Vinnie Cervantes, Organizing Director of the Denver Alliance for Street Health Response, noticed something strange about Denver’s famous 16th Street Mall. While public officials and police encouraged tourists to “linger” on the street, they often cracked down on unhoused people “loitering” there. “The only distinction between those two things is whether or not people have money to spend,” says Cervantes.

That distinction underlies the way the United States treats unhoused people and people with mental illness. Many of us have walked down the street in our towns or cities only to find someone in the middle of a mental health crisis. Considering that, as of 2017, 18.9% of American adults experience mental illness, with 4.5% of American adults havinga serious mental illness, this person may be our family member, or ourselves. What can we do when we encounter a community member in crisis?

As a result of long-standing violence against people living on Denver’s streets, Cervantes’ group partnered with other community organizationsto create the Support Team Assistance Response (STAR) program. In response to 911 calls concerning mental health crises or homelessness, the program dispatches a van with a mental health clinician and a medic, rather than a cop.

STAR represents one model that community organizers have turned to for inspiration in the wake of the ongoing Black-led uprisings against systemic racism and police abuse. Since late May, following Minneapolis officers’ extrajudicial killing of George Floyd, protestors around the United States have been calling for the defunding and abolishment of the nation’s police departments. For Cervantes, STAR is part of a movement toward defunding police and putting money toward community wellbeing instead. “Having a treatment-focused approach to public safety is so needed,” he says.

Americans With Mental Illness Lack Long-Term Support

At the root of the criminalization of mental illness is the United States’ long-term disinvestment in basic mental health care. As of 2017, only 66.7% of those with serious mental illness had received any kind of psychologicalcare in the past year.

Care is often simply too expensive for people to access, even with insurance. In a 2013 survey, half of people who had a mental illness said that theycouldn’t afford basic treatment, like therapy. This is a particular issue for Americans of color, especially indigneous and Black Americans. Because of systemic racism, resulting from the historical trauma of slavery and colonialism, roughly20%of Black andindigenous people of colorhavee a mental illness, while experiencingup to three times the rates of poverty as white Americans.

As a result of structural racism and community disinvestment, America’s prisons have become the country’s largest inpatientpsychiatric care providers. Of course, prison is not a place where humans thrive — and it’s certainly no place to help people with mental illness. Rampant human rights abuses, includinglack of adequate foodandmedical care;frequent sexual abuse; anduse of solitary confinementmean that prisons often cause trauma, rather than heal it.

Partly as a result of these deplorable conditions, up to 21% of incarcerated people havePTSD.

People With Mental Illness Are Vulnerable

In order to improve the way we treat community members with mental illness, we need to change both public policy and our society’s underlying ableist mindset.

Ableist myths

Our society is deeply unequal, rife with racism, ableism, class exploitation, sexism, and homophobia. The bigoted beliefs that result from these systems don’t just impact us on the policy level. They affect us on the level of our emotional reactions, shaping how we see and interact with other people.

Many of us are taught to regard people with mental illness as scary or threatening, especially if they are experiencing psychosis or are behaving in a way that departs from social norms. “We need a community narrative that confronts those feelings and that stigma,” says Cervantes.

Reality

In reality, people with mental illness are more likely to be harmed or to harm themselves than to commit violence against others. People with severe mental illness are ten times more likely than those without mental illnessto be victims of violent crime, including domestic violence and assault.

This vulnerability shows up in several ways. Having a mental illness makes people far more likely to experience poverty and homelessness; the trauma of poverty and homelessnessoften triggers mental illness. As a result, more than 30% of our chronically homeless neighborsexperience mental illness. Similarly, people with mental illness are more likely to use drugs, often as a form of self-medicationto cope with untreated symptoms, which increases their chance ofinvolvement with the criminal justice system.

Some Cities Are Creating Alternatives to Police Responses

Denver’s STAR program isn’t the first of its kind. It was modeled after a similar program, CAHOOTS, a Eugene, Oregon program which has,since 1989, responded to mental health crises with counselors and medics, rather than police. For aroundone percentof the city’s$238 billion police budget, the program answers17% of the department’s calls.

For Cervantes, programs like CAHOOTS and STAR shift our conception of public safety away from police and punishment and toward “meeting basic human needs.” Rather than arriving on the scene of a call and immediately assuming an unhoused person or person in crisis is the source of the problem, STAR counselors ask how they can help that person. “They can talk to somebody or navigate an issue,” says Cervantes. “Most of that is seeing if people are okay.”

