Police in St. Petersburg, Florida, were well aware that Jeffrey Haarsma had mental health issues. Officers had been to the 55-year-old’s home at least 25 times in the year before the 911 call on Aug. 7, 2020. But the lone responding officer shot and killed Haarsma, who was unarmed, as he attacked her during an attempted misdemeanor arrest. Although Pinellas County officials later decided the shooting was justified, they also concluded the call should have been treated as a mental health issue rather than a criminal investigation.
Since that day, there have been nearly 2,000 fatal shootings by police officers in the line of duty. About 1 in 5 involved a police response to someone showing signs of mental illness. It doesn’t have to be that way.
Both the 2020 killing of George Floyd by a Minneapolis police officer responding to a 911 call about a suspected counterfeit bill and the school shooting in Uvalde, Texas, have drawn appropriate attention to police behavior. But what about when they are called upon to deal with non-violent emergencies? How we design our first response systems to deal with emergency events involving mental health and substance abuse deserves just as much scrutiny.
At least a third of the emergency calls that police respond to could instead be safely directed to health-focused emergency professionals such as mental health professionals, paramedics and social workers. This is clearly humane because it provides people in need with proper health care, not arrest (or worse). Psychological first aid services can reduce the risk of tragic and violent escalation and reduce the significant financial costs of moving mentally ill citizens into the criminal justice system.
Redesigning first aid systems to include mental health expertise must also have the enthusiastic support of a broad political coalition. Surveys of police officers show that they feel overwhelmed and frustrated by mental illness calls for which they are not properly trained. Likewise, police reform voices don’t want armed officers responding to nonviolent calls for help. Redirecting existing police resources to fund mental health first responders will allow police departments to focus on their core law enforcement mission.
A small but growing number of cities have implemented innovative programs that screen emergency calls based on the type of incident or with the guidance of a specially trained dispatcher. The aim is to identify calls where trained healthcare professionals can support the police or directly serve as first responders. Boston, Pittsburgh and Seattle have adopted “joint response” models that allow police officers to reach out to mental health professionals for guidance or collaborate in person on calls on scene.
More ambitious but less common “community response” models completely deny police intervention on carefully vetted calls. The flagship program, which began in Eugene, Oregon, more than 30 years ago, involves 911 dispatchers referring nonviolent incidents involving behavioral health to a two-person team consisting of a medic and a mental health crisis specialist. New York and Washington began piloting similar community response initiatives last year and have recently scaled up those operations.
We know too little about the effectiveness of these programs, the appropriateness of the details of their design, and how to meet the challenges of implementing these programs well. Nevertheless, our recent study of a community response initiative in Denver suggests that their promise is compelling and outstanding.
In June 2020, Denver launched a pilot community response program in inner-city neighborhoods, sending a mental health clinician and paramedic in an outfitted van to nonviolent emergency calls related to mental health, substance abuse, and homelessness. These teams most often responded to incidents involving illegal entry, welfare checks and requests for assistance. In its first six months, Denver emergency crews handled 748 calls for service, none of which resulted in an arrest.
Our independent analysis found that in the eight police departments where the pilot was active, Denver’s initiative reduced targeted lower-level crimes such as disorderly conduct, disorderly conduct and substance abuse by 34%. These reductions also occurred during hours when community response services were not available, a finding consistent with evidence that people in untreated mental health crises are likely to offend repeatedly. We also found that the corresponding reduction in police involvement in the program did not lead to an unintended increase in more serious crimes.
These results indicate that the direct cost savings of a community response program can be substantial. We estimated that the Denver Community Response Program costs just $151 per crime averted. That amount is only a quarter of the estimated cost of processing lower-level crimes through the criminal justice system.
We’ll never know for sure if Jeffrey Haarsma would still be alive if his serial engagements with the police included mental health support. But the available evidence of the extraordinary promise and simple common sense of community response programs makes a strong case for studying this innovation nationwide.
Mr. Dee is a professor at Stanford University and director of the John W. Gardner Center for Youth and Their Communities Faculty Center, where Mr. Pine is a research fellow.
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