3 lessons Washington can learn from how Arizona helps people in mental health crisis

Northern Maine is home to some of America's poorest - but it ranks high on national measures of health. Hospital programs visit more patients in their homes where they can be more comfortable and receive everything they need, which in turn reduces medical costs.

Across the country, hospitals are embracing intensive intervention programs to help victims of violence — including those who have criminal histories — after they have been brought in for treatment of injuries. Such programs can help prevent retaliation, reduce the chance a patient will be violently injured again, and put people on track for success.

Health providers are well-positioned to identify and help those who have experienced domestic violence. Nepal is one of several countries training medical workers to identify abused patients and refer them to in-hospital crisis support services.

Across New Hampshire, youth are leading the fight against substance abuse. Programs like Dover’s Youth-to-Youth, Stand Up Sachems, Youth Leadership Through Adventure, and the Making it Happen Coalition, are all youth-led, adult-supported initiatives that are empowering young adults to create and disseminate substance abuse awareness and prevention campaigns. Fundamental to each of these efforts effective communication and creating a sense of community as key to prevention.

Based out of the city of Addis Ababa in Ethiopia, a live radio show is tackling the stigma around mental health care by combining their platform with those in the mental health care field. Not only does the radio show discuss psychological issues on air, but it also offers free and reduced-cost mental health services to those that serve as guests on the show.

More than 2,700 police departments in the U.S. have crisis intervention teams aimed at responding to mental health crises with fewer arrests and less violence, but the death of Daniel Prude in Rochester police custody offers clear lessons in the shortcomings and misuse of the CIT model. A lack of adequate mental health services across the country, coupled with superficial training of the police, too often means a police response to a crisis will not de-escalate the situation or lead to meaningful help for the person in crisis. A recent study found CITs have not shown they will lower violence.

The Violence Against Women Act was billed as a way to make a patriarchal society, and policing profession in particular, take domestic violence more seriously. It encouraged policies making arrest of alleged abusers mandatory, even to the point of punishing victims who refused to cooperate in prosecutions. This has backfired on many victims, especially women of color who distrust police and their punitive approaches to solving family problems. The law also prioritizes punitive approaches in its awarding of federal grants, thus denying victim aid to women who do not wish to cooperate with arrests.

CAHOOTS has become a national model because of its uncommon partnership with the Eugene Police Department. The police chief says CAHOOTS' unarmed first responders to mental health crises can de-escalate crises before crimes occur or someone gets hurt. That's the idea behind the decades-old agency that takes calls where police can sometimes cause worse outcomes. The crisis intervention workers and medics treat people on the scene or transport them to places where they can get the help they need. Police are available but rarely needed for safety on those calls.

Thunder Bay police formed IMPACT (Integrated Mobile Police Assessment Crisis Team), pairing crisis responders with mental health expertise with police officers to respond 24/7 to people experiencing mental health crises. Instead of defaulting to police responses, which risk the use of force and often land people in custody or a hospital, the teams often are able to get people connected to needed social and health services. So far the team has managed to divert about 40 percent of calls to helping services.

The Defender Association of Philadelphia practices community-oriented public defense — also known as "holistic defense" — to connect clients with support services and resources that help address the root causes of crimes. The association works with social workers, investigators, and paralegals to get clients access to housing, food, jobs, and healthcare, as well as mental health and substance use treatment, with more than 150 people referred to treatment providers between September 2016 and January 2017.