Delivering Behavioral Health

Police-Mental Health Collaboration (PMHC) strategies offer behavioral health care providers, at the state and local levels the opportunity to improve the coordination of services with their law enforcement partners. This coordination can lead to improved public health outcomes for people with behavioral health care needs who come into contact with law enforcement.

This section gives an overview of the role of behavioral health providers when treating and delivering services to people with behavioral health care needs who come in contact with law enforcement. It discusses the importance of behavioral health leadership and collaboration to the implementation and sustainability of an effective PMHC strategy and demonstrates the value a PMHC offers to behavioral health care providers. Additionally, the behavioral health section highlights important collaborative activities—such as information sharing, training, and performance measurement—that can positively impact the treatment and daily outcomes of people with behavioral health needs.

• Treatment, Supports, and Services Essential Element

• Guidance for 911 Dispatch Centers – Behavioral health care providers can work with 911 dispatch centers to assist with training for key personnel and to develop succinct questions that call-takers and dispatchers can ask to determine if a call involves someone with a mental illness.​​​​
• Clinicians in 911 Dispatch Centers – A licensed clinician can also be co-located in a dispatch center to help identify and triage behavioral health calls for service that may, or may not, require a response by law enforcement or other first responders (i.e. emergency medical staff).
• Behavioral Health Hotlines and Warmlines – Staffed by clinicians, hotlines can provide support to people in a time of near-crisis. Warmlines are usually peer run and offer support in a time of distress in an effort to prevent crisis. In both scenarios, call-takers can provide the caller with behavioral health care resources appropriate to the caller’s needs. It is important for administrators of these call lines to develop procedures for when callers should be directed to call “911” on their own or when call-takers should transfer calls directly to a 911 center, if feasible.

For More Information:

• Call-Taker and Dispatch Protocols Essential Elements
• RAND's Silent Monitoring Protocol for Assessing Suicide Crisis Line Call Content and Quality

• Dedicated Phone Line for Law Enforcement – The behavioral health partner designates a phone line for use by law enforcement officers to obtain clinical guidance for interacting with an individual or to receive assistance determining the appropriate disposition and locating available behavioral health resources.
• Co-responder Model – A clinician is paired with a law enforcement officer to jointly respond to, manage, and deescalate calls for service, including screening the individual to determine an appropriate course of action.
• Mobile Crisis Model – Behavioral health professionals respond to calls for service at the request of law enforcement to help screen the individual and determine an appropriate disposition.

• Non-Crisis Diversion – In non-crisis situations, when officers suspect that mental illness is a factor in their contact with an individual, they can make a referral to a behavioral health care provider who would then assess the individual and identify community-based support and services as appropriate.
  • Outpatient Facility: Outpatient behavioral health facilities can designate staff to be available to screen individuals brought by law enforcement and engage in treatment and recovery planning.
  • Shelters: When law enforcement encounters an individual without adequate shelter—considered homeless—they often assist with accessing shelter, particularly in inclement weather. This is an opportunity for behavioral health care providers to engage an individual in supportive housing, behavioral health services, and other case management needs.
  • Sobering and Detox Center: When law enforcement officers encounter an individual who is intoxicated, these specialized centers can provide a safe, supportive environment for people to become sober and eventually enroll in a rehabilitation program.
• Crisis Diversion – When there is a crisis situation that does not warrant an emergency room-based evaluation, officers should seek less restrictive alternatives than arrest. In these circumstances, a clinician would assess the individual and make a referral to the appropriate treatment necessary to help stabilize the individual’s mental health. After the crisis is resolved, the individual can participate in discharge planning and be connected to community-based programming in an effort to prevent further crises.
  • Engagement/Diversion Facility: Engagement or diversion facilities are robust settings with an array of crisis (and non-crisis) programming easily accessible to law enforcement. Many operate 24-7, 365 days a year. Services can include a crisis stabilization unit, sobering room, and residential detox.
  • Short-Term Crisis Residential/Respite Center: At the direction of a behavioral health provider, law enforcement can escort people in crisis to short-term crisis residential programs which provide intensive programming to stabilize the individual’s mental health status.
• Emergency Evaluations/Hospitalization – In some jurisdictions, community behavioral health care providers play key roles in responding to law enforcement requests for involuntary evaluations or directing officers to the appropriate facility where an evaluation can occur. Behavioral health care providers can determine whether the individual is a “danger to self or others” and inform the officer’s decision on whether civil or criminal measures can safely be employed. In those jurisdictions, behavioral health care providers work with law enforcement agencies and hospitals to develop policies and procedures that aim to expedite the process so officers can return to service as quickly as possible.
• At Arrest – Some communities employ data-matching, in which arrest information is sent to the behavioral health provider to match with active case logs so that behavioral health care providers are updated when a client is arrested. In other jurisdictions, detention centers and jails employ a clinician to facilitate pre-booking mental health screening. Alternatively, outpatient behavioral health providers can also designate a clinician to be available to screen people under law enforcement detention for behavioral health needs.

