"DEFUNDING THE POLICE"
AND PEOPLE WITH MENTAL ILLNESS
AUGUST 2020

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Policing and Mental Health
The recent killings of George Floyd and many other Black Americans by law enforcement
officers have amplified the national discussion about the role of the police in our
communities. Calls to “defund” the police have prompted urgent examination of what
“public safety” means and brought into sharp relief the cost of having police handle
situations better addressed by people with a different skill set and perspective. Many activists
and community leaders are urging that resources be redirected from law enforcement to
housing, education, and social services to help dismantle institutional racism in the United
States. We strongly support a reduced role for the police and additional spending on
community-based measures that promote the well-being of all.
We urge communities, when implementing such reforms, to consider the role law
enforcement plays in responding to people with mental illness. In far too many
communities, police take the lead in responding to people with mental illness in crisis or in
need, with tragic consequences, especially for Black people with mental illness. As many as
one-quarter of the fatalities from police shootings are people with mental illness. 1 Black
people with mental illness are at great risk of dying at the hands of the police. 2
The shootings of Deborah Danner and Marcus-David Peters illustrate the problem. In both
cases, police encountered an individual with mental illness. Instead of calling on mental
health personnel to engage Danner and Peters, police took the lead. A different response
could have spared both individuals from deadly har m.

Deborah Danner, a 66-year-old Black woman with mental illness, lived in an
apartment in New York City. The police went to her building after a report that
she was acting erratically, yelling in the hallway of the building and tearing posters
off the wall. She was in her apartment when police arrived. Police coaxed her from
her bedroom and then rushed forward to grab her. She retreated back to her
bedroom, jumped on the bed, pulled a bat from her bedclothes, and then took a
batter’s stance, wielding the bat. An officer fired two shots, killing her. 3

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Marcus-David Peters, a 24-year-old Black man, was naked and driving wildly in
Richmond, Virginia, when he slammed into a line of trees. The police officer who
arrived at the scene recognized that Peters was mentally unstable. When Peters,
unarmed, ran from his car into traffic, he was knocked down by a car, got back up,
and approached the officer, who ordered him to get down on the ground. When
Peters did not comply, the officer tased him and shot him twice. Peters died.
At a press conference after Peter’s death, Richmond’s frustrated police chief
complained that his officers are often placed in difficult situations that require
them to “wear different hats.” Police training cannot adequately prepare them. “I
look at what it would take to become a psychologist, psychiatrist, mental-health
counselor. Five to eight years of training. Our police department gives our officers
40 hours. Five to eight years, and we get 40 hours,” he said. While increasing police
training can improve police responses to people with mental illness, the chief is
right that training is not the cure. The fundamental problem is having police, rather
than mental health personnel, address the situation. 4

