When 911 sends police and a social worker

Officer Mason Geer answers some unusual police calls as the mental healthcare responder for the Lawrenceville, Ga., Police Department. There was the woman from El Salvador who was paranoid that death squads were still tormenting her. Or the mentally ill man walking toward the police department wielding a machete.

“When somebody’s going through a crisis, they’ll start exhibiting bizarre behavior—walking on the streets, talking to themselves,” Geer said, “And the normal response from somebody driving by is to immediately call the police.”

In 2021, the police department started a co-responder program with View Point Health, a local mental health clinic. When a 911 dispatcher determines a call is related to substance abuse, mental health, or domestic issue crisis, a police officer such as Geer and a licensed clinician visit the scene together. They ensure everyone is safe and deescalate the situation. Then, the clinician connects the individual with the resources he or she may need.

A growing number of co-responder programs across the country pair clinicians with police. Experts say the programs ease persistent staffing shortages in police departments and connect individuals in crisis with the services they need. But they warn the model is only effective as an enhancement to policing, not as a replacement. While local departments testify to the programs’ benefits, a lack of data makes it difficult to gauge their long-term success rates.

Lawrenceville is the county seat of Gwinnett County, a populous region in Atlanta’s northeastern suburbs. The city’s courthouse, jail, and large hospital serve the surrounding 430-square-mile area. Many of the individuals released from jail or discharged from the hospital don’t have a place to go. “So we saw a need for something other than the traditional police response that sometimes is putting a Band-Aid on a bigger injury,” said Salvador Ortega, the department’s public information officer.

Last year, homelessness rose by 12 percent nationally to its highest reported level of more than 650,000 individuals. At the same time, more Americans than ever before are struggling with a substance use disorder or a mental health issue, often simultaneously. The Centers for Disease Control and Prevention reported that overdose deaths topped 112,000 for the first time last year. On average, 911 receives about 240 million calls per year, 50 million of which are calls related to a mental health or substance abuse crisis, according to NENA The 911 Association.

Lawrenceville City Manager Chuck Warbington said the city has witnessed a similar rise in homelessness over the past decade. “And we have seen in our community a rise in mental health issues,” he added.. Individuals living on the streets or in the grip of addiction often rotated in and out of jail. “So [the co-responder program] has really helped with some of our repeat offenders,” Warbington said, “We don’t address it with that individual anymore, because they’re getting help in a mental facility or substance abuse facility.”

Warbington wasn’t sure how the city’s police officers would respond to the program. “They have really embraced this,” he said. “They care about the people. And we just need to give them the tools so they can continue to keep our community safe.”

At least 14 out of the United States’ 20 most populous cities have co-responder programs. The model has spread rapidly in recent years, though some cities such as Chapel Hill, N.C., have operated similar programs for decades. The city started its co-responder program in 1973. Today, 53 percent of the state’s departments reported running at least one type of alternative response program, according to a 2022 University of North Carolina at Chapel Hill survey.

“This is not necessarily a new concept. But I think the purpose of it has changed,” said Thaddeus Johnson, a professor of criminal justice and criminology at Georgia State University and a senior fellow at the Council on Criminal Justice. Johnson, who is a retired police officer, pointed to pre-pandemic programs like Crisis Assistance Helping Out on the Streets (CAHOOTS) in Eugene, Ore., which began in 1989. Denver launched a co-responder program in 2016. As the use of police force—particularly against people with mental illness—came under the spotlight during the past few years, more cities adopted the model.

Staffing shortages have also contributed to the trend. Maggie Horzempa is the North Carolina state director for Right on Crime, a conservative criminal justice initiative. She said co-responder initiatives enable police officers in departments having trouble filling vacancies to spend more time on patrol responding to violent crimes.

“Law enforcement around the country is really stretched thin. And they need more resources to serve larger and more troubled populations,” Horzempa said. “Not only are you sometimes solving recruitment issues, but you’re also giving a higher quality of public safety.”

But Horzempa emphasized that while mental health clinicians and other civilian co-responders can enhance a police response, the programs shouldn’t detract from police funding.

“They’re not there to take away resources from police or limit police and their ability to do their jobs and keep their community safe,” she said, pointing to a North Carolina Department of Justice survey outlining best practices in programs across the state. To be most effective, cities starting a co-responder program should steer clear of framing the initiative as a way to defund the police, instead emphasizing the positive involvement of law enforcement, the report maintained.

In Lawrenceville, Ga., Officer Geer strives to build long-term relationships with people he meets on duty. “I’m able to connect with people and empathize with their situation,” Geer said. “The department has given me a lot of tools to help accomplish this.” He often orders taxi rides, connects individuals with the local food bank, and refers them to rehabilitation programs if they’re struggling with substance abuse.

“Of course, the challenge is, a lot of times people are unwilling or incapable of making the choices for themselves,” he said. Often, Geer encounters individuals in a mental health crisis who don’t understand why they need help. If they have harmed or threatened to harm themselves or others, the clinician can sign a 1013—a legal form that allows law enforcement to transport the individual involuntarily to a mental health facility for evaluation and treatment.

For those who aren’t suicidal or experiencing a life-endangering crisis, responders can do little if the individual refuses to recognize the problem. Many of the homeless individuals they serve refuse offers of shelter or treatment for their mental conditions.

Warbington, the city manager, also said finding enough mental health professionals so the city can follow up with the people they refer to treatment or rehab is another challenge.

Well-intentioned nonprofits and ministries can also stymie the program. Warbington recalled an instance when a nonprofit paid the bill for homeless men and women living in an Extended Stay America hotel. The city had been working to move them into permanent housing or treatment. Now, “they won’t even return our call,” he said. “We have a very giving community, very passionate, but they're working in silos.”

Johnson with the Council on Criminal Justice said a lack of data makes it difficult to evaluate the long-term results of co-responder programs. There’s some local data that show the model lowers arrests and encounters with repeat offenders, as well as assaults on police officers. In 2023, the co-responder unit at the Lawrenceville Police Department handled 1,072 calls and only made 6 arrests from those calls, according to Ortega. Out of 1,109 calls in 2022 the unit made 1 arrest. The arrest rate for the co-responder unit averaged 0.3 percent, while the arrest rate for the number of overall calls during the same period was 2.5 percent.

But Johnson said that, without a systematic analysis of multiple programs, it’s difficult to evaluate the model without relying on local stories and anecdotal data. And most of the current research relies on the experience of service providers.

“We need more research that talks to the people who have gone through these pipelines,” he said. “They’re being referred and diverted from the criminal justice system, what are their outcomes when they’re on the other side?”