[Senate Hearing 117-772]
[From the U.S. Government Publishing Office]





                                                        S. Hrg. 117-772

                    BEHAVIORAL HEALTH AND POLICING:
                       INTERACTIONS AND SOLUTIONS

=======================================================================

                                HEARING

                               before the

                        SUBCOMMITTEE ON CRIMINAL
                      JUSTICE AND COUNTERTERRORISM

                                 OF THE

                       COMMITTEE ON THE JUDICIARY
                          UNITED STATES SENATE

                    ONE HUNDRED SEVENTEENTH CONGRESS

                             FIRST SESSION

                               __________

                             APRIL 22, 2021

                               __________

                          Serial No. J-117-13

                               __________

         Printed for the use of the Committee on the Judiciary
         


         
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                       COMMITTEE ON THE JUDICIARY

                   RICHARD J. DURBIN, Illinois, Chair
                   
PATRICK J. LEAHY, Vermont            CHARLES E. GRASSLEY, Iowa, Ranking 
DIANNE FEINSTEIN, California             Member
SHELDON WHITEHOUSE, Rhode Island     LINDSEY O. GRAHAM, South Carolina
AMY KLOBUCHAR, Minnesota             JOHN CORNYN, Texas
CHRISTOPHER A. COONS, Delaware       MICHAEL S. LEE, Utah
RICHARD BLUMENTHAL, Connecticut      TED CRUZ, Texas
MAZIE K. HIRONO, Hawaii              BEN SASSE, Nebraska
CORY A. BOOKER, New Jersey           JOSH HAWLEY, Missouri
ALEX PADILLA, California             TOM COTTON, Arkansas
JON OSSOFF, Georgia                  JOHN KENNEDY, Louisiana
                                     THOM TILLIS, North Carolina
                                     MARSHA BLACKBURN, Tennessee
             Joseph Zogby, Chief Counsel and Staff Director
      Kolan L. Davis, Republican Chief Counsel and Staff Director

       

                    SUBCOMMITTEE ON CRIMINAL JUSTICE
                          AND COUNTERTERRORISM

                   CORY A. BOOKER, New Jersey, Chair
                   
PATRICK J. LEAHY, Vermont            TOM COTTON, Arkansas, Ranking 
DIANNE FEINSTEIN, California             Member
SHELDON WHITEHOUSE, Rhode Island     LINDSEY O. GRAHAM, South Carolina
AMY KLOBUCHAR, Minnesota             JOHN CORNYN, Texas
ALEX PADILLA, California             MICHAEL S. LEE, Utah
JON OSSOFF, Georgia                  TED CRUZ, Texas
                                     JOSH HAWLEY, Missouri
                                     JOHN KENNEDY, Louisiana

     Daniel P. Smith and Lynda Garcia, Democratic Chief Co-Counsel
                 Drew Hudson, Republican Chief Counsel
                 
                 
                 
                 
                 
                 
                 
                 
                 
                 
                 
                 
                            C O N T E N T S

                              ----------                              

                           OPENING STATEMENTS

                                                                   Page

Booker, Hon. Cory A..............................................     1
Cotton, Hon. Tom.................................................     4
Durbin, Hon. Richard J...........................................     6
Cornyn, Hon. John................................................     7

                               WITNESSES

Bartness, Martin A...............................................    10
    Prepared statement...........................................    56
    Responses to written questions...............................    77

Delany-Brumsey, Ayesha
    Prepared statement...........................................   146

Mangual, Rafael A................................................    12
    Prepared statement...........................................    61
    Responses to written questions...............................    82

Martone, Kevin...................................................    22
    Prepared statement...........................................    51
    Responses to written questions...............................    83

Mims, Margaret...................................................    17
    Prepared statement...........................................    70
    Responses to written questions...............................   129

Morgan, Ebony C..................................................    19
    Prepared statement...........................................    40
    Questions submitted but no responses.........................    75

Myrick, Kerris Jan...............................................    15
    Prepared statement...........................................    47
    Responses to written questions...............................   133

O'Connor, Terri..................................................    20
    Prepared statement...........................................    68

                                APPENDIX

Items submitted for the record...................................    39









 
                    BEHAVIORAL HEALTH AND POLICING:
                       INTERACTIONS AND SOLUTIONS

                              ----------                              


                        THURSDAY, APRIL 22, 2021

                              United States Senate,
                           Subcommittee on Criminal Justice
                                      and Counterterrorism,
                                Committee on the Judiciary,
                                                    Washington, DC.
    The Subcommittee met, pursuant to notice, at 10 a.m., in 
Room 226, Dirksen Senate Office Building, Hon. Cory A. Booker, 
Chair of the Subcommittee, presiding.
    Present: Senators Booker [presiding], Whitehouse, Padilla, 
Ossoff, Cotton, and Cornyn.
    Also present: Senators Durbin and Blumenthal.

           OPENING STATEMENT OF HON. CORY A. BOOKER,

          A U.S. SENATOR FROM THE STATE OF NEW JERSEY

    Chair Booker. I am calling this hearing to order. It is 
exciting for me that I get to be here with Senator Cotton in 
our first hearing on the Subcommittee on Criminal Justice and 
Counterterrorism. I want to welcome Ranking Member Cotton and 
all the Subcommittee Members and thank the witnesses that are 
here today, both in person--thank you, Kevin--and the virtual 
witnesses that we will have as well.
    I am going to acknowledge in a moment, after I finish my 
opening remarks, should Senator Grassley show up, and I see 
Senator Durbin here. We will offer and make time for both of 
them to give some remarks after Senator Cotton gives some.
    I was asked by one of our Subcommittee Members, Senator 
Klobuchar, who really wanted to be here today, but she is 
unfortunately at home attending the funeral services of Daunte 
Wright, who was shot and killed during a traffic stop. She 
wanted us to express that she is going to be submitting 
questions for the record.
    Right now across our country and in the Senate, we are 
having a long overdue, absolutely critical conversation about 
policing in America. I am very grateful over the last weeks to 
be in good-faith conversations with colleagues of mine across 
the aisle about a larger bill to try to advance policing in 
America.
    But today we are here on a far more narrow topic, and the 
purpose of the hearing is to talk about changes we need to make 
when it comes to how we as an overall society are going to 
respond to people dealing with mental health crisis and those 
who behaviorally have disabilities of behavioral health.
    By and large, we as a society have failed to provide these 
individuals with the support services, compassion, and empathy 
they need to thrive in our communities and live full lives. We 
see our streets with people experiencing homelessness, our 
jails and prisons, and we see unfortunately short and tragic 
deaths of those who are struggling with mental health crises. I 
have not met a warden, when I go visit jails or police leaders, 
who have not spoken with compassion and empathy that they are 
not the ones that should be dealing with this. There should be 
a better way to help people live healthy lives.
    Today we focus in on what is unfortunately too often our 
society's first real interaction with people with mental 
health, and it often goes wrong. We are here to talk about how 
our great police officers try to deal with this issue. It is 
about how we have made police officers first responders for 
mental illness, intellectual developmental mental disabilities, 
substance abuse, and people experiencing homelessness. It is 
about how officers are deeply frustrated and, as is often the 
case, overwhelmed because they are expected to play the role of 
social worker, mental health expert, and medical expert when 
they do not have the training or the skills often to do so. It 
is about how, for this reason, these encounters can quickly 
escalate to violence or turn deadly.
    One study of shooting data for 2015 found that people with 
untreated mental illness were 16 times more likely to be killed 
during a police encounter. The names, many of which we know, of 
the people who have died because of their encounters: Daniel 
Prude, Deborah Danner, Marcus-David Peters, and so many more. 
Often when these deaths occur, I reach out to the police 
officers I trust in the police department that I oversaw as a 
mayor. These are great, tough cops, courageous--fearless, in 
fact--and I ask them: Should those people with mental illnesses 
have died in those interactions? They all conclude with me very 
quickly that there should be a better way. We as a society 
together should be able to avoid these unnecessary deaths.
    Public health issues cannot be fixed with a law enforcement 
response. We must find a different way. What is needed for 
people who live with mental illness or addiction is help, 
services, treatment, access to medication, medical treatment, 
housing, peer support, and more. We know from our experiences 
of sound law enforcement officers, people on both sides of the 
aisle, that this should change in our society. We are better 
than this.
    I mentioned my time as mayor of Newark, and I have to say I 
was elected with a mandate to lower violent crime. My city was 
experiencing a surge in crime when I became mayor in 2006, so I 
spent hours and hours and hours riding along with police 
officers, often until 4 o'clock in the night. I wanted to know 
the challenges they faced. I wanted to learn their profession 
as best I could. I rode with them, and I got to know them. 
Again, I was humbled by their heroism and their service and 
their sacrifice. I got to know them and their families. I saw 
their professionalism. I saw how they were willing to take 
extraordinary risks, often putting themselves squarely into 
life-threatening situations, to carry out their duties.
    Let me tell you right now the job of being a police officer 
in America is extraordinarily difficult. What made their work 
harder was having to answer calls for service that took them to 
the person in a mental distress and screaming in their home, to 
the teenager whose mother called 911 because he was erratic and 
she had no one else to call, to the person experiencing 
homelessness, struggling with addiction, lying in the street. 
We were so frustrated, me and my police leadership, that the 
calls for service kept people chasing what we called queue, 
chasing call after call as opposed to doing the strategic work 
we needed to do to solve violent crimes. Unequipped and under-
resourced, I saw my officers spend their nights chasing those 
calls when they could have been more strategically using our 
manpower as police. Those people who they responded to could 
have gotten better help that would have prevented them from 
having encounters with the police in the future.
    I want to note that I received several letters from law 
enforcement leaders that echoed my own experience across the 
country in advance of this hearing asking, almost pleading, for 
Congress to fix the problem. I am going to submit those letters 
for the record, but I want to read just some of the words.
    Chair Booker. Sheriff Jerry Clayton of Washtenaw County, 
Michigan, wrote: ``I urge the Subcommittee to support and fund 
additional community-based services for people with mental 
health and substance use challenges. Too often people in need 
of treatment end up in our jails. This is not where they 
belong. Wherever possible, we should make efforts to find ways 
to provide community-based care without ever connecting with 
law enforcement.''
    Chief Shon Barnes of Madison, Wisconsin, wrote: ``In this 
era of police reform, we must all challenge our Government to 
provide a better level of service to the community. We can no 
longer simply rely on police responses to mental wellness and 
must view this issue from a community health perspective. We 
have seen far too many times the negative results of police-
only responses to mental health calls. No person deserves to be 
imprisoned or harmed by police simply because they have mental 
wellness challenges.''
    Chief RaShall Brackney of Charlottesville, Virginia, wrote: 
``By simply calling 911, a caller unleashes the full power of a 
system in which few officers are equipped to navigate. The 
Senate Judiciary Committee has the opportunity to inform the 
development of a national framework for responding to 
individuals in crisis. Included in that framework must be a 
pathway toward decreasing the presence of law enforcement in 
the mental health response portfolio and for the allocation of 
funding and resources which build capacity to support 
community-led continuum of care options which incorporate lived 
experiences and racial equity into the system.''
    In the meeting with local police chiefs 2 weeks ago, my 
colleague, my friend, and my partner in a lot of work here in 
the Senate, Senator Cornyn, expressed support for specialized 
training and more social workers and mental health experts so 
that police can do their jobs and, ``keep the bad guys at bay 
and protect the community.'' I believe we can find common 
ground here. I very purposely made this first hearing about 
something that I thought there was a wide common ground to do. 
There are so many issues that we as Democrats and Republicans 
do a good job of delineating our differences. This is something 
that should rise, I think, more grace from all of us. How can 
we come together, right and left, to try to find a way not to 
rehash our differences, but champion our shared interests and 
find commonsense solutions? It is time that we go that extra 
step to end what for many families with someone that has a 
mental illness in them has been a constant nightmare, fears of 
what will happen to their family member.
    I am grateful to all the witnesses that are here. I hope 
today we can narrow in not on our differences but to see if we 
can find some common ground. That is when we as a country move 
forward, when we find ways to stand together and work together 
to the benefit of others. It is the calling of our country to 
lead with that kind of spirit.
    I look forward to hearing from everyone. I look forward to 
a constructive conversation. With that, I am honored to pass it 
on to my Ranking Member and someone who I have a lot of respect 
for, Tom Cotton.

