In May 2023, London Metropolitan Police Commissioner Sir Mark Rowley wrote a letter outlining his plans for officers to no longer respond to emergency calls related to mental health emergencies unless “there is an immediate threat to life.”
“We are failing Londoners twice,” wrote Rowley. “We are failing them first by sending police officers, not medical professionals, to those in mental health crisis, and expecting them to do their best in circumstances where they are not the right people to be dealing with a patient. We are failing Londoners a second time by taking large amounts of officer time away from preventing and solving crime as well as dealing properly with victims, in order to fill gaps for others.”
The Metropolitan Police will adopt an operational model developed by the UK’s Humberside Police titled Right Care, Right Person, which is aimed at making sure the right agency deals with health-related calls, instead of the police being the default first responder as is currently the case in most areas in the United Kingdom. Discussions with partners in ambulance, mental health, acute hospitals and social services are being held to build, test and agree on the approach so that there is a clear and shared understanding of when police will be deployed.
Should police in the United States follow the example of the London Metropolitan Police and stop responding to mental health crisis calls? That is the question our experts debate in this month’s State Your Case. Share your opinions in the comment box below.
The ground rules: As in an actual debate, the pro and con sides are assigned randomly as an exercise in critical thinking and analyzing problems from different perspectives.
Our debaters: Jim Dudley, a 32-year veteran of the San Francisco Police Department where he retired as deputy chief of the Patrol Bureau, and Chief Joel Shults, EdD, who retired as chief of police in Colorado.
Jim Dudley: The United Kingdom could be pioneering a significant change in its decision to stop dispatching law enforcement officers to calls for service involving people in mental crisis. While I have not seen the details of the policy, in terms of lowering the possibility of serious injury or death to the individual in crisis, or the police officers themselves, I am all in.
Police have been facing ongoing criticism for their handling of calls for service involving individuals with mental illness. It’s evident that law enforcement officers lack the specialized training of mental health clinicians and counselors, prompting the question: Why not allow these professionals to address such issues instead? Critics have consistently argued that police often fail to effectively de-escalate these situations, suggesting that many fatalities could have been avoided with a different approach.
My hope is that once clinicians become engaged, they will see the situation through to its resolution. It would be counterproductive if clinicians initiated a response, only for it to escalate into a critical incident necessitating an emergency call for police intervention – likely involving force.
Joel Shults: The debate on non-law enforcement (NLE) response to mental health emergencies may or may not be informed by the UK’s new policy for the largest police service in that country. As with our pros and cons in the U.S. debate, law enforcement is the best response except when it isn’t, and a mental health professional response is the best until it isn’t.
One notable distinction between the cultures of our two continents is the prevalence of firearms, making any call in the U.S. inherently riskier for non-law enforcement responders compared to the UK. Additionally, it’s unclear how the availability and proficiency of mental health practitioners in the U.S. stack up against those in the UK. Are we comparing social workers, chaplains, Ph.D. psychologists, or recent graduates with bachelor’s degrees in psychology? These factors make direct comparison challenging.
While mental health services are provided for free under the UK’s National Health System, a study by the UK parliament shows wait times for services range from four days to 228 days. There is no set funding amount for mental health services by jurisdiction, creating a patchwork pattern of funding shared by the U.S. As with the U.S., there is no guarantee that services are available 24/7 and I don’t know how pulling the rug out from under those in crisis with no police response will pan out.
In-patient services and self-referrals can only be processed through a physician, whereas admission is somewhat easier in the U.S., although we still have many barriers to services. MET officers’ time with these clients involves waiting a long time for a disposition, whereas for most U.S. officers, we can deal with the immediate crisis, make a referral (if no criminal investigation), and hand off the case pretty quickly to NLE resources. So, while I’ll be interested in a follow-up study a few years from now about how the MET’s policy works out for public safety and those needing services, I’m not sure the MET model works as a U.S. strategy.
Jim Dudley: Joel makes great points, but all things considered, the policy should dictate that experienced teams be sent to the calls, rather than a newbie civilian clinician counselor. I’m of the opinion that like prosecutions, we leave that to District Attorneys. I always liked the saying, “We only catch them – we don’t cook ‘em or clean ‘em.” We aren’t responsible for what happens after an arrest. We can only make the best case possible and turn it over.
Still, the question stands: “Should LE stop responding to calls for service involving the mentally ill?” In that regard, maybe it’s time to step away from an issue better to be left to trained professionals. We actually go back to the pre-Ronald Reagan policy of how we should deal with people with mental illness in public. Dealing with these issues was an add-on or “mission creep” from the original duties of focusing on crime.
The public perception of how police deal with those in crisis is hardly ever good. The programs that involve mental health professionals have shown great promise, like the CAHOOTS program in Oregon and other states. It is time to let these programs fly solo. With a security component, like the old-timey white coat orderlies, the public can get what they’ve been asking for, an unarmed response to a medical not criminal case.
Joel Shults: One problem I have is questioning the premise. Is it really that big of a problem for police to respond to mental health calls? The greatest criticism of police competence derives from high-profile encounters that result in fatal outcomes, most of which involve dangerous behavior that prompted the 911 call in the first place and those calls would be refused by NLE responders anyway.
In several so-called success stories I have read about NLE response, the responders did mostly what a police officer would have done. Granted, there would have been a saving of police resources had someone else handled the call, but if cost savings is a major factor and governments are paying for the NLE responders, that might be a null result.
