To reduce police involvement in crisis calls, communities have had to surmount challenges and work together to determine how best to meet their goal of providing the right response at the right time for the right person. Ultimately, they have worked together creatively—police, behavioral health, advocacy, community residents, and others—to create programs that use existing resources and source funding for new ones to promote health and safety for all.

Identifying funding, configuring on-scene responses (who does what, when) while maintaining safety for everyone, and training needed personnel will form the backbone of any effort to replicate these models.

Funding

Programmatic efforts to reform police responses to people in behavioral health crisis around the country have been touted as adding few new costs to policing budgets. Dave McClure, Ellen Paddock, Rayanne Hawkins, and Mayookha Mitra-Majumdar, Pay for Success and the Crisis Intervention Team Model (Washington, DC: Urban Institute, 2017), https://www.urban.org/sites/default/files/publication/94741/pay-for-success-and-the-crisis-intervention-team-model_1.pdf. See also Larry Thompson and Randy Borum, "Crisis Intervention Teams (CIT): Considerations for Knowledge Transfer," Mental Health Law & Policy Faculty Publications, 2006, 548, https://scholarcommons.usf.edu.... Though this may have been true for police agencies, communities often need additional funds for the behavioral health services that would augment or replace police responses. The three communities Vera researchers studied each required significant funding (see case studies), and acquired it through a combination of grants, levies, and federal and state funds. Communities looking to implement new models should consider the following possible funding sources:

  • police department budgets, which can be reallocated to support more comprehensive non-police response approaches;
  • state grants, including police association grants that support non-police first responders or peer outreach;
  • braided funding pooled together from local, state, and federal sources, as demonstrated in Arizona; and
  • public safety levies that explicitly carve out funding for enhanced non-police crisis response.

Legislative efforts

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911 call diversion

To truly reduce the police response to scenes involving people with mental illness, dispatchers must divert calls to 911 (and non-emergency numbers) to non-traditional responders. At the heart of the ability to divert 911 calls are two important needs. Departments must establish policies in conjunction with agency legal staff and train police department staff—and communications personnel—to understand that they are not going to be held liable for situations in which they do not respond to the call. Communities looking to implement new models should consider the following possibilities for 911 diversion practices:

  • alternative first responders carry police radios so they can be dispatched to the scene or monitor and proactively intercept calls that might benefit from their behavioral health expertise; and
  • legal staff address any potential liability for police or mental health service personnel by developing clear guidelines to determine which calls will be dispatched to mental health services or transferred to a mental health expert at the 911 call center.

On-scene response models

The task of removing the police from encounters with people in crisis requires extensive coordination among various responders to reduce potentially dangerous situations and foster connections to services for people with a wide range of needs. The sites Vera talked with have creatively managed to place the right person at the scene of a crisis to help manage a person’s ongoing needs outside of the crisis and establish long-term solutions. Communities looking to implement new models should consider the following possible on-scene response approaches:

Eugene, OR

Specialists responding instead of police

  • 911 operators dispatch CAHOOTS teams composed of a crisis worker and a medic to calls involving a person in crisis.
  • CAHOOTS teams can respond instead of or alongside police.
  • CAHOOTS offers voluntary services only, but can encourage treatment more effectively than police.

Olympia, WA

Specialists responding instead of police

  • Behavioral health specialists monitor a police radio to identify situations that might require their skills. They can respond on-scene based on what they hear and work with officers at the scene on timing of engagement.
  • These teams of two specialists also conduct outreach at encampments of people experiencing homelessness to provide support and make connections to needed services.

Peer outreach

  • Catholic Community Services hired two peers with lived experience in the criminal legal system as well as behavioral health conditions to respond to people frequently in contact with emergency service providers.
  • These peers identify in a novel way with clients referred to the program—they share lived experiences that can enable trust and provide extensive support. The peers do not respond to police dispatch and can work with people over time. Because of valuable relationship building, clients appear to be more willing to engage in strategies to address underlying needs, according to program staff.

Phoenix, AZ

Triaging calls from 911 to behavioral health experts

  • Dispatchers identify calls appropriate for a behavioral-health-only response and forward them to the Crisis Response Network (CRN).
  • If they determine that an on-scene response is necessary, CRN specialists can dispatch a non-police mobile team trained in crisis intervention.


Recruiting and training personnel

The case studies reveal that people with certain traits and abilities are needed to do the work of compassionately and patiently helping people in crisis get the help they need. In addition, extensive training is needed because job responsibilities may be new to staff in these roles. Communities looking to implement new models should consider the following strategies for recruiting and training alternative responders and dispatchers:

  • Rather than prioritizing responders with graduate-level training, programs like CAHOOTS identify team members based on their passion for serving people with behavioral health conditions and their ability to learn about the full range of community resources, work with police, engage people during crisis, and connect them to appropriate services;
  • Training for line-level crisis workers features cross-training with officers to learn about police experiences in their communities, as well as building relationships with community-based organizations to learn about specific treatments and supports;
  • Officers themselves dedicate time to learning about behavioral health outreach strategies and treatment approaches; and
  • Dispatcher trainings include information about the crisis response system and the activities of behavioral health partners to ensure dispatcher confidence in those partners as they conduct their own assessments to deliver alternatives to police response.