             OPENING STATEMENT OF HON. TOM COTTON,

           A U.S. SENATOR FROM THE STATE OF ARKANSAS

    Senator Cotton. Thank you, Senator Booker.
    Policing is on the minds of many Americans today. It is on 
their minds because of the relentless coverage of some high-
profile situations, but, unfortunately, that coverage often 
includes falsehoods which can be incendiary, and if repeated 
often enough, can do significant damage, something that no mere 
retraction can correct.
    There is another reason that many Americans have policing 
on their minds today. Last year, our Nation experienced the 
single largest increase in murders ever recorded, a shocking 25 
percent surge nationwide. In big cities, it was even worse. 
Murders rose in Chicago by 65 percent, in New York City by 58 
percent, and in Washington, DC, by 40 percent. Major cities 
additionally suffered the largest rise in aggravated assaults 
in three decades.
    American families and communities also watched in horror as 
drug overdose deaths rose to the highest level ever in the 
tragic history of addiction: 88,000 Americans died in just the 
last 12 months alone from drug overdoses.
    Our country also experienced hundreds of violent riots last 
year that inflicted billions of dollars in damages and wounded 
more than 2,000 law enforcement officers.
    Policing is a dangerous and difficult profession. It often 
involves individuals, all of whom are imperfect, making split-
second decisions with life-and-death consequences. The vast 
majority of law enforcement interactions involve no use of 
force, in fact, are cooperative and cordial between law 
enforcement and citizens. The vast majority of law enforcement 
officers are good, brave, selfless individuals putting their 
lives on the line every day to protect their communities. They 
face tight budgets, long hours, and sometimes public ridicule, 
all because they dedicate their lives to protecting others.
    Nonetheless, we, of course, have understandable concerns 
about how police interact with the public, including with poor 
communities, minority communities, and individuals with mental 
health challenges. Given the potential consequences if an 
interaction goes poorly, it is no surprise that Republicans and 
Democrats alike are interested in finding ways to improve 
policing and to improve public safety.
    Despite bipartisan interest in this issue, we have seen on 
occasion unfortunate partisan divides that have gotten sharper 
in recent years. There is perhaps no more visible example of 
this partisan divide than calls to defund the police. Activists 
and politicians can mean different things when they use that 
term. Some, including some lawmakers in Congress, have 
literally called for the abolition of all law enforcement, 
although many of these same lawmakers and advocates spend 
enormous sums of money on their own phalanx of private security 
bodyguards. Abolishing law enforcement is, of course, a foolish 
idea that no serious person would ever want to see enacted.
    Others say we should not abolish law enforcement 
altogether, but that we should simply cut their budgets further 
and rely more on unarmed social workers or mental health 
workers to intervene in emergency situations. Of course, we 
need to involve mental health professionals anytime there is a 
crisis situation where a person can receive treatment from a 
mental health professional rather than be subject of our law--
our criminal justice system. We do not need to ask police 
officers to also function as psychiatrists, doctors, and 
educators or to solve every social problem in our society. They 
are on our streets to enforce our laws and keep our communities 
safe.
    I suspect that most police departments would be glad to 
have more and better partnerships with mental health providers, 
as Chairman Booker outlined in some of the letters he 
introduced. I expect we will hear more about this in the 
hearing, and I welcome the opportunity to work with my 
colleagues in a bipartisan fashion to improve the availability 
of things like de-escalation training, and training on how to 
recognize and respond to people facing mental health 
challenges, and to expand partnerships between law enforcement 
on the one hand and mental and behavioral health providers on 
the other hand.
    The suggestion that mental health professionals can replace 
the police rather than supplement and support the police is 
misguided and dangerous. The simple truth is that when law 
enforcement stands down, when it responds less to what some 
people would call small or quality-of-life crimes or when the 
police are defunded, all we get is more crime and more 
violence.
    Let us be clear. Law enforcement is not the enemy, and we 
should not try to reduce law enforcement either. Not only can 
the police prevent additional victims, they can also be the 
opportunity to connect offenders who suffer from mental illness 
and addiction with the professionals that can give them the 
care they need.
    Almost every day that a police officer puts on their 
uniform, they help someone on the worst day of that person's 
life. Our police see the most heart-wrenching tragedies, the 
most gruesome gore, the most pernicious evils in our society. 
They are constantly faced with the worst and are always asked 
to be at their best.
    As violent crime and lawlessness continues to increase, we 
need more police, more resources, and better training, and, 
yes, more and better partnerships between our police and our 
behavioral and mental health professionals.
    I thank the witnesses for appearing today, and I look 
forward to hearing their perspectives on this important issue.
    Chair Booker. Senator Cotton, I am grateful for those 
remarks, and I would like--now invite and ask Senator Durbin to 
give some remarks as well, and I am hoping if Senator Grassley 
is here, he will do the same.

          OPENING STATEMENT OF HON. RICHARD J. DURBIN,

           A U.S. SENATOR FROM THE STATE OF ILLINOIS

    Chair Durbin. Thank you, Senator Booker. I am honored to be 
here for your first hearing as Chair of the Subcommittee on 
Criminal Justice and Counterterrorism. In this room today, we 
are making history. As you take the gavel, you are the first 
African-American Chair of a Senate Judiciary Committee. This is 
not only a historic moment; it is long overdue. I could not 
think of a better person to Chair this Subcommittee. Our work 
together on the FIRST STEP Act showed you as a real leader when 
it came to criminal justice reform, and I know you are showing 
the same leadership when it comes to police reform.
    The topic today is one that is near and dear to me. As 
Senator Cotton noted, there is an abundance and overwhelming 
evidence of gun violence in the city of Chicago and many cities 
across the Nation. As a United States Senator, many groups come 
to me and say, ``Well, what are you going to do about it? You 
are such a hotshot. You are a leader. You are on the Judiciary 
Committee.'' Many times I throw up my hands and think, ``If it 
depends on passing a law, that is so hard to do politically to 
get anything done in so many different areas.''
    I made a trip a few years ago that has really guided me 
since to the Cook County Juvenile Facility. This facility 
houses adolescents under the age of 18 who have been accused of 
gun crimes, many of them murder, and they stay in this facility 
in downtown Chicago until their trial. Sometimes that is years. 
We have created a high school in this facility--classrooms, 
gyms, cafeterias--for these adolescents waiting for trial as 
they are accused of gun crimes. I sat down with the teachers 
and counselors at these facilities and said, ``Who are these 
kids? How did they get into this situation, gang members, gun 
violence? What is this all about?''
    Of course, they said there are many avenues and many paths 
to that outcome, but they said to me, ``There is one 
overwhelming common theme. Over 90 percent of these kids have 
been the victims of trauma.'' Of course, we think of trauma in 
the physical sense, but it also is in the mental sense. If you 
go back to ACEs indicator, adverse childhood experiences, a 
list created many years ago, and realize what can happen to a 
little kid as they are growing up that has a direct impact on 
who they will be, what they will do, you find out there is a 
long, long list.
    The second visit I made--and I will make this very brief--
was to a public school in Chicago that was going through a 
program where they were introducing children in the third grade 
to meditation. I watched as the teacher--I sat in the classroom 
as the teacher called for a few minutes, 5 minutes, of just 
silence and reflection and meditation of the class. As I 
watched and went out in the hallway later, I said, ``There was 
one little boy in there that just could not settle down, could 
not quiet down. What is going on, do you know?'' ``Well, 
something terrible has happened at his home.'' I said to the 
teacher, ``So, what are you going to do about it?'' She says, 
``I teach math in third grade. I am not a psychologist.''
    The issue that I am raising here this morning at the 
beginning of this hearing, all the issues you have raised are 
valid issues, but let us not forget the need for mental health 
counseling for children, intervention in the lives of children. 
I do not think these kids are lost forever. They need help. 
They need a mentor. They need somebody who believes in them and 
who cares, who can turn them to the right path instead of 
seeing them end up on the wrong path.
    I yield.
    Chair Booker. Senator Grassley is one of the busier men in 
the U.S. Senate and moves with the indefatigable determination 
of the Energizer Bunny, so he is not here right now. I invoked 
Senator Cornyn's name, and I would love to extend the courtesy 
to Senator Cornyn if you would like to give any introductory 
remarks.

