On March 3, Najee Seabrooks was shot and killed by two police officers in Paterson, New Jersey, after an hours-long standoff. Seabrooks, who was in mental and emotional distress and had barricaded himself in the bathroom, called 911 earlier in the day, expressing fears that someone was coming after him and that he needed an escort for his safety. His name was added to the list of hundreds of others nationwide killed by police while experiencing a mental health episode or struggling with a behavioral health emergency. His story, however, struck a particularly somber note because he knew of—and called upon—a network of violence interventionists who had the resources, training, and desire to safely respond to his situation but who were turned away by the force they were attempting to serve as an alternative to.
Seabrooks worked as a violence intervention specialist at the Paterson Healing Collective, a local anti-violence intervention organization in partnership with the county’s St. Joseph’s Hospital to support survivors of violence. In addition to mentorship, the group responds to high-risk incidents of community-based violence, connecting those involved with support and resources. In his role, Seabrooks helped forge partnerships with other anti-violence groups nationwide and connected with school-aged youth in the aftermath of violence.
Throughout the standoff, Seabrooks texted members of the collective, asking where they were and pleading to speak with them. But despite collective members’ requests to enter the apartment unit and employ their own expertise in handling situations of this very nature, Paterson police officers denied their pleas and left them waiting in the building lobby.
In much the same way that people who have severe mental illnesses are overrepresented in nearly every part of the criminal legal system, they are also overrepresented in police killings. According to the Treatment Advocacy Center, the risk of being killed by the police is 16 times greater for those with untreated severe mental illness than for other individuals who are approached or stopped by officers. While those with untreated severe mental illness constitute less than 2% of the adult population, it’s estimated that anywhere between 25 and 50% of people killed by law enforcement were suffering from a mental illness. In 2022 alone, police forces killed at least 109 people after responding to someone “behaving erratically or having a mental health crisis.”
In an analysis of the police departments in the nation’s 100 largest cities, 23 do not mandate that officers use deescalation before applying force. Further, a separate report by the U.S. Commission on Civil Rights cited written testimony from police officers which conveyed that they often felt ill-equipped to manage encounters with people suffering from mental illness, often perceiving them as “threatening.”
Given that at least 20% of police calls for service involve someone in a mental health crisis or substance abuse emergency, developing new ways to deescalate mental health crises is paramount. Police incapacity to respond to these interactions without harming or killing people in crisis underscores the need for alternate approaches such as crisis intervention and harm-reduction programs, some of which work alongside police, while others operate largely independently. Some are notified of emergencies through diverted 911 dispatches, while others rely on community outreach efforts to ensure residents are aware of their presence and can lean on them if needed.
Crisis response teams are trained to deescalate the situation, assess an individual’s immediate and long-term needs, and connect those in distress with local services at shelters, job training programs, or rehabilitative services to ensure they’ll receive ongoing support.
In Paterson, community outrage and collective mourning came after news broke of Seabrooks’ death. Advocates from anti-violence groups organized a vigil and began outlining various demands for reform—some of which have been implemented in other counties throughout the state and across the country—including creating a civilian review board, an investigation into the Paterson Police Department by the Justice Department, ending qualified immunity, passing legislation that would increase transparency and allow residents to know the disciplinary histories of individual officers, and deeper investment in non-police responses to mental health emergencies.
In late March, New Jersey Attorney General Matt Platkin announced that his office would be taking control of the Paterson Police Department. Since then, Platkin has appointed a new police chief over the department and established a “working group” to make recommendations for interactions between police officers and violence interventionists. Platkin also announced his intention to revamp state protocols for dealing with people who have barricaded themselves in rooms or buildings and to expand the state’s ARRIVE Together program into Passaic County, which includes Paterson.
ARRIVE Together (“Alternative Responses to Reduce Instances of Violence & Escalation”) was first launched in 2021 in New Jersey’s Cumberland County before expanding to Elizabeth and Linden police departments in 2022. The program, which pairs New Jersey police officers with a certified mental health screener to respond to 911 calls for behavioral health crises, exemplifies a crisis intervention program that is both tethered to existing police resources and yet attempts a new approach. According to research from the Brookings Institute, qualitative data from the program’s pilot, which spanned from December 2021 to January 2023, captured more than 300 police calls and follow-up visits that engaged the ARRIVE Together team. The results were promising: 97% of cases did not use force, and 98% did not result in an arrest during either the call for service or follow-up. Further, outcomes from ARRIVE together calls did not demonstrate any of the profound racial disparities typical of most police encounters.
Despite such favorable results, the report authors also acknowledge that ARRIVE Together is just one of many police mental health response teams being experimented with nationwide and that the program would do well to learn from other models in different states. However, anti-violence advocates argue that the most effective initiatives don’t incorporate the police at all. In a statement released this spring in response to Attorney General Plakin’s takeover of the Paterson PD, the New Jersey Violence Intervention and Prevention Coalition wrote, “Paterson must be compelled to invest in a non-carceral crisis response team made-up of fully funded and trained community members, and there needs to be change at the highest levels of law enforcement in Passaic County.”
