Mental Health and the role of Law Enforcement
Why is behavioral health training important for law enforcement?
Lt. Eric Pisconski (Ret) / Seattle Police Department
Tac-D Solutions – Founder
How did law enforcement’s role in behavioral health develop?
Psychotropic medications designed to better manage mental illness became readily available during in the 1950’s, and the first push toward de-institutionalization began. In 1955, Congress established the Joint Commission on Mental Illness and Health to examine issues related to the mentally ill. There was a concerted effort to deinstitutionalize mental health care and move it toward a system of community-based resources. This culminated in President Kennedy’s 1963 Community Mental Health Act; and combined with parts of the 1964 Civil Rights Act, it laid the foundation for state-based civil commitment guidelines. Since then, the responsibility of primary interaction with those experiencing mental health related issues has fallen largely on the role of law enforcement.
This paradox eventually led to the advent of programs such as ‘CIT’ (Crisis Intervention Training) or the “Memphis Model” as it became known. This initial Crisis Intervention Training was a 40-hour course designed in conjunction with law enforcement and mental health clinicians to provide a foundational understanding of behavioral health issues and techniques for interactions. CIT courses began integrating into law enforcement training nationally around 1998.
Generally, the role of law enforcement has been exactly that, enforcement of the law; focused primarily on life safety. So, how do we incorporate these competing interests into how we handle calls for service? As law enforcement, we generally operate behind the power curve; and tend to be reactionary by nature. Police officers do not know when or where the next call will be dispatched, what or who it will involve and (rarely) if the individual they encounter is currently experiencing a behavioral health crisis. Upon arrival to a call, we must first make every effort to address any immediate life-safety threats and establish scene control. Our goal is to slow things down, assess the situation and attempt to gain voluntary compliance with individuals experiencing a behavioral health crisis. Our role should be to function as the ‘Rosetta Stone’ or intermediate translator to behavioral health calls; respond and stabilize the incident, assess an individual’s immediate needs and connect them to the most appropriate service providers.
Communities and various municipal agencies across the country are routinely exploring options on how to combine mental health professionals with first responders. This “co-responder” model is an effort for 911-based services to take a more holistic approach with individuals experiencing behavioral health issues. While most are law enforcement centric, some cities are pairing these resources with fire and EMS response, as most behavioral health issues are viewed as requiring medical rather than legal intervention.
Why joint training for MHP’s is essential when deploying with law enforcement
Having a mental health professional (MHP) embedded into a law enforcement unit can offer insight into both care and management options for individuals and provides an opportunity for officers to view situations through a different lens. An MHP on staff can also allow for immediate access to services and information otherwise unavailable to officers; and coordinate continuity of care and treatment.
When incorporating an MHP with a law enforcement response, it is crucial to provide access to (or even participation in) law enforcement training. We have the obligation as law enforcement to establish the context for what, how, and why we do things in a tactical setting. If an MHP is provided with a basic understanding of ‘officer safety’ and ‘rules of engagement’, it will assist them in field response and can provide additional legitimacy of their role to other officers. This training exposure will also assist the MHP’s when having conversations with other service providers related to the work of law enforcement.
As law enforcement, we can sometimes take for granted the training and experience accumulated over years of service. Remember back to those early days; learning how to operate the radio and patrol equipment, where the siren is located, familiarizing ourselves with block numbers and directions, radio language and codes, contact and cover principles, and team tactics, just to name a few. Think about the ride-alongs you have done with civilians and all the questions they ask, their gap in knowledge of what we do, why we do it and how we do it. Now, imagine that civilian riding with you every day, having to ensure both your safety and theirs, and trying to provide a cohesive response in a dynamic situation.
Incorporating basic law enforcement awareness training for MHP’s is essential for a program’s success. Law enforcement has long participated in various types of stress inoculation training, so officers perform better during high-stress encounters. Providing MHP’s the opportunity to develop familiarity of what they may encounter while inside a patrol vehicle, responding to and arrival on potentially dynamic calls, and being ‘inside the line’ during an unpredictable incident involving a person experiencing a behavioral health episode will reduce their stress and cognitive load, allowing them to perform at their best.
Another consideration, depending on the number of officers and MHP’s within a unit, is having them rotate with different officers. There will be a variety of personalities within any group; and finding the right cohesion will be important to team effectiveness. The work a co-responder unit engages in will be demanding, emotionally exhausting and extremely gratifying. Team effectiveness requires involved personnel developing a cohesive bond.
Key components to policy and training
First and foremost, your agency must have buy-in for a co-responder program from the top down. Second, work should be done to cultivate support from the community, local service providers and elected officials. Third, determine a funding source – will you be pursuing grants, realigning existing budgets, collaborating with a service provider, or pursuing direct funding?
Primary focus should be on what an agency hopes to accomplish with the implementation of a co-responder model. Goals can include any combination of a decrease in arrests, decrease in uses of force, decrease in calls involving “frequent-flyers”, increase in non-law enforcement service referrals, increase in community perceptions of police legitimacy, etc. Developing guidelines for a ‘Crisis Intervention’ program or unit should include deployment strategies, documentation requirements and data collection, roles and responsibilities, training and qualification standards for both officers and MHP’s, and vetting criteria for assigning follow-up.
Determine what service provider agency(ies) you will partner with to provide the MHP’s. While hiring MHP’s directly is an option, there is an inherent ‘firewalling’ that occurs when MHP’s are contracted. In most jurisdictions, MHP’s have access to systems and databases containing HIPAA protected information that law enforcement does not (and should not) have. This allows the MHP’s to maintain client confidentiality while still providing valuable insight for their law enforcement partners. Additionally, having MHP’s contracted removes potential supervisory leveraging by law enforcement; the MHP’s will have dual oversight which provides a system of checks and balances.
Developing criteria or job description for the MHP position is a good starting point and should be done in conjunction with the agency(ies) providing the service. These qualifications should include: a minimum education level, specific certifications required, salary range, duties and responsibilities, performance expectations, hours of operation, and dress code. Once a candidate pool is established, the interview process should include at least one member of the law enforcement team. Background investigation guidelines must also be established as the MHP’s will likely have ‘view-only’ access to Criminal Justice Information Systems (CJIS) information and physical access to secure police facilities, vehicles, and equipment.
The selection process for MHP’s is important to the overall success of a co-responder program. It would be an understatement to say that MHP’s and law enforcement often view interactions differently; but embracing that difference is exactly the point. A good co-responder team is truly two sides of the same coin, which attempts to take a holistic approach to interactions with people experiencing an acute or chronic behavioral health crisis.
U.S. Department of Health and Human Services. (2025, January 21). National Institute of Mental Health (NIMH). National Institutes of Health. https://www.nih.gov/about-nih/nih-almanac/national-institute-mental-health-nimh
Erickson, B. (2021). Deinstitutionalization Through Optimism: The Community Mental Health Act of 1963. American Journal of Psychiatry Residents’ Journal, 16(4), 6–7. https://doi.org/10.1176/appi.ajp-rj.2021.160404
CIT Center. Overview. (n.d.). https://cit.memphis.edu/overview.php?page=2