             OPENING STATEMENT OF HON. JOHN CORNYN

             A U.S. SENATOR FROM THE STATE OF TEXAS

    Senator Cornyn. Thank you for the courtesy and the 
opportunity. I am glad to be here today, and I appreciate you 
and Senator Cotton convening this hearing.
    I think we have all learned a lot in recent years about law 
enforcement and the role of mental health in that process. I 
guess one of the people that made the biggest impression on me 
a few years back was a journalist named Pete Earley, who 
chronicled his own family's struggle with a son, an adult son, 
who was mentally ill, but in the process would commit petty 
crimes and found himself in a jail cell without any real 
benefit to him or society because that is the only place they 
knew to put him.
    I have been encouraged by the work that we have been able 
to do here in the Congress, passing things like my Mental 
Health and Safe Communities Act, offering grants for those 
police departments that needed help with things like active 
shooter response, things like de-escalation training and the 
like. I have been very much encouraged by the crisis 
intervention teams that are sprouting up in most major cities 
around the country, including the major cities in my State, and 
even the advent of things like mental health courts so that, 
unlike traditional courts that adjudicate guilt or innocence, 
they literally monitor people once they are released into the 
public and make sure that they have the support they need and 
hopefully to deal with their mental health condition and so 
they do not repeat those offenses and they get the help they 
need, hopefully to get better.
    I will never forget, about 5 years ago now, I think it was, 
I was in Dallas at a memorial service where five police 
officers were killed, and Police Chief David Brown at the time, 
who has since gone to Chicago, he said to me and everyone else 
there at the time, ``We ask the police to do too much.'' I 
think we are making progress to try to provide additional 
resources and a more effective response. Frankly, I do not 
think it is an either/or proposition. I do not think the 
question is: Do you support the police or do you support mental 
health providers? We need to do both, in my view.
    I am glad that this Committee and this Congress has been 
productive in passing things like the Criminal Justice Reform 
Act that we all worked together on. I am--Senator Whitehouse 
and I are working on post-release access to services to make 
sure that people who do go through the programs to deal with 
their mental health challenges or with their addictions or lack 
of job skills, that once they are released from prison that 
they have the support they need in order to remain a successful 
and productive member of society and not by going back to the 
same old neighborhood with the same old bad influences and just 
get back into their same old bad habits.
    Thanks for giving me a chance to say a few words, Mr. 
Chairman, and thanks for holding this hearing.
    Chair Booker. Thank you, Mr. Cornyn.
    As I learned as a young boy in a small Black church in New 
Jersey, the choir has now sang, with surprising harmony amongst 
us all. Now, it is time to get on to the sermon, and that will 
come from our witnesses, and I am very excited to introduce 
half of our witnesses, and I will ask my Ranking Member to 
introduce the other witnesses. If I can find my notes here, 
forgive me, if I can get my introductions here--thank you very 
much.
    The first witness is Major Martin Bartness. He is the 
commander of the Baltimore Police Department's Education and 
Training Section, where he is responsible for the development 
and delivery of new recruit training and continuing education 
for approximately 3,000 personnel. Major Bartness also leads 
the Baltimore Police Department's Crisis Response Program, and 
he has served as the chief of staff to the police commissioner 
and commander of the Special Investigations Section. He holds a 
bachelor of arts degree from Creighton University, a master of 
arts degree from the University of Nebraska, Omaha, and a 
master's of criminal justice degree from Boston University.
    Then we have Keris Myrick, who is director of the JED 
Foundation and codirector of the Mental Health Strategic Impact 
Initiative, and she serves on the board of the National 
Association of Peer Specialists. Ms. Myrick is--has previously 
held the position of Director of the Office of Consumer Affairs 
for the Center for Mental Health Services of the United States 
Health and Human Services' Substance Abuse and Mental Health 
Services Administration and the board president of the National 
Alliance on Mental Illness. Ms. Myrick has a master's of 
science degree in organizational psychology from the California 
School of Professional Psychology of Alliant International 
University. Her master's of business administration degree is 
from Case Western University and the university's Weatherhead 
School of Management.
    Ebony Martin is the program coordinator and a crisis 
intervention worker for CAHOOTS. The CAHOOTS program provides 
mobile crisis response in Eugene and Springfield, Oregon, and 
has been connecting people experiencing crisis with uniquely 
trained personnel as an alternative to law enforcement for more 
than 30 years. In her position, she strives to promote and 
enhance the crucial role mobile crisis response plays in 
keeping communities safe.
    Kevin Martone is--Kevin, hi--is the executive director of 
the Technical Assistance Collaborative, a nonprofit 
organization dedicated to helping our Nation's mental health, 
addiction, homelessness, and affordable housing systems 
implement policies and practices that empower people to live 
healthy, independent lives in the communities they choose. 
Previously, Mr. Martone served as the mental health 
commissioner for the great State of New Jersey, president of 
the National Association of State Mental Health Program 
Directors, and CEO of a supportive housing agency.
    Yes, Ranking Member, please introduce your witnesses.
    Senator Cotton. Thank you. I would first like to introduce 
Terri O'Connor. Ms. O'Connor lives in Philadelphia, where she 
was born and raised. She is the mother of two children and the 
grandmother of two. Ms. O'Connor has firsthand experience with 
the challenges faced by our police. Not only is her son a 
police officer, but her late husband was also a police officer. 
In the early years of her marriage, Ms. O'Connor also spent a 
decade working as a 911 operator herself.
    Most recently, and tragically, Ms. O'Connor is also a widow 
after her husband, Philadelphia Police Corporal James O'Connor, 
was killed last year as he was serving a high-risk murder 
warrant on a gang member. His murderer should have been in the 
jail at the time but for the soft-on-crime policies of the 
local district attorney who prioritized so-called decarceration 
and reducing the footprint of the criminal justice system above 
public safety. Ms. O'Connor, I am so sorry for your loss. Thank 
you for your testimony today.
    Next, I would like to introduce Rafael Mangual. Mr. Mangual 
is a senior fellow and deputy director of legal policy at the 
Manhattan Institute as well as a contributing editor to City 
Journal. He has authored or coauthored a number of reports and 
articles on issues ranging from urban crime and jail violence 
to broader matters of criminal and civil justice reform. His 
work has been featured in a wide array of publications, and he 
has also appeared on a number of television and radio programs 
and discussed these issues. He has previously worked in 
corporate communications for the International Trademark 
Association. He holds a B.A. in corporate communication from 
City University of New York's Baruch College and a law degree 
from DePaul University in Chicago. Last year, he was appointed 
to serve a 4 year term as a member of the New York State 
Advisory Committee of the U.S. Commission on Civil Rights. 
Thank you, Mr. Mangual, for appearing before us today.
    Finally, I would like to introduce Sheriff Margaret Mims of 
Fresno County, California. Sheriff Mims has been a peace 
officer for more than three decades and was elected sheriff in 
2006. Not only was Sheriff Mims the first female deputy sheriff 
sergeant to supervise field patrols in Fresno County, she was 
also the first female deputy sheriff there to attain the ranks 
of lieutenant, captain, or assistant sheriff, or to be elected 
to the office of sheriff. She is a member of the California 
Peace Officers Association and the California State Sheriffs 
Association and is also deeply involved in her community in 
other ways, including through her service on the board of 
directors of the Marjaree Mason Center, a local women's 
shelter, as well as on the board of trustees for the Fresno 
County Boys and Girls Club. Sheriff Mims is a graduate of 
Fresno Pacific University and holds a master's degree in public 
administration from National University. Thank you, Sheriff 
Mims, for testifying today.
    Chairman Booker, I would also like to ask consent to enter 
into the record a number of other documents, including four 
peer-reviewed articles regarding policing and behavioral 
health, three commentary articles published in mainstream media 
publications, two documents published by the International 
Association of Chiefs of Police and the Law Enforcement Legal 
Defense Fund, and a written statement from the Council of State 
Governments.
    Chair Booker. Without objection.
    [The information appears as a submission for the record.]
    Chair Booker. I would like to now bring the witnesses on 
one by one. I think I need to swear folks in, and why don't you 
stand up, Kevin? The witnesses at home, please stand in your 
bedroom, living room, wherever you are. Do you affirm--please 
raise your right hand. Do you affirm that the testimony you are 
about to give before this Committee will be truthful, wholly 
truthful, and nothing but the truth, so help you God?
    Major Bartness. I do.
    Mr. Mangual. I do.
    Ms. Myrick. I do.
    Sheriff Mims. I do.
    Ms. Morgan. I do.
    Ms. O'Connor. I do.
    Mr. Martone. I do.
    [Witnesses are sworn in.]
    Chair Booker. With that, we are going to bring on the first 
witness, and the first witness with be Major Martin Bartness, 
the commander, Education and Training Section, at the Baltimore 
Police Department.

          STATEMENT OF MARTIN A. BARTNESS, COMMANDER,

            EDUCATION & TRAINING SECTION, BALTIMORE

             POLICE DEPARTMENT, BALTIMORE, MARYLAND

    Major Bartness. Good morning, Committee Chairman Booker, 
Ranking Member Cotton, and distinguished Members of the 
Subcommittee on Criminal Justice and Counterterrorism. My name 
is Major Martin Bartness, and I am a 24-year veteran of the 
Baltimore Police Department, where I currently serve as the 
commander of education and training and lead the Crisis 
Response Program. I am also a Bloomberg Fellow at the Johns 
Hopkins Bloomberg School of Public Health.
    While it is my privilege to appear before you today, I wish 
my presence were not necessary. We have come together, in large 
measure, because for at least the past decade, law enforcement 
actions have been associated with the annual death of about 
1,100 people nationwide. It is estimated that 25 percent to 50 
percent of these deaths involve persons who have been diagnosed 
with a severe mental illness. In the past 3 weeks alone, more 
than a dozen people who were mentally ill or in the throes of a 
breakdown were killed by police.
    These tragedies point to the urgent need for law 
enforcement to partner with behavioral health professionals, 
community stakeholders, and individuals with lived experience 
to develop and implement solutions to effectively respond to 
persons in crisis and meet the complex behavioral health needs 
of those we serve.
    We are in this situation because of public policy decisions 
made decades ago, when psychiatric institutions were closed and 
those living with mental illness were returned to their 
communities without adequate treatment and support. While these 
institutions were not the answer, States and municipalities 
failed to provide the supports and treatment needed for people 
with mental illness to live free from discrimination in their 
communities.
    To this day, in Baltimore and many other places throughout 
the United States, the behavioral health system's goal of 
crisis prevention has not been realized. I will share a story 
to highlight this point.
    In June of last year, a 19-year-old man, completely nude 
and in psychiatric crisis, repeatedly fired a handgun at 
motorists as he walked the streets of his Baltimore 
neighborhood. Police responded, safely took the man into 
custody, recovered the firearm he had been discharging, and 
drove him to an emergency room for psychiatric treatment. This 
would have been a great outcome except for within 6 days of his 
release from the hospital, he had another psychotic episode. 
This time, when officers answered the 911 call to his home and 
calmly attempted to de-escalate him, the man pulled a handgun 
from his pants pocket and pointed it at the officers. In fear 
for their lives, the officers shot him. He is now paralyzed.
    Far too often, police find themselves in positions where 
the behavioral health system has failed to meet consumers' 
needs. This is why an estimated 10 percent of total police 
calls involve mental health situations. Inadequate funding and 
a system that diffuses responsibility among numerous, 
uncoordinated entities are at the core of the problem. As a 
result, people experience crises more frequently, and police 
are thrust into the role of a last-resort safety net for people 
in crisis.
    Even when police peacefully handle behavioral health calls 
and link consumers to service providers, these calls can be 
time-consuming, which is often at odds with the demands of the 
911 system and the expectations communities have for timely 
police response to crime and disorder.
    I know we can do better. My testimony today is informed by 
10 years of partnering with behavioral health professionals. I 
have witnessed firsthand how service delivery is improved 
dramatically when police partner with highly trained clinicians 
to conduct forensic interviews of sexually abused children; 
when police partner with victim advocates to coordinate 
counseling services to survivors of intimate partner violence; 
when police partner with outreach workers whose credibility 
within our Nation's most marginalized communities allows them 
to mediate disputes to disrupt cycles of retaliatory violence; 
and when police co-respond with licensed clinical social 
workers to de-escalate a person in crisis.
    Through these kinds of successful partnerships between the 
criminal justice and behavioral health systems, we have 
demonstrated how it is possible to improve public health 
outcomes for even the most challenged populations. Moving 
forward, I hope you will help build upon the promising 
practices of behavioral health programs like CAHOOTS in Eugene, 
Oregon; STAR in Denver, Colorado; and GBRICS in Baltimore, 
Maryland.
    I hope you will fund research so that jurisdictions can 
make evidence-based decisions for allocating scarce resources. 
I hope you will incentivize law enforcement, behavioral health 
providers, and academic institutions to collaborate on policy 
development, training, data analysis, and outcome evaluation. I 
hope you will heed the calls of behavioral health practitioners 
and clinicians to fund crisis response services, long-term 
treatment, and community-based providers at the levels needed 
to meet the extraordinary demands.
    I thank you for the opportunity today to discuss how this 
Committee can make our communities safer and more responsive to 
the millions of people who desperately need a robust behavioral 
health and crisis response system. Your support of law 
enforcement, behavioral health professionals, and the citizens 
we serve is greatly appreciated.
    Thank you, Mr. Chairman.
    [The prepared statement of Major Bartness appears as a 
submission for the record.]
    Chair Booker. Thank you so much, Commander. We really 
appreciate your testimony.
    I am really pleased to bring on this next witness. When I 
was mayor of the City of Newark, the Manhattan Institute was a 
partner of ours in helping us to establish the first-ever in 
the State of New Jersey Municipal Office of Prisoner Reentry, 
and so I am grateful now that one of the Manhattan Institute's 
senior fellows is here, Mr. Rafael Mangual. I hope I pronounced 
your name correctly, sir. Would you please give us your 
testimony?

