What are the responses?

This is a particularly complicated issue, because our mental health system is so fragmented and ineffective. The justice system is already overloaded with mentally ill patients, and treating those people in prisons and jails is not a particularly effective long-term fix, in part, because corrections officers aren’t trained mental health professionals. So, what are appropriate and effective intervention points? Can we construct alternative courts, alternative approaches to dealing with mental health issues when they intersect with the criminal justice system?

In Phoenix, a team of professionals provides what’s called “assertive community treatment” (ACT) to those with serious mental illness. An outreach-centered program, it’s becoming an industry standard for treating those with severe mental illnesses. Houston’s police department devotes an entire division to mental health, with programs aimed at helping people in crisis avoid arrest, including a homeless outreach unit and teams of officers paired with mental health counselors to go out on calls for help. The department reduced the number of mental illness emergency contacts in half between 2008 and 2016. In Seattle, police and social workers patrol together, forging an alliance that is placing a dent in Seattle’s homelessness problems, which has a mental health component.

What to look for:

A systematic approach, experts say, is more effective than a series of one-off experiments. Quite often the impetus for that systematic approach comes from a traumatic event: In Houston, the effort began after two people with schizophrenia were shot and killed by police in two months in 2007. Also among the more successful efforts are those with broad acceptance and multiple partners, as well as political support. As with most issues, look for consistency, and results over time. Comparing one city’s response with another’s can be illuminating: Why do efforts work in some communities, but not in others?