Because of over-policing, people with mental illness, especially those who are Black, have
disproportionately suffered both needless death and high rates of incarceration.
Approximately 20% of jail inmates and 15% of prison inmates have a serious mental illness, 5
although people with serious mental illness comprise only 4-5% of the population. 6 Two
million people with a serious mental illness are booked into jails each year, 7 and the risk of
being jailed is particularly high for Black people with mental illness. 8
A contributing cause of these high figures is the widely acknowledged dysfunction of our
public mental health system. Mental health services are limited and available to only a
fraction of those who need them. In especially short supply are services with a good track
record of success for people with the most significant needs. 9 Black people with mental
illness are especially poorly served, and a large percentage of them receive no services at all. 10
As a result, Black people are disproportionately reliant on emergency rooms for mental
health care.11 They are also at greater risk for being involuntarily committed to a hospital,
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and are more likely to have a police encounter when experiencing a mental health
crisis.12
About 1 in 20 police encounters involve individuals with mental illness. 13 Police are deployed
in a wide variety of situations involving people with mental illness. Few of these situations
threaten public safety. Police respond when families are concerned about a loved one, when
people with a mental illness experience a mental breakdown, when homeless individuals with
mental illness are lingering where they are not wanted, when people with mental illness fail
to obey staff in facilities or schools, and when people with mental illness engage in
inappropriate or odd behavior in public because of alcohol or drug use. Police are also
deployed to transport people with mental illness to hospitals, typically in handcuffs, when a
doctor or judge directs that they receive involuntary care. When police are involved, arrest
and incarceration tend to follow and, far too often, the use of deadly force.
We must end this overreliance on the police, especially in predominantly Black communities,
and we must invest in public mental health systems, expanding their capacity to deliver
community-based mental health services, housing assistance, substance use treatment, and
income support. Schools must take a similar approach, ending their overreliance on law
enforcement officers, “school resource officers,” and investing instead in professional staff,
positive approaches to improving behavior, and better services. Many cities and counties
have key elements of a well-functioning public mental health system. 14 Highly effective
models exist, including those reflected in settlement agreements with States entered into by
the U.S. Department of Justice and the Bazelon Center. 15
As we build capacity, we must heed the voices of people with mental illness, including those
who represent the racial, ethnic, gender, linguistic and other important types of diversity in
our communities. Far too often, their voices have been excluded or ignored when changes
are formulated, implemented, and evaluated. In addition, more individuals with lived
experience must be employed in mental health systems. Their experience and perspective
enable them to play a unique and critical role in the service system. Peers develop
relationships of trust, support individuals in obtaining the treatment and other help they
need, and help prevent and resolve crises. 16
Examples of successful efforts exist. Some cities have deliberately reduced the role of the
police in responding to people with mental illness. In the Eugene, Oregon, CAHOOTS
program, a medic and social worker, both unarmed, are dispatched instead of the police to
most situations involving people with mental illness. Police join them in some situations,
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including if someone is in immediate danger or presents a clear threat to others. 17 The
program reports that each year it saves the city $8.5 million in public safety costs and $14
million in ambulance and emergency room costs. 18 Similar programs are underway in
Denver, Oakland, and Portland. A greater number of communities are investing in a
functional equivalent of CAHOOTS, mental health crisis teams that can be dispatched by
911 or law enforcement.

Solutions for A Better Future
To minimize the police’s role in responding to people with mental illness, communities can
implement the following three changes.

Re-direct requests for police intervention. Calls to 911 and the police should be
screened to see if the person about whom the call is made is known to or appears to have a
mental illness. In most cases, such calls should be redirected and handled entirely by a unit
within the mental health system. In some cases, it will be appropriate for the police to
respond jointly or as backup for the mental health system. 19 Communities should adopt
policies and provide training to identify situations that can be handled entirely by the mental
health system and situations, such as those involving violence to others, in which the police
should also respond. The mental health system, and not police, should be deployed when the
individual is suicidal and presents no risk to others.

Capacity for a mental health response. Within the mental health system, there should
be a unit that functions much like 911, receiving and responding to calls directly received,
calls redirected from 911, and calls from the police. Some calls can be resolved by providing
advice, making referrals, or providing transportation. Others will require dispatching mobile
mental health staff. Typically, such staff are organized as mobile crisis teams, which respond
quickly and de-escalate situations.20
In addition, there should be an array of facilities available for crisis care, including respite
apartments,21 apartments for short term stays staffed by mental health personnel including
peers,22 walk-in or drop-off crisis centers (scattered in neighborhoods in urban areas), 23 and
inpatient hospital care.24 Short term detox facilities should be available as well, followed up
by offers of treatment for substance use disorders. 25

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Follow-up care. After the immediate issue is resolved, the mental health system must
follow-up, checking to make sure the individual has access to needed services on an ongoing basis. People who receive crisis care often lack access to on-going mental health
services. If the person was regularly receiving services but becomes the subject of a call to
the mental health crisis unit, 911, or the police, those services must be reviewed and likely
enhanced. Individuals with the most significant mental health needs should have access to
housing assistance, intensive case management, peer support services, assertive community
treatment, and supported employment. 26

Conclusion
Policing must be reformed and removed from tasks for which it is ill-suited. Excessive
policing and excessive use of force are a threat to people with mental illness, especially Black
people with mental illness. We should dramatically reduce the role of the police in the lives
of people with mental illness. As the same time, mental health services should be expanded
and racial disparities in their delivery eliminated. All services must reflect the voices and
concerns of the full diversity of people with mental illness.

