The Lack of Sustainability in Police Reform Mental Health Support and Their Inconclusive Effectiveness

• Published date: 01 March 2025
• DOI: http://doi.org/10.1177/08874034241303422
• Author: Haley R. Moon
• Date: 01 March 2025

https://doi.org/10.1177/08874034241303422

Criminal Justice Policy Review

2025, Vol. 36(1-2) 22 –39

© The Author(s) 2024

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DOI: 10.1177/08874034241303422

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Article

The Lack of Sustainability

in Police Reform Mental

Health Support and Their

Inconclusive Effectiveness

Haley R. Moon1

Abstract

Those calling for police reformation have advocated for reducing police-led response

to mental health crises and instead, transferring these calls to adequately trained

mental health professionals. This support program is commonly referred to as the

mental health, “co-responder” model. The empirical evidence currently supporting

co-responder models suggests inconsistencies in program development, unclear

objectives, and a lack of standards for rigorous program evaluation. Thus, the purpose

of this review was to identify co-responder models throughout the United States and

assess the anecdotal in-/effectiveness of these programs as well as potential factors

contributing to the hindrance of or boost in sustainability of this reformative support

model. The Transform911 initiative facilitated by the University of Chicago Health

Lab from 2020 to 2022 was utilized as the foundation of this review. Findings suggest a

consistent theme across program objectives and render important recommendations

for current and future co-responder teams.

Keywords

community policing, program evaluation, mental health, alternative response

Although individuals with mental illness are more likely to be victims of crime rather

than perpetrators (Ghiasi et al., 2023), negative interactions between police officers

and people with mental illness are all too common. Unfortunately, many of these inter-

actions lead to excessive use of force by police and in the most extreme circumstances,

death. Individuals with significant mental health impairment are approximately ten

1University of Wyoming, Laramie, USA

Corresponding Author:

Haley R. Moon, University of Wyoming, 109 Knight Hall, Laramie, WY 82071-0333, USA.

Email: hmoon3@uwyo.edu

1303422CJPXXX10.1177/08874034241303422Criminal Justice Policy ReviewMoon

research-article2024

Moon 23

times more likely to experience police use of force than individuals without mental

illness (Laniyonu & Goff, 2021). In addition, nearly a quarter of all fatal police shoot-

ings in the United States between 2015 and 2020 involved a person with mental health

problems (The Washington Post, 2022). This level of alarming force inflicted on per-

sons with mental illness has been attributed to a lack of officer training and misunder-

standing of clinical symptomology during times of contact (Puntis et al., 2018). In

turn, efforts to reform the police and mitigate the use of lethal force during interactions

with people struggling with mental health have been prioritized throughout the United

States.

This review will discuss to what extent law enforcement agencies have addressed

the mental health needs of police-involved community members. The discussion of

these initiatives will focus primarily on alternative response options to mental health

crisis calls as they relate to the utilization of qualified mental health professionals

(QMHPs), post-2020. Alternative crisis response programs have resulted in the reduc-

tion of police detainment, civilian distress during calls, and quicker access to mental

health support at the time of crisis (Puntis et al., 2018). Although there has been a

significant expansion in crisis response programs throughout the United States post-

2020, this sudden boom has resulted in prominent variations in program structure and

facilitation. Inconsistent standards for alternative crisis response make it difficult to

measure relevant outcomes.

The inability to measure program effectiveness creates an additional barrier to pro-

gram sustainability as these initiatives require significant monetary support and with-

out clear, measurable objectives, maintenance of funds is unlikely. For example,

Denver, Colorado’s Support Team Assisted Response (STAR) program, an alternative

response team of clinicians and paramedics that respond to individuals experiencing

mental/behavioral health crises, cost nearly half a million dollars to launch ($425,000)

and continues to cost $385,000 per team to operate each year (DeJong, 2022). The

astronomical costs to start and maintain alternative crisis response programs present

an additional challenge to the sustainability of police reform efforts aimed at serving

those with mental illness. Therefore, the second objective of this review is to pinpoint

clear program goals and outcomes that can be used to evaluate program effectiveness

to further support efforts aimed at sustaining funding for alternative crisis response.

Policing and Mental Health

Skills-based mental health training for police officers with a focus on appropriate de-

escalation and positive civilian interactions has been implemented across several law

enforcement agencies to inform officers on how to successfully respond to crisis calls.

First developed in Memphis, Tennessee in 1988, this 40-hour educational model is

referred to as “Crisis Intervention Team (CIT)” and has been perceived as improving

the effectiveness of police officers during crisis intervention (Peterson & Densley,

2018). As of 2017, CIT was considered the most common training for mental health

response across police agencies (Watson et al., 2017), with over 2,700 agencies across