The Need to Change Police Response to Mental Health Crises
The killing of Walter Wallace brought home, among other things, the desperate need to reform mental health crisis response programs. Too often, calls to the police end in injury or killing of the person in need.
The Washington Post has recorded every fatal shooting by police since 2015. One in five killings are of a person in mental health crisis. Stories like those of Scott Huffman, Lyana Gilmore, Walter Wallace, and 1,355 more over the past five years demonstrate the need for a more compassionate response.
Police are often first on the scene in such cases, but are frequently ill-equipped and increasingly understaffed to help these individuals most effectively. For example, individuals in mental health crisis can exhibit erratic behavior, which can seem dangerous to a police officer who is not trained in recognizing and responding to these symptoms. The officer may default to using force, even though this may be the least effective solution.
We need better responses to reduce the number of people in crisis who are criminalized, injured or killed. Co-response programs (police plus mental health professionals) are one alternative. However, these programs are poorly studied and vary in their implementation, methods, and personnel.
The Crisis Intervention Team (CIT) is one such model gaining recognition. CIT has been recognized as a global model for helping individuals in mental health or substance use crises. CIT combines the skills of community mental health professionals and police officers when approaching individuals in crisis. The added mental health professionals can recognize symptoms of mental illnesses and direct individuals to community resources. However, there remain limitations; for example, CIT has yet to form a standardized curriculum for working with autistic individuals.
Individuals with autism provide a clear example of the need for police to understand specific non-violent behaviors of certain populations. Spectrum describes the problem of police force and violent encounters against autistic people and the shortcomings of training efforts in place. For example, traits common to autistic people, including echolalia (repetition of someone’s vocalizations), stimming, or limited communication, may be misinterpreted by a police officer as noncompliant and may lead to unnecessary use of force. These incidents are not limited to individuals on the spectrum; similar situations can occur for individuals with schizophrenia or impaired hearing.
Another, more radical model to address mental health crises is the use of mental health response teams on their own. For example the Oregon-based program Crisis Assistance Helping Out On The Streets (CAHOOTS) offers an alternative to police response by specializing in crisis intervention and practicing trauma-informed de-escalation. Timothy Black, director of the White Bird clinic that coordinates CAHOOTS, explains to NPR that “one of the biggest obstacles in scaling [this program] is overcoming the widely held perception that people in a mental health crisis are inherently dangerous.”
The responders in the CAHOOTS programs are mental health crisis workers or EMTs who do not carry weapons. Unarmed approaches like these can improve outcomes by employing de-escalation the moment the response team arrives. For some people in crisis, the nature of the response can change from the immediate approach; a team that seems calm and willing to talk is less stressful to work with than if the team seems aggressive and tense. CAHOOTS also showed economic benefit by reducing police involvement.
While there’s growing enthusiasm for these models, dissemination and accurate implementation have lagged behind. NPR reported that implementation programs like the Memphis Model (similar to CIT) have not lived up to their promise. Problems with communication and coordination cause confusion and result in flawed implementation. Officers receive inadequate training; the training is often seen as “merely a check-the-box” and is not effective in getting to the root of the problem. While some programs report sending fewer people into the criminal justice system, the programs have not demonstrated decreased killings and injuries during these responses.
As the US Department of Justice explains, “The professionals in the system know much about how to meet the needs of the people it is meant to serve. The problem comes, however, in the ability of the system’s intended clientele to access its services and, often, in the system’s ability to make these services accessible.” Employing these programs could prevent killings and injuries of individuals undergoing mental health crises, and get them quickly to appropriate care. After all, the goal should be to protect and serve.