How sending mental health responders instead of police could save Black lives
“One-quarter of fatal police shootings involve people with mental illness.”
New York City Mayor Mayor Bill de Blasio and first lady Chirlane McCray announced a pilot project this week that experts say could save lives by using mental health professionals instead of police in response to 911 calls that may be mental health emergencies.
The program, modeled after the CAHOOTS program in Oregon, comes after months of historic protests calling for an end to police brutality, particularly in the context of Black lives lost at the hands of police.
“Of the more than 170,000 mental health calls to 911 last year, an estimated one call every three minutes, the majority of concerns were people who just needed help — no indication of violence at all,” said McCray.
“Making health-only teams the default response will reduce the number of times police respond and ensure that people get the physical and mental health care they need quickly,” McCray said.
Although people often call 911 during mental health emergencies, police officers are less capable of managing a mental health crisis than a trained medical professional.
Last month, Philadelphia police were called to the scene of a 27-year-old Black man, Walter Wallace Jr. Wallace was experiencing a violent psychological episode, and holding a knife. He was fatally shot by police, prompting days of protests in the city.
“One-quarter of fatal police shootings involve people with mental illness. Half of those deaths occur in people’s homes,” said Dr. Matthew Goldman, medical director for Comprehensive Crisis Services at the San Francisco Department of Public Health.
“There’s clearly a need for a mental health specialty response, as evidenced by the killing of Walter Wallace,” Goldman said.
People with behavioral health needs are 16 times more likely to be killed by police than the general population, Dr. Jack Rozel, president of the American Association for Emergency Psychiatry, said
“If I have a heart attack or a diabetic emergency and my wife calls 911, the odds are overwhelmingly likely that I will end up on my way to the emergency department. If I am suicidal and I call 911 for help, there’s a good chance the police will respond,” said Rozel. “There’s a lot of ways it can go wrong.”
Psychiatrists agree that asking police to respond to acute mental health crises is not appropriate for several reasons.
“Police are not clinicians,” said Dr. Stephanie LeMelle, director of Public Psychiatry Education at Columbia University. “Asking them to make a clinical assessment or to intervene with a person who is experiencing emotional distress is not reasonable. In fact, it can be detrimental to both the individual in need of help and potentially to the police themselves.”
According to a Washington Post analysis, Black people are 2.5 times more likely to be shot and killed by the police than their white counterparts. And according to The Counted Project, in 2016, Black men ages 15 to 34 were nine times more likely than other Americans to be killed by law enforcement officers. For a Black person with a mental health issue, the risk could be even higher.
“Having mobile crisis teams, staffed with crisis-trained behavioral health clinicians, who are culturally aware of systemic bias and racism, who can respond quickly, assess, deescalate, treat and assist in transporting a person to the correct level of care, instead of involving the police, could save lives,” said LeMelle.
“By removing the armed personnel from the mental health crises, including those of Black individuals, the risk itself would decrease,” Goldman said. “Even if a mental health clinician were to have bias, the absence of a potential lethal force and the presence of clinical expertise and linkage to appropriate care is much more likely to result in positive outcomes. This is what anti-racist policy means.”