In a prior publication, I introduced the growing challenge of mental illness and co-occurring substance use disorders, along with the need for alternative approaches to restitution and treatment. At the time, one chief of police in a Boston area department indicated that nearly 50 percent of their call volume involved citizens with substance use disorder (SUD) of one or another. Addressing these issues requires greater discretionary awareness on the part of police officers, who are often the first professionals to encounter individuals in behavioral health crises. According to the National Institute on Alcohol Abuse and Alcoholism there has been a 14 percent increase in heavy drinking attributed to the Covid-19 pandemic and its isolation. In many houses happy hour started at 3 PM or earlier. Additionally, the prevalence of marijuana by adults has increased to 17.9 percent of the population in the decade from 2010 and 2020. A great number of states have legalized marijuana use for recreational use by adults.

Mental Health Encounters

With these statistics in mind, members of law enforcement require specialized training to respond effectively to calls involving individuals impaired by alcohol or other substances, including opioids, cocaine, heroin, and increasingly, synthetic drugs such as fentanyl and methamphetamine. These encounters are often complicated by co-occurring mental illness, medical instability, and behavioral crises that demand more than traditional enforcement strategies.

Equally important, meaningful alternatives to incarceration must be available if we hope to break the revolving door of minor criminal offenses associated with untreated mental illness and addiction. Diversion programs, crisis stabilization units, detoxification services, and recovery-oriented treatment options provide officers with practical alternatives that address the underlying causes of criminal behavior while enhancing community safety.

There was a time when many police departments maintained “drunk tanks,” where individuals arrested solely for public intoxication could safely sober up under supervision, often without formal criminal charges. While these facilities have largely disappeared, the need has not. Today’s officers continue to encounter intoxicated individuals who require temporary safety, medical assessment, and access to treatment rather than incarceration. Replacing outdated detention models with modern crisis stabilization and treatment resources represents a more effective, humane, and evidence-based approach to addressing substance use disorders.

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The use of the 911 emergency help line is used for all kinds of emergencies. Sometimes a person with substance use disorder can become agitated or violent. In those cases officer discretion is essential and is never an easy call especially when it comes to the use of force. Diversion programs, specialized treatment courts, crisis intervention services, and accessible behavioral health resources offer opportunities to address the underlying causes of offending behavior rather than simply recycling individuals through the criminal justice system. Law enforcement officers witness the devastating effects of addiction every day. Lasting public safety will depend not only on effective policing but also on a coordinated system of treatment, accountability, and community support that offers individuals a genuine opportunity for recovery.

Community Behavioral Health Centers

The Riverside Community Behavioral Health Centers (CBHCs) in the Milford and Norwood regions represent one of Massachusetts’ most significant shifts away from relying on hospital emergency departments and jails to manage behavioral health crises. Developed as part of the Commonwealth’s behavioral health reform initiative, these centers function much like an “urgent care” clinic for psychiatric and substance use emergencies, providing rapid assessment, crisis intervention, and ongoing treatment in a community setting. They are intended to bridge the gap between outpatient therapy and inpatient psychiatric hospitalization.

For police officers, EMS personnel, families, and individuals in crisis, the CBHC offers a practical alternative when a person does not require emergency medical treatment but clearly needs immediate behavioral health care. Walk-in urgent behavioral health evaluations are available without referral, and the centers provide same-day assessments for mental illness, substance use disorders, and co-occurring conditions. Rather than waiting for days or weeks for an outpatient appointment, individuals can be evaluated immediately by an interdisciplinary team consisting of licensed clinicians, psychiatric prescribers, nurses, care coordinators, peer support specialists, and recovery coaches.

A particularly valuable feature for law enforcement is Riverside’s 24-hour Mobile Crisis Intervention (MCI) service. When officers encounter an individual experiencing suicidal ideation, acute psychosis, severe depression, intoxication complicated by psychiatric symptoms, or another behavioral health emergency, the MCI team can respond to homes, schools, community settings, or even police stations. In many situations, this allows officers to avoid transporting an individual to a crowded emergency department or making an arrest when treatment is the more appropriate response. Anyone—including police officers, family members, schools, physicians, or the individual in crisis—may request a Mobile Crisis evaluation.

Another important component is Community Crisis Stabilization (CCS). When an individual requires more support than can be provided during an outpatient visit but does not meet criteria for inpatient psychiatric hospitalization, Riverside offers voluntary short-term residential stabilization in a home-like setting. Typical stays last approximately five to seven days and include psychiatric evaluation, medication management, individual and group therapy, peer support, recovery planning, and coordination of follow-up services. The goal is to stabilize the crisis while avoiding unnecessary hospitalization whenever it is clinically safe to do so.

Community Behavioral Health Centers such as Riverside represent what many police administrators have sought for decades: a place where officers can bring individuals in behavioral crisis knowing they will receive prompt psychiatric evaluation, substance use assessment, crisis stabilization, and linkage to continuing care. These centers transform the police response from one focused primarily on custody to one focused on recovery, public safety, and reducing the revolving door of repeated crisis encounters.