Transforming Police Responses to Mental Health Emergencies: Rapid Integrated Group Healthcare Team (RIGHT Care)

Developed initially through a multi-million dollar grant from the W.W. Caruth, Jr. Fund at the Communities Foundation of Texas, RIGHT Care stands as a national model for shifting the focus of mental health crisis response from law enforcement to paramedics and health systems in order to create the same type of health-based response to mental health crises that we use for other health emergencies. RIGHT Care is reducing the use of jails and emergency rooms as the default response to mental health crises, putting paramedics and social workers in the lead and permitting law enforcement to focus solely on its core public safety role.

The traditional response to mental health crises in every community in Texas and the nation is to send law enforcement first. We do this because, historically, systems have viewed mental health emergencies differently than other health emergencies such as heart attacks, strokes, or out-of-hospital births, treating mental health crises primarily as public safety threats rather than health emergencies. As a result, too often the person in crisis is taken to a jail or to a hospital emergency department. RIGHT Care fundamentally changes this approach, and is a critical tool to eliminate the use of jails and police as the default response for the treatment of mental illness.

A RIGHT Care team consists of a community paramedic, licensed mental health clinician, and specially trained police officer. This integrated team responds to mental health calls placed through 911. The team is skilled in deescalating a crisis while assuring public safety, and can assess both physical and mental health needs on the scene. The team also is linked to community treatment resources, including same-day prescriber access, so the person does not have to be taken to a jail or emergency room.

In its first 18 months, RIGHT Care teams responded to just over 4,000 calls in the Dallas South Central police district. The teams made arrests for new offenses in fewer than 2% of cases, and based on reports from the team, diverted about 900 people from emergency departments and just under 500 people from jail. As evidence of its potential to change policing more broadly, RIGHT Care was associated with a 9% drop in arrests in the South Central district compared to the previous year, and an 11% reduction compared to citywide arrests over the same time period. Many cases were resolved in the community, and connections were made to community care rather than having people languish in jail or emergency rooms.

Dallas intends to expand RIGHT Care to the entire city. In addition, multiple communities across Texas and nationally are pursuing ways to modify the model to address their own policing and mental health crisis challenges. RIGHT Care illustrates that a transformed crisis response can make an enormous difference to the lives of people with mental illnesses and communities more broadly. It also shows that a health-driven response to mental illness is the right response, and that it is possible to eliminate the use of police and jails as the default response to a mental health crisis.