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Learning

Police-Mental Health Collaboration (PMHC) Toolkit

Learning About Police-Mental Health Collaboration Programs

To safely and effectively respond to people with mental illnesses, law enforcement agencies have relied upon Police-Mental Health Collaboration (PMHC) programs for 30 years. What started in a handful of agencies has expanded to thousands of agencies across the country. Effective PMHC programs are defined by collaborative partnerships with law enforcement agencies, mental health providers, and other community based entities. PMHC programs are producing better outcomes for consumers, officers, and agencies.

This section provides an overview of PMHC programs—the 10 essential elements of any PMHC, the various response strategies available to agencies, and the value that PMHC programs provide for law enforcement agencies, communities, and people with mental illnesses.

What is a Police-Mental Health Collaboration?

A PMHC is a law enforcement-based program that enables officers to respond appropriately and safely to people with mental illnesses. Mental health calls for service are among the most complex and time-consuming for law enforcement. PMHC programs allow officers to be safer, reduce repeat calls for service, minimize the strain on agency resources, and connect people with mental illnesses to services.

For More Information:

 


Benefits of Police-Mental Health Collaborations

PMHC programs can create positive changes for law enforcement agencies, law enforcement officers, communities, and consumers alike. Based on research and the experiences of agencies, the most common benefits are:

 

Improved Safety:

De-escalation strategies are a staple in all PMHC models and enable the trained officer to neutralize a situation without the use of force (or with the use of the least amount of force) that results in a decrease of injuries to both officers and consumers alike.

Fewer uses of force: Officers are less likely to use force, even in encounters considered as high violence risk. Additionally, when using force, they generally rely on low-lethality methods.
 

Fewer injuries to officers: Across the nation, police agencies are seeing a reduction in police officer injuries following the implementation of PMHC programs.
 

Fewer injuries to consumers: Officers are able to better understand and interpret crisis behavior and respond appropriately, which leads to fewer injuries to consumers.

 


Increased Access to Behavioral Healthcare:

Officers have a greater awareness of community resources allowing them to connect consumers to treatment, services, and other supports.

Increased use of crisis services: With an improved ability to identify mental health crisis, when appropriate, officers are more likely to divert individuals from the criminal justice system to crisis services.

 

More referrals to appropriate behavioral health services: PMHC officers become acquainted with mental health services in their community and more often provide a referral or even transport to treatment.

 

Increased continuity of healthcare: Police-mental health collaborations result in ongoing community-based treatment solutions that enable the individual to remain stable.

 


Decreased Repeat Encounters with the Criminal Justice System:

When individuals are connected to treatment, they are less likely to engage in unlawful or disruptive behaviors, and therefore have fewer contacts with law enforcement and the criminal justice system at large.

Fewer arrests: Individuals connected to mental health treatment by officers experience fewer subsequent arrests than individuals not connected to services.

 

More jail diversions: With the ability to identify individuals in mental health crisis and their awareness of healthcare resources, officers are more likely to transport the individual to appropriate services than jail or lockup.

 


Reduced Costs:

Improved safety, increased access to mental healthcare, and decreased repeat encounters with the criminal justice system have resulted in reduced costs to law enforcement agencies.

Fewer repeat calls for service (CFS): When individuals are connected to mental healthcare services, they are less likely to call 911 themselves or to be the subjects of repeat complaints.

 

Fewer SWAT call-outs: PMHC officers are able to de-escalate potentially violent situations without having to employ SWAT.

 

Reduction in civil lawsuits: The decline in use of force and injury reduces money spent on litigation.

 

Reduction in time spent on mental health calls: When diversion services or receiving centers are in place, officers are able to resume patrol duties in a significantly shorter time.

 


Improved Community Relations:

Police-mental health collaboration programs lead to improved relationships between law enforcement agencies and their local partners and citizens.