Keeping cops in service and not tied up on mental calls may also be a false benefit. I question the statistics touted by most pilot programs. Quoting my article: “Gathering data on the effectiveness and efficiencies of programs is essential for budgeting and staffing. Optimistic expectations that fewer police will be needed with the addition of an NLE asset, or that major cost savings will occur are likely to be unrealized. Deconstructing total manpower needs before and after the initiation of NLE response cannot be a simple matter of counting the NLE calls and subtracting that number from total police calls.” I visited Eugene, Oregon to explore the CAHOOTS program. Most models in the U.S. have been co-responders rather than totally alternate responders. CAHOOTS is an alternate response rather than a joint response. It certainly has its merits and seems to be as close to the UK proposal as I’ve seen. As I pointed out in that piece, those responders have radio contact with police in case there is a need for law enforcement. Training call-takers is absolutely critical because a mistake in that assessment can be fatal.
Police are going to make similar referrals that an NLE worker might make, especially if there is a bit of an increased training curve for officers who actually have been, on the whole, pretty darned effective at dealing with this demographic for years. Let me be clear that I’m not categorically opposed to response alternatives, but I’ll be interested to see whether we can quantify cost savings, safety and provision of services to show a distinct advantage to excising this kind of call from the police, especially using the UK model in American culture.
Jim Dudley: The idea of a professional civilian mental health response is a good one. Let’s be clear on the criteria, however. Dispatch the civilian response unit to calls of people walking into traffic while ranting, to the individual screaming on a sidewalk in the rain, wearing nothing but pants, or even to the person who brings a dead raccoon onto a restaurant table. Keep calling the police in cases that involve violence and criminality. Let jail psych services sort those.
Police1 readers respond
- Taking the burden off the officer for response to non-criminal mental health incidents is a good first step. Police officers are not trained to deal with these types of issues at anything more than the “Band-Aid” level of care. In my city, we handled approximately 1,700 calls with some type of mental health component associated. Of those, 70% resulted in a formal mental health detention under our state’s law. The average time to handle one of these non-criminal detentions ranged from 1 hour to as high as 6 hours, depending on the circumstances and the handling mental health facility. We are already short-staffed. That is not going to get any better for at least the next couple of years. Most of these problems are non-criminal in nature and do not involve a threat to anyone other than the subject. I 100% believe we (the police) should get out of the mental health response role.
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No, the police should continue to respond to mental health calls. I mean if the police stop responding to those calls, who else is going to respond? Some of the subjects suffering from mental health issues are violent and I think the police must continue to respond.
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Yes. In 1975 the U.S. Supreme Court ruled in O’Connor v. Donaldson, that local law enforcement cannot constitutionally arrest or otherwise confine an individual who was not an immediate danger to himself or others and could live safely by themselves or with the help of willing and responsible family members. Any reading of recent cases focusing on police-citizen contacts with mental health issues demonstrates that police need to steer clear of these contacts and confrontations.
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If and when an effective and sustainable cadre of clinicians are available 24/7/365 to conduct response to the field to handle persons in mental health crisis, then, and only then, can police be relieved of this responsibility. (Of course, unstable scenes should have police there as a security/safety element.) Police are the governmental response of last resort. And while police do an admirable job in handling these cases under ordinary circumstances, this responsibility ought not be that of the police. It’s like sending a plumber to handle an electrical problem, a different wheelhouse. Police just don’t have the tools to steer a patient into effective treatment. Very definitely, mission creep has occurred where the social systems handling the mentally ill became overwhelmed and are simply unable to effectively handle these cases. The problem remains that nestled into many of the calls that police respond to have mental illnesses at their root cause. This is hard to discern. For these reasons, co-response is the starting point for most places and incidents. It is difficult and fraught with liability to discern the exact nature of a call from the 911 caller and because public safety hangs in the balance. Accordingly, a co-response is probably called for in most cases.
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Respond, but a mental health counselor should take primary on scene.
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Having responded to many calls for service with mentally disturbed persons, both with and without crisis worker assistance, I can say this … having police officers on the scene initially does a few things, helps to prevent injuries to both civilians present and the person in crisis, also reduces the prospect of escalation of danger to all involved. If crisis workers become over-challenged, they would then need to seek assistance from the police, putting everyone in danger while waiting for their assistance. On the other hand, if the police need assistance from crisis workers they are better able to control the situation while waiting for their arrival. If the safety of all involved is a priority, as I believe it should be, then I believe having the police on the scene should be the main concern of law enforcement’s policy.
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Yes, we should stop. In our state, the Mental Health Act was changed to no longer allow police officers to take a person into custody for a Mental Health Commitment unless they have personal observation of the issue – previously we only needed probable cause. Given that our EMS providers do not even have that much authority – i.e., NONE – it’s clear that another “entity,” trained and equipped, needs to respond. The fact that we do not have such an entity needs to be placed back onto our legislators (who have not responded to various queries about this issue, nor proposed a solution). It’s a lose-lose for LE and EMS.
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I supervise a patrol division in a large city that could get up to 40 calls a day for suicidal subjects/check welfare of someone who has committed no crime. Most often, the person wants no help from the police but a third party has intervened and the true goal for the person has been lost in translation. Supervision and education of case law are critical for all the officers who must make the decisions to respond or mitigate from a phone or mental health resource. A person has every right to be free and there is no law in the country that supersedes the Constitution’s Fourth Amendment. As morality is concerned, we must base our decision-making on law, ethics and policy and with that, someone who is only a threat to themselves must be left to the mental health resource to attempt to intervene with training. Police will respond when another person is in immediate danger and safety priorities are understood and tactics will be implemented. This shouldn’t be a hard debate, it’s the law.
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