                STATEMENT OF RAFAEL A. MANGUAL,

             SENIOR FELLOW, MANHATTAN INSTITUTE FOR

              POLICY RESEARCH, NEW YORK, NEW YORK

    Mr. Mangual. You did, and thank you, Chairman Booker and 
Ranking Member Cotton, as well as Members of the Subcommittee, 
for the invitation to deliver testimony here today. It is truly 
an honor and a privilege to address this body on an issue that 
is among the most important public policy debates of our time, 
which is police reform.
    Unfortunately, it is also one of the most divisive. A lot 
of the conversation about how to reform policing in the United 
States seems to be driven by a key misconception, which is that 
police violence is a likely outcome of an investigative or 
enforcement interaction. What I would like to do is to start by 
addressing this misconception and talk a little bit about the 
potential risks and limits of an approach to reform that 
primarily seeks to reduce the footprint of police for its own 
sake.
    Right now, 83 percent of Americans--this is according to a 
recent Pew Research survey--guessed that the typical police 
officer has fired his gun at least one time on the job, while 
on duty. In reality, only about one in four actually ever do at 
any point during their long careers. Police very rarely use 
force, and when they do, it very rarely results in serious 
injury. In 2018, police officers in the United States 
discharged their firearms an estimated 3,043 times. That year, 
they made more than 10.3 million criminal arrests. If you 
attributed each of the 3,043 estimated discharges to a unique 
officer, it would mean that, at most, 0.4 percent of officers 
purposefully discharged their firearm in 2018. If we assume 
that every shooting happened during the course of a separate 
arrest, it would mean that, at most, police applied deadly 
force with a firearm in just 0.003 percent of arrests.
    As to non-deadly force, in 2018, a team of researchers and 
doctors published a thorough study of police use of force in 
The Journal of Trauma and Acute Care Surgery. That study 
analyzed over a million calls for service to three mid-sized 
police departments in Arizona, Louisiana, and North Carolina 
over a 2-year period. Those calls resulted in more than 114,000 
arrests. Police force was used in just 1 of every 128 of them, 
meaning that more than 99 percent of all arrests and much more 
than 99 percent of all encounters were effected without any use 
of force.
    That study went on to find that on the people whom police 
used force against, they sustained no or mild injury more than 
98 percent of the time. Only 1.8 percent of suspects sustained 
moderate or severe injuries, and only one suspect was fatally 
wounded by police gunfire during the study period.
    Nor are uses of force likely when you drill down into 
particularly dangerous police encounters, including those 
involving people in crisis. Take my home city of New York, for 
example. In 2020, the NYPD responded to 161,278 911 calls for 
persons in crisis. Yet the department recorded just 42 firearm 
discharges that year, including off-duty shootings, the vast 
majority of which did not begin with crisis calls.
    On average, the NYPD responds to 175,000 calls involving 
people in crisis annually, and its highly trained emergency 
service unit officers try to respond, often responding to about 
125,000 of those per year, usually in conjunction with beat 
cops. In the 3-year period between 2018 and 2020, ESU officers 
recorded just one shooting.
    None of this means that there is not room for improvement 
or that police are perfect. There is, and they are not. 
Exploring opportunities for reform is a worthwhile endeavor 
that has to be undertaken soberly, because pulling the wrong 
policy lever can have disastrous effects, particularly on 
crime. That is the risk that we should be especially cognizant 
of now, given the very sharp uptick in shootings and homicides 
across the country.
    Last year, for the first time since 1995, criminologists 
estimated that the U.S. will have seen more than 20,000 
criminal homicides--an increase of about 4,000 additional 
homicides compared to 2019. That is still a ways off from the 
nearly 25,000 homicides the country experienced in 1991, but it 
is important to note that some cities have actually seen their 
homicide numbers approach and even surpass their 1990s peaks.
    I suspect that some of the sincerely held misconceptions 
about police use of force have shaped some of the overarching 
goals of the reform movement, which, at the moment, seems to be 
to minimize the footprint of police, and the criminal justice 
system more broadly, in any way possible. We have heard calls 
to defund the police, which, in some cities, have been heeded. 
We have also heard calls to divert more responsibility, 
particularly things like traffic enforcement and responding to 
mental health calls, away from police to unarmed civilians.
    On the mental health front, there is some evidence that 
suggests that we should continue to invest in efforts to 
augment the police by deploying civilian crisis intervention 
teams to calls involving people in crisis. In a report released 
just yesterday, my Manhattan Institute colleague, Charles 
Lehman, reviews some of that evidence. Among the approaches 
evaluated in his report is a popular, oft-cited, and promising 
effort launched in Eugene, Oregon, called CAHOOTS. While 
effective, CAHOOTS is also a case study in the limits of 
programs loosely referred to as alternatives to policing. As 
Lehman notes in his report, CAHOOTS responders are highly 
specialized. In 2019, they covered just 17 percent of Eugene 
911 calls, with 75 percent of those calls being a welfare check 
or providing transportation, usually to someone homeless or in 
need. Even in those relatively limited circumstances, CAHOOTS 
responders still called for backup in roughly 1 in every 67 
calls for service in 2019.
    While it doubtless provides a useful service now, groups 
like CAHOOTS are not necessarily a model for how to replace the 
police. As a complement to policing, it is certainly a useful 
model for other cities to adopt. When you consider the sheer 
volume of mental health calls received by the police, not to 
mention the fact that they are often received in the late-night 
or early morning hours, it becomes very clear that we simply do 
not have the capacity to shift this particular responsibility 
in total.
    Another complicating factor is that it is often unclear as 
to whether a call can be accurately categorized as one that can 
be safely diverted to civilian responders in mental health 
crises as opposed to police-based encounters. In other words, 
there is a study, for example, out of the city of Philadelphia 
which found recently that some medical or public health 
activity initially masquerades as crime or other policing work, 
and some events eventually determined to be police or crime 
activity can initially appear to be public health related. The 
study went on to find that about 20 percent of activity in this 
area actually does not appear predictable from the initial call 
type as handled by police dispatch, which is important because 
we need to know that in advance if we are going to successfully 
divert some of these calls.
    I also want to second the comments offered by Major 
Bartness and say that a real solution to the problems that 
sometimes arise in police encounters with those suffering from 
serious mental illness must be built around an effort to 
provide more and better supervision for those in need so that 
they can get the care and services that they desperately 
require in a safe and compassionate setting rather than turning 
them out onto the street where they are likely to get hurt and/
or hurt others.
    Again, none of this is to say that improving outcomes in 
policing is not something that we not should pursue with vigor. 
It is. While reform is a worthy pursuit, it cannot be allowed 
to cause us to lose sight of the government's first duty, which 
is to provide for the public's safety.
    Thank you.
    [The prepared statement of Mr. Mangual appears as a 
submission for the record.]
    Chair Booker. Mr. Mangual, that was really incredible 
testimony, so good that I am considering sending you a tie as a 
gift.
    I would like to now go to Ms. Keris Myrick. Would you 
please give us your testimony?

                 STATEMENT OF KERIS JAN MYRICK,

           CERTIFIED PERSONAL MEDICINE COACH--CPMPC,

             INDUSTRIAL-ORGANIZATIONAL PSYCHOLOGY,

                    LOS ANGELES, CALIFORNIA

    Ms. Myrick. Good morning, Chairman Booker, Ranking Member 
Cotton, and Members of the Subcommittee. I appreciate this 
opportunity to speak with you today about creating behavioral 
health crisis systems that are safe and work for all. You have 
heard my bio, but equally important is who I am as a person. I 
am a daughter, sister, cousin, friend, Army brat, African 
American, and I am a person who has been given a diagnosis of 
schizophrenia.
    I recall when first diagnosed I believed that no one would 
want to be my friend, that I was not worthy of help, and, 
worse, that I was not worthy of love. Initially, I did not even 
believe that my struggles were due to having a mental illness. 
This is how I have felt often as a person of color in this 
country. I rejected any form of help, and due to the 
embarrassment and stigma of mental illness, I did not even let 
the people who loved and supported me the most--my parents--
into the world that I was experiencing.
    My first interaction with the mental health system during a 
crisis when I was in my 30s, in Los Angeles, went badly, very 
badly. When I was in emotional distress, my expectation was 
that an EMT or ambulance would come to help me. I had been told 
repeatedly that a mental illness is like any other physical 
illness and should be treated as such. During a time of 
confusion, paranoia, and extreme emotional distress, the police 
arrived at my small apartment building where I was the only 
African-American resident. The officer banged on the door and 
loudly announced that he was from the police department sent to 
do a welfare check. As a Black person, so many things ran 
through my mind: Will the neighbors think that I fit some sort 
of stereotype about Black people being criminals? Was I safe to 
open the door given the many horrific outcomes for African 
Americans and police interactions?
    My paranoia was not about my illness. It was about the 
realities of what it is like to be Black in America. I let the 
police in, fearing if I did not they would break down my door. 
Being deemed a danger to myself, I was handcuffed and taken to 
the police station where I was then handcuffed to a chair while 
they spoke to an African-American boy about stealing his 
grandfather's gun that was on the table in a secure gun box. I 
was trying to understand how it was possible for me to be what 
everyone said, ``sick and needing psychiatric 
hospitalization,'' yet to be sitting handcuffed to a chair at a 
police station seeing for the first time in my life a real gun.
    This was my first experience being in such distress and 
needing mental health support. What I did not need was the 
police response and being treated like a criminal. I needed 
health care and support.
    I found what ``care'' was all about: asking for help and 
getting instead handcuffs and being harmed physically and 
emotionally. From this, I was unwilling to seek the care I 
needed, especially when I needed it most. All I can think is I 
am very fortunate not to have had the same outcomes as Ms. 
Mitrice Richardson. A 24-year-old African-American woman known 
to have bipolar disorder was picked up by the police in the 
Malibu area of Los Angeles because it was reported she was 
acting irrationally. Like me, she was taken to a police 
station. Sadly for Ms. Richardson, she was released from the 
station in the middle of the night with no car, phone, wallet 
or money. Her decomposed body was found 11 months later in the 
area not far from the station.
    When someone has a heart attack, stroke, dementia, or even 
ready to give birth, is this how they are treated? Police are 
not the default first responders. It is ambulance or EMTs who 
are the default. Why do we have police responding to mental 
health emergency situations when others are trained to do so?
    Peer support specialists should be part of the mobile 
crisis response as one of the ways to remove police from the 
behavioral health crisis response equation. Peer support 
specialists are trained in evidence-based practices such as 
wellness recovery action plan, personal medicine coaching, and 
psychiatric advance directives, and they share their personal 
story of recovery to support another. Peer support has proven 
to help people participate in and adhere to treatment, shown 
reductions in hospitalization, homelessness, an increase in 
employment and social connection, and for parents and family 
members, it helps them to feel more confident in their ability 
to help their loved ones. Peer support is cost-effective and 
particularly valuable in rural and other areas that have been 
strapped for resources. We need more fully funded peer respite 
so people in behavioral health crisis have a safe and 
supportive place to recover.
    These are unprecedented times--a world reeling from the 
pandemic, racial unrest, economic challenges, and trauma, 
especially for those who have been so disproportionately 
impacted. If we want people to engage in their recovery, build 
resilience, and flourish, we need to create crisis response and 
systems that look like other health crisis response without 
police as default first responders.
    Recent reports such as The Group for the Advancement of 
Psychiatry's, ``Roadmap to the Ideal Crisis Systems,'' and the 
Front End Project's report, ``From Harm to Help: Centering Race 
Equity and Lived Experience in Crisis Response,'' provide 
blueprints that could help us get there.
    Developing the new 988 phone number for everyone to call 
specifically for these kinds of crisis situations in lieu of 
911 is a start and has created momentum for more comprehensive 
reforms, including comprehensive police and criminal justice 
reforms. Yet without the explicit inclusion of peer support 
throughout, centered on race equity and lived experience, we 
may not yield the systems that are most effective and the ones 
that people want, even as the police have said that they want.
    This is what we need, and today I ask that we support 
legislation and robust funding to ensure equity is really 
equity in behavioral health crisis response. I ask that if we 
want to move from handcuffs to help, we must work together to 
ensure the safety of all including the police in creating 
systems that are humane, compassionate, effective, and help 
people to flourish and be safe and live to their full 
potential.
    Thank you, Chairman, for this opportunity.
    [The prepared statement of Ms. Myrick appears as a 
submission for the record.]
    Chair Booker. I am very, very grateful for that powerful 
testimony.
    I would like to now introduce Ms. Margaret Mims--I should 
really say Sheriff Margaret Mims. I am so grateful that you 
would take time out of what I know is an intensely busy 
schedule as a sheriff. We are grateful to have you on. Would 
you please give us your testimony?

