Traditionally, law enforcement has been the default first responder to people in crisis. This approach has presented several challenges, including the potential for increased involvement with the criminal justice system and the potential for these interactions to escalate to the point of police use of force. Approximately 25% of people living with a mental health condition have been arrested by police at some point in their life4 and about 41% of people incarcerated in prisons report having a history of a mental health problem.5 According to the Washington Post, since 2015, approximately 1 in 5 people shot and killed by police had a history of mental health conditions or were exhibiting mental distress at the time of the shooting. 6
To enhance responses to people in crisis, many communities have been exploring alternatives to the traditional law enforcement response. Substantial innovation has occurred related to crisis response with the implementation of police-mental health collaboration programs and community responder programs. Several crisis response models have been implemented across communities and significant variation exists in how communities adapt a model to fit their community.
Community responder programs include health professionals and other staff who receive training in crisis response and serve as first responders to calls for service and social disturbances. These teams conduct wellness checks, provide support to people experiencing a mental health crisis and people with housing needs, and other assistance.7
Across police-mental health collaboration programs and crisis response models, there are several common overarching goals, including:8
Law enforcement agencies and communities may operate multiple crisis response models within their jurisdiction to provide a multi-layered response to people with mental health conditions. Various models for crisis response and police-mental health collaboration are described in greater detail below.
Crisis Intervention Team (CIT)
Mobile Crisis Team
Law Enforcement-Based Case Management Services
Law Enforcement Assisted Diversion (LEAD)
EMS and Ambulance-Based Responses
Agencies can utilize the Police-Mental Health Collaboration (PMHC) Self-Assessment tool to assess the status of their current response efforts. The tool helps law enforcement agencies and their behavioral health partners assess their progress toward implementing high quality partnership-based interventions. The PMHC Self-Assessment tool can be accessed here.
Additional Resources on Responses to People with Mental Health Conditions
The Law Enforcement-Mental Health Learning Site Program, led by the Council of State Governments (CSG) Justice Center with support from the U.S. Department of Justice Bureau of Justice Assistance, provides examples of crisis response in practice. This peer-to-peer learning program offers assistance to law enforcement and mental health practitioners to support the implementation of evidence-informed and best practices.
The Police-Mental Health Collaboration (PMHC) Self-Assessment tool helps law enforcement agencies and their behavioral health partners assess their progress toward implementing high quality partnership-based interventions. This tool is designed to provide resources to help improve responses to calls for service for people with mental illnesses and/or co-occurring substance use conditions.
The National Guidelines for Crisis Care – A Best Practice Toolkit advances national guidelines in crisis care within a toolkit that supports program design, development, implementation and continuous quality improvement efforts. It is intended to help mental health authorities, agency administrators, service providers, state and local leaders think through and develop the structure of crisis systems that meet community needs.
The Council of State Governments (CSG) Justice Center (2019) Police-Mental Health Collaborations: A Framework for Implementing Effective Law Enforcement Responses for People Who Have Mental Health Needs
Increasingly, law enforcement officers are called on to be the first, and often the only, responders to calls involving people who have mental health needs. To begin tackling that challenge, The Council of State Governments (CSG) Justice Center released a framework to help law enforcement agencies across the country better respond to the growing number of calls for service they receive involving this population.
National Alliance on Mental Illness (NAMI) Divert to What? Community Services That Enhance Diversion
Many communities are committed to diverting people with mental illness away from the criminal justice system. However, in order to do so, communities need effective mental health services, such as outpatient, inpatient and crisis care. This publication is meant to help communities identify the gaps and opportunities in the existing system that will enhance their efforts to divert people from justice system involvement.
This webpage features an interactive library of policies, practices, and programs implemented by jurisdictions across the country to reduce the prevalence of people living with mental health conditions in jails. The database includes dozens of different programs, policies, and practices (e.g., crisis intervention team, co-responder team), including definitions and local examples.