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References
See Wesley Lowery et al., Distraught People, Deadly Results, Wash. Post (June 30, 2015),
https://www.washingtonpost.com/sf/investigative/2015/06/30/distraught-people-deadly-results/ (finding
that 27% of people killed by police in the first half of 2015 were in crisis); Amam Z. Saleh et al., Deaths of
People with Mental Illness During Interactions with Law Enforcement, 58 Int’l J. of L. and Psychiatry 110, 112-114
(2018) (estimating that 23% of people killed by police have a psychiatric disability). See also Overlooked in the
Undercounted, Treatment Advoc. Ctr. (Dec. 2015), https://www.treatmentadvocacycenter.org/overlooked-inthe-undercounted (estimating the risk of death as sixteen times greater than for people without mental
illness); Shaun King, If You Are Black and in a Mental Health Crisis, 911 Can Be a Death Sentence, The Intercept
(Sept. 29, 2019, 7:00 AM), https://theintercept.com/2019/09/29/police-shootings-mental-health/ (“Studies
show that as many as 50 percent of people killed by American police had registered disabilities and that a
huge percentage of those were people with mental illnesses”); Robert Laonga, Report: Mentally Ill are in Nearly
40 Percent of South Bay Police Shootings, The Mercury News (last updated May 14, 2018, 9:03 AM),
https://www.mercurynews.com/2018/05/11/report-mentally-ill-are-in-nearly-40-percent-of-south-baypolice-shootings/ (“a new civil grand jury report reveals that nearly 40 percent of officer shootings in Santa
Clara County involve someone who is mentally ill”).
1

Two circumstances contribute to this result. First, the over-policing of Black people and communities, and
second, the high percentage of people killed by police shootings who have a mental illness. See Camille A.
Nelson, Frontlines: Policing at the Nexus of Race and Mental Health, 43 Fordham Urban L. Rev. 615, 621 (2016)
(finding that Black people report higher rates of serious psychological stress than White people, and “people
who exhibit mental health challenges are more likely to attract heightened police scrutiny and reasonable
suspicion; they are less likely to respond to police in ways that comport with police behavioral expectations
and may, thereby, prompt unfortunate police escalation.”); King, supra note 1 (“young black men with
mental illnesses are in the single most at-risk category in the nation for fatal police violence”).
2

Matt Stevens & Joseph Goldstein, New York City Agrees to Pay $2 Million to Family of Mentally Ill Woman Killed
by Police, N.Y. Times (Dec. 13, 2018), https://www.nytimes.com/2018/12/13/nyregion/deborah-dannersettlement.html.
Danner wrote a compelling essay on her experience with mental illness, in which she mentioned the
possibility of being killed by the police. Deborah Danner, Living with Schizophrenia, N.Y. Times (Jan. 28,
2012), https://www.nytimes.com/interactive/2016/10/19/nyregion/document-Living-With-Schizophreniaby-Deborah-Danner.html.
3

Similar stories unfortunately abound.
Osaze Osagie, a 29-year-old Black man, was shot in his home in State College, Pennsylvania, by police
performing a mental health “wellness check.” Osagie, living in his own apartment and having a rough time,
sent texts to his family suggesting he might harm himself. They called 911. The police reported that Osagie
had a knife he refused to put down. When he walked toward the officers, they tased and then fatally shot
him. King, supra note 1.
4

