo a one-week Crisis Intervention Training from the National Institute of Mental Health. They also receive training from health and social service professionals, including the MUSC clinical operations manager and Charleston’s homeless outreach coordinator. This holistic approach gives police officers the knowledge and support they need to deal with situations involving mental illness.
Potential Weaknesses in CIT Programs
Not all CIT programs have in-depth training and ongoing community connections. Some programs only rely on the minimum required 40 hours of CIT training. The results can be disastrous, as seen in the Daniel Prude and Cameron Linden tragedies. Fortunately, communities are recognizing the need for new approaches to dealing with mental health emergencies.
Co-Response Models
In some communities, police departments partner with social service and mental health professionals. A variety of these co-response programs have been established at state, county and municipal levels.
Eugene, Oregon: CAHOOTS
Many cities have modeled their crisis response programs after Eugene, Oregon’s Crisis Assistance Helping Out on the Streets (CAHOOTS). Established in 1988, CAHOOTS relies on a non-law enforcement response to most mental health emergencies. Dispatchers at 911 or the police non-emergency number are trained to route nonviolent, behavioral health calls to CAHOOTS.
After receiving a call, CAHOOTS sends a two-person team consisting of a mental health professional and a nurse, EMT, or other medic to the crisis situation. At the scene, the team can provide services such as stabilization, referrals, advocacy, and — if needed — transportation to a treatment provider. The crisis team can call for police backup if there is an immediate danger to the person in crisis or others. In a June 2020 National Public Radio interview, CAHOOTS crisis worker Ebony Morgan estimated that in the previous year, police backup was warranted in just 150 out of 24,000 calls.
Idaho: Mobile Crisis Response Unit
The Idaho Department of Health and Welfare created the Mobile Crisis Response Unit to handle mental health emergencies with or without police backup. People can call the unit’s hotline 24/7, and the unit can either provide assistance over the phone or send an in-person response. If necessary, the mobile unit can call for police backup.
Local police CIT’s often call the Mobile Crisis Response Unit for assistance. For example, the police CIT in Meridian, Idaho, can reach out to a mobile unit in Region 4, which covers Ada, Valley, Elmore, and Boise counties.
Pima County, Arizona: Mental Health Support Team
In Pima County, Arizona, the Sheriff’s Office and Tucson Police Department created a trained Mental Health Support Team (MHST). A valuable resource to law enforcement as well as the community, the unit includes a captain, lieutenant, sergeant, two detectives, and 11 officers. An MHST officer and a licensed mental health professional ride together in civilian clothes and an unmarked car, and respond to calls together.
The absence of uniforms and marked police cars can help de-escalate a tense situation. The presence of a mental health professional allows a quick assessment of needs, such as referrals or immediate treatment.
Going Forward: We Need Both Models
Researchers have found that the co-responder model is generally more effective than the CIT model in reducing violent encounters with police. However, as Jeff Fladen, MSW points out, we need both models. When law enforcement are the first to arrive on the scene, they must have the necessary knowledge and de-escalation skills. Co-responder teams must have the resources to assess potential danger.
In 2022, the federal government will launch a National Mental Health Hotline. Calls to this number will trigger crisis responses at the local level. The success of this hotline, like all other crisis response programs, will depend on a community’s commitment to adequate resources and training. A united effort could prevent unnecessary suffering and save hundreds of lives.