Grand Rapids' major effort to fundamentally reform behavioral health services becoming a model for others

One-third to half of those killed by police are disabled, a recent report says. “Our problem isn’t with police,” one mental health advocate says, but both sides say officers need more training.

*Medical research has done wonders to rid populations of diseases; however, the U.S. health care system has failed to appropriate the right resources to Medicare patients with one or more chronic conditions. Health Quality Partners in Doylstown, PA enrolls Medicare patients with at least one chronic illness and hospitalization and sends a trained nurse to see them on a routine basis, whether they are healthy or sick. As a result, the HQP program has reduced hospitalizations and cut Medicare costs.

The Law Enforcement Assisted Diversion (LEAD) program in Alamosa, Colorado, gives police officers the option of sending people to substance abuse treatment rather than straight into the criminal justice system. Used in non-violent cases, the diversion program is based on a harm-reduction model that uses a health-care approach rather than a punitive approach to address the underlying issues when a crime is committed. Some police officers object to the program's mission, but proponents say that forcing compliance would be counterproductive.

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.

Crime-tracking mobile apps give millions of Brazilians crowdsourced data on urban violence, alerting people to dangerous places and filling gaps in government data on shootings, robberies, and other risks. But apps such as Fogo Cruzado (“Crossfire”) and Onde Tem Tiroteio (“Where There's a Shooting”) offer statistically crude glimpses of crime, distorted by media and racial biases that one expert blames for myths about the risks people actually face.

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.

Mexico's Pilot Program for Licensed Physicians brings Mexican doctors to the states to address the lack of culturally relevant healthcare and Spanish-speaking healthcare providers, particularly in rural areas with large immigrant populations. Currently, the program has 30 Mexican doctors working in various counties throughout the state.

A pair of doctors are working to make healthcare more accessible and affordable by training area hospitals to use new technology, like ultrasound devices, to detect non-communicable diseases. Through their newly established non-communicable disease clinic staffed with personnel trained to provide more precise medical care, about 1,100 patients have been cared for.

Birth in Color's doulas are filling the maternity care gap as rural labor and delivery rooms close, disproportionately impacting people of color. Doulas provide physical, emotional and informational support before, during and after childbirth, and advocate on the mother’s behalf. Doula care leads to improved birth outcomes and lower rates of C-sections, and in April 2022 doula services were added under the state’s Medicaid program.

Anambra State’s telemedicine program is closing the healthcare access gap in rural communities, making universal health coverage more possible. The program began in 2022 and has since hired and trained 42 doctors in providing remote healthcare. As more people use the telemedicine program, public trust in primary healthcare across the region is increasing.