Theresa Sheehan, a woman of color in her 50’s, lived in a San Francisco group home for people with
mental illness. When a staff member checked on her one day, she told him to leave her room, threatened
him, and said she had a knife. He called the police to have her transported to a hospital. When two police
officers entered her room, she grabbed a small bread knife and yelled at them to leave. They retreated but
then re-entered the room with guns drawn in an effort to arrest her. Still holding the bread knife, Sheehan
yelled at the officers to go away. The officers shot her five times, once after she had fallen to the ground.
Remarkably, Ms. Sheehan survived, but with permanent injuries. City of S.F. v. Sheehan, 135 S. Ct. 1765,
1774 (2015). Her claims for damages pursuant to the Americans with Disabilities Act and Section 504 of
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the Rehabilitation Act were eventually settled. Alex Emslie, Landmark S.F. Case on Police Force and
Mental Illness Settles for $1 Million, KQED (Oct. 14, 2016), https://www.kqed.org/news/11129913/
landmark-s-f-case-on-police-force-and-mental-illness-settles-for-1-million.
Kayla Moore, a Black transgender woman with schizophrenia, was suffocated by Berkeley police when she
was held down on a futon during a struggle. Angela Ruggiero, Judge Throws Out Case of East Bay Transgender
Woman’s In-Custody Death, E. Bay Times (Mar. 28, 2018, 11:45 AM), https://www.eastbaytimes.com/
2018/03/27/judge-throws-out-case-of-transgender-womans-in-custody-death/.
Wayne Jones, a Black man with mental illness, was shot 22 times by police officers in Martinsburg, West
Virginia. He was stopped by police for walking in the street instead of on the sidewalk. The encounter
escalated. Jones was tased, kicked, and placed in a chokehold. When one of the officers felt a sharp poke on
his side and yelled that Jones had a knife, a semicircle of officers fired their guns and killed Jones. Emily
Davies, Family of Man Fatally Shot by Police Reaches $3.5 Million Settlement, Wash. Post (July 21, 2020, 5:43 PM),
https://www.washingtonpost.com/local/legal-issues/family-of-man-fatally-shot-by-police-reaches-35million-settlement/2020/07/21/da918e9a-cb6c-11ea-bc6a-6841b28d9093_story.html.
“Alfred Olango, a 30-year-old Black man, was killed by police after his sister called 9-1-1 seeking medical
assistance. Olango was suffering from a mental breakdown after the loss of a friend. He was behaving
erratically and walking through traffic—putting himself at risk. His sister called 9-1-1 seeking medical
assistance and told the dispatcher that her brother was mentally ill and unarmed. She called 9-1-1 repeatedly
over the 50 minutes it took [El Cajon, California] police to arrive on the scene, telling them that he needed to
be taken to a mental health facility. Olango was erratically pacing in the parking lot of a taco shop with his
hands in his pockets when the police arrived. Police officers and his sister repeatedly asked him to raise his
hands. He eventually pulled an electronic cigarette from his pocket in the direction of the police, at which
time one of the police offers discharged his firearm while another discharged his Taser, ending in the fatal
shooting of Olango.” Erin J. McCauley, The Cumulative Probability of Arrest by Age 28 Years in the United States by
Disability Status, Race/Ethnicity, and Gender, 107 Am. J. Pub. Health 1977, 1977 (2017).
“35-year-old Paul Castaway was shot and killed by police [in Denver] after his mother called 9-1-1. Castaway,
who had a history of schizophrenia and alcoholism, was holding a knife to his own throat when he was fatally
shot by police.” Id.
“In Oklahoma this past April, 17-year-old Isaiah Lewis, also naked and in a mental health crisis, was shot
and killed by police. This past June, Taun Hall called 911 for support with her 23-year-old-son, Miles,
who had a mental illness. Police shot and killed him.” King supra note 1.
Marcus Berzofsky & Jennifer Bronson, Indicators of Mental Health Problems Reported by Prisoners and Jail Inmates,
2011-2012 1, Bureau of Just. Stat. (June 2017), https://www.bjs.gov/content/pub/pdf/imhprpji112.pdf; How
Many Individuals with Serious Mental Illness are in Jails and Prisons?, Treatment Advoc. Ctr. (last updated Nov.
2014), https://www.treatmentadvocacycenter.org/storage/documents/backgrounders
/how%20many%20individuals%20with%20serious%20mental%20illness%20are%20in%20jails%20and%20p
risons%20final.pdf.
“Serious mental illness” is a term of art that refers to individuals who have particular diagnoses and whose
functioning is significantly impaired due to their illness. Serious Mental Illness and Serious Emotional Disturbance,
Substance Abuse and Mental Health Servs. Admin. (last updated Jan. 23, 2020), https://www.samhsa.gov/
dbhis-collections/smi.
5

