As noted in
last month’s blog post by David Eckert, “the goal of effective crisis response is to establish a safe environment that allows the individual to move past feeling overwhelmed and begin to create a plan to use effective coping strategies.” When police are the first responders to those in crisis, however, many individuals do not feel safe, and the presence of law enforcement can add to the overwhelmed feelings. Unfortunately, a well-intended response by police can be traumatic for some individuals. To address that issue, many communities are questioning whether police should be the first or lone responders to individuals experiencing behavioral health crises.
New York State has two programs that directly address these concerns. The first is the state-wide Crisis Intervention Team (CIT) program. CIT programs work to transform crisis response systems to minimize the number of times that law enforcement officers are the first responders to individuals in emotional distress. In other words, if there’s a mental health-related crisis, we ought to have a mental health response.
CIT program development starts with an evaluation of a community’s crisis response system (called Sequential Intercept Model Mapping or simply “mapping”). Mapping involves bringing key stakeholders together with experienced facilitators who guide the group through a process to identify both strengths and gaps in the current system. A system “map” is created that shows how individuals with behavioral health challenges, particularly those in crisis, interact with the behavioral health and criminal justice systems. Following a mapping session, stakeholders receive a summary of the mapping workshop with recommendations for system refinement to help individuals receive timely and optimal services as well as avoid contact with law enforcement.
The second part of CIT programs is to ensure that when police are the first responders they have the knowledge, skills, and support to de-escalate situations and divert individuals from the juvenile and criminal justice systems, when possible. This is accomplished by a week-long training about recognizing and responding to mental illness and related disorders. Experienced officers who volunteer and are screened for suitability attend the training.
The other program in NYS that addresses police as first responders to individuals in crisis is the Mobile Access Program (MAP). MAP connects residents in distress with mental health clinicians utilizing iPads (via Zoom for Healthcare, a secure teleconferencing software program) when law enforcement officers request assistance. Mental health staff conduct an evaluation remotely to help plan for an appropriate disposition. The main goals of the program are to provide timely mental health consultations to individuals in emotional distress and to avoid unnecessary transports to the hospital. To date, about 80% of the individuals who had the benefit of a remote evaluation have remained where they were.
Initially started as a pilot program in several counties in Western New York in 2019, by April 2022, MAP will be operational in 22 counties, with 18 different mental health agencies – serving 40 law enforcement agencies, with over 170 iPads deployed.
To avoid further traumatizing individuals who are in acute distress, we need to refine our crisis response systems to be less reliant on police. Police should only be dispatched when there is some concern about illegal and/or dangerous behavior. The CIT program strives to minimize police responses to those in distress and prepare police for times when they are the first responders. Relatedly, the Mobile Access Program provides a rapid connection to mental health clinicians via iPads that some police officers have. There is a lot of work left to be done, but New York has made some progress in transforming our crisis response systems to be more trauma-informed.