Partners in Crisis: Improving Police Response to Individuals in Moments of Crisis by Providing Service Alternatives, Roanoke Valley, Virginia, 2022 (ICPSR 39294)

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Study Purpose View help for Study Purpose

The goal of this study was to evaluate the effectiveness of co-response teams on hospitalization outcomes of individuals in crisis using a place-based randomized controlled trial in southwest Virginia, and also to reduce the subsequent police contacts of people with mental illness (PWMI).

Study Design View help for Study Design

To evaluate the effects of the co-response teams, researchers conducted a six-month randomized experiment in Roanoke Valley, Virginia. The study involved partnership among four police agencies across the Roanoke Valley with Blue Ridge Behavioral Healthcare, a mental health service provider, to establish a standard crisis response protocol that provides police with peak-hour access to trained mental health professionals (MHPs) who can offer stabilization services and guide individuals into further treatment if needed. Following the recommendations of a recent evaluation of co-response models and the hot spots policing literature, researchers designed and implemented the co-response program on the mental health hot spots, defined by the amount of mental health calls for services, from May 16th 2022 to December 31st, 2022. The Roanoke Valley, which includes Roanoke County, the cities of Roanoke and Salem, and the town of Vinton, is a mixture between urban-suburban-rural region in southwest Virginia. Each of the jurisdictions listed has its own police department, but due to scarce resources and geographic dispersion of the region, each department had concurrent jurisdiction in the other areas. Although the overall Roanoke Valley crime rate is low, mental health-related (MH-related) calls were a major and persistent concern for both the police and community in the region.

The co-response team program, which partners police officers and mental health professionals (MHPs) in responding to mental health-related (MH-related) calls for service (CFS), provides individuals in crisis with more opportunities to access services than police alone are able to provide. It also reduces the time and resources spent by police on MH calls by allowing them to hand-off individuals to MHPs when safety is not a concern.

To maximize the benefits of the scarce resources, the co-response teams responded to calls during the hours of peak MH needs, from 10 am to 8 pm, Monday to Friday from May 16th, 2022 to December 31st, 2022. Across the four police agencies, Roanoke County Police Department (RCPD) served as the pilot agency to test out of the intervention program. Therefore, the intervention period in Roanoke County started a month earlier than the other three agencies. Due to the lack of resources and understaffing situations in both police agencies and the mental health service organization, it was not possible to form a co-response team for each agency. Thus, the clinicians responded to MH requests based on the receiving order of the requests.

Two clinicians (one full-time and one half-time) were on-call during these hours and any requests made during the non-service hour were recorded and responded on the next business day when eligible. In this study, the teams often acted as a secondary responder, arriving the scene after the first responding police officer evaluates the crisis situation as appropriate for the clinicians and as low risk for violence. Sometimes, the co-response team responded to calls directly when dispatchers were able to verify the requests involving individuals in a mental health crisis.

Also, the large geographic area of Roanoke Valley posed challenges for the co-response teams to get to the scene in a reasonable time frame. To avoid the delay and better allocate limited resources, the study implemented a place-based experimental design and focused treatment on designated mental health hot spots rather than the whole region. Based on a recent study conducted in Roanoke, VA, the concentration patterns of MH incidents are more salient than the common crime concentration found in prior literature. Specifically, found that 100% of MH-related calls clustered in less than 2% of the street segments in Roanoke County annually. The concentration patterns remain when they look at MH hot spots in a longitudinal fashion and see that a very small number of segments (n=63, 0.4% of the total streets) were responsible for 44.6% of MH calls over a five-year period.

Following the hot spots policing research and literature on crime concentration, researchers decided to use street segments with high rates of MH incidents (i.e., MH hot spots) as the study unit at the beginning of the study. Researchers considered the MH needs (judged by the volume of MH CFS) and the population size of each agency when selecting the MH hot spots. CFS data from the four police agencies from January 2018 to June 2021 were used to identify these MH hotspots.

Street segments with high volumes of mental health calls for service were randomly assigned to either treatment hot spots (n = 113) or control hot spots (n = 115). The results suggest that the co-response teams had a significant effect on reducing subsequent hospitalizations, with an estimated effect size of -0.22. The findings, challenges, and recommendations for future co-response team implementations were discussed.

Sample View help for Sample

The data contain clinical records, and no sampling techniques were used.

Time Method View help for Time Method

Universe View help for Universe

Number of Temporary Detention Orders issued in the given streets.

Unit(s) of Observation View help for Unit(s) of Observation

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Description of Variables View help for Description of Variables

The study is for public release with a total of 9 variables. The study includes a unique ID: StreetID (unique street segment identification within each jurisdiction.) The data included indirect identifiers, which are PD (the list of the police departments that took part in the study), TOTAL_OUTCOME_TDO (the number of Temporary Detention Order pre and during intervention) and TOTAL_MH (the total number of mental health-related calls for service pre and during intervention). Also, number of TDOs was the primary outcome and number of MH calls for service was a secondary outcome.

Original Release Date View help for Original Release Date

2025-05-14

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