Listen actively. Establish empathy. Build rapport.
When responding to behavioral health crises, officers at the Pittsburgh Bureau of Police are taught to form a genuine connection with the person in crisis — it helps them guide the person to pursue treatment.
But empathy is a two-way street, said bureau Lt. Logan Hanley. When officers respond to crises with negative outcomes — or repeatedly engage with people who are struggling — it batters their own mental health.
“It’s not always something that they’re forthright about, but it’s something that clearly weighs heavily on a lot of the members of the bureau,” said Hanley, who serves as the administrator for the Tactical Negotiations Team that often responds to crises. “Just by law of averages, you’re going to see or experience something that’s going to weigh heavily on your mind.”
Human services officials would like to lift that burden, moving more crisis response duties to mental health professionals. But the paper trail documenting responses to behavioral health emergencies suggests that police may be more involved in the process than they were even a few years ago.
“If you send in a police officer, there’s going to be a greater likelihood of escalation,” said Nev Jones, a professor at the University of Pittsburgh’s School of Social Work. “How severe the escalation is, is then going to vary depending on: Is a weapon present? How agitated are people? Is there some sort of red flag in the person’s file?”
For years, police have maintained a prominent presence within Allegheny County’s behavioral health crisis response system, whether they’re spearheading responses or just providing transportation to psychiatric treatment facilities. That’s increasingly evident in “302” petitions for involuntary psychiatric commitment, a tool used when responding to some of the most severe behavioral health crises. In 2021, police filed 63% more 302 petitions than in 2015 — at least twice the growth logged by other petitioner groups, including family, physicians and mental health professionals.
As concerns about police involvement in behavioral crisis response simmer following 2020’s nationwide boiling point, county officials have begun experimenting with initiatives to minimize police officers’ role in the local system, like sending social workers to 911 crisis calls either independently or alongside law enforcement.
Even so, state mental health laws may curtail the depth of the county’s efforts.
“Fundamentally, there’s actually deep structural issues that require this police involvement, and they’re not going to change until we change the law,” Jones said.
Are police increasingly responding to severe crises?
Involuntary psychiatric commitment is used to direct people experiencing behavioral health crises toward treatment when they may be unable or unwilling to seek it on their own. It’s often called a 302 in reference to the section of the Pennsylvania Mental Health Procedures Act governing its procedures.
302s are typically reserved for the most serious behavioral health crises because they pose a risk of inflicting severe trauma. Hanley said Pittsburgh police officers only initiate 302 petitions when they encounter a person who’s endangering themselves or others and there is no one else available to file the petition on their behalf.
“It almost becomes a measure of last resort,” Hanley said. “Ideally, someone who knows the subject better, we’d prefer them to be the petitioner. But sometimes we’re limited in that respect, and we have to act as the petitioner.”
“The law’s there for a reason — to try to strike the right balance of assuring appropriate treatment in emergency situations, but also protecting the rights of people who are receiving treatment or in need of treatment.”
dr. Jack Rozel, director of upmc’s resolve crisis services
Allegheny County recorded a 21% increase in 302 petitions filed from 2015 through 2021. Police initiated about 14% of the 302 petitions in 2015, rising steadily to 19% of petitions in 2021.
302 petitions are on the rise. Whose filings grew the most?
The growth rate of petitions filed by police doubled any other group, though family members and relatives filed a higher quantity of petitions.
Not all police-initiated petitions result in commitments. After a petition is filed, it typically must receive approval from a delegate within the county Department of Human Service’s Office of Behavioral Health, and a physician must conduct an examination to confirm the person should be committed. In 2021, 43% of the police-filed 302 petitions were overturned, yielded inconclusive results or were left incomplete. In 2015, less than a quarter of police-filed 302 petitions were overturned, inconclusive or incomplete.
As of Nov. 10, police officers have filed 1,121 petitions for involuntary psychiatric commitment so far this year — about 7% more than at this point in 2021.
Local researchers can’t pinpoint what’s driving the rise in police-initiated petitions because the data currently available does not efficiently show the “narrative” of the situation — the factors and circumstances leading police to file petitions. The data also hinders researchers from assessing police involvement in 302s they did not initiate, like those where they only served a warrant or provided transportation.
“The thing that really needs to be done is systematic coding of those narratives to look at what actually is the chain of initiation — who all was involved, not just the one signature that ends up on the paper and in the county’s public reporting system,” Jones said.
Jones also couldn’t rule out the possibility that the increase in police-initiated petitions stems from procedural changes, like police listing themselves as the petitioner more often.
Hanley, as a member of one of the county’s more than 100 police departments, said the increase in police-initiated petitions is surprising and he is unsure what is driving it.
McKees Rocks Police Chief Rick Deliman pointed to the COVID-19 pandemic as a possible root cause.
“I do think the isolation and the disruptions to the normal daily processes that COVID-19 has caused over the last two-plus years has had a detrimental impact on society as a whole,” he said. “I’m sure there are other factors as well.”
Reducing police presence
In September 2020, the county’s Department of Human Services [DHS] convened the Crisis Response Stakeholder Group to brainstorm ideas for improving its handling of behavioral emergencies. A central tenet of the group’s final recommendations was preventing police from serving as the first or only responders to behavioral health crises whenever possible.
