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Addressing Obstacles of Today: Mental Health vs. Law Enforcement

The National Alliance on Mental Illness reports that 22.8% of U.S. adults experienced mental illness in 2021 representing 1 in 5 adults. Our youth (ages 6-17) was recorded that 16.5% U.S youth experienced a mental health disorder in 2016.

911 calls involving mental health have been a growing concern, particularly in the U.S., as emergency services often find themselves responding to crises that might be more appropriately handled by mental health professionals.

With the deinstitutionalization movement that began in the 1960s, many individuals with serious mental illnesses were moved from psychiatric hospitals into community settings. As a result, the responsibility for crisis response shifted towards law enforcement and emergency services. Mental and behavioral health issues make up 20% of 911 calls. One study noted between 21-38% of 911 calls are related to mental health, substance use, homelessness, and other quality of life concerns.

Several cities have created programs to address and respond to health crisis calls. Rather it be the Crisis Assistance Helping Out on the Streets (CAHOOTS), Crisis Response Unit (CRU), Support Team Assistance Response (STAR), Street Crisis Response Team (SCRT), all have similar objectives tackling mental health crisis in communities. One state is taking this to the next level, New Jersey!

In late 2021, Acting Attorney Andrew Bruck and New Jersey State Police Colonel Patrick Callahan announced the beginning of a pilot program that pairs a New Jersey State police law enforcement officer with a certified mental health screener to respond together to 911 calls. The program referred to as ARRIVE Together was expanded statewide as of July 2023. The Alternative Responses to Reduce Instances of Violence & Escalation (ARRIVE Together) program saw positive outcomes in reducing violence and allowing for de-escalation upon arrival to these calls in unmarked police cars with non-uniformed officers and certified mental health screeners.

The ARRIVE Together program is gaining attention from many as law enforcement officers have reported that they do not feel adequately trained to handle mental health related calls. It is estimated that people with untreated mental illness are 16 times more likely to be killed during a police encounter than other civilians approached by law enforcement and sometimes lead to tragic outcomes.

When we discuss mental health-related 911 calls, it's essential to understand that emergency personnel, especially if they aren't medically trained, may not diagnose a condition during a crisis call. However, when individuals are subsequently seen by a healthcare professional, a more specific diagnosis might be given.

Below are ten common mental health diagnoses and their corresponding ICD-10-CM codes:

F32.9 - Major depressive disorder, single episode, unspecified A mood disorder characterized by a period of at least two weeks where a person experiences a persistent feeling of sadness or a lack of interest in outside stimuli.

F41.9 - Anxiety disorder, unspecified General diagnosis for patients who have anxiety or phobic symptoms not meeting the criteria for any other anxiety disorders.

F20.9 - Schizophrenia, unspecified A severe mental disorder in which people interpret reality abnormally, leading to hallucinations, delusions, and disordered thinking and behavior.

F10.20 - Alcohol dependence, uncomplicated Chronic disease characterized by uncontrolled drinking and preoccupation with alcohol.

F11.20 - Opioid dependence, uncomplicated A pattern of behaviors that include a higher priority given to drug use than to other activities.

F43.10 - Post-traumatic stress disorder, unspecified Can develop after a person is exposed to a traumatic event, symptoms might include flashbacks, nightmares, and severe anxiety.

F31.9 - Bipolar disorder, unspecified A disorder associated with episodes of mood swings ranging from depressive lows to manic highs.

F40.9 - Phobic anxiety disorder, unspecified An anxiety disorder characterized by an excessive, irrational dread of everyday situations.

F44.9 - Dissociative and conversion disorder, unspecified Disorders characterized by a disconnection and lack of continuity between thoughts, memories, surroundings, actions, and identity.

F60.9 - Personality disorder, unspecified

Patterns of thoughts and behaviors that are inflexible and chronic, and differ significantly from the expectations of the cultural norm.

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