OPINION: Police-Led Mental Health Welfare Checks — Getting to the Root of the Issue

by Ayomi Rajapakse

There is an increasingly popular argument suggesting that investment in Mental Health First Responders over new police hires may help reduce fatal interactions between police officers and individuals experiencing a mental health crisis, but these proposed reforms often miss the bigger picture.

Currently, police act as mental health first responders when they provide "welfare checks," a non-crime-related service in which local law enforcement checks on the wellness and safety of the individual(s), usually requested by concerned friends, family, or neighbors.

But as a Washington Post database shows, 1 in 5 individuals shot by police had a mental illness or was experiencing a mental health crisis, often during a welfare check. The risk of being shot by a police officer increases at the intersection of Blackness and having a mental illness. Would further mental health training for police and law enforcement actually increase safety in these situations?

In response to calls for police reform, many states have implemented policies that establish improved practices. These practices have varying degrees of police involvement, from police-based responses to community- or professional-based responses. Police-based responses can include crisis intervention teams, where police officers with 40 additional hours of specialized training are dispatched when appropriate. Community-based responses can include 911 dispatchers triaging calls and dispatching mobile crisis teams of EMTs, peers, and behavioral crisis experts instead of police.

Unfortunately, while well-intentioned, these policies are missing the point. The reliance on police officers to respond to welfare check requests in any capacity underscores the weaknesses and inadequacies of U.S. mental health services. Policymakers must take comprehensive steps to provide widely accessible, destigmatized mental health care and substance use treatment on a County, State, and federal level to serve their citizens better.

As decision-makers begin to rethink the role of police in mental health crises, adopting a strategy that layers these approaches to build a robust and comprehensive crisis response model would best serve their community's needs. But, any attempt to address police killings of people experiencing a mental health crisis must also address the stark inequities and barriers that exist in our mental health systems and expand early intervention and prevention services.

I think about these issues a lot, in part because I'm in school studying public policy and administration, but also because I have personal experience with how terrifying a "wellness check" can be.

Just over a year ago, I was upstairs in my room listening to a lecture for a class I'm taking for my master's degree. Then, I heard my doorbell ring. I looked out onto the street below and saw four police SUVs outside my house.

I have privilege; I have not interacted with many police officers in my life. But, I am a Brown, 26-year-old woman who immigrated to the United States from England. So, I immediately panicked. I closed my laptop, grabbed my phone, called my mum, told her what was happening, asked her to take the rest of the day off work, put her on speaker, and told her to stay on the phone with me. Then, hands shaking, I walked downstairs and opened the door.

Four County sheriff officers were standing on my front porch. The officer closest to my door was in full tactical gear and holding one of those shields that protect them from … I'm not sure what. I'm originally from England, where police officers carry a baton or pepper spray, so I've rarely encountered or interacted with police officers holding guns.

I don't remember what the two officers in the middle were doing, because I looked behind them and saw the final officer holding an assault rifle aimed toward me. The first thing I did was put my hands up, and I told my mum (who was still on speaker) to come home now, and I would call her back. One of the officers then explained why they were standing on my front porch.

They asked if my friend was inside. I said no, he had left to stay with someone else. Then they asked if they could enter my house to check for themselves. I said yes, and informed them that the three golden retrievers in the house were not aggressive, just a little excited.

My friend — who lived with me — had a history of alcoholism and was experiencing a mental health crisis and needed help, and a worried member of our community had called for a welfare check.

But how was this militarized response, which terrified me and immediately escalated the situation, supposed to help? And what if my friend had access to free substance use treatment and mental health care instead?

We need a strategy that focuses on mental health crisis prevention and intervention.

We can't prevent all mental health crises, so a crisis response — informed by cognitive and behavioral health — is necessary when they do happen. The mere presence of police officers escalates any situation, triggering an inevitable increase in anxiety, tension, and fear, putting all parties involved at an increased risk for injury and death. The National Alliance on Mental Illness (NAMI) provides a clear position on this: "While law enforcement may still play a role in some mental health crises, the primary response should come from mental health crisis response professionals."

Nationwide protests roused some cities to reimagine mental health crises responses. Eugene, Oregon, has implemented the Crisis Assistance Helping Out On The Streets (CAHOOTS) program, which diverts calls away from police to a more appropriate service to resolve the situation. Similar programs can be found in Denver, Colorado's Support Team Assisted Response (STAR). But, as frustration and fatigue grow over the stalled pace of change, the sense of urgency around this issue has seemingly dissipated. Moreover, CAHOOTS only diverts 5%—8% of calls for service away from Eugene's police department to other more appropriate services.

To that end, President Biden's "Strategy to Address Our National Mental Health Crisis" is an encouraging leap forward. It promises millions of dollars from the president's FY23 budget to investments for programs that will increase the supply of behavioral health providers to underserved communities. It would also create community-based mobile crisis response teams, evidence-based community mental health services, and research into innovative mental health treatment models.

My experience ended peacefully, but many end in trauma, violence, and, in the most harrowing instances, death. Access to affordable and sustainable outpatient or inpatient mental health services is a crucial part of avoiding police intervention that too often ends in tragedy.

The South Seattle Emerald is committed to holding space for a variety of viewpoints within our community, with the understanding that differing perspectives do not negate mutual respect amongst community members.

The opinions, beliefs, and viewpoints expressed by the contributors on this website do not necessarily reflect the opinions, beliefs, and viewpoints of the Emerald or official policies of the Emerald.

Ayomi Rajapakse (she/her) is a second-year graduate student at the Daniel J. Evans School of Public Policy and Governance, and program associate for the Center for Trust and Transformation.

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