                  STATEMENT OF MARGARET MIMS,

               SHERIFF, FRESNO COUNTY, CALIFORNIA

    Sheriff Mims. Thank you, Mr. Chairman, Mr. Ranking Member, 
and Members of the Committee. I am honored to appear before you 
to discuss challenges faced by local governments, communities, 
and families as we work together to respond to those with 
mental illness. Although there are no simple solutions, we 
continue to develop and implement initiatives to better serve 
our communities, including increasing access to mental health 
treatment, diverting individuals with mental health conditions 
away from the criminal justice system, and working with mental 
health professionals on training programs to address those with 
mental health needs.
    Increasing numbers of people with mental illnesses are 
coming into contact with the criminal justice system. Many 
times, as first responders, we do not know that a call for 
service may involve someone with mental illness until we 
arrive. These calls can be very dynamic and, in some cases, 
dangerous. In Fresno County we have had two deputy sheriffs 
killed in the line of duty by mentally unstable individuals who 
had armed themselves. These calls for service often are 
repeated as we often respond to the same location or the same 
individual. All law enforcement agencies in my county book 
those they arrest into the Fresno County jail. We have three 
correctional facilities, and our average daily population for 
March was 2,620 inmates. Of that population, 97 percent are in 
custody for felony charges; only 3 percent are misdemeaners. 
For all intents and purposes, we are an all-felony jail. To put 
this into perspective, this high number of felony cases exists 
after California passed an initiative in 2014 reducing many 
felony drug crimes to misdemeanors.
    In addition to responding to calls, we are working 
tirelessly to provide treatment to those inside our 
correctional facilities. In March of this year, 41 percent of 
those in our facilities received psychotropic medication for a 
mental health disorder. Recently, our inmate health care 
services received accreditation from the National Commission on 
Correctional Health Care.
    As we evaluated our system, we learned that many 
individuals were not receiving care when they were not in 
custody. No one should have to be in jail to receive mental 
health services. The sheriff's office worked with our 
Department of Behavioral Health to form a strategy to improve 
the continuum of care when individuals leave our facilities. 
Rather than release these individuals out the door, we 
transport them to a safe location. It should be noted many of 
these individuals are homeless, so they are taken to a shelter 
at one of our map points that I will discuss in a moment. These 
efforts have resulted in strengthening our partnerships, a 
safer jail release plan, and in the long term the goal is to 
reduce recidivism.
    Moreover, most law enforcement leaders I talk to agree that 
incidents involving mental health crises require more than just 
a law enforcement response. However, the lines are rarely 
bright, and in many cases law enforcement response is required 
to help save lives. Our law enforcement agencies worked with 
our Behavioral Health Department who provided us with crisis 
intervention training, which included de-escalation techniques. 
We have established a crisis intervention team comprised of 
mental health professionals and emergency medical services to 
respond with law enforcement so that both safety and 
professional services can be available during interactions with 
individuals in need of care.
    We have also activated a Sequential Intercept Mapping 
initiative. This is a cross-system approach that identifies 
locations where law enforcement most often comes into contact 
with those with mental illness. We use the data from this 
initiative to establish a system that bridges criminal justice 
and mental health services and minimizes criminal justice 
involvement for persons with mental illness. Our action plan 
includes creating a county-wide crisis intervention team, 
increasing treatment of co-occurring disorders, and creating a 
sobriety center. We are also focusing on discharge and reentry 
planning to reduce recidivism in addition to developing 
diversion tools.
    We want to continue to expand these efforts, but enhanced 
response to mental health crises will require significant 
increases in training and personnel. Federal support for this 
would be helpful, as long as it does not displace core law 
enforcement support programs.
    We should be clear that replacing law enforcement--or 
defunding the police--would result in more harm to the citizens 
that we serve. ``De-policing'' has the same effect. The rule of 
law is a fundamental principle that must be respected. When 
laws are broken, our citizens expect an effective response--
especially when their lives and their homes are threatened.
    I began my statements this morning by saying solutions need 
cooperative relationships. A multidisciplinary approach is 
needed that includes all stakeholders, mental health 
professionals, public safety and community-based organizations. 
I can assure you, Senators, that law enforcement professionals 
across the Nation want to be a part of the solution and at your 
service to provide any additional input you may need as policy 
is developed.
    Thank you.
    [The prepared statement of Sheriff Mims appears as a 
submission for the record.]
    Chair Booker. Sheriff, thank you. I am aware of the 
enormity and responsibility of your job, so I am grateful for 
you taking time to share your testimony and remaining for 
questions as well.
    I would now like to bring on someone who has been invoked 
numerous times. We have heard CAHOOTS mentioned by previous 
witnesses and others, so I am very excited to hear from Ms. 
Ebony Morgan. Would you please share your testimony with us.

                 STATEMENT OF EBONY C. MORGAN,

            OUTREACH MANAGER AND CRISIS INTERVENTION

            SPECIALIST, CAHOOTS CRISIS INTERVENTION,

                         EUGENE, OREGON

    Ms. Morgan. Good morning, Chairman Booker, Ranking Member 
Cotton, and Members of the U.S. Senate Committee on the 
Judiciary. I was asked to come before you today to discuss my 
experience providing mobile crisis intervention services with 
the CAHOOTS program of Eugene and Springfield, Oregon.
    My name is Ebony Morgan. I am a registered nurse, and I 
work as the program coordinator of CAHOOTS. CAHOOTS is a mobile 
crisis response team. We respond in unarmed pairs of a crisis 
worker and a medical professional to calls for service through 
police dispatchers via police radios. We coordinate with the 
police departments, our community partners, to take on the 
appropriate calls and meet community members where they are at. 
I am inspired to do this work in very personal ways.
    My grandmother, Carolyn, was an extraordinarily kind human 
being who lived with severe and persistent mental illness. She 
thrived until her passing under the care of my mother, also a 
nurse. Growing up watching my mom care for her so diligently 
taught me that people experiencing a mental health crisis are 
not to be feared, rejected, judged, or punished. They are to be 
cared for. Someone in a crisis needs de-escalation, respect, 
safety, and support. As a society, we often fail to deliver 
that to the most vulnerable populations.
    My father, Charles Morgan, did not get a chance to 
participate in raising me. He died during an encounter with the 
police when he was just 25, a young Black man. My family was 
devastated. I was 5, and my sister had not yet experienced a 
birthday.
    When I graduated from nursing school, I declined an offer 
to work at our local hospital and double my income. I chose to 
remain with CAHOOTS, where we are underfunded, because this 
work matters. As others have also noted today, behavioral 
health services should not have to be limited by a lack of 
funding in their efforts to support the community in a way that 
is proven to be safe and effective.
    Mobile crisis responses are worth every effort of 
implementation. For more than three decades, CAHOOTS has 
utilized unarmed de-escalation to meet the needs of the 
community. This frees up local police officers to handle the 
calls that they are trained to respond to and matches the needs 
of the community with the appropriate response. If we arrive on 
a call and find that a law enforcement presence is necessary, 
we can request them via police radio and work together to come 
to an outcome.
    We can respond independently for welfare checks, suicide 
prevention, mediation, crisis counseling, substance abuse, and 
so much more. In 2019, CAHOOTS had some level of involvement in 
17 to 20 percent of the total incoming public safety calls for 
service. No employee has ever lost their life or been seriously 
injured on the job despite never carrying a weapon, and no 
clients have died as a result of us showing up to help.
    CAHOOTS crisis responders are trained to overcome our own 
fight-or-flight response. When a scene is escalated, we remain 
cognizant of safety, show the client that we are there to help, 
and skillfully de-escalate the situation. In order to de-
escalate a client, they must be able to identify that we are 
not a threat to them, so it helps significantly that we are 
not.
    The honed ability to intervene calmly without giving in to 
reactivity or impulsivity is imperative. Being unarmed allows 
us to default to our client-centered training because it is our 
only way forward. Does the client need to talk? Do they need to 
go to the hospital? Do they need time to sober at the sobering 
center? Helping begins when you stop seeing the client as a 
threat and start evaluating what feels threatening to the 
client. Cultural competency is imperative to trauma-informed 
care. Build in anti-racist practices from the start to learn 
from and avoid perpetuating systemic racism.
    Mobile crisis teams can also connect a client to existing 
community resources, but are not a replacement for them. These 
can include a 24/7 walk-in crisis center and phone line, low-
barrier shelters, permanent supported housing, sobering and 
detox centers. Each area must be empowered to identify its 
needs and fund those programs.
    As the Nation is recognizing that mental health crises are 
best responded to by trained mental health professionals, I am 
extremely hopeful that together we can find a way to provide 
humans with the appropriate resources for every situation 
instead of a one-size-fits-all approach to public safety that 
overburdens a group of people that did not necessarily get 
specifically trained for these encounters. One size fits all 
never fits all.
    CAHOOTS is one longstanding example of the role that mobile 
crisis response can play in a community. We operate as an 
addition to existing structures and, thus, do not replace or 
change the current public safety systems. Mobile crisis 
response, however, is a necessary and logical service to 
provide to communities.
    Thank you for making time for me today.
    [The prepared statement of Ms. Morgan appears as a 
submission for the record.]
    Chair Booker. We are really grateful for that testimony and 
looking forward to the questions that will come.
    I now have the honor to introduce Ms. Terri O'Connor, who 
is--truly has an extraordinary American family: her son as a 
law enforcement professional and her late husband as well. We, 
as Senator Cotton said, give you our deepest condolences. Your 
family is a family of heroes, and we are very much looking 
forward to hearing your testimony.