This argument that non-carceral mental health responses would be safest and more effective is further supported by data from other pilot programs. In 2021, the New York City Police Department piloted B-HEARD in Harlem, dispatching mental health professionals and EMTs to respond to non-violent behavioral health emergencies. Early data from the program’s first month showed promising results aligned with the goals set forth by city officials: more people received emergency mental health assistance, fewer hospital transports were made, and there was a notable increase in follow-up visits.
However, as reported by Prism, the program’s success was stymied by its very infrastructure—namely, its reliance on police dispatchers to choose whether to deploy the B-HEARD team or traditional law enforcement. According to an analysis conducted last fall by The City, 911 dispatchers have continued to deploy NYPD to about 75% of mental health-related calls, and the teams’ response rate has steadily declined as well: between January and March of last year, teams responded to only 68% of calls routed to them by 911. Yet, despite such troubling results, New York Mayor Eric Adams continues to expand B-HEARD, with the Bronx set to be the first borough fully covered by the program by 2024. The Mayor’s Office of Community Mental Health has begun to initiate efforts to educate police officers about the B-HEARD program by attending roll calls in the assigned precincts and sharing information with officers about when it would be appropriate to call in a B-HEARD team for assistance. Thus far, this approach has been effective with more cases of officers requesting support from B-HEARD.
Despite such efforts and the fact that B-HEARD is still relatively new, existing data reveals serious capacity strains that can hinder its long-term success, as well as the limitations of initiatives that remain tethered to the police and don’t allow residents to seek out assistance independently.
Those limitations were echoed by ACLU of New Jersey Deputy Policy Director Jim Sullivan, who, while supportive of ARRIVE Together as a first step, feels that other programs better achieve real public safety.
“I think that non-carceral intervention units are the way to go, and we should be resourcing and funding them in as many places as we can,” said Sullivan. “Having said that, I don’t think that ARRIVE is good for places like Paterson and Newark, where they already have non-carceral alternatives to policing on the ground.”
Instead, Sullivan recognized groups like Paterson Healing Collective and the Newark Community Street Team as what he considers some of the best models for non-carceral emergency responses and violence intervention.
“I can see a world where ARRIVE units would be a positive step forward for counties and cities that don’t have groups like that,” said Sullivan. “But I think that the best way forward would be a non-carceral approach, especially in both the mental health interventions and violence interrupters. There’s a lack of trust between many communities and the police, which complicates things in these situations. So I think that the non-carceral alternatives that we have in the state are the shining example of what we should be doing in more places.”
The success of crisis intervention programs in cities nationwide, paired with growing awareness of the fatal outcomes of police responses to emergency calls, has also inspired greater public buy-in for these new initiatives. In a national poll conducted in March 2021, 65% of likely voters expressed support for reallocating some of police budgets to create civilian emergency first response programs to address mental health issues and substance use.
A new California-based response program
While New York’s B-HEARD and New Jersey’s ARRIVE Together are built into and reliant upon local police departments, myriad initiatives offering trauma-informed, non-carceral responses to mental health crises abound and provide a window into the potential of expanding such approaches.
Last November, The TRUST Field Response Program in California’s Santa Clara County joined a suite of other mental health and substance use-related emergency response programs in the area. However, it differs notably in that its response teams do not include police officers. Operating in partnership with the county and three local nonprofit agencies, TRUST, or “Trusted Response Urgent Support Team,” responds to calls for help with mental health and substance use emergencies throughout North County, Gilroy, and San Jose.
TRUST teams include a first aid responder, a crisis services specialist, and a peer support specialist, all trained in deescalation and crisis resolution with professional and personal experience in navigating behavioral challenges. In an interview with Prism, Bindu Khurana-Brown, associate director of the Crisis Stabilization Unit and Mobile Response at Momentum for Health, one of the nonprofits partnering with TRUST, says that TRUST teams are also trained to understand the community dynamics that may inform how they approach each incident. This is just one of many ways the program diverges from typical law enforcement responses.
“Oftentimes, the emergent symptoms arise from fears that [an individual] may not be understood or heard in what they are struggling with,” said Khurana-Brown. “The TRUST teams respond in a way that values the importance of hearing an individual and not making assumptions about the experience of that person. This is done by the use of a non-threatening stance, facial expressions that convey understanding, and interactions from a culturally competent lens. TRUST arrives with the intention that a person is going to be deescalated and symptoms will be reduced before it becomes violent.”
