The Bazelon Center, in partnership with five communities across the country, is conducting a three-year Performance Improvement Project (PIP) designed to reduce reliance on law enforcement officers in responding to psychiatric emergencies. The goal of the project, launched in January 2010, is to help community mental health systems take responsibility for meeting the needs of consumers who are at risk of arrest or incarceration. The PIP builds upon local reform efforts and pinpoints areas where additional system change is required.
The goal is for communities to take a proactive—and more cost-effective—approach to psychiatric emergencies. As in the healthcare system, mental health treatment is most accessible—and most expensive—during an emergency. When individuals are regarded as dangerous to themselves or others, enormous quantities of expensive resources are consumed within a brief time span. Police calls, hospitalization, adjudication and jail detention are costly interventions. Once the crisis has passed, however, the individual often finds intensive, indeed even routine, treatment services out of reach.
This project goes beyond the calls for closer collaboration between mental health and criminal justice agencies or better mental health care in jails. It reframes encounters between people with mental illnesses and law enforcement as failures in service systems, shifting accountability back to mental health and related agencies. The PIP promises to show how community leaders can take ownership of the constellation of problems that stem from systems failing to meet the basic needs of consumers.
Five community entities—Travis County, TX, Allegheny County, PA, Wayne County, MI, Multnomah County, OR and Westchester County, NY—participate in the PIP. They were selected because they have both a history of providing coordinated community services designed to help avert crises that lead to law enforcement contact and an interest in reforming systems to secure better outcomes for individuals and more accountability for government investments in mental health and other human services.