If that person is experiencing an acute mental health crisis, counselors can take them to a treatment center. If the person is experiencing homelessness, counselors can connect them with shelter resources. If the person uses drugs, they can connect with treatment orharm reductionresources. Cervantes describes one particularly traumatic encounter in which an unhoused person simply needed water to avoid dying of dehydration.

Tellingly, most of the calls STAR has received since its opening pertain to trespassing — largely due to an unhoused person attempting to find shelter. For Cervantes, this indicates a need to invest in community well-being more broadly. His organization advocates for greater investment in substance use treatment, affordable housing, restorative justice programs, and programs supporting people who have been incarcerated.

Take Action In Your Community Today

“As we start to create these programs or think about alternatives to policing, they really should be community-run, community-owned,” says Cervantes. While programs like STAR have yet to take root in most American cities, you can advocate for a more humane and effective response to mental illness and homelessness in your community starting now.

You can attend protests, educate yourself and your loved ones on mental illness and mass incarceration, and hold local politicians accountable for reinvesting funds in mental health and housing support. You can also directly engage in more caring ways with your neighbors, and learn basic de-escalation skills.

Build relationships

People who experience homelessness are valuable members of our communities. If there are unhoused people living in your neighborhood, treat them with the respect you would any neighbor. Say hello, look them in the eye, and wish them a good day.

If an unhoused neighbor asks you for support, pause and look them in the eye when you answer, even if your answer is no. If you do want to help out, remember that your neighbor is the best judge of what they need, sodon’t be afraid to ask them. If that person asks for money, and you are comfortable or able to give it, give without strings attached—remember that it’s not your job to judge other people’s spending habits. If you don’t want to or can’t offer them money, ask what else they might need. Food? Socks? A prepaid calling card? A connection to any kind of service?

Listening to our neighbors with an open heart affirms their dignity, and our own.

Learn about local resources

We often rely on police for help because we are simply unaware of alternative options. Get to know what resources are available in your locality for people experiencing homelessness, mental illness, or drug use.

What homeless shelters are around? Are there clinics that offer free mental health care? What organizations are doing mental health outreach or harm reduction for people who use drugs? Find out if your local shelter or harm reduction center has an outreach number for people who may need assistance. You can also volunteer at a local organization to build those connections, lend your skills, and help educate yourself.

De-escalate tense situations

You canlearn some basic de-escalation skillsto help support yourself and other community members in moments of crisis. If a loved one or a stranger is experiencing a mental health crisis, it’s important to stay calm and react in as non-threatening a manner as possible. People in crisis are often scared; when they do lash out, it’s usually in self-protection against a perceived threat.

First, if someone is in crisis, you can ask onlookers to disperse. A group of people watching or filming someone in crisis can feel extremely threatening and violating for that person. Unless those onlookers are actively helping, or are loved ones of that person, you can ask them to move along in order to prevent the situation from escalating.

Next, try to make your voice and body language as calm and reassuring as possible. Don’t confront the person, yell at them, or try to overpower them; the only time it’s okay to use a raised voice or physical violence is if you are being directly, immediately physically attacked. Speak in simple, soothing sentences. You can directly ask the person what they need and if they would like you to call for help. You can also always leave the space if you feel unsafe or if you feel you lack the tools to help.

Community Is For Everyone

Our society’s status quo approach to mental illness — to punish those who are unable to receive care — is not working. Currently, says Cervantes, when we see people in distress, “We want to get rid of that person or dispose of them.” Yet, as manyprison abolitionists have pointed out, when someone is incarcerated, they don’t disappear. Instead, they are sent to a place where their trauma often compounds, leading to further violence.

Rather than attempting to discard people whose behavior is merely symptomatic of our society’s broader issues — racism, gender-based violence, wealth inequality — we must solve those root problems.

Inone of the richest countries in the world, we have more than enough resources to support the well-being of everyone in our communities, unconditionally and without exception. Hopefully, with the example of the current uprisings, and programs like CAHOOTS and STAR, we will now have the popular will to do so. “We as a community — whether that’s non-profits, neighborhoods, or individuals — really do have the power,” says Cervantes.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

Articles contain trusted third-party sources that are either directly linked to in the text or listed at the bottom to take readers directly to the source.

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