Swanson Leonard, Zettner Catherine, Watson Amy, Hinojosa Melanie, Roddy Juliette, Kubiak Sheryl
Center for Behavioral Health and Justice Wayne State University Detroit Michigan USA.
Department of Criminology and Criminal Justice College of Social and Behavioral Sciences Northern Arizona University Flagstaff Arizona USA.
Psychiatr Res Clin Pract. 2025 May 2;7(3):182-190. doi: 10.1176/appi.prcp.20240100. eCollection 2025 Fall.
Mobile crisis and co-response models are increasingly popular mental health crisis response alternatives to law enforcement. In theory, crisis response models could increase behavioral health treatment connections and divert people with mental illnesses from jails. This exploratory study compares post-year arrests of individuals who received services from three crisis response models (co-response, mobile crisis, and office-based crisis) against individuals who received law enforcement-only responses in five communities.
Medicaid billing data and clinician service records identified ( = 474) crisis service recipients of two co-response models, two mobile crisis models, and one office-based crisis model in Michigan. Researchers collected law enforcement reports ( = 690) of mental health crises in the respective jurisdictions. Michigan State Police data revealed subject-level pre- and post-year arrests. Inverse probability of treatment weighting accounted for differences between crisis response and law enforcement groups by age, sex, prior-year arrest, and jurisdiction. A weighted Poisson regression examined each crisis response model's impact on post-year arrest rate relative to law enforcement-only responses.
Bivariate analyses supported the inclusion of response types in a regression. All three crisis models showed fewer post-year arrests than their respective law enforcement-only comparisons, but only the mobile crisis response predicted a statistically significant reduced incidence rate of arrest (incidence rate ratio 0.548; < 0.05).
This study is the first to assess post-year arrest outcomes of mobile crisis teams and adds to the null arrest literature of co-response teams. Mobile crisis teams may divert future crisis service pathways away from 911, decreasing law enforcement involvement and arrest risk.
移动危机应对模式和联合应对模式作为心理健康危机应对的替代方式,正越来越多地取代执法部门来处理危机事件。从理论上讲,危机应对模式可以增加行为健康治疗的联系,并使患有精神疾病的人免于入狱。本探索性研究将接受三种危机应对模式(联合应对、移动危机应对和基于办公室的危机应对)服务的个体在接受服务后的年度逮捕率,与在五个社区中仅接受执法部门应对措施的个体进行了比较。
医疗补助计费数据和临床医生服务记录确定了密歇根州两种联合应对模式、两种移动危机应对模式和一种基于办公室的危机应对模式的(n = 474)危机服务接受者。研究人员收集了各自司法管辖区内心理健康危机的执法报告(n = 690)。密歇根州警方的数据显示了个体层面的年度前后逮捕情况。治疗加权的逆概率考虑了危机应对组和执法组在年龄、性别、上一年逮捕情况和司法管辖区方面的差异。加权泊松回归分析了每种危机应对模式相对于仅接受执法应对措施而言,对年度后逮捕率的影响。
双变量分析支持在回归中纳入应对类型。所有三种危机模式的年度后逮捕人数均少于各自仅接受执法应对措施的对照组,但只有移动危机应对模式预测逮捕发生率有统计学意义的显著降低(发生率比0.548;P < 0.05)。
本研究首次评估了移动危机应对团队的年度后逮捕结果,并补充了联合应对团队无逮捕情况的文献。移动危机应对团队可能会使未来的危机服务途径远离911,减少执法部门的参与和逮捕风险。