Each year, New York City receives upwards of 170,000 mental health crisis calls, more than twice the volume of a decade ago. But the city’s investment in mental health crisis response has not expanded to meet that need. Instead, we overwhelmingly rely on armed police officers to respond to situations that police leadership around the country acknowledges its workforce is not trained to handle.
Unsurprisingly, the outcomes of these encounters with police range from problematic to tragic. In just the past six years, 18 people have been shot and killed by the NYPD while seeking help for a mental health crisis.
The full extent of the problem is even greater. Every day, hundreds of New Yorkers in crisis are detained, sedated, involuntarily hospitalized or otherwise confronted by police because, at present, force is the default response to mental health crises. When asked in a recent survey by New York Lawyers for the Public Interest, community members highlighted how traumatic this system is, describing police responses that were confrontational and coercive, escalating risk rather than mitigating it. Just as revealing, almost none of the community members surveyed reported receiving the long-term supports they needed to manage their mental health needs.
Deborah Danner was shot and killed by NYPD police on Tuesday, October 19, 2016 in the Bronx. (Handout)
In a system dominated by police, it’s often forgotten that the people involved have typically committed no crime. In fact, policing and involuntary hospitalization do little for the long-term problems these community members face. What they need is a health-based response to their mental health crisis and, very likely, long-term supports such as health care, housing and employment. What they receive is a police officer — with no expertise in handling the situation and none of the tools to help.
It’s a situation where no one wins. And it doesn’t need to be this way.
Across the country, cities like Austin; Denver; New Haven; Oakland; Rochester and San Francisco have developed evidence-based, community-led mental health crisis response programs that remove police from an ever-growing portion of calls. In Eugene, Ore., the three-decade-old CAHOOTS program handles the vast majority of the city’s mental health emergency calls, providing non-police response to nearly one-fifth of the city’s 911 calls.
Importantly, the programs do this safely.
In CAHOOTS’ 32 years of service, handling as many as 24,000 calls a year, not a single person — neither community member nor staff — has ever been seriously injured. Other programs have similarly stellar safety records. A recent review of 33 non-police crisis response programs across the country found that none had experienced a serious injury to staff or community members. That same review found that even minor injuries (like injuring a finger) were exceptionally rare, occurring only once in every 25,958 calls.
Over the next four years, New York City has a unique chance to build something even better.
This year, the city committed $112 million to develop and deploy a citywide mental health crisis response system. That is a major step in the right direction. But New York needs to think more critically and expansively if we hope to create real change.
Despite much fanfare, the recently adopted pilot program — B-HEARD — operates in just three of the city’s 77 police precincts and has accepted a mere 19% of crisis calls in those zones. The other 81% of calls continue to receive police response.
In other words, for the vast majority of people experiencing a mental health crisis, police intervention remains the default response. This must change.
Correct Crisis Intervention Today — New York City, a coalition with more than 80 mental health advocacy organizations as members, developed a proposal, first shared with the de Blasio administration in early 2020, that would eliminate the problems presented by the B-HEARD program and chart a path toward a more holistic crisis response. Its core proposals, modeled on CAHOOTS, include:
making non-police teams — consisting of an emergency medical technician and a highly-trained peer (individual with lived mental health experience) — the default response to all mental health crises, and utilizing the federal 988 hotline to connect residents to these services; providing consistent 24/7 coverage citywide; connecting recipients to quality preventative and follow-up services that are integrated into the broader public health, housing and social-support systems — like New York State’s newly-authorized Crisis Stabilization Centers; and creating an oversight board, the majority of whose members would be peers from low-income backgrounds and communities of color, to review program data and guide development of the program.
New Yorkers have long called for a mental health crisis response system that prioritizes the well-being of those it serves, rather than a system that treats them as criminals.
Mayor-elect Adams: You have a chance to answer those calls. Please don’t waste it.
Arnold is a legal fellow in New York Lawyers for the Public Interest’s Disability and Health Justice Programs. Lowenkron is director of the Disability Justice Program at New York Lawyers for the Public Interest.