Mental Illness, Nat’l Inst. of Mental Health (last updated Feb. 2019), https://www.nimh.nih.gov/health/
statistics/mental-illness.shtml. See also Kevin Martone et al., Olmstead at 20: Using the Vision of Olmstead to
Decriminalize Mental Illness 3 (Sept. 2019), http://www.tacinc.org/media/90942/olmstead-at-twenty_09-046

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2018.pdf (“[there is a] vastly disproportionate number of people with mental illness in the U.S. criminal
justice system”).
Contrary to a misguided and unfortunate public perception, people with mental illness, or serious mental
illness, are not more violent than the population at large. See Heather Stuart, Violence and Mental Illness: An
Overview, 2 World Psychiatry 121, 123 (2003) (“members of the public undoubtedly exaggerate both the
strength of the relationship between major mental disorders and violence, as well as their own personal risk
… It is far more likely that people with a serious mental illness will be the victim of violence”); Mental Health
Myths and Facts, MentalHealth.gov (last visited July 14, 2020), https://www.mentalhealth.gov/basics/mentalhealth-myths-facts (“The vast majority of people with mental health problems are no more likely to be violent
than anyone else. Most people with mental illness are not violent and only 3%-5% of violent acts can be
attributed to individuals living with a serious mental illness. In fact, people with severe mental illnesses are …
more likely to be victims of violent crime than the general population”).
Moreover, people with mental illness do not engage in criminal behavior more than people without mental
illness. “Mental illness itself is not predictive of criminal behavior, and research suggests that crime rates for
people with mental illness are similar to those of the general population.… As with the general population,
there are people with mental illness who might commit criminal acts irrespective of their mental illness….
The risk factors that predict crime among people with serious mental illness are the same risk factors that
predict crime among people without serious mental illness.” Martone, supra note 7, at 3-4.
Mary Giliberti, Treatment, Not Jail: It’s Time to Step Up, Nat’l All. on Mental Illness (May 5, 2015),
https://www.nami.org/Blogs/From-the-CEO/May-2015/Treatment,-Not-Jail-It%E2%80%99s-Time-toStep-Up. The people with mental illness who are being arrested and jailed are also cycling in and out of
emergency rooms and psychiatric hospital units. In many communities, there is a discrete and identifiable
group of poor and poorly served people with mental illness, often homeless, who cycle in and out of jail,
emergency rooms, and hospital beds, at great cost to the taxpayers.
7

Studies show that for less than what is now being spent on these individuals, they could be provided housing
and effective community-based mental health services. See Alexi Jones & Wendy Sawyer, Arrest, Release, and
Repeat: How Police and Jails are Misused to Respond to Social Problems, Prison Pol’y Initiative (Aug. 2019),
https://www.prisonpolicy.org/reports/repeatarrests.html (finding that investment in community-based
mental health and substance use treatment “is estimated to yield a $12 return for every $1 spent, as it reduces
future crime, costly incarceration, and lowers health care expenses”). See also Frequent Users of Public Services:
Ending the Institutional Circuit, Corp. for Supportive Hous. 6 (2009), https://www.csh.org/wpcontent/uploads/2011/12/Report_FUFBooklet.pdf (calculating that investment in supportive housing saves
between $2,953 and $7,231 in incarceration costs per person placed in that housing).
Black and African American Communities and Mental Health, Mental Health Am. (last visited July 14, 2020),
https://www.mhanational.org/issues/black-and-african-american-communities-and-mental-health.
8