              STATEMENT OF TERRI O'CONNOR, WIFE OF

           THE LATE SGT. JAMES O'CONNOR, PHILADELPHIA

    Ms. O'Connor. As you heard from my short bio, my husband, 
Jim, was a Philadelphia police officer. Jim was a corporal in 
SWAT who was shot and killed in the line of duty on March 13, 
2020. Jim's death will never seem real. He served the police 
department for 23 years. His father was also a police officer, 
serving for over 40 years. Our son and daughter-in-law are both 
currently Philadelphia police officers. Our police family 
extends to numerous other family members, too. This is the one 
job we all know too well.
    I, myself, started out as a police dispatcher. I had 
firsthand experience of hectic situations and numerous 
emergencies. My job was to keep a cool voice and calmness to 
whatever situation needed to be dealt with. Our goal was to 
have every officer go home at the end of each shift.
    Defunding the police is dangerous. Look at what has 
happened in cities like Seattle and Portland and in so many 
large cities across the country. Murders are up, and there is a 
sense, especially among criminals, that there is no law and 
order on the streets.
    The mayor and city council have accepted zero 
accountability. This brings me to Philadelphia, where we had 
one of our highest murder rates in decades last year. Five 
hundred murders were committed in 2020, and more than 2,400 
shootings, including 225 women and 195 children. This year, we 
are already on pace for an even higher murder rate. Four months 
into the year, and we have over 145 murders, 440 shootings, and 
55 of those shooting victims were children.
    Philadelphia is a prime example of what happens when police 
are demoralized and feel the pressure of a no-consequences DA 
like Larry Krasner along with the narrative that often goes 
along with the defund the police rhetoric that all cops are 
bad. My son has told me that while locking criminals up, they 
laugh and say that they will be out of jail in a day or two. 
The criminals know there are no real consequences here in 
Philadelphia.
    My husband's four murderers had rap sheets that could go on 
for days, including multiple violations of probation, drug 
charges, and gun charges. They all had reduced bail and cases 
dropped. The man who pulled the actual trigger has five murders 
under him, including my husband. Those were only the ones they 
have learned about so far.
    One of the other males in the room was wanted for two prior 
murders. The other males both had previous gun charges. They 
were holed up in a tiny, rented, one-bedroom apartment, with 
nine guns lined up and multiple drugs throughout the room. Who 
do you think should be responsible for going into the room and 
responding to incidents involving hardened criminals like this? 
Mental health workers? Maybe a negotiator? This is the job my 
husband and his coworkers signed up for. There are split-second 
decisions that needed to be made.
    Nobody hates a bad cop more than a good cop, but the 
movement to defund the police is now about demonizing every 
officer and taking our country into anarchy by abolishing the 
police altogether. Every officer is given at least 9 months of 
training before graduating the academy. They then have 
continued yearly training. SWAT officers alone have an extra 3 
months of training before they can serve warrants, handle a 
barricaded situation, et cetera.
    The morning of March 13th, they used some of their training 
and used restraint, when fired upon, to return fire, but stop 
and negotiate through a closed door. The criminals asked them 
to stop shooting, and the police responded for them to do the 
same. Four other males could have been killed that day. The 
police used their training to not make the situation even 
worse. All our officers could use high-risk training. They 
sometimes have a split second to make a decision.
    During--Defunding the police reduces funding for vitally 
important training and ongoing professional development that 
needs to occur to address bad policing tactics. Police 
brutality usually occurs when overly aggressive policing 
tactics are implemented in a dramatic fashion or with evil 
intent. To reduce this type of violence, we should reevaluate 
policing tactics and make sure our police are trained in the 
most effective de-escalation skills and techniques possible. 
Good policing requires a commitment to robust training that 
must be ongoing. This requires funding.
    A recent shooting in Philadelphia reflects the continued 
need for money and training. Walter Wallace was a knife-
wielding, mentally ill man who was shot when he aggressively 
approached police. Although I do not believe there was enough 
time for a mental health worker to be called in on this type of 
job, if a taser was used, he could have been subdued until he 
was taken to the proper facility. The officers were not 
equipped with tasers. More than half of Philadelphia officers 
do not carry the recommended tasers. Funding is an issue.
    There are many reforms that we can debate; however, 
defunding the police is not one of them. To think that 
criminals are victims of society and the system is totally 
absurd. There needs to be a respect level for our police 
officers. We need stricter penalties. We hear too many times 
that a criminal has a lengthy list or prior arrests, but is out 
of jail because of reduced bail or convictions overturned and 
thrown out of jail. Our DA and others need to be held 
accountable for letting these people out of jail.
    I know personally that Jim's murderers should have been 
locked up. If they had been kept in jail, where they deserved 
to be, I would not be spending today, April 22d, my 26th 
wedding anniversary, testifying on his behalf at this 
congressional hearing. Jim should be here. His life mattered.
    Thank you.
    [The prepared statement of Ms. O'Connor appears as a 
submission for the record.]
    Chair Booker. Ms. O'Connor, that testimony could not have 
been easy. Thank you for sharing your pain and your purpose, 
and we honor your husband, his heroism, and his service.
    Ms. O'Connor. Thank you.
    Chair Booker. I would now like to bring up a Jersey boy and 
someone who I have a tremendous amount of respect for, again, 
the executive director of the Technical Assistance 
Collaborative, Mr. Kevin Martone.

