Guest Commentary: De-Criminalizing Mental Illness – Providing 911 Alternatives to Individuals Experiencing a Mental Health Crisis

by Dr. Corrine McIntosh Sako

Sacramento County Board of Supervisors are set to vote at the end of March on a program that will provide alternatives to 911 for mental health emergency calls. The goal of the program is to increase mental health response to calls for service; decrease the need for law enforcement to respond to mental health distress, crisis, or other quality of life issues; decrease unnecessary emergency department visits and psychiatric hospitalizations; and decrease relapse into crisis by linking to ongoing outpatient mental health services.

The Alternatives to 911 pilot program stemmed from a Board of Supervisors discussion in September 2020 budget hearings. District Two Supervisor Patrick Kennedy directed Department of Health and Human Services staff to propose alternatives to law enforcement responses to quality of life issues that can be better addressed by mental health professionals.

“It’s important to develop a more appropriate and robust system for care for individuals in crisis,” said Kennedy. “We need to meet the needs of people outside of the criminal justice system and take a public health approach to their quality of life issues, both in the moment of crisis and long term.” Appropriately funding a 911 Alternatives program – one that operates 24 hours a day, 7 days a week and is able to service all of Sacramento County – will definitely save lives.

Studies suggest that anywhere from 5 to 20% of all police incidents in the United States involve a person with mental illness. Currently, a call to 911 for a mental health emergency leads to a response from law enforcement.

Although they have had training on how to deescalate confrontations with people experiencing mental illness, law enforcement does not have the proper knowledge, training, or experience to make meaningful clinical assessments in the field. They rely on their standard procedure for an armed suspect – which is to yell commands & prepare to use deadly force – which only leads to increased agitation or aggression of the person suffering from a mental health crisis – and this prompts police to open fire. In fact, 1 in every 4 police killings is that of a person with a mental illness – this means that they are 16 times more likely to be killed by the police than other people.

Additionally, the Sacramento County Sheriff’s department uses more deadly force than 50% of all other Sheriff’s departments in our state. Joseph Mann, Gabby Nevarez, Mikel McIntyre, Darell Richards, & Dazion Flenaugh are just a few of the names of individuals who have died by the hands of Sacramento law enforcement while experiencing a mental health crisis.

We need to shift how we view those experiencing mental health crises. Instead of viewing these individuals as dangerous sources of disorder that need to be controlled through aggressive & intensive policing, let’s look at them as individuals experiencing a significant deterioration in their mental health functioning – due to a lack of adequate treatment & services to support their stable functioning.

Police and sheriffs are not equipped to provide adequate services to our community members with mental illness, and their lack of specific training within law enforcement leads to arrest, injury, and trauma. The current proposal for Alternatives to 911 is based on a service delivery model operating Monday through Friday 9am to 6pm. These hours of operation would leave 44% of mental health calls unanswered, and thus falling back on law enforcement for response.

We need more proactive, pre-emptive, & collaborative interventions that do not involve law enforcement. We need easy access to culturally-appropriate community-based services. A 911 Alternatives program should operate 24 hours a day, 7 days a week. Response teams should consist of mental health clinicians, peers with lived experience, social workers, and medical clinicians. These response teams should have expertise in de-escalation and be trauma-informed, behavioral health-centered, and responsive to race, culture, gender, and disability.

Because a majority of mental health emergencies including quality of life issues, crisis services must be included and consist of housing and shelter, mental health assessment and services, food, water, and other survival needs, medical care and medication, and crisis stabilization and respite centers. Yes, these interactions can be dangerous. And people trained and experienced in dealing with mental illness know these risks and they have techniques for dealing with them. We can decriminalize mental illness by providing access to mobile peer support, de-escalation assistance, and other non-punitive and life-affirming interventions.

MH First Sacramento has been operating since January 2020. It is a cutting-edge new model for non-police response to mental health crisis. The goal of MH First is to respond to mental health crises including, but not limited to, psychiatric emergencies, substance use support, and domestic violence situations that require victim extraction. They are volunteer-based, operate on a shoestring budget, and are available Friday through Sunday, 7pm to 7am. Due to the COVID-19 pandemic, they are currently available for phone support only – call/text (916) 670-4062.

If Sacramento County is going to seriously consider non-law enforcement crisis response for things like mental health, it needs to be sufficiently funded to be successful. Let your voice be heard. Call and/or email your County Supervisor and join me in letting them know that the current proposal is insufficient; it doesn’t have enough funding and has limited hours, while the need for these services is 24/7.

Find your county supervisor here:

About the Author:

Dr. Corrine is a licensed clinical psychologist and a licensed marriage & family therapist. She has over 20 years of experience providing mental health services in a variety of settings (i.e., school, community mental health centers, group home, intensive outpatient treatment program). She has been in private practice for the past 15 years, providing mental health services to the greater Sacramento community. She has extensive experience helping people with a range of presenting issues, from situational stressors to severe mental health concerns. Additionally,
she has specialized training in treating anxiety disorders (Obsessive-Compulsive Disorder, Panic Disorder, Social Anxiety, Specific Phobias, etc.) using Cognitive-Behavioral Therapy (CBT), including Exposure and Response Prevention Therapy (ERP).

Social justice has always been a major interest and her passion for activism was ignited after the killing of George Floyd. Since then, she has volunteered with local racial justice organizations to foster awareness of social injustices and to promote community solidarity. Her involvement has included consultation regarding the importance of self-care for activists, design & co-facilitation of healing spaces for community events, and promoting awareness & organizing support for non-law enforcement response to mental health crises. Dr. Corrine strives to not just be a culturally competent practitioner but an anti-racist psychologist. She believes that to be an anti-racist psychologist requires not only acknowledgement of racism but active opposition to racism within ourselves, our research, our teaching, our organizations, our practice, and the policies shaping our society.

You can find out more about her by visiting her website or following her on social media (IG: @drcorrine; Facebook: Dr. Corrine McIntosh).

About The Author

Disclaimer: the views expressed by guest writers are strictly those of the author and may not reflect the views of the Vanguard, its editor, or its editorial board.

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1 Comment

  1. Alan Miller

    I agree to the idea of alternative to law enforcement as first responders to a mental health issue.  However, isn’t the entire name of this idea flawed:  “Alternatives to 911” ?  Isn’t the point the response, not the dispatching?  Most people aren’t going to have the alternative phone number with them, or possibly even know it exists.  Having a central dispatch point for all emergencies is an advantage for all – and dispatchers should be trained and be the ones determining who responds to what.  If an alternative number is also available that is OK, but 911 should always be an available gateway and central point for all emergencies.

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