9 See Martone, supra note 7, at 5 (“Throughout the country, communities lack the capacity to provide intensive
community-based mental health services, including Assertive Community Treatment, mobile crisis services,
intensive case management, peer outreach and support, and supported housing, all of which have been
proven successful in reducing arrest and incarceration as well as other forms of institutionalization. For
people with mental illness and co-occurring substance use disorders, there is not enough medication-assisted
treatment, detoxification services, or peer outreach and support, among other treatment options.”); id.
(“Unfortunately, throughout the United States, inadequate community-based treatment options exist for
individuals with mental illness. Consequently, too many people with mental illness end up in crisis, landing
them in much more restrictive settings than needed, including emergency rooms, hospitals, and jails.”); id. at 3

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(“a disproportionate number of people with mental illness are incarcerated in jails and prisons, segregated
from society for offenses that could well have been prevented had they had access to appropriate communitybased services and supports.”); id at 5 (“Psychiatric crisis services are often nonexistent or insufficient to
respond to, divert, or refer individuals back into the mental health system, leaving law enforcement
professionals with the dilemma of having to arrest a person because no treatment diversion option exists.”);
Robert Bernstein, Ira Burnim, and Mark J. Murphy, Diversion, Not Discrimination, Judge David L. Bazelon Ctr.
for Mental Health L. 24 (July 2017), http://www.bazelon.org/wp-content/uploads/2018/07/MacArthurWhite-Paper-re-Diversion-and-ADA.pdf (“Public mental health systems are underfunded. While most
overwhelmingly embrace the core principles of deinstitutionalization and community mental health …
services such as Assertive Community Treatment and supported housing are in short supply and are reserved
for frequent users of psychiatric hospitals…. Often, this tendency results in mental health systems placing too
little priority on people with mental illness who are–or who are at high risk of becoming–justice-involved”);
Diversion to What? Evidence-Based Mental Health Services That Prevent Needless Incarceration, Judge David L. Bazelon
Ctr. for Mental Health L. 2 (Sept. 2019), https://secureservercdn.net/198.71.233.254/
d25.2ac.myftpupload.com/wp-content/uploads/2019/09/Bazelon-Diversion-to-What-Essential-ServicesPublication_September-2019.pdf (“Investing in community-based mental health services provides numerous
benefits, including a reduction in law enforcement intervention and incarceration”).
See U.S. Dep’t of Health and Human Servs., Mental Health: Culture, Race, and Ethnicity-A Supplement to Mental
Health: A Report of the Surgeon General (2001) (finding that racial and ethnic minorities have less access to
mental health services than do white people, are less likely to receive needed care and are more likely to
receive poor quality care when treated); Michelle Dalencour et al., The Role of Faith-Based Organizations in the
Depression Care of African Americans and Hispanics in Los Angeles, 68 Psychiatric Servs. 368, 368 (2017) (finding
that only 30% of Black people who need mental health care receive any services); Ronald C. Kessler et al.,
U.S. Prevalence and Treatment of Mental Disorders: 1990-2003, 352 N. Eng. J. Med. 2515, 2519 (2005)
(finding that among people with psychiatric disabilities, Black people are half as likely as white people to
receive any kind of mental health treatment even after adjusting for the disorder’s severity); Mental Health
Disparities: African Americans, Am. Psychiatric Ass’n 2 (2017),
www.psychiatry.org/File%20Library/Psychiatrists/Cultural-Competency/Mental-Health-Disparities/MentalHealth-Facts-for-African-Americans.pdf (“Only one-in-three African Americans who need mental health care
receives it”). See also Benjamin Le Cook et al., Trends in Racial-Ethnic Disparities in Access to Mental Health Care,
2004-2012, 68 Psychiatric Servs. 9, 9 (2017) (“disparities in mental health care remain wider than in most
other areas of health care services”).
10

See Lonnie R. Snowden et al., Disproportionate Use of Psychiatric Emergency Services by African Americans, 60
Psychiatric Servs. 1664, 1664 (2009) (“African Americans appear in emergency rooms for mental health
problems in numbers well out of proportion to their representation in the U.S. population at large”).