Similar to other programs, such as New York City’s B-HEARD pilot, TRUST also includes individuals who have had their own experiences with recovery. Khurana-Brown notes, “that lens often results in a deeper connection to the challenges that individuals may be facing.”
A key part of TRUST’s work is linking individuals to resources and referring them to services in their area so that they may continue receiving ongoing care. If TRUST cannot respond because a particular call requires more concentrated support, team members can divert the call to other program providers within the county. The team typically receives 40-50 calls for services per week and responds to a wide breadth of issues.
“Some common themes are individuals who are worried about a loved one’s shift in behaviors, such as an adult child who has decreased their engagement outside of their room. We have also received calls related to an elderly grandparent who is struggling to adapt to a life following the death of a spouse,” said Khurana-Brown. “The real benefit of this team is we have a wide range of capacities we can respond with when people are able to function in the world but maybe aren’t fully engaged in it.”
The idea that groups like TRUST are designed to help those who are functioning yet not fully engaged brings to light how many people may be struggling with issues that hide in plain sight. Reaching out to them is necessary before that lack of engagement metastasizes into behavior that harms themselves or others. TRUST staff members, most notably the team’s community collaborator, engage county residents at community events and local institutions, like coffee shops, to increase awareness of the program.
“One interesting challenge is that we are taught at a young age that you go to the police for help and call 911,” said Khurana-Brown. “Adjusting the paradigm [to recognize] that there is another number to access nationally (988) and another response will take time to be learned.”
Alternatives to police vs. “police-lite”
While groups like TRUST focus on emergency crisis response, in Atlanta, PAD (Policing Alternatives and Diversion Initiative) centers on harm reduction using a unique model.
PAD’s Community Response Services works with Atlanta’s 311 services to respond to calls where an individual is experiencing a concern related to mental health, substance use, or extreme poverty. To reach PAD, community members call 311, and a PAD harm reduction team will respond in real time, engage the individual posing a concern, assess their needs, and provide adequate support. While PAD only responds to calls that are “non-emergency,” meaning they don’t pose imminent risk to themselves or others, former Community Engagement Manager Clara Totenberg Green notes that the language often used in the field does not always fully capture the realities of people’s individual experiences.
“We have kind of moved away from saying emergency and non-emergency just because what we’ve realized is that emergency or non-emergency or even crisis or non-crisis are very much defined by each person,” Totenberg Green said. “I don’t think that harm reduction is inherently not crisis intervention, like I think you can absolutely do crisis intervention through a harm-reduction lens. And I think that we do that all the time.”
For instance, a restaurant owner may call PAD one evening after noticing a young person sleeping outside his restaurant’s door. Upon arrival, the harm-reduction team can learn more about this individual and ascertain that they have recently become unhoused and need help finding shelter for the night. The team can then provide them with a MARTA card, a warm meal, shelter options, and details on a partner agency where he can receive services during the day. Through partnerships forged with local agencies, a PAD referral coordinator can call and let a local shelter know someone will be stopping by for services. For individuals with open criminal cases, PAD helps provide long-term case management and legal navigation in addition to other forms of support. Importantly, consent is at the core of PAD’s work—unlike many other intervention services, especially law enforcement.
“We know that so many people that we work with have been forced into treatment or have been forced to modify behavior to receive services and that this has often caused enormous harm to them and broken down the trust that they might have—or never have had—with institutions that are providing resources or providing connection to care,” said Totenberg Green. “And so for us, the kind of consent basis of our services is non-negotiable; it’s absolutely foundational.”
Another feature of PAD’s response services that sets it apart—and one that Totenberg Green said groups hoping to launch their own response services program should adopt—is how they close the loop with the person who initially placed the 311 call to PAD. Within 48 hours, a PAD referral coordinator will call the initial referrer (such as the restaurant owner) to update them on how their call was addressed. These calls can help ensure that residents know their calls were answered and thoughtfully responded to, and it gradually works toward PAD’s larger goals of shifting how we think about public safety. These conversations are crucial as many who are aware of PAD’s services are often wealthier residents who, at times, Totenberg Green says, view the service as “police-lite.”
“Sometimes someone will be like, ‘Why didn’t you just remove [the person I called about]? I had this concern, and they’re still here today,’ and we can have the conversation about why we work on a consent basis and why we don’t remove people and the harm that’s caused when we do,” said Totenberg Green.
Just this May, PAD responded to 145 calls for service, yet they are trying to increase this number. Currently, some 911 calls do get rerouted to PAD if they are eligible for community response services, and new processes such as call code transfers are helping to facilitate this relationship.
However, even as PAD is ramping up transfers from 911, the majority of their calls still come via 311, which poses what Totenberg Green fears is an equity issue: those who are aware of services like 311 and thus utilize PAD are often not from over-policed communities. While PAD was created in light of demands for an alternative to calling the police, dialing 911 remains a default. Just as Khurana-Brown stated, youth from every part of the country know to call 911, but many fewer are aware of the existence of 311.
