9 a.m. Joseph Binder and Collin Jevmore’s morning starts slowly, driving in a circle around Miller Playfield looking for a man who sometimes sleeps near the No. 12 bus stop. It’s a surprisingly nice day in April and the two just started their shift.
He’s not here as far as they can see, but it was worth a shot.
Earlier that month, the man — who appears to face mental health challenges — was detained by police after yelling at some schoolchildren nearby who were teasing him. Because verbal threats were made, school staff called law enforcement. That’s when Binder, a Seattle police officer, and Jevmore, a social worker on the crisis response unit, followed up.
Today, they were hoping to check in with the man and build rapport with him.
***
For people with severe, untreated mental illnesses, care is often experienced as a series of stops and starts. A long night in an emergency room bed. Weeks in a secured facility. A stint in jail.
Frequently, those encounters with the mental health crisis response system begin with police.
In the midst of a continuing national debate over policing and a federal rollout of the new 988 crisis phone line, a key question remains: What role should law enforcement play in responding to mental health crises?
In large West Coast cities like Seattle that face growing homelessness, and tangled in it, mental illnesses and drug use among some of their most vulnerable residents, the question is particularly crucial. Seattle received an estimated 11,000 to 14,000 emergency calls last year for mental and behavioral crises alone.
Evidence shows people with mental health problems experience worse — sometimes lethal — outcomes when police get involved. According to a national 2015 study by the Treatment Advocacy Center, people with untreated mental illness are 16 times more likely to be killed during a police interaction than other residents.
Since 2016, Seattle police have killed at least five people in a mental health crisis or with a prior record of mental health challenges, according to Seattle Times records and an analysis of news coverage, though in many other cases it was unclear whether mental health could be a factor.
“Police response can be traumatic or triggering for people,” said Summer Starr, the deputy director of the Washington chapter of NAMI, the National Alliance on Mental Illness. She said police were dispatched to her Bellingham home in 2016 while she was in a manic episode. “We don’t need that kind of armed response.”
In many cities, residents are interested in alternatives that keep marginalized communities safe and incorporate mental health professionals or peers in response to mental health crises.
While cities continue to pilot new approaches, some of these types of programs — including in Seattle — have been around for years. They’ve shown some success, but they’ve often remained small, needing the necessary alchemy of funding, sufficient staffing, political willpower and trust among departments.
The result? That by and large, most communities still send out officers for mental and behavioral crises.
***
10 a.m. Binder and Jevmore strike out — they can’t find the man at Miller Playfield. This happens often in their line of work. Other times, they reconnect with people, but they’re not interested in services. The team leaves business cards behind.
“We never know what might change,” Binder said. “It could be one really bad night and they’re like, ‘You know what? I want housing.'”
The team then heads to Capitol Hill to respond to a man who’s called 911 over a dozen times this morning saying he wants to die.
He’s a “frequent flyer,” someone who calls often enough that dispatch and officers recognize him. But it’s hard to connect with him — both to build a trusting relationship and quite literally.
The man rarely answers the door, despite his constant calls. Today is no different.
***
SPD has had some version of a crisis response unit since 1998 — their approach is similar to a program first piloted in the late ‘80s in Memphis, Tennessee, called crisis intervention training or CIT. In the 40-hour curriculum, officers learn about mental illnesses, how to communicate with people in crisis, and actually sit down and talk with someone with lived experience. Officers say it’s helpful to meet people with mental illnesses or substance use in a calm setting — it often changes their perspective.
All officers in Washington must now have an 8-hour training in crisis intervention since the passage of Initiative 940 in 2018, which regulates use of force, as well as mandates police to receive de-escalation and mental health training. About 54% of SPD officers are certified in the full 40-hour curriculum, according to the department.
In 2010, SPD also received a federal grant to pilot a program called the crisis response team. It created teams made up of one officer with a gun and one mental health professional who respond to mental and behavioral health-related calls — a model they still have today. The team has since grown to 10 people, and works alongside Health One, a similar initiative from the Seattle Fire Department.
A 2015 evaluation of the program by Seattle University researchers in the International Journal of Law and Psychiatry found some success: About a third of cases were referred to mental health agencies or substance use treatment, and a smaller percentage were administratively cleared, meaning the case was closed without an arrest. While researchers were “hesitant to make policy recommendations,” it was a hopeful window into a new system that diverted people from jail or hospitals.