11

See Snowden, supra note 11, at 1665 (“[A]frican Americans are overrepresented among persons subject to
involuntary commitment and among persons admitted for inpatient psychiatric hospitalization”); Abigail
Adams, Black, Disabled and at Risk: The Overlooked Problem of Police Violence Against Americans with Disabilities,
Time (June 25, 2020, 8:56 AM), https://time.com/5857438/police-violence-black-disabled/ (“The
combination of disability and skin color amounts to a double bind”); McCauley, supra note 5, at 1980 (finding
that Black people with disabilities have a significantly higher probability of being arrested than other groups);
Jeffrey Swanson et al., Racial Disparities in Involuntary Outpatient Commitment: Are They Real?, 28 Health Affs. 816,
821 (2009) (“Rates of outpatient commitment per 10,000 were higher for blacks than for whites at every
level”).
12

See Martha Williams Deane et al., Emerging Partnerships Between Mental Health and Law Enforcement, 50
Psychiatric Servs. 99, 100 (1999) (estimating that 7% of all police contacts involve someone with a psychiatric
disability); Lodestar, Los Angeles Police Department Consent Decree Mental Illness Project: Final Report (May 28, 2002),
13

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http://assets.lapdonline.org/assets/pdf/consent_decree_mental_ill_finalrpt.pdf (estimating that 2-3% of
calls to the Los Angeles Police Department involve mental health); Jennifer L.S. Teller et al., Crisis Intervention
Team Training for Police Officers Responding to Mental Disturbance Calls, 57 Psychiatric Servs. 232, 234 (2006)
(finding that 6.55% of calls to the Akron, Ohio Police Department involve mental health). But see Alexander
Black et al., The Treatment of People with Mental Illness in the Criminal Justice System: The Example of Oneida County,
New York, Levitt Ctr. for Pub. Affs. At Hamilton Coll. (June 2019) at 9,
https://digitalcommons.hamilton.edu/cgi/viewcontent.cgi?article=1005&context=student_scholarship
(estimating that ten percent of police calls involve mental health).
These encounters can be especially time-consuming. See Laura Draper, Melissa Reuland, & Matthew
Schwarzfeld, Law Enforcement Responses to People with Mental Illnesses: A Guide to Research-Informed Policy and Practice
7 (2009) (finding that the Los Angeles Police Department spends 28,000 hours each month on calls that
involve someone in psychiatric distress).
Diversion to What? Evidence-Based Mental Health Services That Prevent Needless Incarceration, supra note 10, at 2. See
also Martone, supra note 7, at 3 (noting that “many states have implemented policies, programs, and new
housing options” that effectively serve people with mental illness in the community and “[w]hile progress has
been slow, the increased attention Olmstead has brought to individuals with mental illness … has resulted in
many more people with mental illness living in integrated, community-based settings”).

14

United States v. New Hampshire, No. 1:12-cv-53-SM (D. N.H. Feb. 2, 2014) (settlement agreement);
United States v. Delaware, No. 11-cv-591 (D. Del. July 15, 2011) (settlement agreement).
15

Peer Support: Research and Reports, Mental Health Am. (last visited July 23, 2020),
https://www.mhanational.org/peer-support-research-and-reports; City & County Leadership to Reduce the Use of
Jails: Engaging Peers in Jail Use Reduction Strategies, Nat’l League of Cities & Pol’y Rsch. Inst. (last visited July 23,
2020), https://www.nlc.org/sites/default/files/users/user60554/Peers_Support_Brief_v3.pdf.
16

17 ‘CAHOOTS’: How Social Workers and Police Share Responsibilities in Eugene, Oregon, Nat’l Pub. Radio (June 10,
2020), https://www.npr.org/2020/06/10/874339977/cahoots-how-social-workers-and-police-shareresponsibilities-in-eugene-oregon.
A joint response by both CAHOOTS staff and police happens infrequently. Anna V. Smith, There’s Already
an Alternative to Calling the Police, Mother Jones (June 13, 2020),
https://www.motherjones.com/environment/2020/06/theres-already-an-alternative-to-calling-the-police/.