 

 


Quote from Chief Michael Sauschuck, Portland (ME) Police Agency

People with Mental Illnesses and Family Members

People with lived experience of mental illness—both individuals and family members—are key partners in police-mental health collaborations.  They have first-hand experiences with the challenges of the mental health and criminal justice systems, and unique perspectives about the treatment and supports needed for recovery. Community organizations representing individuals and family members affected by mental illness also have significant community support and can contribute education, training, policy review and problem-solving to your collaboration.

Learn More about Partnering with People with Mental Illness and Family Members

Types of PMHC Programs

This toolkit highlights five types of PMHC programs. There is no one “right” type. Agencies need to first assess their community’s needs and resources to determine which type of PMHC is most appropriate. The five approaches are not necessarily mutually exclusive. That is, some agencies incorporate elements of different approaches into their programs, such as relying upon CIT officers or generalists and augmenting them with co-responder or mobile crisis teams.

Known as “CIT,” the crisis intervention team is the most commonly used approach by law enforcement agencies. The CIT model originated in the Memphis, Tennessee, Police Agency and is therefore often called the “Memphis Model.” CIT is based on the idea that experienced officers who volunteer are best at responding to mental illness calls. Agencies select a group of qualified patrol officers (representing approximately 25 percent of the patrol force) who volunteer to take on this responsibility in addition to their normal patrol duties. After completing a 40-hour training course, CIT officers are dispatched to mental health calls or to assist officers who are not CIT qualified. These CIT officers rely upon their expertise to work with mental health providers to reach an appropriate disposition.

Working as a co-responder team, a specially trained officer and a mental health crisis worker respond together to mental health calls for service. By drawing upon the combined expertise of the officer and mental health professional, the team is able to link people with mental illnesses to appropriate services or provide other effective and efficient responses. The most common approach is for the officer and crisis worker to ride together in the same vehicle for an entire shift, while in other agencies the crisis worker meets officers at the scene and they handle the call together. Co-responder teams can respond throughout the entire jurisdiction, or they work in areas with the greatest number of mental health calls.

The mobile crisis team is a group of mental health professionals who are available to respond to calls for service at the request of law enforcement officers. The mobile crisis team’s goal is to divert individuals from unnecessary jail bookings and/or emergency rooms. These crisis workers are skilled at helping to stabilize encounters and assume responsibility for securing mental health services for persons, including those in crisis who may need further evaluation and treatment. Mobile crisis teams are not necessarily dedicated to assisting only law enforcement officers, but respond to requests directly from community members or their families and friends.

A proactive team approach in which behavioral health professionals and officers provide outreach and follow-up to repeat callers and high utilizers of emergency services. Officers do not treat or diagnose the individuals, but work with behavioral health professionals to develop specific solutions to reduce repeat interactions. This approach strives to keep people connected to mental health services and community resources, to abide by treatment plans, and meet other responsibilities such as work, school and training. Case management is used in agencies in conjunction with other police-mental health collaboration strategies.

A tailored approach is one in which an agency intentionally selects various response options from multiple PMHC programs to build a comprehensive and robust program. This allows the agency to adhere to a consistent policing philosophy while being responsive to community needs. Other factors agencies consider when choosing this approach can include the size of the jurisdiction and the number of officers on a given shift. When using the tailored approach, a law enforcement agency begins with the expectation that every patrol officer must be able to respond effectively to mental health calls. Agencies enhance their patrol force with officers or detectives whose primary responsibilities are to liaise with stakeholders to coordinate criminal justice and mental health resources.

 

Agency Experiences

CMPD Crisis Intervention Team (CIT)

Law Enforcement Officers are frequently front-line responders to persons in crisis with a serious mental illness. In an effort to better prepare officers to respond to these individuals, CMPD is training with the Crisis Intervention Team, CIT. CIT is a community-based collaboration between law enforcement, local National Alliance on Mental Illness (NAMI), mental health consumers, mental health providers, community colleges and law enforcement training centers. CMPD's finest are better equipped to serve our community by providing appropriate care, for a crisis involving persons with a mental illness. If you would like to learn more about mental illness, please call 704-365-3454 or go online to http://mhacentralcarolinas.org/

For more information about Charlotte City Government:
AGENCY WEBSITE

The Essential Elements of PMHC Programs

For any type of PMHC program, there are 10 essential elements that, if implemented, will contribute to the program’s success. The essential elements are drawn from existing PMHC programs to ensure that they are practical and valuable, while allowing for differences in every jurisdiction’s needs and resources. Because the elements provide a common framework for program design and implementation, they can be used to build a new PMHC program or improve an existing program.

