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The Need for New Mental Health Emergency Response

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Amidst the COVID-19 pandemic and attention on widely-documented police brutality against POC, many white Americans are opening their eyes to what marginalized folks have known for generations: the glaring racism of American law enforcement.

America’s over-reliance on police has created a law enforcement system that disproportionately targets Black and brown Americans, from outsized police presence in schools fueling disproportionately high suspension rates amongst students of color, to domestic interventions, traffic violations and numerous social services. The problem is particularly acute when we look at police response to mental health emergencies.

The Racist History of Law Enforcement

Our hyper-militarized police response often contradicts the duties of mental health professionals, who seek to minimize harm and help folks through their traumas. Too often, those most in need of support end up further marginalized and traumatized by their experiences with law enforcement. 

The problem is far from new, and unique to the United States. What we now understand as “policing” and “police forces” evolved from the enforcement of chattel slavery at the expense of Black bodies. In an interview with NPR, Keisha Blain, an associate professor in history at the University of Pittsburgh, explains that while most historians view the first metropolitan police force as having been founded in 1830s Boston, looking back further paints a fuller picture. In 1790 the Charleston City Watch and Guard was founded. Their primary task was acting as slave-catchers and controlling the movement of the slave population. This racist mission served as an early blueprint for “law enforcement” in America. 

With the end of the Civil War and the abolition of slavery, conversations emerged around policing and use of force. Any potential for meaningful reform was stunted as newly-emancipated Black Americans were not included, leaving the future of law enforcement in the hands of the white and well-connected. In the 1920s, Chicago erupted in protest after Eugene Williams, a 17-year old Black boy, was stoned to death for swimming in the “wrong” part of Lake Michigan. A commission found that Chicago police were aiding and abetting white mobs while disarming and arresting Black protestors. It is easy to draw the line from that, to firehoses and german shepherds loosed on protestors during the Civil Rights Movement, to today. 

Trauma from Law Enforcement Encounters

In 2018, the American Public Health Association (APHA) published a report outlining the severe public health risks people of color face: specifically, a system which sanctions violence in law enforcement. Their findings speak for themselves:

 “In two large surveys, Black individuals were more likely than White individuals to report stress as a result of encounters with police—a concern given evidence of an association between stress due to perceived racial discrimination and risk factors for chronic disease and early mortality. A nationally representative study showed an association between deaths among Black individuals due to legal intervention and subsequent poor mental health among Black adults living in the same state.”

While defunding the police is a hot-button issue, the reallocation of resources for emergency response should be priority, especially pertaining to mental health. In 2016, an article for Governing.com further illuminated the problem. At the time, they estimated 1 in 10 police calls in the USA were mental health situations, many involving undiagnosed mental health issues that police are not trained to understand, let alone handle. The result? While it’s estimated 3% of US adults suffer from severe mental illness, data shows they make up 25% of all fatal law enforcement encounters, a number which many suggest skews low because of chronic underreporting. Clearly, it’s time for a change. 

911 Alternatives Around the Country

Over the past couple years, there have been policy moves in some cities and localities to address this problem. For example, Dallas, TX enacted the RIGHT Care program in 2018. Though far from a quick fix, the initiative partners a police officer, a licensed clinical social worker, a paramedic and off-site clinicians who answer upwards of 200 to 250 emergency calls a day.

The program is credited with diverting thousands away from the jail and prison system and has contributed to a 10% drop in “quality of life citations” (e.g. disorderly conduct, public intoxication, and trespassing). Much of this success is likely related to the program’s follow-up protocol for patients with whom they interact. 

As seen in this Kaiser Health News article, attention to shifting resources is becoming more widespread. The article follows the story of Matt Vinnola, a 25 year old struggling with substance abuse and chronic paranoid schizophrenia. Since his diagnosis in 2014, Vinnola has faced a slew of criminal charges ranging from misdemeanors to felonies, all while he is pushed further away from the care he needs. Together with his mother, Vinnola fights for Denver to replicate the CAHOOTS program which was first reported in the Wall Street Journal after its pilot in Eugene, Oregon.

Similar to the RIGHT Care program in Dallas, CAHOOTS seeks to divert funds from police departments to fund mental health emergency responders instead, like social workers and other clinical experts. The results not only save money and resources but, more importantly, support more promising health outcomes. 

Looking for New Ways to Respond to Emergencies

With continued civil engagement and media attention on senseless violence against BIPOCs, the US must reckon with how we address generational and systemic mental illness and trauma. Though a one-size-fits-all solution oversimplifies the matter, there’s hope and promise in programs across the country seeking to defund police departments and involve clinical experts in mental health emergencies. 

In New York City, we have our work cut out for us. The NYPD remains one of the most heavily funded police departments in the nation, but with a mental health infrastructure pushed close to its capacity, those in need of proper care are increasingly crammed into jails and neglected. In the meantime, a number of nonprofits and organizations provide local alternatives to New Yorkers who do not want police involvement in mental health emergencies. We’ve included a list of some numbers you can call below. 

With growing support in cities across the nation, we could enact policy fixes that address this growing crisis. Until that day, Vinnola’s mother and many others like her will continue to rely on the goodwill of friends, family and strangers on social media. The sad fact is, calling 911 during a mental health emergency carries a risk can make it an unsafe choice. Funding communities, not cops, is necessary for safe outcomes in mental health emergencies.