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Police Are Still the Most Qualified First Responders for Mental Illness

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Police Are Still the Most Qualified First Responders for Mental Illness

New York Post December 27, 2021
Policing & Public SafetyAll

A new 911 alternative for mental illness cases ignores the key role cops play in emergencies.

Next year, Americans will start hearing a great deal about 988, a new alternative to 911 for “Americans in crisis to connect with suicide prevention and mental health crisis counselors.” 

Its purpose: to isolate such cases so that they can be responded to in a more specialized fashion — with social workers and, in some cases, specially trained cops, as opposed to just a random officer who happens to be closest to the emergency. Advocates believe that the new system may lead to fewer mental health-related shootings by police and less involvement of the mentally ill in the criminal justice system. 

But after 30 years of experience with enhanced police training in techniques such as de-escalation, cities remain uncertain about what works, and to what degree. We should not expect social services providers, who don’t always garner much respect from the population they’re trying to help, to perform miracles on the street. 

Mental health emergencies are estimated to make up anywhere from 5 percent to 20 percent of police calls for service. Sending out police to respond to such calls is often said to be wasteful and dangerous. In the United States, 200 to 250 fatal police shootings that are in some way mental health-related happen each year. Fatal police shootings of mentally ill people are tragic but rare. Spread across a nation of nearly 20,000 law enforcement agencies, 200 to 250 incidents annually translates to very few per jurisdiction per year, even in big cities — and, in most places, zero. The rarity of fatal shootings of mentally ill people explains much of why we know so little about how to stop them. 

Pushes to reform response protocols are heavily premised on the idea that police are prejudiced toward mentally ill people — they think they’re violent, when they’re not. So cities have cops take time off from their patrol duties to listen to mental health professionals give lectures about anxiety, PTSD, personality disorders, and “stigma.” But being force-fed lessons about how most mentally ill people aren’t violent serves as poor preparation for how to handle mentally ill people who demonstrably are violent. Between January 2015 and June 2021, the Washington Post documented 1,474 fatal police shootings that were somehow mental health-related. In 916 of those cases (62 percent), the victim was attacking someone and was usually armed with a gun or knife. 

The essence of alternative response protocols is persuasion. Advocates want to see cops resort less to force when handling tense situations. The situations in which persuasion will be most effective are those least likely to result in tragedy. Conversely, there could scarcely be worse conditions for persuasion than situations involving a man with untreated psychosis armed with a knife and charging at a cop. Anti-police activists heap scorn on the quality of the average officer, while also promoting a superhero conception of policing that implies near-magical powers of persuasion. 

Nor should we expect that social services personnel, in dangerous situations, will excel at persuasion. Police-defunding advocates exaggerate the degree to which mentally ill people like social services personnel, who are often seen, by the population they’re employed to help, as paternalistic and unreliable. Advocates also expect too much from “peers” — people who have overcome their mental illness and are now employed to help others do the same. It’s presumptuous to believe that someone with one kind of experience of mental illness will possess special influence over someone with an entirely different experience and whom he has only just met at a crisis scene. The appeal of social workers and peers, as response team members, is mainly negative: They are not armed and not authorized to arrest. 

Knowledge is power in fast-moving crisis situations. The most valuable form of knowledge may simply be that of a community and its members, which is not gained through listening to lectures about stigma but through experience: walking a beat or responding to hundreds of calls on patrol, attending barbecues, and so on. Giving cops knowledge of the community requires a serious commitment on the part of governments because experience is an expensive mode of instruction. “Community policing,” rightly understood, is labor-intensive. 

Some research suggests that more than 90 percent of patrol officers have had encounters with mentally ill people. What percentage of the general population has substantial experience with people with mental illness, especially the particularly disturbing psychotic variety? What percentage of “mental health professionals” has substantial experience with people with untreated psychosis and violent tendencies?

We will always need cops to be involved in responses to mental health emergencies. Transportation alone guarantees it. Helping someone in crisis often entails taking him to another location, such as a jail, hospital, or crisis stabilization facility. That will often require the assistance of police. We could instead hire entirely separate and new teams of “crisis transport security officers,” but if we did that right, they’d resemble cops in many ways. Social workers sometimes welcome the presence of cops on the scene of crises because not having to worry about their personal security helps them focus on their particular expertise. 

Cops, for their part, would just as soon not have to deal with mental health emergencies. But it’s not true to say that they’re unqualified to do so. Police have a great deal of hard-won knowledge about the nature of untreated mental illness that they can usefully bring to bear to resolve particular crises, or as contributions to the broader debate over mental health policy reform. Mental health emergencies are too important to be left to the experts.

This piece originally appeared at the New York Post


Stephen Eide is a senior fellow at the Manhattan Institute and contributing editor of City Journal.

Photo by tzahiV/iStock