Education ARTICLE/DATA ANALYSIS EXERCISE ASSIGNMENT INSTRUCTIONS

2

Chapter one

Shaquanna Edwards

Liberty University

July 26, 2026

Chapter one

Background

Police officers are becoming more often first responders to people in mental health crisis. Police departments across the United States have been called upon to respond to more calls for help related to individuals with serious mental illnesses, substance use disorder, or behavioral health crises over the last 10 years (Lum et al., 2022). These interactions often involve officers having to make decisions quickly under unanticipated conditions and while dealing with the person's acute medical needs as well as the safety of the general public. The traditional police response to mental illness, however, is not necessarily tailored to the needs of mental illness and can leave individuals with mental illness and psychological disorders facing unnecessary arrests, use of force encounters, emergency hospitalizations or prison sentences in lieu of treatment. As a result, criminal justice systems have begun to see the need for alternative criminal justice models that incorporate public safety and behavioral health services.

A more recently adopted approach is the use of co-responder mental health crisis (MHC) teams (Eaton et al., 2025). With this model, the behavioral health crisis response includes law enforcement officers working with licensed mental health professionals for crisis assessment, de-escalation and referral to community treatment services. Co-responder teams are not just about enforcement, but about helping people avoid the criminal justice system as much as possible when they are not in need of it, and providing them with the resources that can help them when they are. There is some evidence found in existing research that co-responder programs could help limit the number of arrests, lower the number of citing for use of force, lower the number of emergency department visits, and enhance the relationship between police and the community (Every-Palmer et al., 2025). However, results have been mixed among jurisdictions due to the differences in staffing, funding, implementation strategies and community resources among agencies. Therefore, more empirical work is needed to establish whether co-responder programs always or regularly have a positive effect on criminal justice outcomes.

This research is not just relevant to law enforcement activities. People with mental illness are overrepresented in the criminal justice system and often in need of medical, rather than jail or prison, treatment. Poor crisis response potentially can result in more trauma, loss of faith in the police, and re-arrest for people with mental illness. Through the effectiveness of co-responder mental health crisis teams, I hope to provide evidence that helps policymakers, police administrators, behavioral health workers and community leaders design a mental health crisis response that not only is effective for ensuring public safety, but also is equitable in the treatment of vulnerable populations.

Problem Statement

One of the largest duties of law enforcement in the modern era is mental health related calls (Watson & El, sabawi, 2023). Police officers regularly encounter people suffering from schizophrenia, bipolar disorder, severe depression, suicidal ideation, substance-induced psychosis and other behavioral health crises (Karystianis et al., 2025). While there is a spectrum of crisis intervention training that officers receive, most departments still use conventional policing methods which focus on control, compliance, and enforcement. These tactics can inadvertently worsen situations with people whose actions are directly related to an untreated mental illness but not necessarily criminal. As a result, many people having behavioral health emergencies are unnecessarily arrested or coerced into being arrested rather than getting the medical care that they need.

Studies have shown that people with a severe mental illness are much more likely to come into contact with the police than people in the general community (Compton et al., 2023). Police encounters can be more likely to cause misunderstandings due to behavioral symptoms including: confusion, paranoia, hallucinations, emotional dysregulation, and impaired communication. Often officers are called into a situation where they must make split-second decisions under very stressful conditions, without immediate access to a behavioral health professional with specialized clinical expertise. This disconnects between the demands on public safety and mental healthcare results in poor outcomes for people in crisis, for officers, families, and communities.

To address these issues, many jurisdictions have implemented mental health crisis teams with co-responders. The programs are multidisciplinary, bringing together sworn law enforcement and licensed mental health clinicians to respond together to behavioral health crises. Mental health professionals conduct clinical evaluations, crisis stabilization, de-escalation, and safety planning, as well as making referrals to community treatment services, and officers ensure the scene is held secure and any criminal or public safety issues are addressed (Lavoie et al., 2022). The collaborative strategy aims to keep unnecessary arrests to a minimum; limit the use of force; enhance access to behavioral healthcare; and increase public confidence in law enforcement. While many agencies can report success after implementing these programs, there is limited empirical data on the long-term effectiveness of these programs in different jurisdictions.

One more important issue is community trust in the police. The media attention surrounding high-profile encounters with people who are mentally ill has brought attention to police practices during mental health crises (Alker et al., 2026). Community members increasingly expect law enforcement agencies to take a de-escalation, compassionate, procedural justice, and working with healthcare professional approach to their policing work. This lack of expectations can diminish public confidence, inhibit police investigation and lower perceptions of police legitimacy. The implications of whether co-responder models are enhancing community perceptions is thus of interest to criminal justice administrators who are looking to enhance police/community relations.

