Often, the police respond to mental health emergencies. Yet, a handful of ambitious programs have proved that there’s a better way.
CW: The following piece discusses suicide
Instead of sending the police to respond to mental health emergencies, New York City has started dispatching social workers and paramedics in their place. According to the data from the program, 95% of the time, the subject of the call accepted the team’s offer of assistance. In the existing model, all mental health crises went direct to the hospital. The program has halved that number, often taking those in crisis either “aided at home, or taken to a non-emergency community centre,” per NBC News.
As NBC New York reported in July, “The Behavioral Health Emergency Assistance Response Division, or “B-HEARD” program, which started in a portion of Harlem a month ago, has already responded to about 110 calls where there was no weapon or imminent risk of violence.”
As the publication noted, “one of the major concerns going into the program was the safety of the first responders, but so far the program has only called for NYPD backup seven times. On the other hand, the city said, the NYPD has called in B-HEARD teams 14 times after finding police services weren’t needed.”
On social media, the response has been positive, with one user stating: “When we talk about defunding the police, this is what we mean”.
Clearly, this different approach is needed, as February saw officers in Rochester handcuff and pepper spray a nine-year-old after they responded to a mental health emergency. In justifying their actions, the Rochester police also noted that they were “required” to use handcuffs and the pepper spray “for her own safety.”
As CNN noted, the incident has “has troubling similarities to the death of Daniel Prude, a Black man who died in March after Rochester police pinned him to the ground and placed a hood over his head as he experienced a mental health crisis. The police body camera footage of that incident, released in August after city officials intentionally delayed its release, led to protests over the police’s treatment of Black people and those experiencing mental health crises. Mayor Lovely Warren later fired the police chief, saying there was a ‘pervasive problem’ in the police department.”
One of the major concerns going into the B-HEARD program was the safety of the first responders, but they’ve only called for NYPD backup seven times. On the other hand, the city said, the NYPD has called in B-HEARD teams 14 times after finding police services weren’t needed.
This, of course, is not an exclusively American problem. In September 2020, footage emerged showing Victorian police officers ramming a civilian in the back with their car before swarming him on the ground. The Victorian Police Force said in a statement that “during the highly dynamic incident a police officer was assaulted”. While the man’s father explained that his son had just been hospitalised for severe mental illness. In New South Wales, the response to a mental health crisis results in numerous armed officers entering the property, echoing the mantra followed by the Rochester police.
Over in Sweden, 1,500 suicides and 15,000 suicide attempts are reported on a yearly basis. It poses, as all mental health does, a serious puzzle to solve. In order to step closer to understanding, Stockholm’s health care services have introduced the Psychiatric Emergency Response Team (PAM) – which is an ambulance dedicated solely to mental health care. It represents the first of its kind in the world, which ostensibly makes it an emergency response therapy room that can weave through traffic.
While the PAM looks like the conventional ambulance on the outside, on the inside, comfortable seats have replaced stretchers, and the bright lights have been altered for a warmer glow.
The team that operates the PAM includes two mental health nurses and one paramedic. In Sweden, the police traditionally handled cases such as those. By having trained professionals handling those cases, the benefits are twofold, a) the level of care is increased and b) the stigmatisation of those suffering from mental health conditions is reduced. Just spitballing here, and not a knock on our police force, but perhaps better outcomes may be better worked, when the truncheon, the Glock, or the taser has been previously chosen.
In Stockholm, PAM responds to over 130 calls per month on average. The vast majority of these calls are mental health emergencies, often related to suicidal risk.
Anki Björnsdotter works as a mental health nurse and gave a small insight into VICE’s John-David Ritz.
“We help people who are suicidal and people who suffer from severe mental illness. It can be someone who is manic and not aware of their own mental state, such as a person who needs to go to a hospital without realising they need to. Also, people who are psychotic and people suffering from schizophrenia who haven’t taken their medicine and are in distress.
“It used to be the police who handled these kinds of calls. But just the presence of the police can easily cause a patient to feel like they’ve done something wrong. Mental illness is nothing criminal so it doesn’t make sense to be picked up by the police.
“When we first arrive at the scene, we evaluate the situation. If it’s a suicide case, it can take some time before you reach a contact person or someone who’s able to calm the patient down. We talk to the person in order to make a call about whether we should bring the patient to the hospital, or give them a ride home.
“For example, if we get a call about a person on a bridge about to commit suicide and things have cooled down by the time we arrive, we might consider the situation and decide that, in this particular case, the patient won’t try to commit suicide after all and won’t need to be hospitalised,” Björnsdotter said.
During its first year of operation, PAM was requested 1,580 times and attended to 1,254 cases. That’s an average of 4.3 requests and 3.4 cases per day. 1,036 individuals of all ages were attended to, and 96 of them had contact more than once. One-third of all attended cases resulted in no further action after a psychiatric assessment and sometimes crisis intervention had been made on site.
It is a scheme that is widely believed in, offering the right response to such delicate emergencies. PAM plans to continue operating in Stockholm after a successful trial, according to Fredrik Bengtsson, Head of Mental Health Emergency at Sabbatsberg Hospital. “I can’t see any reason as to why the project shouldn’t continue,” Bengtsson told VICE Sweden. “It has been considered a huge success by police, nurses, healthcare officials, as well as by the patients.”
Currently, Stockholm is the only Swedish city to have taken such measures to reduce suicide rates. However, Because of its success, other regions – like Skåne, Örebro, Blekinge, and Jönköping are all looking into the possibility of using PAM. In Gothenburg, they have already set up a scheme that takes mental health nurses to emergencies by car, again delivering the right type of care for patients suffering from mental health conditions.