Using a mental health team, not police, on 911 calls lowers crime

June 14 – Pairing a mental health expert with a paramedic to respond to low-level nonviolent 911 calls reduced crime rates in downtown Denver, a new study reveals.

These non-police response teams are trained to address issues related to mental health, depression, poverty, homelessness, and/or substance abuse. Over 6 months in 2020, the project has reduced crime related to alcohol and drugs, disorderly conduct and other crimes against people by 34%.

During the same pilot phase, the total crime rate decreased by 14% in the eight police zones that participated in the Support Team Assisted Response (STAR) program, compared to the police zones where the police responded to all types of 911 calls.

The program has trained coordinators to recognize calls where traditional responses may not be necessary, including situations without evidence of serious criminal activity such as threats, weapons or violence.

The police also called the teams themselves in about a third of the cases. “One of the striking details — a change in the broader sense — is that in some cases, the police responded and then called in mental health professionals,” said lead study author Thomas Dee, PhD.

The study was published on June 10 in scientific progress

These teams of mental health experts and paramedics are less likely to report people breaking the law, says Dee, a professor in the Graduate School of Education at Stanford University.

“We also found no evidence of adverse effects on more serious or violent crimes.”

The wider political context

While programs to give nonviolent 911 calls to non-police officers have been around for years, the idea “is now getting more attention because of its larger context,” Dee says.

Sending a health care response team instead of police officers on some calls could appeal to both sides of the debate about policing in the United States, he says. “There is a broad political context and this program needs to have broad appeal.”

For example: “If your politics are ‘back the blue’, support it. Police officers often say they don’t want to respond to these kinds of calls and delegate [to other responders] can raise police morale,” he says.

On the other hand, he says, “if you’re politically ‘cutting the police,’ this program reduces the footprint of police officers and can reduce police budgets over time.”

Police spend a significant amount of their time responding to nonviolent emergency calls for help that often involve people with a mental health or substance abuse crisis, the researchers wrote.

But the police are often not trained to help in these kinds of situations.

“As a result, emergency calls for help can be viewed as criminal offences, sometimes with unnecessarily violent or even tragic consequences, while better addressed as health concerns,” they wrote.

What about security?

The safety of first responders is a “completely legitimate concern,” Dee says, adding that a concern is that if there is no police officer present, the situation could escalate.

But this “is not a ready-made reform. You still need careful training, recruit the right people and have good protocols in place to keep them safe. And you still have to consult with the police every now and then,” he says.

Investigators found that none of the 748 field calls handled by the emergency responders ended in an arrest, resulting in 1,376 fewer reported offenses over 6 months.

The STAR program at the time cost $208,151 to run, or $151 for each prevented violation, Dee says. The cost to arrest and process someone, meanwhile, is about four times that, or about $646 in 2021 dollars.

“Even if the program wasn’t money-saving, it’s a very humane way to respond,” Dee says.

Training, co-reacting or replacing?

The Denver STAR program is one of the top three options for responding to nonviolent emergency calls. Other approaches include training police officers on how to respond to someone in a mental health or drug crisis as special crisis intervention teams or dispatching mental health professionals with the police.

The results of the study “show that a response from the community [can be] effective in de-escalating crises and improving the referral process,” said Étienne Blais, PhD, who has studied similar programs in Canada.

There can be pros and cons to the police presence in the collaborating teams, says Blais, a professor in the School of Criminology at the University of Montreal.

“For example, the presence of a police officer allows mental health specialists to provide psychosocial advice and apply de-escalation techniques even if the person in crisis shows signs of aggressiveness,” he says. “On the other hand, some individuals will not disclose sensitive but relevant information — such as drug-related matters or involvement in criminal acts — in the presence of police officers.”

The right team can make the difference

“It is one of the first studies to demonstrate the effectiveness of unarmed responses to behavioral health calls for service,” said Bradley R. Ray, PhD, a senior researcher in RTI International’s Division of Applied Justice Research.

But it probably won’t be the last. “I would expect there to be many more studies like this in the future that show the potential for non-police response,” he says.

Using the program in other communities can be challenging given the different designs of shipping systems across the country, Ray says. In some cases, for example, a sheriff manages the system, while others are controlled by city governments that require firefighters, emergency medical services, and police to respond to all calls.

Over the years, I’ve constantly encouraged law enforcement agencies to carefully consider the calls where they need police officers, where they need co-answers, and where they don’t have to respond,” said Ray, who is also a senior. author of a study published in April comparing police and mental health co-response teams to traditional police responses in Indianapolis.

“In my own research on co-response teams, as usual, we found minimal and often non-significant differences between co-response and police responses,” he says. “When agencies are frustrated with those results, I often tell them it’s about selecting the right calls for service and sending the right team.”