Binder, the officer on the crisis response team, said other SPD officers join them for short 30-day rotations to learn more and share back with their precincts. He’s also noticed more officers want to work on the team full-time.
But services remain limited: The team is small, and they don’t have enough dedicated staffing to cover overnight hours or weekends.
“The goal is to have two different parts … the crisis response team would be the one that’s out in the field doing field stuff [and another team] would be doing follow-up cases in the office,” said Binder. “Unfortunately, it’s us doing both of those things.”
***
11 a.m. An older man is calling from a building near Broadway Avenue with allegations about his neighbors, saying they’re out to get him.
Binder and Jevmore talk to the landlord downstairs. The tenant has bipolar disorder and may be off his medication, Jevmore says. Neighbors complain that he’s yelling and stomping about. He’s also verbally aggressive, the landlord warns. She mentions they’re filing to evict him.
The team heads upstairs with two additional officers who joined as backup. The resident, who opens the doors for officers easily, is animated and talks loudly, jumping from topic to topic. But he’s unable to respond to questions clearly — likely in a manic episode, Jevmore says later.
“He was trying to center himself and he couldn’t for more than a couple of seconds,” explains Jevmore.
Binder, the police officer, asks the man whether he takes any medication and if he intends to hurt himself. The man says he would never hurt himself, but starts on another tangent. Jevmore makes a note to check on him later in the week.
***
An estimated 6-7% of Washingtonians face serious mental illness like schizophrenia and bipolar disorder. Recovery is possible, often with the assistance of medication and therapy. But relapses can occur, especially during stressful periods. In a painful twist, a condition called anosognosia can also cause people to not recognize their own illness and make it hard for them to keep up with treatment.
Often, officers on SPD’s crisis response team have to decide whether to refer cases to designated crisis responders, or DCRs, who are mental health professionals specifically authorized by regional behavioral health care agencies to determine whether someone should be involuntarily committed to psychiatric care temporarily. The law in Washington says people can be committed if they are considered a threat to themselves or others, or if they are “gravely disabled” and cannot care for themselves.
The calls that crisis response teams like SPD’s respond to often are also interwoven with broad societal issues, like housing.
It’s a devastating, self-perpetuating loop, documented by academic studies. In one common example, what starts as a noise complaint or lack of cleanliness due to someone’s behavioral health, leads to a person getting labeled as a nuisance. They get evicted and destabilize even more. Finding housing again becomes harder with an eviction record, which can result in homelessness.
***
12 p.m. The radio buzzes and dispatch tells the crisis response team that Seattle Fire is requesting them. A man in an apartment stairwell is not moving, but the situation is under control. Binder and Jevmore weigh their options: They can’t do much more than the team that’s already there — and to reach them, it’s 45 minutes with traffic.
Another call comes in and the team is rerouted to Pacific Place instead. Tourists walk by, staring at two bike patrol officers and a tall man in gym shorts, a black coat, and scuffed white sneakers.
A coffee shop called about an incident involving this man, who apparently thought someone stole his phone card. Officers believed he has intellectual or developmental disabilities. Jevmore calls around and confirms the man is also diagnosed with schizophrenia and has a history of drug use.
Over the next half-hour, the team tries to calm him down and ask if they can call anyone for him. At times the man walks into traffic but officers ask him to step back onto the sidewalk. At one point, he gets frustrated and empties his duffel bag. A toothbrush, razor and orange medication bottle tumble out on the sidewalk with other belongings.
Officers pick up the items and keep trying to talk to him. Eventually, he agrees to ride with another officer to the Downtown Emergency Service Center’s crisis facility.
***
Other cities have taken their own approaches to crisis response. Often, the question is whether these teams are set up to respond to psychiatric emergencies in progress — particularly involving weapons or a safety risk — or work more proactively, focusing on lower-urgency calls in hope of preventing larger crises in the future.
For example, CAHOOTS, an often-cited model out of Eugene, Oregon, that’s been around for over 30 years, sends out a mobile crisis team staffed with a medic (like a nurse or EMT) paired with a mental health professional. In some cases they’ll co-respond with a police officer, but in general the calls they respond to are more limited than SPD’s unit. They do not respond to any 911 calls that include criminal activity, a weapon or any kind of physical threat or unsafe setting.
