“Pre-arrest diversion has been shown to be successful when law enforcement and mental health professionals respond together to behavioral health emergencies. Individuals are more often referred to the services and treatment that they need, rather than enter the criminal justice system as an offender. This co-responder model has delivered great results in Massachusetts to date. Programs run by Advocates, Inc. a human services agency here in Massachusetts or Riverside Community Care, in Dedham, MA in partnership with several police departments here in Middlesex County. These are funded in part by the Department of Mental Health have generated over 4,000 diversions and $11 million in savings since 2003.” as published by Diane Gould Worcester Telegram February 2018.

Most agencies I have spoken to feel that the co-response model has freed police officers from the sometimes uncomfortable role working outside their realm of training. However, after the de‐institutionalization of mental health services in the 1960s, law enforcement has become one of the primary first responders for dealing with these individuals in many jurisdictions (Manderscheid et al. 2009; Slate et al. 2013). The initiative in the co-response model of intervention pairs law enforcement with a licensed mental health clinician with the understanding that the police officer provide security for the trained mental health clinician to conduct a thorough exam.

In cities like Boston, co-response teams pair Boston Police officers with clinicians from the Boston Emergency Services Team (BEST) to respond to 911 calls involving mental health crises. This model has been in place since 2011 and handled thousands of interactions in 2023 alone, helping officers de-escalate situations and connect individuals to services rather than arrest or emergency hospitalization according to the Boston Police website. Interestingly, I have applied for a role at the BEST program twice and have never heard a word. I have a strong commitment to emergency mental health and have worked with adults and children since 1986, while at the Los Angeles County Department of Mental Health. If I were more future focused at the time, I may have made a career at LA County. Like Boston City Hospital, where I trained, there were some very good people at county Mental health and I miss the work to this day.

In smaller police departments without co-response programs, the arrest of someone with suspected mental illness can take a police officer off the road sometimes for 48 hours until the prisoner can be brought before a judge. The irony is not lost in the fact that the judiciary has little to no experience in deciding whether or not a person is dangerous or should be evaluated for dangerousness. Coupled with a high prevalence of cases of substance abuse and the continuing menace of opioid addiction, police officers have their hands full with cases in which changes in mental status add to the complexity of decision-making and expose a dearth of alternative dispositions. And judges just throw up their hands, ignorant to the risks some pose and what a continuum of care should look like. Co-occurring substance abuse along with acute traumatic events and depression is a symbiotic response to chronic behavioral health challenges.

“Most people with mental illness are not dangerous, and most dangerous people are not mentally ill” according to Liza Gold, 2013.

Recent Evidence Supporting the Co-Response Model (2022–2025)

In the last several years, empirical research has expanded our understanding of how co-response models operate in real-world settings, showing both promise and complexity in their outcomes. Both agencies mentioned above have co-responders riding in cruisers across eastern, Massachusetts. The recent data have support the utility of this model. In Massachusetts and broadly across the northeast department budgets for these services are facing a cut in the governmental funding that ends in June 2026.

Youth Mental Health and Crisis Disposition

A 2024 quasi-experimental study examined a law enforcement–operated co-responder program for youths experiencing mental health crises. Compared with traditional police response alone, encounters involving co-responders were significantly more likely to be de-escalated and resolved in the community with safety plans rather than through involuntary psychiatric examinations. Moreover, co-response involvement was associated with a lower likelihood of involuntary commitment within one year post-encounter. So there is a quantifiable difference using the co-response method.

Nevertheless, the programs for teens and young adults are abysmal for admission options. Kids still wait in emergency departments for 3-6 days on average before getting into a psychiatric program. By then many have resolved their “crisis” – simply taking a time out from their stress experience can be useful but in the long run they require careful monitoring.

Make no mistake about it, putting police officers in the place of psychotherapists and psychiatrists is not going to happen here or anywhere. But cops are being asked to act as mediators to defuse encounters with persons with suspected mental illness – some who may be psychotic. The intention is to reduce violent encounters between the police and those with mental health issues. “Most people with mental illness are not dangerous, and most dangerous people are not mentally ill” according to Liza Gold, 2013. Yet in the past several years there have been many high profile officer-involved shootings involving people afflicted with a variety of psychiatric conditions including major depression raising the specter of suicide by cop (SBC).

Reducing Psychiatric Detentions and Future Crises

A 2025 quasi-experimental analysis published in Nature Human Behaviour showed that co-responder programs pairing mental health clinicians with police officers led to a 16.5 % reduction in involuntary psychiatric detentions over two years. Importantly, this reduction did not significantly change overall call volumes or arrest rates, suggesting that co-responders specifically influence disposition decisions without simply reducing responsiveness.

These results reinforce the idea that clinician presence at crisis scenes can prevent unnecessary detentions while maintaining public safety. Funding for these initiatives should continue. I would argue that greater support for the needs of cases of mental illness so that a true continuum of care can be established. This is still missing here in Massachusetts and in the US. These citizens are still being brought to emergency departments and put on hold until there is medical clearance – sometimes for hours or days.