Moving From Crisis Response to Crisis Prevention in U.S. Mental Health Systems


From STAT: “Neither mental health¬†nor¬†policing can be fixed by simply pouring more money into business as usual. To improve either will require building non-police crisis response systems while also reconceptualizing community-based systems for mental health.

Several major U.S. cities, including New York City, Atlanta, San Francisco, Albuquerque, and Denver, have been engaging in the first part of this work by launching or expanding programs to send mental health responders rather than police to address emergency calls related to mental health. These programs have been remarkably effective at deescalating crises while preventing violence, crime, needless arrests, and wasteful police and health care spending. But they remain profoundly limited by a narrow orientation around crisis response rather than prevention.

In Chicago, a coalition of community organizers is trying to take the national movement toward non-police crisis response systems a step further by refusing to take crises for granted. If it succeeds, it will, in the process, provide a new foundation for both community mental health and public health writ large.

This effort has coalesced around a policy demand called¬†Treatment Not Trauma, which recently elected Mayor Brandon Johnson has endorsed as a central policy for rebuilding the City‚Äôs public infrastructure. Treatment Not Trauma begins from the recognition that the most important part of addressing mental health crises is to prevent them from ever arising. It therefore calls for neither a psychiatric nor police model of mental health response ‚ÄĒ both of which are dominated by reaction rather than prevention ‚ÄĒ but instead for a¬†public health model of community wellness.

. . . Treatment Not Trauma puts into practice a¬†model¬†of preventive social care that has been shown in numerous¬†examples¬†around¬†the¬†world¬†to¬†be¬†more¬†effective, efficient, and equitable than¬†top-down professional medical approaches¬†to mental health. To succeed, it will have to upend the medical industry‚Äôs narrow, self-serving vision of who can provide care that has for so long over-prioritized expensive (and¬†often ineffective) professional mental health services while marginalizing and divesting from¬†nonprofessional care workers¬†and systems for everyday social support.”

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