1. Collaborative Planning and Implementation

Organizations and individuals representing a wide range of disciplines and perspectives and with a strong interest in improving law enforcement encounters with people with mental illnesses work together in one or more groups to determine the response program’s characteristics and guide implementation efforts.

2. Program Design

The planning committee designs a specialized law enforcement-based program to address the root causes of the problems that are impeding improved responses to people with mental illnesses and makes the most of available resources.

3. Specialized Training

All law enforcement personnel who respond to incidents in which an individual’s mental illness appears to be a factor receive training to prepare for these encounters; those in specialized assignments receive more comprehensive training. Dispatchers, call takers, and other individuals in a support role receive training tailored to their needs.

4. Call-Taker and Dispatcher Protocols

Call takers and dispatchers identify critical information to direct calls to the appropriate responders, inform the law enforcement response, and record this information for analysis and as a reference for future calls for service.

5. Stabilization, Observation and Disposition

Specialized law enforcement responders de-escalate and observe the nature of incidents in which mental illness may be a factor using tactics focused on safety. Drawing on their understanding and knowledge of relevant laws and available resources, officers then determine the appropriate disposition.

6. Transportation and Custodial Transfer

Law enforcement responders transport and transfer custody of the person with a mental illness in a safe and sensitive manner that supports the individual’s efficient access to mental health services and the officers’ timely return to duty.

7. Information Exchange and Confidentiality

Law enforcement and mental health personnel have a well-designed procedure governing the release and exchange of information to facilitate necessary and appropriate communication while protecting the confidentiality of community members.

8. Treatment, Supports, and Services

Specialized law enforcement-based response programs connect individuals with mental illnesses to comprehensive and effective community-based treatment, supports, and services.

9. Organizational Support

The law enforcement agency’s policies, practices, and culture support the specialized response program and the personnel who further its goals.

10. Program Evaluation and Sustainability

Data are collected and analyzed to help demonstrate the impact of and inform modifications to the program. Support for the program is continuously cultivated in the community and the law enforcement agency.

FAQs

Learning

Law enforcement agencies and the mental health system (i.e., state and local mental health agencies, community mental health providers, and hospital emergency departments) can work together to develop strategies to meet the mental health demands in their community. It is about building​ trust and an appreciation for each other's expertise, but that can be a challenge. 

The police play an important role to connect individuals with services and supports that will reduce problematic behavior and promote public safety. Likewise, mental health agencies and providers can steer officers to resources for people with mental illnesses when crisis services are responsive to law enforcement needs.​

To do so, police and mental health agencies and providers will need to understand and appreciate each other's roles, responsibilities and resource constraints. Building a collaborative partnership takes time and patience, and law enforcement and mental health agencies and providers may need to first address long-standing challenges. For example, it is not unusual in many communities for each system to believe that their counterparts are not accepting full responsibility for their role in handling mental health calls for service.  Taking the time to discuss points of friction will ease misunderstandings, but it will also identify opportunities to clarify roles and improve efficiencies between the systems.  ​

For more information see: 

This is a community issue that requires a holistic approach to be successful.  Although law enforcement agencies are the initial responder to many people with mental illnesses, they are not equipped to provide the resources and services this population needs.  Law enforcement must seek to partner with both mental health professionals and advocates and the families of those with mental illnesses to emphasize collective ownership of the issue along with solutions. Law enforcement must seek to partner with both public health officials, mental health professionals, and advocates and families of those with mental illnesses to emphasize collective ownership of the issue along with solutions. 