While a number of co-responder programs are gaining popularity, there is a substantial gap in the Criminal Justice literature. There has been a substantial amount of research testing individual agencies or isolated pilot projects which do not provide for widespread generalizability. Comparisons between jurisdictions are further complicated by differences in program design, program funding, staffing, availability of community mental health resources, and departmental policy. So, there remains a lack of solid empirical data on the impact of co-responder teams on arrest outcomes, use of force, and community trust. This research gap matters because as we continue to expand evidence-based crisis response models, there are implications for criminal justice policy, officers' safety, access to behavioral healthcare, and the public's trust in the police.

Research Questions

The following research questions will help guide my study:

RQ1: To what extent do co-responder mental health crisis teams lower arrest rates during law enforcement response to behavioral health crises versus traditional law enforcement response?

RQ2: How effective are co-responder mental health crisis teams at reducing use-of-force incidents during mental health crisis encounters?

RQ3: What impact do co-responder mental health crisis teams have on building community trust of law enforcement agencies?

Purpose Statement

This quantitative study aims to explore the effects of co-responder mental health crisis teams on arrest rates, use of force and community trust in law enforcement agencies. Specifically, I want to know if law enforcement agencies with co-responder teams have better results than agencies that do not have co-responder teams. Implementation of a co-responder mental health crisis team is the independent variable of this study, and the dependent variables are: arrest rates while responding to calls involving mental health, use of force incidents, and community trust in police. I will use the measurable outcomes that are reported by agencies to compare and contrast co-responder programs to see if there is a significant difference in the outcomes of criminal justice response with and without a co-responder.

The need for this study is due to the rising occurrence of persons in behavioral health emergencies with police officers. The criminal justice system is a huge problem as mental illness is a major concern, as a large percentage of people who come into contact with the criminal justice system need clinical intervention, but not incarceration (Carter et al., 2022). Although this is beginning to be recognized, many agencies continue to find it is difficult to balance their public safety duties with the need to deliver services that meet mental health needs. While examining the existing literature, I realized that, while co-responder programs have become widespread throughout the United States, there was a lack of empirical evidence on the overall effectiveness of these programs (Fisher et al., 2024). Past research tends to be site-specific, and/or limited to pilot programs, which restricts the possibility of generalizing to other agencies. The lack of knowledge is a driving force behind my research and the need for more quantitative data that will aid in evidence-based policy making.

This study has implications for various stakeholders involved in the criminal justice and behavioral health systems. The results could be used as evidence about the effectiveness of co-responder programs for law enforcement administrators when they are deciding whether to implement them or not. Police leaders are always striving to find ways to make officers safer, hold them to less liability, build good police-community relationships and build more public trust in the police (Hernandez, 2025). The results could be used to promote the widespread adoption of collaborative crisis response models if they are proven to lower arrest and use-of-force rates and help build public confidence. Likewise, policymakers can draw on the findings when deciding on funding proposals for the legislature, statewide implementation plans, and allocating resources for statewide behavioral health initiatives.

This study can also benefit mental health professionals and community organizations. A partnership between law enforcement and behavioral health can enhance treatment access, minimize re-encounters of the criminal justice system and minimize the criminalization of mental illness (Inzunza, 2022). When behavioral health crises occur, people need to be assessed, stabilized and referred to long-term treatment not detained in the criminal justice system (Bah, 2025). In reviewing the measurable outcomes of co-responder programs, I hope to add evidence that will reinforce an integrated approach to crisis intervention and encourage collaboration between criminal justice and healthcare providers.

Lastly, this research adds to the scholarly literature by filling a gap in the literature on the effectiveness of co-responder mental health crisis teams. While the results of previous studies are mostly positive, a variety of methodological, sample size, geographical, and program implementation factors have led to varying results. To support the evidence base, my study aims to compare the measurable criminal justice outcomes of different agencies through the application of standardized quantitative methods. Results can help support future research on the development of crisis response models, and can provide criminal justice practitioners with evidence-based data for policies and program evaluation.

Operational Definitions

The following definitions will help to clarify the concepts that are described throughout this study.

Behavioral health crisis: Time of severe emotional, psychological or behavioral distress that necessitates prompt action to assure a person's safety or the safety of others (Swan &Hamilton, 2023).

