Cops don’t want to deal with people having a psychotic episode any more than the people who call because someone is having a mental health crisis want cops to kill them. The problem was one of default. Who else can you get to respond? In New York City, there’s a standing army of NYPD to take the call, but no smaller army of mental health personnel on top of the cops to respond. So they tried an experiment and it turned out pretty well.
The B-HEARD program — it stands for Behavioral Health Emergency Assistance Response Division — launched in a portion of Harlem last month and has sent teams of three unarmed, behavioral health specialists to respond to more than 100 911 calls.
Between June 6 and July 7, 911 dispatchers rerouted about 25% of all mental health-related calls to B-HEARD teams, according to the city’s data. Once the teams arrived on scene, about 95% of the people in crisis accepted medical assistance. When there is a traditional response from police and EMS workers, about 82% of people in crisis accept help.
The program was modeled after the Oregeon CAHOOTS (Crisis Assistance Helping Out On The Streets) program, where mental health professionals were sent in lieu of cops.
These programs also aim to reduce violent encounters between police and people in crisis, while easing strain on police resources. A 2015 study by the Treatment Advocacy Center found that for people with an untreated mental illness, the risk of being killed by law enforcement was 16 times higher than the rest of the population.
Good for cops. Good for people in mental health crisis. Good for everyone. But a sample of 100 calls barely scratches the surface, and shows the a critical aspect of the program working is vetting calls for those which are strictly mental health where there is no risk of violence. That requires extreme care by the referring 911 operator and a lot of luck. As any cop will tell you, a person going through a psychotic episode can turn deadly at any moment. It’s not that they all do, or even most do, but when it happens and you’re not prepared for it, bad things happen.
Once this ramps up, as it probably should, there will be mistake, accidents and, ultimately, a dead or maimed mental health person who tried their best to help and things went south. Will all the city 911 operators be as careful as those in this pilot program? Will they care? Will they have the knowledge to glean those calls that are safe from those that pose a risk of harm? What happens when a mental health person gets beaten or killed? What happens when a few do, as there are a lot of calls in NYC and probabilites will eventually mean that this will happen. Will mental health personnel still want the job? Will they remain as kind and empathetic, or will they, like cops, start worrying about the First Rule?
NYC’s pilot program allowed for officers to be dispatched to a mental health emergency if there was a threat of violence or a weapon involved. B-HEARD teams requested police assistance just seven times in the program’s first month, according to the data, while the NYPD requested assistance from the behavioral health teams 14 times.
The idea of cops and B-HEARD teams (maybe they could come up with a shorter and less pretentious acronym?) working together is another variation on the theme, where the cops will recognize and appreciate their limits when dealing with someone having a mental heal crisis and bring in people better equipped to help without killing them. Cops don’t like crazies and are more than happy to shift them off their plate, provided they don’t feel threatened before the team arrives and kill them in the meantime.
These mental health teams aren’t going to replace cops, and they will be an additional bureaucracy and expense on top of the current huge and very expensive numbers. It’s possible that if it works well, it could serve to reduce the number of cops, but that’s going to be a long time in changing because you never know when you’ll need 100 cops instead of 2, and when you do, you need them available upon command. At least that’s the way the brass and pols see it, as nobody wants to tell the public that it would have responded but they cut the size of the force.
Even so, this will still only serve a limited purpose. Not all calls involve mental health crisis. Not all calls involve non-violent requests. And a lot of mental health calls have a risk of violence which makes sending out unarmed mental health workers a dubious option. People promoting these ideas as a panacea are not only unhelpful from a reform perspective, as people will reject them when they fail to live up to the grossly exaggerated promises being made, but fail to explain that they will be imperfect, expensive and carry risks that should be fully understood before leaping blindly into reform.
The issues with police, not to mention prisons, becoming the “mental health” provider of last resort was also the product of reform, when horrible institutions like Willowbrook were shut and the mentally ill were given their right to be free and to reject treatment. As with many current notions, it was a nice idea that had one significant failing. It left the mentally ill, and their families, with no place to turn by the cops. That was a bad option.
Mental health teams are a much better option, but as much as they will help many and save lives, they too will have their problems and failures. If we know and accept that going in, it will come as no shock when it happens and we can appreciate the benefits they provide without cursing their imperfections.
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