When Mental Health Crisis Responders Reach Rural Residents

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.

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.

Teams of Community Direct Distributors (CDD) are leading drug distribution campaigns to prevent and eliminate neglected tropical diseases in hard-to-reach, rural areas. These CDDs are members of the community they serve and are trained to educate the locals on disease prevention and administer the drugs themselves. With the CDDs’ help, several states have already eliminated some diseases and greatly reduced the spread of others.

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.

To enhance rural access to healthcare in Nigeria, the Parkers Mobile Clinic partners with local volunteers, healthcare professionals, educators, and community development advocates to identify and remedy unique healthcare gaps. Outreach programs are then designed to provide localized mental health support, nutritional counseling, and other reproductive health services.