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Can Fire Departments Better Handle Mental Health Crises?

San Francisco experiments with the makeup of its Street Crisis Response Teams.

Key points

  • Without guns or a focus on punitive action, fire departments might be better suited than law enforcement in responding to mental health crises.
  • To be most effective, fire departments must ally with individuals who have mental health conditions, their providers and their families.
  • First steps can include helping reduce the stigma of mental illness and joining efforts to strengthen the country’s mental health system.
Source: TFoxFoto/Shutterstock

When my now grown daughter was only three or four, the local fire department chief visited her preschool and offered some interesting advice. He told the kids that if they ever had an emergency and needed a grownup’s help fast, the best thing they could shout was “fire.” More than “help” – a word kids too often use in horseplay – “fire” gets people’s immediate attention.

I do not know if firefighters are still teaching this lesson – after all, it is illegal to shout fire in a crowded movie theater – but I have been reflecting on the advice since reading about the progress San Francisco has made in reforming how its 9-1-1 dispatchers respond to mental health crises.

Instead of sending police officers, calls go to a Street Crisis Response Team composed of members of the City’s public health department and their fire department.

Just like my daughter learned 20 years ago, firefighters can offer assistance in a variety of emergency situations. They do not carry guns. They do not make arrests. They are there strictly to help. It is no wonder that most EMS – Emergency Medical Services – teams are a component of the services provided by fire departments.

Equally, it is no wonder that San Francisco opted to make its fire department a central part of its Street Crisis Response.

This move represents one of many experiments that cities are undertaking to better protect those with serious mental illness. It is badly needed given the high rates at which those with diagnosed (and often undiagnosed) mental illness suffer injury, arrest or die at the hands of the police.

This is not to say law enforcement should not ever handle mental health emergencies. With expert training and close partnerships with mental health professionals and organizations, there is no reason officers cannot diffuse tense standoffs and escort individuals to psychiatric facilities, as needed, focusing their attention on individual and public safety instead of punitive action.

But police must regain the trust of many underserved communities if they expect those who need help to see them as a resource.

In the meantime, fire departments in San Francisco and elsewhere can do much to improve the lives of residents with serious mental illness and their families. For example:

  • They can be part of the effort to reduce the stigma of mental illness. One way to do this is to create and enforce policies surrounding inappropriate language concerning those with mental health conditions.
  • They can ally with mental health organizations and individual practitioners to encourage schools, workplaces, and other organizations to take a more proactive, preventive approach to mental health issues.
  • They can join efforts to strengthen the country’s mental health system, creating a stronger safety net for individuals and families, including more supportive housing and outpatient care.

I sincerely believe there are many ways to fix our system that too often and unjustly views those with mental illness as criminals, but all of these begin with treating such individuals with empathy and compassion, recognizing their dignity and humanity.