How mental health crisis response became police work
By Suzi Morales
Ford School of Public Policy
Looking through a historical lens offers insight into today’s proposals for alternative emergency responders
Police officers are trained to respond to urgent situations, but when they encounter people experiencing mental health crises, those encounters can escalate quickly.
In 2025, 116 people were killed by police responding to reports of someone behaving erratically or experiencing a mental health crisis, according to the nonprofit Police Data Archive. That represents nearly 10% of the total 1,201 fatalities in its database. A separate study using data from 2015 to 2020 found that 23% of people injured in police shootings showed signs of a mental or behavioral health condition or substance use.
Since the racial reckoning sparked by the murder of George Floyd — a black man — at the hands of a white police officer in 2020, individuals, organizations, and government agencies have increasingly called for alternatives to police responses in some emergencies, including sending social workers or other trained responders to mental health-related calls.
Recent research by David Thacher, associate professor of public policy and urban planning at the University of Michigan Gerald R. Ford School of Public Policy, sheds historical light on the current debate.
Based on studies of about a century of police history, with a primary focus from the 1900s to the 1970s, Thacher suggests that addressing a “messy situation that nobody, including the police themselves, is happy with” may depend not only on alternative responders, but also on learning from officers who handle mental health crises effectively.
An unexpected history
Thacher began his research with an assumption shared by many in academia and law enforcement: Police officers began responding to more mental health-related calls around the 1960s, as states moved people out of psychiatric institutions, often without adequate community-based support.
He was surprised to find, instead, that these police responses began increasing much earlier, alongside the spread of household telephones and radio-equipped patrol cars in the 1930s and ’40s.
As those technologies spread, Thacher found, police officers’ daily routines became less centered on patrolling set routes and more centered on responding to emergency calls. Those calls often came from family members or neighbors seeking help for people experiencing mental health crises.
Some police forces and individual officers turned to clinicians for advice on how to handle these crises, but the guidance was not well suited for law enforcement’s needs.
“There’s been a lot of criticism of policing, and in many cases, those criticisms are entirely warranted. But there are some really thoughtful, really humane, really progressive police practitioners out there who are doing a really difficult job that most of us would really struggle with, and the best of them have a lot to teach their fellow officers, but also emergency responders.”
Thacher found that a 1954 handbook and subsequent videos created by an association of mental health professionals became the most influential source of police training on mental health for more than three decades.
Much of the guidance offered commonsense advice — such as avoiding actions that might agitate a person in crisis — or discussed how to classify mental illness.
“The more common task of managing an immediate crisis in the community received less attention,” Thacher wrote.
In other words, the materials had little to say about the specific challenges police encountered in the field.
Using the past to inform future responses
Thacher sees a parallel between today’s calls for alternative responders and earlier efforts to bring clinical expertise into crisis response. In both cases, clinical training alone may not prepare someone to manage an emergency in the field.
Although proposals for greater involvement by mental health professionals have merit, he said that “we’ve got to recognize that people have been saying that exact same thing for close to a century, and so it’s not for lack of trying.”
Cities working to implement alternative-response solutions often have trouble finding enough trained workers willing to take on crisis-response roles, Thacher notes.
Although an increasing number of Michigan communities are exploring such programs, county sheriffs and local police chiefs said they would be difficult to implement because of funding, staffing, and other challenges, a 2024 Michigan Public Policy Survey found.
“I think what a lot of these cities that are doing the alternative response thing are finding is that just sending clinicians or social workers out to these scenes is not necessarily a complete solution because the skill set that you need to respond to emergency crises is different from the skill set that you need to do therapy or social work in an office setting,” Thacher said.
Thacher suggests that law enforcement agencies systematically evaluate officers’ practices and develop training programs in partnership with officers with more experience in mental health situations.
“There are police officers out there that are better at doing this work than their [police] colleagues are, and we need to bottle what they know and disseminate it,” he said. Alternative responders can also benefit from training provided by these officers.
“There’s been a lot of criticism of policing, and in many cases, those criticisms are entirely warranted,” Thacher said. “But there are some really thoughtful, really humane, really progressive police practitioners out there who are doing a really difficult job that most of us would really struggle with, and the best of them have a lot to teach their fellow officers, but also emergency responders.”