Law enforcement leaders should identify which mental health agencies in their communities provide services to individuals with mental health issues or intellectual/developmental disabilities. This will help identify services and resources needed to effectively develop collaborative strategies for effective short- and long-term responses. Collaboration within the community, to include partnerships with municipal and county nonprofits and other service providers, as well as state associations will help make the work successful. Consumers of mental health services, their families, and advocates should all be engaged in planning, delivering, and monitoring a collaborative law enforcement-mental health partnership.​ 

For additional information see: 

As first responders, law enforcement professionals encounter people with mental illnesses or intellectual/developmental disabilities every day. Some of these individuals are in an emotional crisis, or unable to care for themselves, and need assistance. Other individuals exhibit behavior that is perceived as threatening, or they may be linked to or engaged in criminal acts. And, research has shown that persons who have mental illnesses, like many persons who have disabilities, are at a greater risk for victimization.

Law enforcement agencies have responded to people with mental illnesses throughout their history. Since the mid-1980s the frequency with which officers encounter persons with mental illnesses has steadily increased to the point that all law enforcement agencies—large and small, urban and rural—now have regular interactions with people in their communities who have mental illnesses. Consensus exists among that law enforcement agencies are bearing a disproportionate responsibility for these encounters because of an inadequate mental health system. Nonetheless, the reality is that these encounters are occurring and it is therefore important to ensure an appropriate response.

Responding to mental health calls for service can be difficult for officers, but by recognizing the extent to which officers interact with people with mental illnesses, agencies can take the necessary steps to train and prepare officers, develop policies, and build collaborative partnerships with mental health providers that will lead to safe encounters and appropriate dispositions.

Recognizing the impact these encounters have on policing, both as a public safety and as a public health concern, addressing these encounters should be a priority for law enforcement leaders.

For additional information see:

​PMHCs can create positive changes for law enforcement agencies, law enforcement officers and consumers alike.  Based on research and the experiences of agencies, the most common benefits are:

Improved safety for all

  • Improved safety for all
  • Fewer injuries to consumers
  • Fewer uses of force

Increased access to mental health treatment, supports and services for consumers

  • More diversions from the emergency room
  • More referrals of consumers to the appropriate behavioral health provider
  • More crisis prevention services

Decreasing the frequency of these individuals' encounters with the criminal justice system

  • Fewer arrests
  • More jail diversions

Reduced costs incurred by law enforcement agencies

  • Fewer repeat CFS
  • Fewer SWAT call-outs

For additional information see:

Focused Tools for Law Enforcement

Many communities struggle with the PMHC program design process. Communities are unsure how to design and develop a PMHC program that meets their distinct needs and challenges. One way to increase knowledge of PMHCs, is to review programs that other jurisdictions have developed and tailor those programs to your specific community needs.

Law Enforcement agencies interested in expanding their knowledge base, starting, or enhancing a PMHC, can contact The U.S. Department of Justice’s Bureau of Justice Assistance (BJA) or BJA’s Training and Technical Assistance (TTA) Provider. BJA supports these urban and rural police departments to act as host-sites to visiting law enforcement agencies and their mental health partners.

Located across the country, these learning sites represent a diverse cross-section of perspectives and program examples and are dedicated to helping other jurisdictions improve their responses to people with mental illnesses.

Opportunities

The ten learning sites host site visits from interested colleagues and other local and state government officials, answer questions from the field, and work with BJA’s TTA provider to develop materials for practitioners and their community partners.

TTA is provided to law enforcement agencies and their community partners in an effort to assist with the development or implementation of PMHC strategies. Supplemental funds can be made available to agencies that are interested in visiting the learning sites. This is a focused approach intended to provide your agency with access to outstanding peer resources for police-mental health collaboration programs.

To request TTA and receive confirmation within 36 hours of your request

For frequently asked questions about the Law Enforcement Mental Health Learning Sites, access the TA FAQs.

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Law Enforcement Learning Sites

Support jurisdictions in exploring strategies to improve the outcomes of encounters between law enforcement and people who have mental illnesses.

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Contact PMHC

Please submit questions, policies and training materials that can benefit others for review and consideration.

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