A mother calls 911 because her son is in psychiatric crisis, pacing the house, talking to people who are not there, and she is frightened for him and for herself. Within minutes, police officers arrive, uniformed, armed, trained to secure scenes and neutralize threats. Her son sees them and panics. What happens next can go many ways, some ending in hospitalization, some in jail, some in injury, some in death. She did not know what else to do, and now she is not sure she made the right call. A man having a mental health crisis on a public street draws concerned looks from passersby who call police because they do not know who else to call. The officers who respond see behavior they cannot interpret, resistance they perceive as threat, and they do what they are trained to do. Later, the community asks whether there could have been a different outcome, whether the response matched the situation, whether the man needed help or control. A woman with bipolar disorder has learned to fear police from past experiences where she was handcuffed during manic episodes, transported in police vehicles, treated as dangerous when she was sick. Now when she feels an episode coming, she hides rather than seeking help, knowing that involving the system may mean involving police. A department implements crisis intervention training, sending officers through courses that teach mental health awareness and de-escalation. The trained officers respond to crisis calls differently, but the department cannot train everyone, and the culture remains shaped by perspectives that training does not entirely change. Police have become default first responders to mental health crisis in many communities, a role they did not seek and for which they may not be suited. Whether police should continue in this role, how it might be reformed, or whether alternatives should replace police response remains one of the most contested questions in mental health and public safety policy.
The Case for Police Reform in Mental Health Response
Advocates for police reform argue that police will continue to encounter people in mental health crisis and that improving police response is necessary and achievable. From this view, better-trained police can be part of effective crisis response.
Police have capacity that other responders lack. They can respond quickly, are available 24/7, and have authority to act when safety is at risk. Until alternatives exist everywhere, police will remain part of crisis response. Improving how they respond is essential.
Crisis intervention training works. Officers trained in CIT respond differently to mental health situations. They de-escalate more, use force less, and divert more people to treatment rather than jail. Expanded CIT training would improve outcomes across many departments.
Co-responder models pair police with mental health professionals, combining security capacity with clinical expertise. These models allow appropriate response to situations that involve both mental health crisis and potential danger. Co-responder should be expanded as bridge between pure police response and mental health-only response.
From this perspective, improving crisis response requires: mandatory crisis intervention training for all police; co-responder models in all communities; police protocols that prioritize de-escalation; accountability when police response to mental health crisis results in harm; and culture change within policing to see mental health response as legitimate role.
The Case for Replacing Police in Mental Health Response
Others argue that police are fundamentally unsuited to mental health response and that reform cannot address the underlying problems. From this view, police should be removed from mental health crisis response entirely.
Police are trained to control situations, not to help people in distress. Their presence, their uniforms, their weapons all signal threat to someone in psychiatric crisis. De-escalation training cannot overcome the fundamental nature of policing. Mental health response requires different responders.
People with mental illness are overrepresented among those killed by police. This is not coincidence but consequence of sending police to situations where mental health expertise, not law enforcement, is needed. Reforming police response to mental health has not prevented these deaths. Different approach is needed.
Alternatives exist. Mobile crisis teams, community responders, and mental health professionals can respond to crisis without the risks police response creates. These alternatives should be built as primary response, not as supplements to police.
From this perspective, transforming crisis response requires: routing mental health calls away from police to mental health responders; mobile crisis teams available 24/7 as primary response; police role limited to situations involving actual criminal behavior or imminent danger; and recognition that police reform within mental health response is insufficient.
The Use of Force Question
Use of force during mental health crisis, including Tasers and restraints, raises serious concerns.
From one view, force is sometimes necessary for safety. A person in crisis who is violent or armed poses real danger. Police have tools to control dangerous situations that mental health professionals lack. Force should be minimized but remains necessary option.
From another view, force in mental health crisis is often counterproductive and traumatic. It escalates rather than de-escalates. It creates fear that prevents future help-seeking. Force should be last resort, used only when life is at immediate risk, not as tool for compliance.
When and how force can be used during mental health crisis shapes both immediate outcomes and long-term system trust.
The Crisis Intervention Training Debate
Crisis intervention training for police has been widely promoted but its effectiveness is debated.
From one perspective, CIT is proven intervention. Research shows CIT-trained officers have better outcomes in mental health calls. CIT creates specialized officers who can respond more appropriately to crisis. All departments should have CIT programs.
