The police chief and the entire command staff of the Rochester, New York, force resigned Tuesday amid outrage at the killing of Daniel Prude after a police encounter in March. Last week, police body camera video became available showing Prude, while he was in the midst of a psychiatric emergency, in a “spit hood” the police had put on him to guard against the coronavirus, limiting his ability to breathe and apparently leading to his death.
For people in mental health emergencies who are already feeling inordinate amounts of confusion, stress and anxiety, police on the scene are often not a solution but a problem.
Tragically, the death of a person with mental illness during a police encounter is far from rare. Last month, Damian Daniels, a military veteran who was experiencing mental distress, was killed in a tragic confrontation with San Antonio police. In June, George Zapantis, a man in the midst of a mental health crisis reportedly wielding a sword in his home in Queens, New York, died after police repeatedly used a stun gun on him.
People with mental illness are 16 times more likely to be killed by police during encounters than the general population, and 1 in 4 deaths at the hands of police involve people having mental health emergencies. They are disproportionately Black and other people of color.
We mourn with the families, friends and communities of the victims of these tragic and needless losses, just as we mourned when Deborah Danner, a 66-year-old woman with schizophrenia and a member of Fountain House — the national mental health nonprofit that I lead, which is rooted in the dignity of those living with mental illness and empowers their life choices — was the victim of a police shooting in her Bronx apartment in 2016 as part of a mental health call.
What if, instead of these tragic and deeply unnecessary killings of innocent people, there was a straightforward model that saved money as well as lives, was supported by community groups and police and advanced the dignity and health of people with mental illness? Wouldn’t this be something we all could immediately stand up and say should happen — and happen now?
At a news conference, Joe Prude said he called police to help his brother. Calling 911 is an instinct many of us have when we are seeking help for a loved one. It is, in most cases, our only recourse for help when we don’t know what to do, as most parts of the country lack dedicated mental health crisis response hotlines. Unfortunately, for people in mental health emergencies who are already feeling inordinate amounts of confusion, stress and anxiety, police on the scene are often not a solution but a problem.
Instead of dispatching a health team focused on the well-being of the person in crisis, we regularly treat mental health as a safety issue. We don’t dispatch police to take care of people with heart attacks or diabetic emergencies. Why do we do so for mental illness, which is also a health condition?
Mental health professionals, ideally working with peers with lived experience of mental illness, provide the best solutions for these tragedies. Even though San Antonio police are nationally recognized for their training to defuse mental health crises, that wasn’t enough to prevent the killing of Daniels.
Many police recognize that mental health workers are needed in cases like these, and that is why they have collaborated on alternative community policing initiatives. The best-known example, active for more than 30 years in Eugene, Oregon, is Crisis Assistance Helping Out on the Streets, or CAHOOTS.
The program diverts nonviolent calls involving people experiencing mental health crises from police departments to unarmed two-person teams of a nurse or an EMT and a crisis worker with mental health experience. When they arrive, they provide services including welfare checks, crisis counseling, conflict resolution and transportation to social services, substance abuse treatment facilities and medical care providers.
The teams are skilled at de-escalation techniques and building trust with people with mental illness, and they have the capacity to restrain people who are more unstable. Much as in an emergency room, where violent situations occur regularly, options for nonviolent confrontation, such as chemical or other restraints, are available to mental health crisis response teams that police are not trained, prepared or directed to employ.
This successful model has been proven to save lives and money. Of the 24,000 calls CAHOOTS responded to last year, police were requested just 250 times. In 2019, the program saved an estimated $14 million in ambulance and emergency room treatment costs, as well as $8.5 million in public safety costs, nontrivial amounts in a city with an annual budget around $800 million. A crisis worker told NPR this summer that “in 30 years, we’ve never had a serious injury or a death that our team was responsible for.”
Other communities have taken notice, and versions of the model are being considered and replicated in San Francisco, New York City and Indianapolis, and they are being taken further in places like Baltimore, where Mobile Crisis Teams are separate from law enforcement altogether.
As the leader of an organization that works directly with people living with mental illness, I understand the importance of community-based solutions that recognize and elevate the dignity in each of us. This isn’t a right versus left issue; it is a right versus wrong issue — and the opportunity to right that wrong is now. These programs must become a part of federal policy and be expanded to state and local municipalities across the country. And because these preventable deaths reflect the toxic intersection of mental health, racial injustice and law enforcement, programs must incorporate responses informed by the impact of generations of trauma inflicted by systemic racism.
Many police recognize that mental health workers are needed in cases like these, and that is why they have collaborated on alternative community policing initiatives.
That is why Fountain House is partnering with other organizations around the country that share our community-based, dignity- and choice-centered restorative model — working alongside health care, housing and law enforcement professionals — and joining with creative policy professionals to support and institute alternative mental health crisis response models at the local level. To that end, we are also developing a blueprint, centering racial equity and the voices of those with lived experience of mental illness, with recommendations that will influence policy and investment at all levels of the system.
We know we can’t just dismantle existing systems. We must pilot and build effective alternatives in their place.