Scottie Andrew, This Town of 170,000 Replaced Some Cops with Medics and Mental Health Workers. It’s Worked for
Over 30 Years, CNN (last updated July 5, 2020, 10:10 PM), https://www.cnn.com/2020/07/05/us/cahootsreplace-police-mental-health-trnd/index.html.
18

There are different ways to implement a joint response. A pre-existing team comprised of police and
mental health personnel can be dispatched, or the police and mental health system can separately deploy
personnel who coordinate and converge on the scene. Communities have implemented a variety of coresponder models. Ashley Krider et al., Responding to Individuals in Behavioral Health Crisis Via Co-Responder
Models: The Roles of Cities, Counties, Law Enforcement, Providers, Nat’l League of Cities (Jan. 2020),
https://www.nlc.org/sites/default/files/users/user60554/RespondingtoBHCrisisviaCRModels.pdf.
19

20

Diversion to What? Evidence-Based Mental Health Services That Prevent Needless Incarceration, supra note 10, at 7-8.

Daniel Fisher et al., Peer-Run Respites: An Effective Crisis Alternative (last visited July 23, 2020),
https://www.nasmhpd.org/sites/default/files/Peer%20Run%20Respite%20slides.revised.pdf.
21

See Nat’l All. on Mental Illness, Crisis Services (March 2015), https://www.nami.org/NAMI/media/NAMIMedia/Images/FactSheets/Crisis-Service-FS.pdf (“Crisis respite centers and apartments provide 24-hour
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observation and support by crisis workers or trained volunteers until a person is stabilized and connected
with other supports”); Diversion to What? Evidence-Based Mental Health Services That Prevent Needless Incarceration,
supra note 10, at 7-8 (describing “community crisis apartments where individuals can stay for a short period as
an alternative to hospitalization, incarceration, or stays in costly and hospital-like crisis facilities” that provide
support from clinicians and peers); United States v. New Hampshire, No. 1:12-cv-53-SM (D. N.H. Feb. 2,
2014) (settlement agreement) (providing for crisis apartments).
“Crisis drop-off centers that are open 24 hours a day and have a ‘no refusal’ policy enable law enforcement
to divert persons with mental illness away from the criminal justice system.” Martone, supra note 7, at 10-11.
23

24

Most psychiatric crises can be addressed without resort to hospitalization.

A widely respected example of such a center is the Houston Recovery Center. Harris County Confidential Jail
Diversion Programs, Hous. Recovery Ctr. (last visited July 23, 2020), https://houstonrecoverycenter.org/harriscounty-confidential-jail-diversion-programs/.
25

See Martone, supra note 7, at 5 (noting these services “have been proven successful in reducing arrest and
incarceration as well as other forms of institutionalization”); Bernstein, Burnim, and Murphy, supra note 10, at
18 (noting these services’ success in preventing needless institutionalization and pointing out that their
availability increases jurisdictions’ compliance with the Americans with Disabilities Act); Diversion to What?
Evidence-Based Mental Health Services That Prevent Needless Incarceration, supra note 10, at 7-8 (describing these
services and the evidence of their success in preventing incarceration).
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JUDGE DAVID L. - -

BAZEL ON
CENTER
FOR MENTAL HEALTH LAvV

The mission of the Judge David L. Bazelon Center for Mental Health Law is to
protect and advance the civil rights of adults and children with mental illness or
developmental disabilities. We envision a society where Americans with mental
disabilities live with autonomy, dignity, and opportunity in welcoming communities,
supported by law, policy, and practices that help them reach their full potential.
www.bazelon.org