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Current crisis response approaches are wide ranging, with varying degrees of police involvement, and communities might pursue multiple approaches simultaneously. Why, then, do communities choose one strategy over another or adopt multiple, layered approaches? These decisions are typically based on the specific problems that communities face and the resources available to address them. A lack of non-police resources often demonstrates how much local governments have prioritized criminal justice investments to address public health problems.[]Vera Institute of Justice, What Policing Costs: A Look at Spending in America’s Biggest Cities, dataset (New York: Vera Institute of Justice), accessed August 18, 2020, https://www.vera.org/publicati....

As the following typology illustrates, existing approaches to crisis response are designed to handle a wide variety of situations, and multiple approaches may be needed to build a robust crisis response system that meets local needs. As communities rethink the role of police in crisis response, they must seek out and invest in community-based solutions.


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Police-based responses

  • Crisis Intervention Team (CIT) model—Police officers with 40 hours of specialized training respond to behavioral health crisis calls, de-escalate the situation, and direct people to services when appropriate.[][] CIT International, Crisis Intervention Team (CIT) Programs: A Best Practice Guide for Transforming Community Responses to Mental Health Crises (Memphis, TN: CIT International, 2019), https://www.citinternational.o.... The model is based on strong community partnerships.
  • Case management teams—Police convene multidisciplinary teams that use law enforcement and health data to identify people who frequently use emergency and behavioral health services and develop individualized response plans to connect them to services and other supports. The teams might involve proactive outreach of co-responding clinician/police officer teams, with the goal of developing solutions that reduce repeat interactions.
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Police-based co-responses

  • Primary co-response teams—Behavioral health clinicians co-respond with officers in patrol cars as first responders to situations involving someone in behavioral health crisis. These teams may include peer specialists. Clinicians may also co-respond remotely via phone or telehealth support.
  • Secondary co-response teams—Behavioral health clinicians co-respond with officers in patrol cars at the request of police officers who respond first to situations involving someone in behavioral health crisis. Clinicians may also co-respond remotely via phone or telehealth support.
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Community-based responses

  • Crisis and “warm” lines—Crisis telephone lines are staffed by trained call-takers who provide remote counseling to people in crisis as an alternative to calling police. Warm lines are staffed by specially trained peers, who have lived experience with mental illness and provide phone support to people who are not in crisis.
  • Peer navigator programs—Programs in which peers support recovery for people with behavioral health disorders. These programs hire and train peers who have lived experience with mental illness and/or substance abuse.[]SAMHSA, “Peers,” April 16, 2020, https://www.samhsa.gov/brss-ta.... Programs may focus on people at risk of criminal justice involvement, offering them direct peer-to-peer support to avoid calls to police or trips to the emergency department.
  • Mobile crisis teams (MCTs)—Teams composed variously of medics, crisis workers, and/or peers available to respond to people in crisis and provide immediate stabilization and referral to community-based mental health services and supports. When available, police may coordinate with MCTs for an alternative to police response, or community members can request them by calling appropriate service providers.
  • EMS-based responses—Teams consisting of licensed counselors, clinical social workers, physicians, and EMTs who respond to people in crisis instead of police. The goal is to reduce arrests. These teams can transport people to services other than the emergency department to facilitate more appropriate treatment.[]See for example Stein Bronsky, Robin Johnson, and Kristin Giordano, “Mobile Integrated Healthcare Program Changing How EMS Responds to Behavioral Health Crises,” Journal of Emergency Medical Services 41, no. 10 (2016), https://www.jems.com/2016/09/3....
  • 911 diversion programs—Procedures used by police, fire, and EMS dispatchers to divert eligible non-emergency, mental health-related calls to behavioral health specialists. These specialists manage the behavioral health crisis by telephone and offer referrals to needed services.