Cities need better mental health care and better policing

One year before racial justice protesters flooded the streets and cries to “defund the police” took the internet by storm, the Denver Police Department helped organize a pilot program that transferred low-risk 911 calls from a police officer to a mental health clinician.

In 2019, city lawmakers, officials, and police officers flew to Eugene, Ore., to do ride-alongs with responders from their mental health program called CAHOOTS (Crisis Assistance Helping Out on the Street). The community policing initiative sends two-person teams (a medic and a crisis worker) to respond to mental health–related crises.

Denver officials spent three days learning the ins and outs of the program. That November, Police Chief Paul Pazen presented a plan of his own to the Denver City Council: the Support Team Assisted Response Program—STAR. At the time, “we didn’t see cardboard signs about alternative responses, defund the police, and all of that,” Pazen said. The police department wrote the grant proposal, and the council approved $208,141 for a six-month trial funded by the Caring for Denver Foundation.

Now, other cities are looking to STAR as an effective example of an alternative to policing. Denver law enforcement and program designers warn that while programs like STAR can provide better outcomes for individuals in crisis, they do little to fight crime.

Carleigh Sailon, a social worker who helped found the program, is the operations manager for STAR. She describes the program as a partnership with the police by helping them answer calls that shouldn’t end up on their plate in the first place. During the first six months, STAR responded to 748 incidents with a low risk of violence—calls related to substance use, indecent exposure, or mental health crises. Sixty-eight percent of the calls involved individuals experiencing homelessness.

A typical call? If a homeless person is trespassing by sleeping in the doorway of a business, STAR responds to the business’s concerns. Instead of an armed police officer, a paramedic and a clinician arrive at the scene in a white van with a blue and white stripe at the bottom. They transport the individual to a nonprofit shelter or connect him or her with other city resources. “Police have historically been tasked with moonlighting as social workers or case managers because that’s who responds when you call 911,” Sailon said.

Denver police officers make 30 percent of all calls to STAR. An officer may arrive on the scene and realize a STAR staff member could provide the right kind of help. “We’ve never run this as a defund-the-police program,” Sailon said, “This was not an effort that was done to say we don’t need police in our city or that we need fewer police.”

Stanford University researchers Thomas S. Dee and Jaymes Pyne conducted a study that found the program contributed to a 34 percent decrease in low-level crime such as indecent exposure and trespassing in neighborhoods where STAR was available. The researchers attributed this drop to police giving fewer citations for minor offenses and repeat offenders getting the help they needed.

But STAR has little to no effect on violent crime, the study found. In fact, violent crime in Denver has exploded since 2020. That year, the city witnessed the highest number of homicides since 1981—95 people killed—a 51-percent increase from 63 deaths in 2019. In 2021, violent crimes took the lives of 96 people.

Chief Pazen pointed to the national police staffing shortage and to state laws that make it easier for previously convicted drug dealers and carjackers to obtain guns. The department is about 240 officers short, Pazen said. That’s 15 percent of its workforce. “At the same time, the total calls for service have increased,” he said. It takes about 15 minutes for the department to respond to high priority calls.

After the visit to Eugene, Ore., in 2019, STAR launched on June 1, 2020—five days after the death of George Floyd in Minneapolis. About a week later, as racial justice protests swept the city, the city council voted to move STAR from the police department to the Denver Department of Public Health and Environment. Pazen says STAR “has been politicized” and worries that some people see the program and similar initiatives as the panacea for all social problems—and an argument for de-policing.

“STAR is not crime prevention. It’s not a crime reduction. It’s not a crime fighting strategy. It is better outcomes for individuals in crisis,” he emphasized. To tackle violent crime, Pazen said the city needs many more officers, not fewer. “If people think they’re going to get caught for a crime, they don’t commit that crime.”

Lars Trautman, a former prosecutor who works with the conservative criminal justice reform initiative Right on Crime, agrees. Expanding these programs shouldn’t mean downsizing police departments. “There’s often a little bit of this zero sum approach,” he said. Mental health emergencies make up a small proportion of overall 911 calls. The program alone can’t assuage the national shortage of 911 operators.

From January through July of this year, 37,958 callers to 911 in Austin, Texas, have hung up, often because of long wait times. The shortage forced a rural dispatch center in Washington to close. Sailon says STAR and programs like it won’t solve this problem, though they do help. Denver processes about 1.4 million 911 calls every year. STAR only takes between 3 and 6 percent of those calls, she said.

Still, the program has its place. Pazen hopes the city continues to expand STAR. The Denver City Council approved a $1.4 million contract with the Mental Health Center of Denver to expand the program from three to six vans.

New York City, Washington, San Francisco, and Austin have started experimenting with similar programs. Sailon has met with officials from Lubbock, Texas; Indianapolis; Hennepin County, Minn.; and Durham, N.C.,—cities interested in starting their own pilot programs.

“Let’s figure out those long-term strategies so we can get them [individuals in crisis] the help that they need,” Pazen said. “But let's not be distracted thinking that this is all of a sudden going to reduce crime.”