Cops, Clinicians, or Both? Collaborative Approaches to Responding to Behavioral Health Emergencies

Balfour, Margaret E.; Stephenson, Arlene Hahn; Delany‐Brumsey, Ayesha; Winsky, Jason M.; Goldman, Matthew L.

doi:10.1176/appi.ps.202000721

Cited by 49 publications

(32 citation statements)

References 55 publications

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“…International research implications on crisis intervention involving police generally described future aims that involve cross‐systems collaboration to decrease the involvement of police in crisis intervention (Horspool et al., 2016; Kirst et al., 2015; Lamanna, 2015). A (2021) article by Balfour et al, 2021 called for a shift from ‘crisis services’ to ‘crisis systems’ that integrate and coordinate crisis lines, mobile crisis teams, community crisis facilities and postcrisis care that ultimately decrease jail, ED and inpatient admissions. Beyond police training and frontline collaboration with healthcare workers, a holistic crisis response involves avoiding police involvement and offering community‐based alternatives with varying levels of care, tailored to service user needs (Steadman & Morrissette, 2016).…”

Section: Discussionmentioning

confidence: 99%

Re‐examining mental health crisis intervention: A rapid review comparing outcomes across police, co‐responder and non‐police models

Marcus

Stergiopoulos

2022

Health Social Care Comm

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Police are the default first responders in most mental health crisis intervention models worldwide, resulting in a heavy burden on police, perceived criminalization of individuals with complex mental health needs, and escalation of aggression that resort to violence. Models, such as crisis intervention teams (CIT), and co-response programmes aim to improve service user experiences and outcomes by providing mental health training to police, or pairing law enforcement officers with mental health clinicians, respectively. Despite these efforts, mental health-related calls continue to result in negative outcomes, and activists and policymakers are advocating for nonpolice models of crisis intervention. Evidence-based practice in mental health crisis intervention is urgently needed. The present review's main objective was to examine, synthesise and compare outcomes across police, co-responder and non-police models of mental health crisis intervention internationally using a rapid review framework. A systematic search of four electronic databases of studies published between 2010-2020 and a grey literature search was conducted, yielding (n = 1008) articles. A total of 62 articles were included in the present review. Studies were largely observational, lacking control groups and were of low-moderate quality with a high potential for bias. Overall, there is little evidence to suggest that the CIT model impacts crisis outcomes. Co-responder models evidenced improved outcomes compared to police only models, however, evidence was often mixed. Non-police models varied significantly, and studies tended to be too low quality to make comparisons or draw conclusions, however, research on youth models and crisis resolution home treatment suggested positive outcomes. Findings highlight the need for high-quality studies and policies to facilitate the implementation and evaluation of novel approaches not involving police.Cross-sectorial collaboration and service user input are urgently needed to inform, develop, test and disseminate effective models of crisis intervention acceptable to service users.

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Section: Discussionmentioning

confidence: 99%

Re‐examining mental health crisis intervention: A rapid review comparing outcomes across police, co‐responder and non‐police models

Marcus

Stergiopoulos

2022

Health Social Care Comm

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“…Individuals with SMI face legal involvement at a high rate, which has been attributed to a reduction in community resources following deinstitutionalization (Teplin, 1983). It is estimated that individuals with SMI account for about 2 million jail bookings and one-quarter of police shootings a year (Balfour et al, 2020). Individuals with SMI may be committed to treatment involuntarily due to mental health or safety concerns or diverted to a psychiatric hospital setting as a result of a jail diversion program (Prison Policy Initiative, n.d.).…”

Section: Types Of Legal Involvementmentioning

confidence: 99%

Legally involved individuals in state hospitals and community mental health settings: Introduction to the special section.

Snyder¹,

Davenport²,

Kearney³

et al. 2022

Psychological Services

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“…Diversion to mental health services is of ten put forward as a remedy for addressing the problems occurring at the intersection of mental health access and criminallegal systems 4 . However, data about crisis pro grams resulting in meaningful diversion and reducing disparities have been equivo cal.…”

Section: Centering Equity In Mental Health Crisis Servicesmentioning

confidence: 99%

Centering equity in mental health crisis services

Goldman

Vinson

2022

World Psychiatry

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Cops, Clinicians, or Both? Collaborative Approaches to Responding to Behavioral Health Emergencies

Cited by 49 publications

References 55 publications

Re‐examining mental health crisis intervention: A rapid review comparing outcomes across police, co‐responder and non‐police models

Re‐examining mental health crisis intervention: A rapid review comparing outcomes across police, co‐responder and non‐police models

Legally involved individuals in state hospitals and community mental health settings: Introduction to the special section.

Centering equity in mental health crisis services

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