ACLU Outlines Community Alternatives to Policing for Mental Health Crises

When Rochester, New York’s Joe Prude called 911 in March after his brother, Daniel Prude was experiencing a mental illness episode and under the influence of PCP, he never expected the encounter would end in tragedy — the death of Daniel Prude, an unarmed Black man, at the hands of the police.

“I didn’t call them to come help my brother die,” Joe Prude told NPR’s Rachel Martin on a Sept. 4 episode of Morning Edition. “I called them to come help me get my brother some help.”

Daniel Prude’s death sparked protests throughout the city, and is just one example of how people with untreated mental illness are 16 times more likely to die in encounters with law enforcement than neurotypical people, despite the vast majority of people with mental illness not posing threats to others.

In October 2020, the American Civil Liberties Union (ACLU) discussed the issue on their podcast, At Liberty. According to a study published by the Ruderman Family Foundation, 50 percent of people who die in police hands have some sort of disability, the most common being mental illness. When mental illness intersects with race, the outcome is even more likely to be lethal. On the podcast, Gregg Bloche, a professor of law at Georgetown University and a mental health care policy expert, explained that white women exhibiting mental illness symptoms that may be seen as threatening or erratic are most likely to be taken to the hospital and treated for their illness rather than funneled into the criminal justice system like Black men in similar situations are.

“If you’re African American and you’re male, the same kinds of symptoms are much more likely to be treated as a matter for the criminal justice system,” Bloche said.

Calling 911 is the best known and most accessible way to call for help during a crisis, but when armed police officers show up as the first responders, their presence and lack of mental health training tend to escalate the situation, especially for someone experiencing anxiety, fear and paranoia. In reality, there are other ways to call for help during a mental health emergency that doesn’t require armed law enforcement.

Some of these options already in place in many cities show a world where police are not the first responders to every situation is possible — and not merely a utopian idealization.

For example, in Eugene, Oregon, a specialized mental health emergency intervention team called Crisis Assistance Helping Out On The Streets (CAHOOTS). Founded in 1989, it is made up of a team of emergency intervention professionals specially trained to de-escalate dangerous situations and provide care for people with mental illness. At Liberty discussed how the program has saved the city millions of dollars over the years and how only a small percentage of the thousands of cases CAHOOTS responds to requires a request for backup law enforcement.

At Liberty also highlighted the Community Action Teams (CAT)-911, a Los Angeles county-based autonomous network that works to operate as alternatives to 911 by training community members in how to respond to crises.

In New York City, there are crisis services and mental health mobile crisis teams made up of groups of nurses, social workers, psychiatrists and other health professionals that can respond to people’s homes. Last year, Oakland, California looked into the possibility of piloting a program called the Mobile Assistance Community Responders of Oakland (MACRO) that would allow counselors and EMT to respond to certain 911 calls instead of the police.

These programs are attainable — and in many cases already in place — but when cities like New York are spending more than $10 billion annually on police budgets (even after this year’s budget cuts), the issue becomes one of accessibility, resources and knowledge of these programs. Bloche said the solution is having mental health care professionals as immediately available as police officers.

This capacity may come in the form of better training of 911 personnel to make judgments on who to send as first responders, sending police to locations with EMS professionals or having an entire team of EMS workers sent as first responders. On the show, Bloche also discussed the importance of systemic change in health care systems, substance abuse treatment, poverty and racism.

“This has a more than 50-year history that begins with deinstitutionalization and tracks through a series of policy decisions that are made informed by who we count fully as people and who we disregard. … When cops are sent to the scene in the case of Mr. Prude, there’s a structure in place that they are participating in,” Bloche said.

To learn more about how CAHOOTS serves as a promising model for community-based solutions to police violence against people with mental illness, click here.

For the Substance Abuse and Mental Health Services Administration (SAMHSA)’s mental illness and substance abuse hotline, call 1-800-622-HELP (4357).

For the National Suicide Prevention Lifeline, call 800-273-TALK (8255).

For the Crisis Text Line, text HOME to 741741 to be connected to a trained crisis counselor for free.