For More Information:

• Emergency Hospitalization for Evaluation: Assisted Psychiatric Treatment Standards by State
• Information Sharing

• Case Management – Behavioral health providers and law enforcement can collaborate on case management aimed at promoting recovery, maintaining wellness, and avoiding crisis. The team would assess the individual for behavioral health needs, make appropriate referrals, or encourage the return to treatment. When special populations are involved (e.g., homeless individuals, veterans, and people with substance use disorders), coordination with other service providers would be required to address complex needs.
• Mobile Outreach – Mobile outreach services are similar to the non-crisis version of mobile crisis. These non-crisis referrals to mobile outreach can come from law enforcement, behavioral health care providers, and family and friends, with the purpose of assessing the individual’s wellness and encouraging engagement in treatment before the individual has a crisis.

For More Information:

• Behavioral Health Framework
• Principles of Recidivism Reduction
• First-Episode Incarceration: Creating a Recovery-Informed Framework for Integrated Mental Health and Criminal Justice Responses

• Crisis De-escalation – Behavioral health care providers often have at least some access to medical and behavioral health care information that can be used during a crisis situation, especially with the addition of county-wide and regional Health Information Exchanges (HIEs) in many local jurisdictions., A clinician with access to the individual’s records may be able to guide the officers to help deescalate a crisis and reach an appropriate disposition. This guidance can be made available on-scene or by phone consultation.
• Collaborative Meetings – Many jurisdictions have implemented criminal justice-behavioral health collaborative meetings to bring together practitioners from both systems to lawfully share information and identify and address the needs of people with mental illnesses who are prone to frequent contact with law enforcement.
• Person-Centered Tools – The use of person-centered tools, such as Psychiatric Advanced Directives (PADs), can allow the person’s experiences, perception of recovery needs, and preferences to be shared with the responding officer and considered in crisis prevention and planning.

For More Information:

• Information Sharing in Criminal Justice - Mental Health Collaborations
• Behavioral Health and Criminal Justice Systems: Identifying New Opportunities for Information Exchange
• Summary of the HIPAA Privacy Rule

• Curriculum development – Each system helps develop and refine the relevant content of the other’s curriculum, including goals and objectives, lesson plans, supporting literature to improve accuracy, and practicality; and
• Cross-systems training – This type of training allows staff from each agency to become familiar with the policies and practices of the other and can include both classroom and community instruction. One example might be the opportunity to shadow each other’s work by participating in ride-alongs with officers or observing a crisis hot-line.

For More Information:

• Training for PMHC Programs
• CUCS’ Academy for Justice-Informed Practice

• Behavioral health care provider requests of law enforcement can include data measurements such as the number of contacts between a person with behavioral health care needs and law enforcement, frequency of contacts, who initiated the contact, the reason for contact, and the final disposition of the encounter (e.g. medical or psychiatric ER or other community-based crisis center arrest, left on scene with referral information, etc.).
• Law enforcement requests of behavioral health care providers can include data measurements such as the frequency and type of assistance requested from the partner agency, the reason for the contact (e.g. referral to services, information sharing, recovering planning/case management, etc.), and the circumstance of contact with a person with behavioral health care needs (e.g. period of overall stability, escalation, or crisis).

For More Information:

• PMHC Measuring Performance
• Justice Counts: Actionable Data to Bolster Public Safety
• Measuring Police-Mental Health Collaboration Performance