How to help someone struggling with mental illness

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.

Despite being an island of seamen, Iceland used to experience high numbers of drownings every year, fostering a keen interest in swimming education. The government stepped up and tapped into the underground hot water generated by Iceland’s volcanic activity to create geothermal pools, which quickly became more than a humble municipal investment, but perhaps the very secret to the country’s happiness. Every town now enjoys communal pools, which create a neutral, recreational space that brings all manner of people together.

Miami is home to a special type of child welfare program called CHANCE (Citrus Helping Adolescents Negatively Impacted by Commercial Exploitation) that is designed specifically for youth in foster care that have been trafficked. CHANCE has an intensive curriculum that educates foster parents and clinicians about child sex trafficking and child trauma, and families are only allowed to take in one child at a time so that they are prepared for the child's unique health needs. Studies done on the program have found that the youth have significant improvement in many emotional and mental categories.

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.

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.

Even before the coronavirus pandemic limited access to health care facilities, health specialists across Africa were already beginning to turn to technology-based mental health services to offer care with fewer barriers for patients. Despite its growth in use during the pandemic, some doctors caution that it does not necessarily replace in-person consultations, but is still very useful.

Although Eugene, Oregon's long-running, successful CAHOOTS program serves as one model for the new Portland Street Response, a more relevant model can be found in Denver's STAR program. Like CAHOOTS, STAR responds to mental-health and other crisis calls with medics and counselors rather than police officers. But Denver's size, demographics, and homelessness make it much more analogous to Portland. In STAR's first six months, it handled nearly 750 calls without a single arrest. Both STAR and PSR are starting small, so more resources are needed if the pilot projects succeed.

Tucson Police Department's Substance Use Resource Team reaches out on the streets to people with substance-use disorder, offering them treatment instead of arrest and jail. The team is an extension of the department's mental health support team and was started in response to the opioid epidemic. Officers talk to people they find on the streets, or follow up on 911 calls for overdoses. Not everyone accepts the offered help, and some end up arrested on warrants. But, at a time of rising overdose deaths, the officers and the peer support specialists who accompany them often can get people into treatment.

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.