Law enforcement officers are most often the first responders to individuals experiencing a mental health crisis. Some research studies have estimated that at least 20% of police service calls involve a mental health or substance use crisis, and this demand has been increasing for many departments. In a nationwide survey of over 2,400 senior law enforcement officials, approximately 84% reported an increase in mental-health-related calls during their careers, and 63% noted that their department now spends more time on mental illness calls than in the past.

Over the past few decades, the way that police agencies handle these encounters has come under increased scrutiny. Concerns have been raised by people with mental illness and mental health advocacy groups, particularly regarding interactions that involve the use of force. One study estimated that one in four people with a mental health condition has been arrested at some point in their lifetime. This increase in mental-health-related cases and incidents has progressively led leaders and policymakers to question the adequacy of officers’ training in responding to mental health crisis calls. Consequently, more communities have been developing programs where police and professional mental health clinicians have been collaborating more closely on such emergency call responses.

Some research studies have estimated that at least 20% of police service calls involve a mental health or substance use crisis.

Policymakers have shown a keen interest in improving police responses to individuals experiencing mental health crises through numerous hearings and more robust legislation. A joint report by the Vera Institute of Justice and Bazelon Center for Mental Health Law underscores the strong support of the U.S. Departments of Justice (DOJ) and Health and Human Serivces (HHS) for federal laws mandating that individuals with behavioral health and other disabilities are to receive a health response — not a law enforcement response — in situations where others would receive a health response. In other words, when someone is experiencing a mental health crisis, a team of workers with mental health expertise should be dispatched, similar to how an ambulance would be sent for a physical health emergency. Failing to provide this type of response violates the civil rights of individuals with disabilities.

In addition, the DOJ and HHS assert that deploying co-responder teams, which pair officers with clinicians, can be considered a “reasonable modification” in situations where a police response is necessary. However, continual reliance on co-responder teams and other police-led approaches will tend to “perpetuate the criminalization of individuals experiencing behavioral health crises.” They also emphasize that ongoing federal guidance and support is available for communities that have historically depended heavily on police for mental crises responses and want help in reducing police involvement related to behavioral health situations.

While it may be fair to assume that of the approximately 18,000 U.S. law enforcement agencies, few have actively followed the federal directives described above, it is also true that quite a number of communities have been successfully implementing effective models that follow the spirit, if not the exact letter, of the mandates regarding mental health crisis incidents.

In exploring options for improving and enhancing their mental health incident responses, a number of agencies nationwide have adopted specialized approaches, often through directives from their local governments, such as crisis intervention teams (CITs), involving specially trained law enforcement officers who respond to mental health crisis calls, coordinating with mental health providers, and co-responder teams (CRTs), where law enforcement officers are paired with trained clinicians to jointly respond to emergency calls involving a mental health crisis.

While these approaches may fall somewhat short of the mandates described by the DOJ and HHS, the above models are arguably preferable to having officers respond to such events with little or no specialized training in handling a mental/behavioral health crisis.

A third model, mobile crisis teams (MCTs), seems closer to meeting federal guidelines, where community-based mental health professionals respond to such crises, with police being involved only when necessary. The Vera Institute and Bazelon Institute support this approach, where “jurisdictions should not assume that the proper response to a crisis is always to send law enforcement.” They advocate for law enforcement and 9-1-1 dispatch to divert calls to unarmed, properly trained behavioral health responders “whenever appropriate.”

According to the Congressional Research Service, CITs, CRTs and MCTs may each improve certain outcomes, such as enhancing police officers’ perceptions of and responses to people with mental disorders and helping to connect individuals with mental health services. However, it is less certain whether these improvements will lead to tangible benefits in the long run for those with mental health needs, such as fewer arrests and reduced use of force overall.

One of the more forward-thinking communities to address these issues is Ithaca, New York, a city of some 31,000 residents in the Finger Lakes region, home to Cornell University. In the wake of a tragic mental health response several years ago that resulted in the death of a beloved local police officer, the city sought to reform how such events were handled. There were several different models attempted, and after struggling for some years with how to form a workable policy, a forward-thinking mayor, along with the city’s Common Council, developed the Crisis Alternative Response and Engagement (CARE) Team approach, which had professional clinicians leading the response to mental health incidents, backed by trained officers. With a change of administration and police leadership came a less robust program. However, in December 2023, the Re-imagining Public Safety initiative was introduced in Ithaca, and thereafter the Common Council passed a resolution to replicate the CARE Team program.

In the Ithaca Police Department (IPD), mental and behavioral health clinicians collaborate with officers by responding to calls involving individuals who may be in dangerous situations due to their mental state. CARE services may include de-escalating situations and providing support after a crisis that may have involved violence or potential injury.

Harmony Ayers-Friedlander, the deputy commissioner for mental health services for Tompkins County Whole Health, explained that the CARE Team was established based on research and data on the effectiveness of co-response teams. Friedlander noted that such research has also helped address the issue of people unnecessarily going to emergency departments for mental health crises.

Colorado Springs, Colorado, a community of just under a half-million, famous for being where the U.S. Air Force Academy is located, as well as the U.S. Space Force and Focus on the Family, may stand to represent the model closest to the federal guidelines for handling such critical incidents.

In Colorado Springs, the Community Response Team (CRT) is indispensable for managing mental health emergencies. When residents contact 9-1-1 or the state crisis line for a mental health crisis, a team consisting of a Colorado Springs Fire Department paramedic, a Colorado Springs Police officer and a mental health technician from Diversus Health responds. The CRT was established in 2012 to improve support for individuals experiencing behavioral health crises. This followed almost a decade of exploring and developing new models of handling such events, first initiated by Chief Fletcher Howard before the turn of the century.

One reason they believe their CRT has been so successful is that the clinician and the fire department personnel take the lead in such events, both of whom seem less frightening and authoritative to a distressed individual than a law enforcement officer.

Regardless of the approach adopted by local legislatures and police agencies, it’s high time we stop relying on police officers — whose primary role is law enforcement and not mental health care — to handle critical mental and behavioral crises.