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Current Affairs

A Magazine of Politics and Culture

Our ‘Normal’ Responses to Mental Health Crises Are Not Working

People in pain need care and support, not state-sanctioned violence.

On January 6, 2021, a young woman in Tigard, Oregon called the police. She was seeking help for Jacob MacDuff, a 26-year-old man who was in a mental health crisis. Upon arrival, the police got on the phone with his mother, who was out of state. She begged them to be “gentle with him, remain calm, please take care of my baby.” Police shot him five times. Four days later in Killeen, Texas, 58-year-old Patrick Warren Sr. was shot dead in his front yard after his family requested a mental health check. These two recent cases followed a more high profile incident in Philadelphia in October 2020, when a mother called the police to help her 27-year-old son, Walter Wallace Jr., who was suffering a mental health crisis. According to the police, they arrived to find Walter screaming while his mother was trying to hold on to him. Both of the responding officers fired seven times—14 shots in total. Instead of helping Walter, they killed him. 

As a mom and public defender who specializes in mental health cases in Harris County, Texas, I wish I could say that these are just isolated cases. But they are not. Such tragedies are “normal.” People with mental health issues are 16 times more likely to be killed in a police encounter than other civilians. All of this underscores a key point: when we continue to invest in police, prosecutions, courts, jails, and prisons—instead of true mental health intervention and response— our communities are not made safer or healthier. Instead, people die. 

But police shootings and killings don’t tell the full story of the impact of the criminalization of mental health issues on the people, families, and communities most targeted by police, especially Black and Brown people. 

Every day, both here in Harris County and around the country, families with loved ones who suffer from mental health issues end up on the receiving end of “help” that only hurts. Family desires are steamrolled by police and prosecutors, and the “solution” only creates a new stigma or problem. For every police killing of someone with mental health issues like Jacob MacDuff, Patrick Warren, Sr., or Walter Wallace, there are thousands more violent and counterproductive police interactions that go unnoticed by the public. 

Often, these interactions start with calls for help and end with systemic violence against people who are already struggling to get by. People like Anna, who I represent, and her mother Rose.

It was an early December evening in Houston, Texas. Rose, who is 57, and her daughter Anna, 31, were tucked into the privacy of the apartment they shared. They were arguing, as family members often do. Soon, the difference of opinion turned into a fight. Anna, in exasperation, threw a dinner plate down too hard on the family table. The plate bounced up and hit her mother’s nose. Rose began to bleed, and due to blood thinner medications, her nose didn’t stop bleeding. Out of an abundance of caution, Rose dialed 911 and asked for medical help.

Medical help did come—but so did three armed, uniformed police officers. As Rose received attention for her nose, officers asked her a series of questions. She answered honestly: yes, her nose was hurting, but she didn’t need an ambulance. No, her daughter didn’t mean to hurt her, it was an accident. She didn’t fault her daughter Anna, who suffers from bipolar disorder and schizophrenia and sometimes loses control of her emotions. Rose didn’t want her daughter arrested; that wasn’t why she called. An arrest would only hurt her daughter. 

But the police didn’t listen to Rose’s wishes. They arrested Anna. And the familiar nightmare began.

An arrest for anyone, let alone someone with mental health issues, is deeply traumatic and violent. Anna, a young woman in need of help, was forced into the back of a police car. The cuffs were too tight and the air in the car too stale. She was then held in a cage, sitting on a cold cement bench with a room full of strangers for more than 18 hours as she waited to see a magistrate judge. The walls had no clocks and the guards didn’t answer simple questions. Anna was terrified. 

Aside from the emotional toll, criminalization of mental health is also enormously costly. Beyond the over $100 billion taxpayers spend on “solutions” that only make matters worse (i.e., de-escalation and racial bias training for police; prosecution, prison, and supervision; and court-mandated treatment), families have to pay money they can’t afford to bail their loved ones out of jail. Rose had to scrape together the money to get Anna free. Still, after Rose picked her up, they both thought at least the worst was over. Anna was safe at home. Rose, who lives with a variety of health issues, had her primary caretaker back. The next morning they would figure out a way to get through this together. 

Unfortunately for Anna, Rose, and so many others, the criminalization of mental health issues also separates families. Neither Rose nor Anna knew that a nameless prosecutor working the bond docket that night had asked—as is routine—for an order of protection, a court order that meant Anna couldn’t be around her mother and therefore couldn’t go home. Nobody knew that Rose didn’t want that order in place because nobody asked her—she would have told anyone who’d listen that she didn’t. But one week later, a police officer knocked on the door, asked Rose if Anna was home, then woke Anna up in her own bed and handcuffed her for being in violation of a court order. The arresting officer’s body camera captured Rose’s frantic pleas as her daughter was once again escorted to a police car. The last thing that can be heard is Rose saying she has no idea where she will get the money to make a second bond.

Such criminalization of mental health issues is oppressive. Rose spent more than six months pleading with prosecutors and state-sponsored social workers to let the matter go, drop the charges, and send her daughter home. In total, she spoke with three prosecutors and two defense attorneys in an attempt to unwind both of Anna’s criminal cases. Rose was without her daughter and primary caretaker for the better part of nine months.  If you asked the police or the prosecutors, they would tell you that Rose was the victim here. Rose would tell you that it’s true—but the culprit wasn’t her daughter. Rose would say that she was the victim of an inappropriate social response to a mental health crisis and society’s over-reliance on police to intervene in every social issue. 

When people hear the words “defund the police,” many think anarchy. But as advocates, scholars, and activists have been explaining in considerable detail for decades, defunding the police really means greater public health and safety, more investment in robust community health responses, and trained professionals responding with care to mental health crises. We, as a society, are limited by what we are used to—the “normal” way of doing things, in other words. “Normal,” in turn, tends to get associated with words and concepts like “good,” “acceptable,” and “reasonable.” In the context of the criminalization of mental health issues, however, “normal” really just means frequent and cruel. We can’t claim to care about human beings, about rational policy, about fiscal responsibility, or about health and safety and at the same time claim that what happened to Rose and Anna is normal. 

Problems that arise from mental health diagnoses are complex, and require medical professionals and social workers who approach the work from a place of trauma-informed care, sensitivity, and help. They need to have a broader and deeper understanding of appropriate responses, services, and interventions. Instead we invest near-exclusively in criminal enforcement, armed officers, jails, and prisons. The complexities surrounding crises in mental health call for a public health response. And calls to help people experiencing mental health crises can be more safely and effectively addressed by community organizations and non-law enforcement responders, as shown in a growing number of cities and states. Getting people the care and services they need is public safety—it is crime prevention. There are ample models of non-police response around the country that work. If these models became the norm instead of the exception, we could save taxpayer money, families’ trauma and heartbreak, and yes, Black lives. 

I can relate to the desire for normal. There is a comfort in the status quo. As I sit here in front of my laptop—which is currently my office, the kids’ school, our church, and my window into the homes of friends who I miss dearly—I can’t help but wish that I had my old life back.  The one where I could come, go, and relate freely to people. I miss restaurants and movies. I miss dropping my kids off at school and picking them up at the end of the day. I miss what I took for granted. I miss normal.

But at least in the context of mental health justice, it is time that we scrap “normal” and talk more about how things should be. How they could be. How we might bridge the great gaping spaces between our historical expectations and the actual needs of the world we are living in now—and what that might mean for millions of our loved ones living with mental health issues.

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