From another perspective, CIT evidence is mixed. Brief training cannot fundamentally change police response. CIT-trained officers are often not dispatched to crisis calls. Department culture may not support what training teaches. CIT may be necessary but is not sufficient for meaningful change.
Whether CIT training is effective reform or inadequate response shapes training investment.
The Co-Responder Model
Co-responder programs pair police with mental health professionals on crisis calls.
From one view, co-responder is effective hybrid. Police provide safety while clinicians provide mental health expertise. The combination produces better outcomes than either alone. Co-responder should expand as primary model for mental health crisis calls.
From another view, co-responder maintains police in mental health response when police should be removed. The presence of police, even alongside mental health professionals, affects how situations unfold. True alternatives require mental health-only response for mental health calls.
Whether co-responder is appropriate bridge or inadequate compromise shapes crisis response development.
The Call Routing Challenge
For alternatives to police to work, mental health calls must be identified and routed appropriately.
From one perspective, 911 systems can triage calls and dispatch appropriate responders. Mental health calls can be identified and routed to mental health teams. This requires dispatcher training and protocol changes but is achievable.
From another perspective, calls are often ambiguous. What seems like mental health crisis may involve weapons or violence. What seems like crime may involve mental health crisis. Clean separation of mental health calls from police calls may not be possible.
How calls are identified and routed shapes which responders arrive.
The 24/7 Availability Requirement
Police are available 24/7; alternatives may not be.
From one view, alternatives must match police availability. Mental health crisis happens at all hours. If alternatives are only available during business hours, police will respond at night. True alternatives require round-the-clock availability.
From another view, building 24/7 alternative capacity takes time and resources. Partial availability is better than none. Police can be backup when alternatives are not available while alternatives expand coverage.
Whether alternatives must match police availability immediately or can expand over time shapes implementation.
The Small Town Challenge
Small communities may lack resources for alternatives to police response.
From one perspective, small communities deserve alternatives just as larger communities do. Regional models, telehealth support, and creative approaches can bring crisis alternatives to small towns. Geographic equity matters.
From another perspective, small communities cannot sustain specialized crisis teams. Police with better training may be the realistic option in communities without capacity for alternatives. Different approaches may be appropriate for different community sizes.
Whether alternatives can work in small communities shapes rural mental health response.
The Liability Question
Liability concerns shape both police response and alternatives.
From one view, fear of liability should not drive policy. Sending police to situations where they may cause harm creates its own liability. Alternatives designed with appropriate protocols can manage liability while improving outcomes.
From another view, liability concerns are real for departments and municipalities. Alternative programs must address liability explicitly. Fear of what might go wrong when police are not present affects willingness to try alternatives.
How liability concerns are addressed shapes willingness to change response models.
The Community Trust Factor
Past negative experiences with police affect willingness to call for help.
From one perspective, building trust requires changing police behavior. If police respond appropriately to mental health crisis, trust can be rebuilt. Community policing approaches and better training can restore relationships.
From another perspective, trust cannot be rebuilt while police remain primary responders. For communities with histories of police violence, no amount of reform will make police response acceptable. Alternatives are necessary for trust to develop.
Whether trust can be rebuilt through police reform or requires alternatives shapes community relationships.
The Canadian Context
Canada has implemented CIT training in many police departments, developed some co-responder programs, and piloted alternative response models in several cities. Calls for police reform and alternatives have increased following high-profile deaths of people in mental health crisis during police encounters. Yet police remain primary responders to mental health crisis in most Canadian communities.
From one perspective, Canada should rapidly develop mental health crisis alternatives and remove police from situations that are primarily mental health rather than criminal.
From another perspective, police reform including expanded training and co-responder models can improve outcomes while alternatives are developed.
How Canada approaches police and mental health response shapes safety and outcomes for those in crisis.
The Question
If police training and culture are oriented toward control and threat management rather than care and de-escalation, if people in mental health crisis perceive police as threat that escalates rather than calms, if fatal encounters between police and people in crisis continue despite reform efforts, if alternatives exist that could respond without the risks police response creates - why do police remain primary responders to mental health crisis? When a mother calls for help and police response ends with her son dead, was there any other call she could have made? When reforms are implemented but outcomes remain, at what point do we acknowledge that reform is not enough? When we know that police response to mental health crisis can be fatal but continue to send police because alternatives do not exist, whose responsibility is it to build alternatives? And when someone dies during police response to their mental health crisis, what does that death reveal about our actual priorities and values?