                  STATEMENT OF KEVIN MARTONE,

            EXECUTIVE DIRECTOR, TECHNICAL ASSISTANCE

              COLLABORATIVE, BOSTON, MASSACHUSETTS

    Mr. Martone. Thank you, Senator, Ranking Member Cotton. My 
name is Kevin Martone, and I will be speaking to you regarding 
one aspect of police reform: the overutilization of law 
enforcement to manage mental health emergencies.
    I have spent nearly 30 years working in the public mental 
health system as a provider of direct services, as commissioner 
for the mental health system in New Jersey, and on various 
national boards and committees. I am also part of a racially 
diverse family and a family member committed to helping a loved 
one define her life beyond mental illness and navigate the 
racism that she experiences in her daily life.
    In many parts of the United States, 911 is the default 
mental health crisis line, law enforcement is the default 
mental health emergency response, and local jails are the 
default treatment provider. We have criminalized a public 
health issue and delegated responsibility to law enforcement 
and the criminal justice system.
    There are approximately 240 million calls made to 911 in 
the United States each year. Estimates are that behavioral 
health emergencies constitute between 5 to 15 percent, or 
somewhere between 12 million and 36 million of the calls to the 
911 system. Many of these are classified by local dispatchers 
as ``wellness checks,'' ``disturbances,'' ``intoxicated 
persons,'' or ``mental crises'' and do not always require 
police presence. It is estimated that 80 percent of mental 
health calls to 911 are resolved without the need for police 
involvement when diverted to a crisis line. However, law 
enforcement are often sent.
    While a police response may be justified, especially if a 
weapon is involved, we know that it can also create 
substantially adverse outcomes for communities of color and 
individuals with behavioral health disorders and other 
disabilities.
    According to the International Association of Chiefs of 
Police, ``the mere presence of a law enforcement vehicle, an 
officer in uniform, and/or a weapon . . . has the potential to 
escalate a situation'' when a person is in crisis. All too 
often, these calls for service result in unnecessary 
fatalities. People with serious mental health disorders are 16 
times more likely than the general public to be killed during a 
police encounter. Today, in an era when deadly violence--police 
violence is top of mind, one in four fatalities by police 
involve people experiencing a mental health emergency.
    Half of all people killed by police are people of color, 
and when combined with mental illness, the difference is nearly 
tenfold.
    The problem is more complex than we have time for today, 
and I will highlight a few of the factors that have resulted in 
this. Generally, a series of cascading issues over the past 
several decades has resulted in two driving factors.
    One, a fragmented, underfunded, undervalued, and 
inaccessible mental health system. This is compounded by poor 
health insurance coverage, limited funding for services at the 
Federal, State, and local level, mental health workforce 
shortages, and geographic challenges and transportation issues 
that impact services access, especially in rural areas. This 
has been exacerbated during COVID by increasing demand and 
reduced provider capacity.
    Two, mental health and other systems that do not 
sufficiently address social determinants of health, such as 
racism, poverty, and access to affordable housing, employment, 
and education. People with mental illness, especially those in 
communities of color, are disproportionately poor, homeless, 
and unemployed. All of these are correlated with worse outcomes 
for people with mental illness.
    The result is a de facto national policy that it is 
acceptable for law enforcement to manage mental health 
emergencies. Most law enforcement officials that I have spoken 
with would prefer to see people with mental illness served in 
the mental health system. People with mental illness, their 
families, and providers agree. The events that we have 
witnessed in the past year alone--the public health and 
economic impact of COVID, racial and social unrest, and deadly 
police encounters for Black and brown people with mental 
illness--have elevated awareness of the need to treat mental 
health as the public health issue that it is.
    The good news is that there is activity. Recent 
congressional action has resulted in additional block grant 
funding for mental health and crisis services, a new Medicaid 
benefit for mobile crisis services, and funding that can 
support additional workforce capacity. We have seen important, 
bipartisan legislation passed recently, including the Crisis 
Stabilization and Community Reentry Act and the National 
Suicide Hotline Designation Act that establishes a new 988 
suicide prevention and mental health crisis hotline as an 
alternative to 911.
    Solutions exist. In recent years, several communities have 
established mental health-led or--involved emergency programs, 
such as CAHOOTS in Oregon and RIGHT Care in Texas. Our system 
response efforts need to push further upstream to prevent 
crises from occurring to begin with. Access to evidence-based 
services like supportive housing, assertive community 
treatment, specialized peer support, employment supports, 
children's systems of care, and other approaches exist to serve 
adults and children in the community, but do not have the 
capacity and workforce to meet demand in many areas of the 
country.
    In closing, to the extent that law enforcement will likely 
continue to have some role for the foreseeable future in 
responding to mental health emergencies, at least in situations 
when public safety is a concern, law enforcement must own 
reforms for how it responds to people with mental illness, 
especially those who are Black--Black and brown. This work 
should be informed by people who experience mental illness, 
racial equity and justice groups, and other key stakeholders. 
If we are to reduce law enforcement response to mental health 
emergencies, we must commit to addressing mental health reform 
and build the infrastructure needed to create an accessible 
mental health system.
    Just a note. There are 17,000 police departments in this 
country--that is a lot--and an underfunded mental health 
system. If we are to do this one by one, we are never going to 
get there. We really need a national strategy that funds 
treatment and services and includes intentional multi-system 
efforts that include planning and training and design and data 
collection and research if we are really going to collectively 
address this issue. One by one is not going to get us there. 
There needs to be a national strategy.
    Thank you.
    [The prepared statement of Mr. Martone appears as a 
submission for the record.]
    Chair Booker. Mr. Martone, that was incredibly valuable, 
and I love the point you made about a lot of our solutions 
should not be about just simply responding to crisis but 
preventing those crises from happening in the first place. 
There is a lot of wisdom in that and that last point you made 
about a larger system to deal with this. Unfortunately, the 
focus of this hearing today is: What should we be doing in 
terms of the first response? I do not want to let that 
important part of your to be lost on Congress about getting a 
larger national strategy for mental health awareness. It is 
fractured. There are so many gaps that swallow up so many folks 
that then perpetuate the crises that we are seeing. I think 
that that was worth highlighting.
    We are at a point where everybody's testimony is really 
important for the record and for the strategies I think 
Congress is going to do in a bipartisan way, the Senate. I do 
not know if my friend Senator Blumenthal would like to ask some 
questions first. I will yield to him.
    Senator Blumenthal. I really appreciate this opportunity, 
Mr. Chairman, and I just want to say how important I think this 
hearing is.
    My thanks to Chairman Booker for bringing us together on 
this critically important topic. I served as United States 
attorney in Connecticut for 4-1/2 years and then as attorney 
general in our State for 20 years. I have worked very 
extensively with law enforcement, and police interactions with 
people who may have disabilities or mental illness or autism 
ought to tremendously concern us. I am sure many of my 
colleagues have said, as I did, that Tuesday's guilty verdict 
in the Chauvin trial provides necessary accountability for the 
murder of George Floyd last May. It is not true justice, not 
for George Floyd, not for any other Black or brown American 
killed by law enforcement in this country. No single verdict in 
a single case can eliminate the generations of racial 
injustice, inequality, and inequity faced by Black and brown 
Americans in policing and across many other aspects of society. 
There is so much work to do, and Senator Booker has been at the 
forefront nationally, but also in the Senate among us, 
reminding us of our obligations to commit ourselves to true 
justice, equality, and equity. There is a need for real action, 
real reform, and real change, and I am very proud to work with 
him on legislation that can achieve that change.
    We find ourselves in a moment of reckoning. While Derek 
Chauvin may have been held accountable for violating his sworn 
oath to protect and serve, at least three more Black and brown 
Americans were killed by law enforcement in high-profile 
incidents just in the last month: Adam Toledo, Daunte Wright, 
and 20 minutes before the Chauvin verdict was announced on 
Tuesday, Ma'Khia Bryant. Something must change, and we in the 
United States can make it so.
    Let me tell you one reason why I am committed to this most 
important mission. Last October, one of my constituents from 
East Hartford, Maureen Sorensen, reached out to my office to 
share her concerns about her son, Curtis. See, Curtis is 13 
years old. He is African American. He is also a person with 
autism and intellectual disability. Maureen is worried about 
what would happen if law enforcement were ever to interact with 
her son. She wrote to me recently, ``From the outside, my child 
appears to look neurotypical,'' but ``there is a delay in 
processing information, which scares me that an officer will 
not take the time to understand. Others, without knowing the 
situation, may see this as being defiant. I do not want him nor 
any child or adult to be traumatized or lose their life because 
law enforcement did not take the time to know how to approach 
the situation.''
    Maureen is an incredible mom. She has a task that is 
unimaginable for many of us. I have four children. Being a 
parent is the hardest thing I have ever had to do, and I think 
it is the most serious task that I or any parent face in life. 
Maureen is doing her very best to teach Curtis about law 
enforcement, how to react if he is ever approached by police, 
or even if he is just asked a question. Quite frankly, she has 
every right and reason to be concerned. She is doing everything 
in her power to prepare Curtis for what may be an inevitable 
encounter with police.
    Maureen should not have to prepare Curtis. She should not 
have to prepare him differently than any other parent would 
prepare a child. Law enforcement needs to know how to deal with 
these kinds of situations, how to respond to people like Curtis 
with autism or other behavioral health diagnoses, how to bring 
in community mental health services and experts when a police 
response is necessary but also capable of becoming violent, not 
only for Curtis but for others who may present with 
disabilities, difficulties, or illness.
    I want to ask a question, and I really appreciate the 
Chairman indulging me with this time. Major Bartness, I 
understand that you have been with the Baltimore police for 24 
years. What should law enforcement in East Hartford and around 
the country be doing to ensure that Curtis and people like him 
are treated appropriately and safely by the police?
    Major Bartness. Thank you for your question, Senator. I 
think the kind of training that we are currently developing and 
delivering in the Baltimore Police Department is moving in the 
right direction. We have training for CIT officers, which 
comprised about 30 percent of our patrol ranks, and that 
training expressly deals with the kinds of topics you 
recommended: identifying individuals with autism and how to 
interact with them. We work with a host of behavioral health 
organizations in creating our training and delivering it, so it 
is not just law enforcement. We are representing in the 
classroom what we want to see practiced in the field. We work 
with the National Alliance on Mental Illness. We work with 
Behavioral Health System Baltimore. We work with Baltimore 
Crisis Response Inc.; the Arc, which is an organization that 
works with individuals with intellectual and developmental 
disabilities; Disability Rights Maryland. These kinds of 
partnerships are absolutely essential to ensuring that our 
officers are prepared to meet the challenges that they are 
going to have to face on the streets to de-escalate incidents 
and then make referrals to the appropriate services.
    Senator Blumenthal. Thank you, Major Bartness, and thank 
you, Mr. Chairman. This hearing is so valuable, and I hope that 
we can build on it in the Judiciary Committee going forward, 
because it is a key part of what we need to do to reform and 
improve policing in America. Thanks.
    Chair Booker. Thank you, Senator.
    I would like to now call on Senator Whitehouse, who is 
remote.
    Senator Whitehouse. Thank you very much, Chairman Booker. 
It is good to be with all of you. I appreciate the testimony of 
everyone.
    Ms. O'Connor, my daughter lives in Philadelphia, so I am 
very glad that your husband's family and your family have been 
protecting that community through multiple generations, and I 
just wanted to express my appreciation for their service. It is 
not at all, as you know, uncommon for police work to be passed 
on from father to son, and now daughter, and be a very 
important part of a family's traditions, and I am grateful that 
you shared your experience with us today.
    Senator Cornyn and I have been working for some time on a 
bill to improve the coordination between law enforcement and 
behavioral health, mental health, addiction, and recovery. Both 
of our States have similar situations, although they are 
different in many, many, many ways.
    One of John's sheriffs came to him and said, ``You know, 
John, I am providing more mental health services than I am 
providing law enforcement services, and that is not what we are 
trained for.'' My police chiefs in Rhode Island tell me the 
same thing. I think the problem reaches across a whole variety 
of areas.
    First of all, at the point of engagement with an 
individual, to have the crisis intervention teams and to have 
the crisis intervention centers available so that there can be 
a timely and appropriate response to support the police 
response is essential.
    Mr. Martone talked about how jails are too often the 
default collection point for individuals having a behavioral or 
mental health crisis or an addiction issue. We see that in 
Rhode Island as well. We also see our emergency rooms as 
another place where people are brought, and for emergency room 
doctors trying to deal with regular medical emergencies, this 
is not appropriate. They need to be in behavioral health 
treatment, and quickly. The reason that the jails and the 
emergency rooms are playing that role, in Rhode Island anyway, 
is not because people are misdirected about where folks should 
go. It is because there are not the behavioral and mental 
health services and resources to meet the need.
    We need to not only do a lot of crisis intervention support 
and develop new models for supporting police departments with 
behavioral health crisis intervention, but we need to make it a 
lot more robust in terms of the resources for those people.
    Someone in the nonpolice-involved mental health crisis who 
goes to the emergency room in many places, including in 
Providence, Rhode Island, can spend days waiting in the 
emergency room for services or a room to become available. The 
whole question of how much we invest in the necessary 
infrastructure is a really vital part of this conversation.
    I would like to add that I was delighted to hear Senator 
Cornyn mention mental health courts, because we are working our 
district court chief judge, Judge LaFazia, who was instrumental 
in supporting the growth of our veterans court, which stood on 
the record that the superior court had in a program I started 
when I was attorney general of having a drug court, and I think 
the mental health court is a really good idea, but as we look 
around for how do you resource that, there are not a lot of 
resources.
    Taking the idea of mental health courts to stand on drug 
courts' and veteran courts' experience I think is another 
aspect that we have to work on.
    I wanted to invite all colleagues to join Senator Cornyn 
and I in working on that measure. We have worked together 
successfully before on the reentry measures that were part of 
the sentencing reform bill, and we hope very much to get a 
significant piece of legislation put together.
    What I would ask the witnesses to do is to share with us 
what from your experience you think are the best practical 
models that you have seen, whether in your own State and your 
own jurisdiction or whether, because this is your field of 
inquiry, you are aware of really good examples that are taking 
place in other States and other jurisdictions around the 
country. I will ask that as a question for the record, if you 
all do not mind. There will be a week or so after the close of 
the hearing when Chairman Booker will allow written answers to 
questions for the record. If you do not mind writing down a 
brief summary of what you think are the best examples of 
behavioral health coordination with law enforcement or the best 
way for engaging with this population and successfully dealing 
with de-escalation, we would love to know, because the broader 
the support that we can get from States where there are really 
good examples, the broader the base for legislation grows in 
the Senate, and the more likely we can get something big done.
    I will close with that real gratitude to all of the 
witnesses, each of whom made a very special contribution to our 
understanding and to this hearing, and to the extent you would 
not mind supplementing that with a list of what you think best 
practices are out there, I think we would be very grateful as 
