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I've edited not to change anything you said, but merely to shorten and make more clear my responses
(09-10-2020 01:30 PM)OptimisticOwl Wrote: [quote='Hambone10' pid='16985637' dateline='1599754079']
Mental health: similar to the above. All is unpredictable, not all is dangerous.
In any case, this is the situation where I don't know how and when you rsystem will know who to dispatch -cops or counselors. Just because the reported rapist was imaginary the first 99 times doesn't mena it is imaginary this time.
I agree... If you don't know, you send a cop. If its a rapist/attacker there at the time, you're probably sending more than 1, probably more than 3. Once they arrive and see what's going on, the counselor stays and everyone else (maybe except one) goes.
Quote:It's not a binary question to me. In the example given, it's not clear if the new programs (outside of one-time start-up costs) costs more or less than the 'old' way.. and its not clear if it is more effective... i.e. are we including the cost to society and property values of petty criminals or incarceration etc... I wouldn't take money away from cops unless i was also taking responsibilities away from them.
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Reasonable, but the report we are reference seems t have taken away about 4-6 calls a day city wide.
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Understood... its still early... it's not just about the 4-6 calls though, it's about getting better outcomes. That can include everything from public perception to drops in crime rates to drops in officer related deaths (including officers) or reductions in recidivism or drug use etc. That's why I'm frustrated at the delays. Things that take years to 'study' before anything is put in place mean they often span elections... with purpose. They are often forgotten or at least turned over to people who don't want to fix them/aren't responsible for them so they don't support them.
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Most UK police aren't armed. I strongly suspect that when Uncle Joe is off his meds, the first responders are unarmed. I can't speak to the other places... and only anecdotally about this place. I've been there, but didn't look to see who responded to crimes.
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But the UK police are still police, with power to arrest and subdue. Would your mental health experts have the power to take people into custody and reman them somewhere? What is they had to wrestle the person to the ground and restrain them? Do they call for the caps and wait in their car for the muscle to arrive? What is the out of control crazy guy is hurting people or themselves while we wait?
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That's why I talked early on about 'defunding police' to anyone that was really serious about it really only meant redefinining roles. I'm not even engaging those who want to eliminate police. That's a non-starter.
I'd say they would have powers similar to UK police with far more emphasis than their US peers on de-escalating and far less on subduing. Let me use your own example... I may get details wrong but it doesn't matter... I think you'd call and say, my sister is out of control again... can you send someone... they'd ask if she was armed or had a history of physical aggression... if you say yes, they send a cop and the counselor. If no, MAYBE they send the counselor alone, who assesses the situation and makes the call to engage or to stay back and wait. If you don't know (maybe its a crazy neighbor instead of your sister) then they send both. As I said, when in doubt, send the cop.... I'm just suggesting that if you suspect its mental health that you include a mental health specialist.
Let me give an example... One of the issues we've been facing in healthcare finance is an inability to meet government requirements regarding 'quality' which often includes simple things like people 65+ getting osteoporosis screening. In our Behavioral Health group, it was suggested that insurers call members to remind them to follow up or keep their appointments or take their meds... and BH experts noted that if a random person called or god forbid, sent a text to someone with some version of paranoia/anxiety telling them to get to the doctor, it could trigger an event. Depending on the patient, the call/text/letter needed to come from their providers office... someone they knew and associated with their issues and not some random person. These were highly trained people, but not BH experts. That's how I see cops. They usually don't REALLY know how to manage people having events or episodes... even with some training and good intentions.
Quote:wouldn't this be akin to staffing ERs with specialists rather than generalists? Your medical experience may be of help here. I am not adverse to the idea of specialists, but doesn't that imply a need for another type of specialist - the one who decides which specialty is needed for each call?
I think that's already happening... and its some combination of 911, police dispatch and officers on the scene providing additional information continuously so as to tailor the response.... same in an ER where you have 911/the ambulance/ the triage nurse/the NP/PA and then the MD.
there are lots of differences between what happens in an ER and what happens with police and I don't want to get too far off into the weeds.... but you bring up part of my original point.
The mantra of a doctor is 'first, do no harm'. An ER doc would generally hold a patient or keep them stable and wait on the expert... unless they absolutely had to do something right then... and even then, it would rarely be a 'surprise'... hey doc... multiple GSW on the way in... I've called the surgeon on call and they're on the way. OR being prepped, OR nurses ready to take over...
That's what I see happening... but they're going to the scene rather than waiting for them to come in... and if the call is something like 'a guy walking naked down the street', then you notify so they're ready, but don't dispatch (at least not code 3) the armed police. They're on their way without speeding or sirens unless they hear different from the counselor.
I think the experience of the UK plus our own data suggests that there is a significant number of calls where cops are acting as counselors rather than subduers... even when arrests for things like possession or intoxication are involved... and I'm betting you can triage those calls as you would in an ER easily ranking them on a 1-5 or similar scale... a 1 means you send a kitten in, a 5 you send the whole lion pride. A 2, you send a kitten with a single lion back-up, a 3 they have 2 lions, a 4 you send 4 lions with a kitten back-up. The bottom line is that a big part of de-escalation is removing the threat of escalation... and a guy armed to the teeth is going to struggle to do that... no matter how nicely he talks... especially to someone who isn't all there from either mental health issues or drug usage... and with other cops and sirens all around. I'm not talking about a paradigm shift in law enforcement... I'm talking about an annual review and resource re-allocation based on best practices. A six-sigma analysis.