Models like this minimize an armed response by police. Still, Jessica Shook, a designated crisis responder in Thurston and Mason counties and president of the Washington Association of Designated Crisis Responders, said the result is people in acute crisis sometimes don’t get immediate help because the situation is too unsafe for mental health workers.
She gave the example of a crisis responder entering a chaotic scene where there’s someone experiencing a mental health crisis, several other people, weapons, drugs and a history of violence.
“You’re going to tell me that my crisis workers … they’re gonna walk into that house and they’re just going to talk everybody into health?” she asked.
Though she doesn’t want police to be the first or only response, she also can’t imagine a world where law enforcement isn’t at least part of the solution.
“You know who’s gonna go to that? Cops,” Shook said. “Wouldn’t it be better to have cops and mental health professionals go together?”
In Arlington, Snohomish County, a new pilot program called the Center for Justice Social Work launched this year, with $375,000 from the state Legislature funding four social workers and four clinical interns over two years.
They are not immediately dispatched during crises, but instead follow up on referrals from local police and fire. The team also responds to substance use, social and financial issues, and older adults who are struggling to live independently, managing anywhere from 20 to 90 referrals a month.
Kaitlyn Goubeau, the founder and CEO of the Center, previously worked with the Everett Police Department responding to crisis calls. She saw a need for a program that is well-partnered with law enforcement, but not actually part of the same response.
“The balance of being part of the police department — and not being part of the police department — is this fine but a very gray line,” said Goubeau. “You’re ultimately never going to make everybody happy.”
***
1:30 p.m. Jevmore and Binder get called to West Seattle by a team of designated crisis responders seeking support.
In this situation, the King County DCRs were called to determine whether a young man could be committed for psychiatric care. When Jevmore and Binder arrive, two DCRs are outside talking to the landlord, and another officer joins them as back up.
Within minutes, they decide to come back another time. The young man is known to have a gang affiliation and firearms, and the situation is deemed too unsafe to enter. The DCRs will call the crisis response team tomorrow and try again.
***
Starr, with NAMI Washington, knows that for people who are very sick and physically aggressive, police may have to respond. She advocates for a better crisis system, one that’s comprehensive and centers people with mental illness.
“Mental health is not something that exists by itself,” she said. “If someone experiences housing instability … oppression of their sexual or gender identity, all of those things surround an individual. It’s really huge that we start looking at mental health from these larger social contexts.”
She also advocates for alternatives like peer respite services, “Residential places that people can go sometimes for up to two weeks to recover and they’re not locked down,” Starr explained. Research on peer respite programs has shown to be successful in reducing the need for more costly emergency and inpatient services.
“They are places that normalize altered experiences or people who are in crisis. And I think that that’s a major thing — our regular community just doesn’t know how to respond to someone (with mental illness).”
Sgt. Corey Williams, overseeing SPD’s crisis response unit, agrees, and advocates for diversions like drug or mental health court when officers are responding to property or lower level crimes. (Otherwise, officers, for the most part, have the discretion to arrest a person in a mental health crisis if a crime has been committed.)
“It’s a tough balance, because we’re not gonna arrest our way out of this situation,” Williams said. But the overlap between social services and law enforcement is already there as far as he sees.
There’s certainly room for law enforcement to learn more skills in mental health and social services, he said. He also wants more social workers alongside officers, ideally one for every precinct, at every shift.
“What I hear from a lot of the officers is they didn’t come to this job to do crisis intervention, they came to … serve their community or help people,” he said. “But then they quickly find that crisis work takes up so much of their calls.”
***
3 p.m. The team starts wrapping up and heads back to the East Precinct. Now it’s paperwork, extreme risk protection orders limiting firearms for people at risk of harming themselves or others, and following up on past cases.
As the officers head up First Hill, a construction worker flags down the patrol car.
“See that sleeping bag up there?” she says, pointing down a street corner. “Someone’s passed out and they’re unresponsive.”
The car turns around and Jevmore gets ready with Narcan, a medication that can be used to treat an overdose, just in case.
“Sir, hello?” Binder calls out. A minute passes. Eventually, a quiet voice comes from the blue sleeping bag.
The man is from Sequim, 60 miles away. He doesn’t accept medical or housing services, but takes a cigarette and asks for a bus ticket home.