Co-responder Mental Health Crisis Team: A model of collaboration between a sworn law enforcement official and a licensed mental health professional that collaboratively responds to behavioral health crisis calls to deliver crisis intervention, assessment, de-escalation, and follow up referral to treatment services (Miller, 2026).

Community trust: Public trust in the local law enforcement agency with regard to fairness, legitimacy, professionalism, transparency and procedural justice (Stoops, 2024).

Crisis intervention: Communication, de-escalation, assessment and referral strategies used to help stabilize persons in crisis situations (Zaiser, 2025).

Police agency: The local, county or state police department tasked with providing law enforcement and public safety services in its area (Goodison, 2022).

Mental illness: A condition of the mind characterized by a diagnosable psychological, emotional or behavioral disorder which significantly impacts a person's thinking, mood, perception or functioning in their daily life (Tse & Haslam, 2023).

Use of force: Any physical action, restraint, conducted energy device, chemical agent, firearm or other approved force used by law enforcement officials during a police encounter to achieve compliance and/or to protect the individual (Koh, 2023).

Arrest rate: Percent of BH calls that are actually arrested during law enforcement intervention.

Scope and Limitations

This research specifically examines the effectiveness of co-responder mental health crisis teams in U.S. law enforcement agencies. Specifically, I will study if the agencies that use the co-responder program have lower arrest rates, fewer incidents of use of force and higher levels of community trust, when compared to agencies that do not use the co-responder program. This research will involve quantitative data from official law enforcement records and community standardized surveys. The study only focuses on behavioral health crisis response, and does not include other types of criminal incidents where the police might be engaged.

There are several limitations that could affect the results of this study. First, the study is of a nonexperimental design and so the results are not definitive in establishing cause-and-effect relationships between co-responder implementation and outcomes that were observed. Second, the organizational culture, staffing level, training needs, availability of funding, and community demographics of participating agencies can vary, which can impact program effectiveness. Third, the official agency records are based on reliable reporting procedures and might be inconsistent from one jurisdiction to another. Lastly, indices of community trust are based on self-reported answers to survey questions, and these responses can be subject to personal experiences, attitudes, media coverage and/or social desirability bias. These restrictions cannot be avoided completely, but careful study design and statistical analysis will minimize such restrictions of the study's validity.

Summary

Chapter One provided background information for this dissertation and explained the background of the study, a problem with law enforcement responses to behavioral health crises, research questions, and purpose and significance of the proposed research. Operational definitions were used to clarify the main concepts studied in the study and the scope and limitations were used to set boundaries and possible limitations of a study. As a whole, these sections highlight the need for further empirical research regarding the effectiveness of co-responder mental health crisis teams in reducing arrests, decreasing the use of force, and enhancing trust in law enforcement by the community. A thorough review of existing literature on mental health crisis response, co-responder models, procedural justice, crisis intervention strategies, and past empirical studies relevant to this proposed study will be presented in Chapter Two.

References

Alker, T., Hine, K., McKillop, N., & Prenzler, T. (2026). De Facto Mental Health Responders: A Contemporary Systematic Literature Review of Police Encounters with Persons Experiencing Mental Illness.  Journal of Police and Criminal Psychology, 1-17. https://link.springer.com/content/pdf/10.1007/s11896-026-09829-y.pdf

Bah, C. H. (2025). Psychiatric Hospitals and the Criminal Justice System need a data tracking system to help collect and record consistent client information across the two settings, thereby improving mental health outcomes and reducing recidivism for individuals (Doctoral dissertation). https://digital.lib.washington.edu/bitstreams/29111f28-2b8b-4cb2-8381-53e6f1ec2b10/download

Carter, A., Butler, A., Willoughby, M., Janca, E., Kinner, S. A., Southalan, L., ... & Borschmann, R. (2022). Interventions to reduce suicidal thoughts and behaviours among people in contact with the criminal justice system: A global systematic review. EClinicalMedicine, 44. https://www.thelancet.com/pdfs/journals/eclinm/PIIS2589-5370(21)00547-2.pdf

Compton, M. T., Zern, A., Pope, L. G., Gesser, N., Stagoff-Belfort, A., Tan de Bibiana, J., ... & Smith, T. E. (2023). Misdemeanor charges among individuals with serious mental illnesses: A statewide analysis of more than two million arrests.  Psychiatric Services,  74(1), 31-37. https://psychiatryonline.org/doi/pdf/10.1176/appi.ps.202000936

