For 911 Calls, Are Mental Health Specialists Often the Better Choice?

MONDAY, June 13, 2022 (HealthDay News) -- One American city's "radical" approach to handling low-level 911 calls -- sending mental health professionals rather than police -- may have taken a bite out of crime, a new study finds.

The study evaluated Denver's STAR program, which removed police from the response to select 911 calls: those involving a nonviolent person suffering from a mental health or substance abuse crisis.

The program instead dispatched a two-person health team -- generally a mental health provider and a paramedic -- who arrived on the scene with offers of bottled water and warm socks. The goal was to defuse whatever situation prompted the 911 call, and then connect the person with social and mental health services.

One result, the new study found, was a 34% reduction in less serious crimes, such as trespassing and disorderly conduct, over the program's six-month test run.

There is one obvious reason, the researchers said: When police don't respond to a call, there is no arrest or citation.

But it appears there was also a "real reduction" in low-level crimes, said researcher Thomas Dee, a professor at Stanford University's Graduate School of Education.

For one, he said, those offenses declined both during the STAR program's hours of operation, and outside of them. That suggests it reduced recidivism, Dee said -- possibly by directing more people in crisis to the help they needed.

"Another important finding is, we didn't see an increase in more serious crimes," Dee said.

That has been one concern raised about the no-police approach, he noted: If law enforcement is not there, a nonviolent situation might escalate.

"But we saw no evidence of that," Dee said.

The study, published June 8 in Science Advances, comes at a time when a growing number of U.S. cities are looking for alternatives for handling nonviolent 911 calls.

Police are the usual first responders to incidents involving a person having a mental health crisis, such as a psychotic break or a substance abuse issue. The result is that many people end up in jail rather than receiving social and mental health services.

Some cities, including Denver, have trained police officers in how to respond to mental health emergencies, while others have mental health providers go with police on certain calls.

Approaches like the STAR program are "more radical," Dee said, because police are kept out of the initial response altogether. And there has been little research on the effects of that tactic, he noted.

For the latest study, Dee and colleague Jaymes Pyne analyzed data from the six months before and after the STAR program was launched in June 2020. During that six-month pilot phase, the program operated during limited hours in eight of the city's police precincts.

Overall, the study found, those precincts recorded nearly 1,400 fewer low-level crimes during the program.

Dee said there was also evidence of savings: The six-month pilot cost just over $208,000, which meant each averted low-level offense cost $151. Had each instead been handled by the criminal justice system, the costs would have been four times higher.

This study focused on crime statistics. But, Dee said, "directing people to health care rather than the criminal justice system is obviously the humane thing to do."

Hannah Wesolowski, chief advocacy officer for the nonprofit National Alliance on Mental Illness, agreed.

"We need to make sure these people get help rather than handcuffed," said Wesolowski, who was not involved in the study.

When police respond to a mental health crisis, she said, the presence of uniformed, armed people can actually escalate the situation.

Mental health teams, arriving with water and blankets, create a different environment.

"They ask questions: Does your head hurt? How are you sleeping?" Wesolowski said. "They connect with the person and try to get at the root of what's going on."

Dee made another point: These approaches are something people across the political spectrum can get behind -- whether they support "defunding" the police or "backing the blue."

As it stands, Dee said, police officers spend much of their time responding to calls related to mental health and substance abuse. Passing those responsibilities to mental health professionals, he said, could allow police to focus on the task for which they are trained: responding to crime.

Wesolowski agreed: "We see a lot of support from law enforcement for this approach."

There is still a lot of work to be done to get programs like these off the ground in more U.S. cities. And Dee said that while the Denver findings are "exciting," the approach will not necessarily translate to all communities.

Wesolowski agreed that cities, or counties, trying similar programs will have to tailor them based on their needs and resources. She noted that 911 operators have to be trained -- not to mention the need for health professionals to work as first responders, and community organizations to send people for help.

But she said the Denver findings offer "compelling data" on the potential benefits.

Since the pilot run, Denver has rapidly expanded the STAR program. The city allocated nearly $4 million in its 2022 budget to broadening the program's reach, according to the Denver Post.

More information

The National Alliance on Mental Illness has more on responding to mental health crises.

SOURCES: Thomas Dee, PhD, Barnett Family Professor, Stanford Graduate School of Education, and senior fellow, Stanford Institute for Economic Policy Research, Stanford, Calif.; Hannah Wesolowski, MPA, chief advocacy officer, National Alliance on Mental Illness, Arlington, Va.; Science Advances, June 8, 2022, online