Last winter, DHS began plans for a law enforcement assisted diversion program, which will train police officers to connect people who frequently encounter the criminal legal system with long-term case managers. The goal is to guide people away from incarceration and toward treatment, especially harm reduction services for people with substance use disorders.
From May through August, DHS accepted proposals for providers to operate a program training community members to serve as informal peer mental health supports, who would help address mental health needs before they snowball into crises. The department is in the process of reviewing the proposals and intends to select 10 projects.
DHS is also experimenting with having mental health professionals respond to crisis calls, either alongside police officers or independently as a “true alternative response,” said Jenn Batterton, the department’s manager of special initiatives. Research shows that alternative response programs are successful because people in crisis may prefer social workers’ “softer approach,” often fearing the very presence of police.
“We have very, very negative societal attitudes toward people experiencing psychosis. The public associates that with dangerousness. Certainly police officers are no exception.”
nev jones, professor at the University of Pittsburgh’s School of Social Work
One pilot, in partnership with McKees Rocks, will send social workers to 911 crisis calls that were initially directed to police but wouldn’t necessitate their involvement. The municipality approved the program in September and expects to launch it in around six months.
Deliman said that his department is in the process of working with DHS to establish the framework of the pilot.
“My hope for the program is to get people the help they actually need, or at least be able to get them into contact with someone who can help facilitate and navigate that process,” Deliman said. “This will help improve my department’s response to these situations knowing there are professionals, trained in dealing with these situations, on hand and available.”
DHS is also exploring ways to improve UPMC’s resolve Crisis Services, which sends teams of social workers to either independently respond to crises or assist police in their response.
“There’s probably a future world where [resolve is] that nerve center that’s deploying teams — some of which are theirs, and some of which are other teams,” said DHS Director Erin Dalton.
Dr. Jack Rozel, resolve’s director, said there will never be a crisis response model that perfectly balances police with behavioral health services. A successful model hinges on strong cooperation, strong political support and a clear mission and strategic vision.
“Even the best designed program is going to have bad outcomes,” Rozel said. “Bad outcomes don’t necessarily mean bad process. The work is incredibly high stakes, incredibly variable.”
Are police necessary for crisis response?
Experts say there are several potential consequences when police handle behavioral crisis response, including the potential for officers to use excessive force and perpetuate structural racism. One worry is that police officers, like all members of society, are vulnerable to the negative stigma surrounding mental illness.
“We have very, very negative societal attitudes toward people experiencing psychosis,” Jones said. “The public associates that with dangerousness. Certainly police officers are no exception. So it’s sort of a perfect storm for situations that are frequently going to go wrong.”
Compared to mental health professionals, officers receive significantly less training to respond to crises, heightening the potential for escalation.
“They may elect to participate in additional training as part of their service, but that’s going to be much more constrained than somebody who has a degree in the mental health field or years of experience working in community mental health,” said Leah Jacobs, a professor at the University of Pittsburgh’s School of Social Work.
Pennsylvania’s current certification and training standards require all officers to complete 22 hours of training for “responding to special needs,” which encompasses crisis intervention.
Hanley said Pittsburgh’s police bureau typically offers refresher courses monthly. The bureau could not provide an estimate of how many officers typically participate in the refresher courses. The bureau also provides extensive crisis training to its SWAT team and specialized negotiations team.
Elizabeth Sinclair Hancq, the director of research for the Treatment Advocacy Center, pointed to cases culminating in 302s as an example of situations that could warrant a police presence. “Especially in a place like Pennsylvania, where the standard is imminent dangerousness, those are dangerous situations, and law enforcement might be necessary,” Hancq said.
Rozel believes police can be essential for responding to some dangerous situations, even if their presence is “upsetting” and potentially exacerbates the crisis.
“When they’re necessary, they’re absolutely necessary,” Rozel said.
Baked into state law
If a behavioral health crisis becomes dangerous, police may be the county’s most-equipped responders because they have the manpower and transportation means to arrive at the scene within minutes, while it can take teams of social workers potentially hours.
This — along with a unique power within state law — often makes police the default responders to emergency situations involving behavioral health crises.
During emergency situations, the Mental Health Procedures Act vests police with the ability to initiate 302 petitions without approval from a county administrator. They share this power with physicians and county-authorized delegates, but often become the main group to exercise it because they are more accessible in emergency situations.
“M.D.s are very, very expensive,” Jones said. “The police are the easy out.”
Dalton is the county administrator authorized to select delegates who can initiate 302 petitions without county approval during emergency situations. She’s only delegated this power to officials within her office and said she hasn’t studied the delegation process thoroughly, but is open to considering anything that could improve the system.
Jacobs said DHS could consider granting other authorities, like social workers, the power to authorize 302 petitions without a warrant as a way of reducing their reliance on police in moments of crisis.
Rozel said he would not want this power to be granted to his teams at resolve. He fears that removing barriers to initiating 302 petitions could infringe on the rights of people in crisis.
“The law’s there for a reason — to try to strike the right balance of assuring appropriate treatment in emergency situations, but also protecting the rights of people who are receiving treatment or in need of treatment,” Rozel said. “Taking away a check and balance on that is not something that I would leap for.”
Amelia Winger is PublicSource’s health reporter with a focus on mental health. She can be reached at amelia@publicsource.org or on Twitter @ameliawinger.
This story was fact-checked by Aavin Mangalmurti.