Hoping to expand and shift the demographic of people taking advantage of the service, PAD has worked on educating Atlanta residents through canvassing, attending community events, and leading conversations every month with residents and local businesses.
“I think a lot about frankly the percentage of my time that is spent trying to get the buy-in and trying to shift the mindset of many people in the city who have an outsized influence on politics and power here,” said Totenberg Green. “Those are not the people that are being over-policed … but they are the ones calling the police. So you’re simultaneously trying to meet the needs of the people that are being policed and respond to them with dignity and care while recognizing that the people that are calling the police on them have a very different outlook and have a lot of political power.”
How to implement?
The approaches offered by these programs diverge significantly from law enforcement, and the task of getting them off the ground may be less arduous than expected—if state and local officials allocate adequate resources.
Civilian emergency first responder programs cost much less than what communities spend on policing and can benefit from multiple funding streams. According to an analysis from the Vera Institute, the combined annual budget for policing in Eugene and Springfield, Oregon, is $90 million, while the yearly budget of the region’s mobile crisis intervention program, CAHOOTS, is $2.1 million. While CAHOOTS costs less than 3% of what these two cities spend on law enforcement, the Eugene Police Department communicated concerns about their capacity. In March of this year, they released a request for proposals for crisis intervention response services, recognizing that CAHOOTS has grown overburdened due to expanded services and higher demands for their unique approach. This July, the city made a historic shift in removing the program from under the Eugene Police Department and placing it under the oversight of the city’s fire department.
While favorable responses still need to be met with adequate resources and staffing to ensure that initiatives have the capacity to meet the high needs of community members, the history and success of programs like CAHOOTS have served as a blueprint that has made newer programs possible and ensured that they have adequate resources to operate efficiently. Santa Clara’s TRUST program received a $2 million earmark.
Elsewhere, where local and national media has brought attention to new mental health emergency response initiatives, it remains to be seen whether effort will be put into fully using and sustaining them. In 2020, New York City began establishing “Support and Connection Centers” (SCC) in East Harlem and the Bronx—facilities designed to offer clinical services, including primary and psychiatric care, counseling, health screenings, food, showers, laundry, and withdrawal treatments for those suffering from mental health or substance-related issues. Services are catered to each client’s needs, and clients are allowed to stay for up to five days but can check themselves back in at any time. The centers are in part designed to be used alongside B-HEARD, offering a place for responders to take individuals after responding to an incident. In that way, they serve as a safe alternative to hospital emergency rooms or jails, which are typically where individuals are transferred to by the police.
While the centers hold a great deal of promise, they’ve been slow to operate at full capacity, with providers citing the pandemic as a major obstacle. While advocates cite B-HEARD and these support centers as steps in the right direction, their underutilization coupled with recent city mandates may undermine their potential impact. Late last year, Adams issued a new directive empowering city officials, including NYPD officers, to forcibly remove and involuntarily transport to a hospital for evaluation anyone who appears to have a mental illness or is in psychiatric “crisis” and “appears to pose a danger to themselves or others.” The mandate received swift pushback from local organizers and even professional entities, including the New York City Bar Association, which argued that the directive’s broad language would allow for removals that are not justified under the U.S. Constitution and would direct resources away from the strategies such as B-HEARD.
In that way, the directive cobbles together so much of what mental health response teams aim to work against: making access to care contingent upon people relinquishing their own consent and agency and working off dangerous assumptions about what mental health crises look like. While Adams’ mandate is an extreme version of both, even violence intervention groups themselves can replicate these practices. Organizers at PAD Atlanta note that larger shifts are called for to yield sustainable change in the broader field of crisis intervention. One is expanding our conception of what types of community needs can and should be serviced: thinking beyond solely mental health calls is a huge start.
“A lot of times, mental health crises are the thing that result in a response, and often those are escalated and end in tragedy,” said Totenberg Green. “But our approach is very much that the vast majority of calls that are resulting in police contact are not for mental health crises, they’re for the things that we go out to every single day—that guy who’s sleeping on the sidewalk and will not move, the person walking down the middle of the street that might be unclothed, the person who is kind of coming in and out of someone’s business panhandling and won’t leave.”
It’s often those types of calls, Totenberg-Green says, that result in not just contact but potentially fatal encounters. Thus, while funding and strong infrastructure are necessary for these programs to see success, societally, there also needs to be a shift in how we engage with people in varying types of distress so that the abnormality of how they might present their problems doesn’t keep us from learning about what they need. That shift can open up new possibilities for what types of situations emergency response groups or harm-reduction teams are brought in to address.
CORRECTION: An earlier version of this article misstated the standard for NYC officials to forcibly transport people in mental health crisis to a hospital. The story has since been updated to accurately reflect the policy.