Eaton, A. D., Rowe, M., Nguyen, A., Lowe, L., Fletcher, K., Adenwala, A., ... & McInroy, L. B. (2025). Processes of co-response crisis mental health models: A scoping review. Advances in Mental Health, 1-24. https://osf.io/download/s2wky/

Every-Palmer, S., Kim, A. H. M., Cloutman, L., & Kuehl, S. (2023). Police, ambulance and psychiatric co-response versus usual care for mental health and suicide emergency callouts: A quasi-experimental study.  Australian & New Zealand journal of psychiatry,  57(4), 572-582. https://www.researchgate.net/profile/Susanna-Every-Palmer/publication/361905409_Police_ambulance_and_psychiatric_co-response_versus_usual_care_for_mental_health_and_suicide_emergency_callouts_A_quasi-experimental_study/links/64b7051e95bbbe0c6e46772d/Police-ambulance-and-psychiatric-co-response-versus-usual-care-for-mental-health-and-suicide-emergency-callouts-A-quasi-experimental-study.pdf

Fisher, O. J., Donahoo, C., Bosley, E., Du Cloux, R., Garner, S., Powell, S., ... & Wyder, M. (2024). Barriers and enablers to implementing police mental health co-responder programs: A qualitative study using the consolidated framework for implementation research. Implementation research and practice, 5, 26334895231220259. https://journals.sagepub.com/doi/pdf/10.1177/26334895231220259

Goodison, S. E. (2022). Local police departments personnel, 2020.  Bulletin (NCJ 305187). https://bjs.ojp.gov/sites/g/files/xyckuh236/files/media/document/lpdp20.pdf

Hernandez Jr, J. (2025). Improving Legitimacy and Public Perception. https://shsu-ir.tdl.org/bitstreams/0bc8d597-a70e-454e-a487-f980e469c4ac/download

Inzunza, M. (2022). The significance of victim ideality in interactions between crime victims and police officers.  International journal of law, crime and justice,  68, 100522. https://www.sciencedirect.com/science/article/pii/S1756061621000677

Karystianis, G., Stephenson, F., Taflan, P., Reutens, S., Heffernan, E., & Butler, T. (2025). Who you gonna call? Examining police reports involving people with psychosis to improve front line management.  Frontiers in Psychiatry,  16, 1728409. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1728409/pdf

Koh, S. A. (2023). Policing & the Problem of Physical Restraint.  BCL Rev.,  64, 309. https://scholarship.law.bu.edu/cgi/viewcontent.cgi?article=4405&context=faculty_scholarship

Lavoie, J. A., Alvarez, N., & Kandil, Y. (2022). Developing community co-designed scenario-based training for police mental health crisis response: A relational policing approach to de-escalation.  Journal of police and criminal psychology,  37(3), 587-601. https://link.springer.com/content/pdf/10.1007/s11896-022-09500-2.pdf

Lum, C., Koper, C. S., & Wu, X. (2022). Can we really defund the police? A nine-agency study of police response to calls for service. Police quarterly, 25(3), 255-280. https://journals.sagepub.com/doi/pdf/10.1177/10986111211035002

Miller, R. P. (2026). Lived Experiences of Law Enforcement Officers Assigned to Co-Response Teams Responding to Mental Health Crises (Doctoral dissertation, Walden University). https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=21488&context=dissertations

Swan, J., & Hamilton, P. M. (2023). Mental Health Crisis Intervention and Support for Patients. https://wildirismedicaleducation.com/courses/pdf/Mental-Health-Crises-CEU-Wild-Iris-Medical-Education.pdf

Stoops, P. D. E. (2024). Authority with Procedural Justice: The Establishment and Enforcement of Expectations of Public Trust. https://pdxscholar.library.pdx.edu/cgi/viewcontent.cgi?article=2717&context=honorstheses

Tse, J. S., & Haslam, N. (2023). What is a mental disorder? Evaluating the lay concept of mental ill health in the United States.  BMC psychiatry,  23(1), 224. https://link.springer.com/content/pdf/10.1186/s12888-023-04680-5.pdf

Watson, A. C., & El-Sabawi, T. (2023). Expansion of the police role in responding to mental health crises over the past fifty years: driving factors, race inequities and the need to rebalance roles.  Law & Contemp. Probs.,  86, 1. https://scholarship.law.duke.edu/cgi/viewcontent.cgi?article=5086&context=lcp

Zaiser, B. (2025). Hooks and triggers are an ill-informed shortcut in de-escalation and crisis intervention.  Journal of Community Safety and Well-Being,  10(4), 243-249. https://www.journalcswb.ca/index.php/cswb/article/download/472/1349