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The Need for Mental Health Counselors as First Responders

Just days after the 2016 tragedy at the Pulse nightclub in Orlando, more than 650 mental health practitioners had signed up for shifts to offer support to victims and community members. At the time, the Pulse incident was the deadliest mass shooting in modern U.S. history with 49 people killed. Counselors and other mental health professionals providing their services in response to a tragedy is essential, commonsense and, fortunately, routine in this country. But why aren’t we providing those same routine services in other situations that could prevent tragedy in the first place?

According to a Washington Post tally, 1,165 civilians were fatally shot by police nationwide and more than 200 of them were confirmed as having a mental illness. A 2015 report from the Treatment Advocacy Center estimated that one in four of all fatal police encounters and one in 10 of all law enforcement encounters involve a person with severe mental illness. When we think about concepts like public safety, emergency response, and crisis intervention, making decisions about who should be engaged as a first responder is key. 

Over the last several years, there has been a growing demand throughout the country for reevaluating who responds to encounters with people experiencing a mental health or substance abuse crisis. A demand that is also being fueled by socioeconomic disparities in accessibility of essential services and racist, fatal encounters with law enforcement. Specifically, the focus has been on the need to remove resources currently being poured into militarization of police and reallocate them to programs and professionals equipped with de-escalation and mental health care training.

The National Alliance on Mental Illness (NAMI) has highlighted the multiple benefits of more thoughtful, community-based responses to crises involving people with mental illness. These crisis intervention teams (CIT) typically involve creative partnerships among mental health care providers, emergency services personnel, law enforcement, other community services and individuals. 

Last year, the Brookings Institute examined several innovative CIT-style programs around the country and outlined next steps for further developing similar approaches on a larger scale. Among the issues they highlighted were the ongoing question of whether police will ever be a safe or adequate response to a mental health crisis (regardless of any specialized de-escalation training) and the growing need for professionals with behavioral health knowledge and training who are easily accessible in any area of the country. 

Right now, pressure is mounting to reverse the cycle of defunding behavioral health institutions and programs and allowing the criminal legal system to replace it. Harmful stigma attached to mental health issues, particularly in BIPOC communities, and the often explicitly racist conflating of mental illness in those communities with violent behavior, has resulted in the criminalization of even the most common of mental health challenges. Reversing that mental health criminalization cycle and preventing unnecessary tragedy in many cases means replacing police with counselors, social workers and other mental health professionals as first responders.

The 2021 State of Mental Health in America report noted that even before COVID-19, the prevalence of mental illness among U.S. adults was increasing, as was suicidal ideation. As we move from BIPOC Mental Health Month in July to National Suicide Prevention Week in early September, we’re continually reminded of the urgent need to focus more of our resources on preventative crisis response approaches that alleviate and de-escalate. And meeting that need will require a collective, national commitment to destigmatizing mental illness and redefining the concept of “first responder.”

Dr. Lynn Linde is the Senior Director of the Center for Counseling Practice, Policy and Research at the American Counseling Association, where she also served as the association’s 58th president. She has over 35 years of experience as a school counselor, counseling supervisor at the local and state levels, and counselor educator. She presents and writes on ethical and legal issues, particularly for school counselors.

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