we pull this legislation together.
    Senator Whitehouse. Chairman Booker, thank you for this 
terrific hearing, and I will yield back whatever time I have 
remaining.
    Chair Booker. Senator Whitehouse, I am grateful for your 
comments and the work you are doing with Senator Cornyn. I 
think there will be a lot of rich contributions from the 
witnesses in hopes that we can work with you to make that bill 
something that goes a long way into covering what a lot of our 
witnesses are saying is urgently needed. We appreciate Senator 
Whitehouse's leadership.
    I want to jump in. If there are no other Democrats on line, 
then I will just jump in myself. I want to just first jump to 
Ms. Morgan. There was a little bit of a shadow cast on, I 
think, the work that CAHOOTS does in some of the testimony, and 
I am wondering, could you just give us a characterization how 
many incidents does CAHOOTS respond to each year? In how many 
of them do responders call police for backup? Can you 
characterize those moments when--I think it was represented by 
another witness that one out of every 60 or so times, you guys 
call for backup. Could you give some light on that data point 
and also talk to us a little bit about what happens when they 
call for police?
    Ms. Morgan. Absolutely. The total amount of calls we were 
dispatched to in 2019, which is our most recent data, wound up 
to be about 17 percent of the calls, or just over 17,000--
17,700. On those calls, we requested police backup about 1.5 
percent of the time. It was 311 out of that 17,700. Of those 
calls that we did call for backup, the 311, we called for Code 
3 cover, which is lights and sirens, about 5 percent of the 
time. It is very----
    Chair Booker. Could you be more explicit? Code 3 coverage, 
just explain what that means.
    Ms. Morgan. Code 3 coverage means that in that exact moment 
we believe there is an imminent threat to someone--ourselves, 
the clients, a bystander--that we are going to need a police 
response for immediately. Part of what makes this program work 
is that we have that access. By carrying the police radios, if 
a situation either escalates or is a situation that came to us 
but is appropriate for a law enforcement response, we can 
request them, and they can come quickly.
    What might have us determine that we need a law enforcement 
response is typically going to be safety related. It is going 
to be--we are a consent-based program because we do not have 
the authority of law enforcement to take anybody's rights away, 
so people can choose to engage with us or not. If they choose 
not to but are not behaving in a safe way, we cannot just let 
them be unsafe, and that is where we might end up bringing in 
law enforcement for that reason.
    Chair Booker. It is safe to say it is a fraction of the 
time, 1.7 percent you call for police, and a fraction of that 
is because of imminent harm or danger to other people?
    Ms. Morgan. Correct.
    Chair Booker. Got it. Can I--I want to move on from you in 
the limited time that I have.
    Mr. Martone, again, I just find your perspective on this so 
valuable about the larger crisis in America that we are not 
doing--do not have a mental health care system that in any way 
meets the challenges we have. It is a crisis of empathy. It's a 
crisis of compassion. It's a poverty, really, of our ability to 
love one another in a substantive way and protect ourselves. 
Clearly, our lack of doing it is not just a harm to the person 
struggling with mental health. It is a harm to all of us. It is 
a self-inflicted wound.
    Can I just ask you, I am just trying to figure out ways to 
build upon your testimony in terms of really good guidance 
about what we should be doing. When you work with States and 
local governments, what resources are there that they most 
frequently request? What are these professionals that are 
supposed to keep us safe saying to you that they most need?
    Mr. Martone. Thank you, Senator, for the question. You 
know, in the crisis space--and I think you heard this from the 
CAHOOTS program--when calls are diverted to crisis centers, 80 
or 90 percent of those calls can be diverted on the phone from 
the start. Then those that cannot be diverted often then go to 
a mobile response program like CAHOOTS or many different States 
have different types of mobile response programs. Then when 
mobile response programs engage a person, they then can divert 
a person from more restrictive settings like law enforcement or 
emergency departments. They can divert people to linkages with 
outpatient services and things like that.
    What we hear in the crisis space is, yes, we may have a 
program in Eugene or we may have a program in, you know, some 
State, there is one in a county for a million people, you know? 
The problem is there is not enough capacity, right? When we 
think about the capacity for call centers--you know, we have 
the new 988 National hotline that is going to be stood up. We 
need to make sure that there is enough capacity in those 
systems to sufficiently handle calls that may be--instead of 
going to 911, go to 988, or may be triaged from 911 to 988, and 
we need enough resources so that we can stand up sufficient 
mobile capacity so that, you know, police can respond right 
away. Mobile crisis teams, if they cannot respond in a very 
short period of time, it is going to just default again to the 
police response. Mobile response programs need to have that 
capacity.
    Then there needs to be sort of that next step beyond 
mobile, right? There needs to be crisis stabilization programs 
or drop-offs or a mental health program that can receive that 
crisis and then begin to serve that person, all that trying to 
divert a person back upstream and away from the law enforcement 
system.
    Chair Booker. I am going to give you--just cogent, quickly 
as you can, because you are going to be asked this in writing 
by Senator Whitehouse. You are now the better-looking, more-
haired Senator from New Jersey. Three things that you would 
want to get into the bill, give it to me real quick. Three 
things.
    Mr. Martone. I think we need additional Federal Medicaid 
dollars to match State dollars so that we can provide enhanced 
capacity to provide these services out there. There is some of 
that. I think we need more linkages to upstream services. Some 
of that is State funding, but a lot of it, again, is Medicaid 
matching dollars. Some of it also, frankly, is rapid rehousing, 
access to housing. Right? Many of these folks are homeless. We 
need rapid linkages to housing situations for folks as well 
because so much of this is tied to that.
    Chair Booker. That is my experience as well. That is 
really, really insightful.
    I would like to jump to Major Bartness, and, again, thank 
you for your incredible service and leadership. Building on 
some of the things we have asked before with CAHOOTS, tell me 
this: Does responding to calls involving people in crisis or 
with mental illness divert law enforcement resources? In other 
words, is this crisis a drain on your ability to focus your 
Department on other areas where you could help better keep 
people safe?
    Major Bartnessr. Thank you for the question, Senator. It 
absolutely is. As I indicated in my testimony and Mr. Martone I 
believe also indicated, a very significant percentage of 911 
calls coming into law enforcement, somewhere around 10 percent, 
is substantial, and that is time spent away from addressing 
more traditional matters related to public disorder, crime, and 
safety. These kinds of calls, to be handled properly, are not 
disposed of quickly. Police officers--and we are very 
intentional about this in educating our officers to spend time 
with consumers on these calls, because we do not want to have 
to continually come back. We want to do our very best to link 
them through to community-based services, and so we connect 
them with the crisis hotline at our crisis response center, and 
we really endeavor to get these folks the treatment that they 
need. The reality is, as Mr. Martone has stated, the services 
are not there to meet the demands of the population.
    Chair Booker. I really appreciate that.
    I want to jump to Ms. Myrick really quick. One thing we 
have not talked too much about is peer support, peer to peer, 
and how powerful that could be. Could you just give me really 
quickly why do you think peer support is so important in 
behavioral health care and generally what function does it 
serve?
    Ms. Myrick. Sure. Thank you for the question. Peer support 
is essential, is all I can say. The first time I met a peer who 
looked like me, it was the first time I thought, okay, wow, I 
can really get better, somebody who had been through what I had 
been through. You know, evidence has shown that peers who have 
training, who are certified and have training can really 
support people, especially in crisis, to help identify kind of 
what is going on. They can slow things down. We have heard from 
other people giving testimony about how it is important to slow 
things down in order for people to make their needs known, 
especially when they are in crisis, and then help get connected 
to the resources that they need. Peer supporters are trained to 
do that, and they use also other evidence-based tools and 
mechanisms to do so.
    One of the things that I think is critically important are 
things like wellness and recovery action plans which could help 
people to understand what are they doing well and when are 
things starting to break down in order to prevent a crisis and 
then develop a plan for what happens if they do enter a crisis 
and post-crisis. The legal means to do that is through 
psychiatric advance directives, which peers can also help 
people do.
    I also think that peers who have families to support other 
families and other parents is also another critically important 
step so families and parents have a better kind of 
understanding of how to support their loved one pre, post, and 
during crisis. You know, having peers on mobile crisis teams, 
being able to meet people where they are, possibly support them 
in the field, having them as part of the 988 workforce response 
also is--988 is the number people can call when they need 
support, where they can take the time on the call to help with 
some of the triage and work with people immediately, is another 
way that peer supporters can be used.
    Last, we have heard people need places to go. It might be 
fine that you can get the crisis team there, but what about 
where the people go if they need someplace safe to go but may 
not need hospitalization. Peer support is totally 
underutilized, totally underfunded, and if there were more peer 
support respites where people can go and have peer support 24/7 
and get that space away from possible crisis that is 
contributing to their mental health distress is critically 
important and needs to be part of the mental health crisis 
response ecosystem.
    Chair Booker. That is excellent, and it also resonates 
somewhat the point of Mr. Martone about the power of supportive 
housing with people that are there.
    Senator Cotton, who had to attend to business on the floor 
of the U.S. Senate, is back. Just so folks know, he is going to 
give his questioning. Then we are going to go to Senator 
Padilla, and then I think we are going to end at that point and 
wrap up the hearing. I appreciate the patience of the 
witnesses, and I am honored to turn it over to my Ranking 
Member, Senator Cotton.
    Senator Cotton. Thank you, Senator Booker, and thanks to 
all the witnesses for your patience. As Senator Booker said, we 
are all at the mercy of the Senate floor schedule, but I know 
that all of our colleagues on this Subcommittee have taken a 
great interest in this subject and very much appreciate your 
appearance here.
    Ms. O'Connor, I would like to start with you. What happened 
to your husband is a tragedy, especially because it was so 
preventable. If it was not for the criminal leniency efforts in 
Philadelphia that released dangerous criminals over and over 
again, we would not have officers like your husband repeatedly 
facing the same kind of dangerous arrests.
    You mentioned in your testimony the extensive training that 
he received throughout his career, including high-risk 
training. You also come, as you testified, from a law 
enforcement family. Do you find that improving training 
available to officers helps to protect not only the officers 
but also the suspects they encounter?
    Ms. O'Connor. I think that the training is necessary. My 
time as a 911 dispatcher takes me back to the--there is just 
not enough time. When these calls come out, they need immediate 
response. I do not know how long it would take to get a mental 
health worker to show up to a situation. I feel like the police 
are always going to be the first ones to respond, and then 
maybe they can go from there and decide--you know, they can get 
a mental health worker in, but I could not get somebody to come 
out and, you know, change the lights on the corner for 2 days, 
or if we needed, you know, a tow truck to come, it could take 
hours. My concern would be how long it would take to get 
someone out there.
    The police, they need the extra training as much as 
possible, because they are probably going to be the first ones 
to deal with the situation at hand immediately, and they can 
assess from there. The response time is probably--it is not 
realistic.
    Senator Cotton. In your experience in law enforcement, and 
your husband's and your entire family's, when budgets are 
tight, and especially when budgets are cut, is training often 
the first thing that gets cut?
    Ms. O'Connor. I would say so, yes, definitely. They have 
to. It is just unfortunate that is the way things are going to 
happen. Also, right now in Philadelphia and probably across the 
country, the police officers, they are low. People are retiring 
and people are not joining the academy right now. All of it, we 
are in trouble. Our numbers are really too low because of the 
concerns of not having the support and overall defunding the 
police. They are who is going to be called first in any 
situation. If you need help, you are calling the police. They 
need to have all training possible in many different 
situations.
    Senator Cotton. Thank you, Ms. O'Connor.
    I want to turn to Sheriff Mims. You said in your testimony 
that 97 percent of the inmates in your jail are there on felony 
charges and have committed pretty serious crimes. A large 
number of those inmates were also receiving some sort of 
medication for a mental health disorder while in your jail. Is 
it fair to say then that a significant number of the serious 
criminals you encounter also have mental health issues? Would 
it put mental health workers and possibly bystanders in danger 
to have only a nonpolice response to these incidents?
    Sheriff Mims. Yes, Senator, a large number of our calls for 
service do involve those with mental health services--or mental 
health illnesses. Of course, the concern is we have some dual 
diagnosis going on. Not only do they have criminal behavior, 
they have the mental health behavior, as well as maybe a 
substance abuse issue. These are calls, for instance, that I 
testified to that are very dynamic. They unroll very fast. Law 
enforcement do come into contact very often with those that are 
mentally ill and have to take enforcement action because of the 
crimes that they committed.
    For example, the two deputies that we lost in the line of 
duty at the hands of an armed mentally ill person, one was a 
vehicle stop where that person came right out of the vehicle 
and shot the deputy as he was approaching the car. The other 
one was a burglary in progress. We do not know that the person 
that is involved in this also has a mental illness. They are 
very dynamic calls. They unfold very quickly. They are very 
dynamic. We are coming into contact with people who have been 
in criminal activity that are also mentally ill more and more.
    Senator Cotton. Thank you.
    As my time is concluding, I would like to return to Ms. 
O'Connor and just express again my deepest condolences and 
sympathy for your loss as well as my gratitude for your 
testimony today. I know that this must have been a hard day to 
tell your story, but may the memory of your husband and your 
loving marriage always be a blessing to you and to those who 
loved him. Thank you.
    Ms. O'Connor. Thank you.
    Chair Booker. Thank you, Senator Cotton.
    I would like to turn to Senator Padilla, who is on 
remotely.
    Senator Padilla. Thank you, Mr. Chair.
    My first question is for Ms. Myrick, and I want to begin by 
just thanking you for openly sharing your experience of living 
with mental illness. You know, it is only by talking about it 
more that we can improve understanding and awareness of mental 
health conditions and the impact it has on people's lives, on 
families' lives, and in so doing help undo the stigma often 
associated with mental illness that keeps us talking about it 
individually, as families, and certainly when it comes to 
passing public policy and investing in better services and 
supports. I just want to acknowledge that up front, and it 
means a lot to me, and I commend you for that.
    In your testimony you did--have mentioned your personal 
experience with a police encounter. What I would like to hear 
more about is how that encounter, in turn, affected your mental 
health and your general well-being.
    Ms. Myrick. Thank you for the question, and I, you know, 
speak up and speak out, especially as an African American, 
because I could not find anybody who was talking about their 
personal story of living with a diagnosis specifically of 
schizophrenia. I have to ask permission from my father, ``Can I 
speak out?'' Because he is part of this story, too. Without his 
loving support of him and my mom, who is no longer living, and 
the rest of my family, you know, truthfully I would not be 
here.
    The impact of that first experience, I was actually wearing 
a pair of my beloved red--cherry red Doc Marten shoes, and I 
loved those shoes. It was my first pair of Doc Martens. It 
takes forever to break those suckers in. They were broken in, 
and I was wearing them on that day, and they were ripped from 
my feet as people were struggling with me trying to subdue me 
to participate in what I did not understand was happening. It 
was not, again, about my mental illness. It was about seeing 
people who looked like me in my past treated awfully and having 
bad outcomes. I did not want to be a victim. I just did not. 
That is what I was really fighting against.
    What that really led to was, number one, I never wore those 
red shoes again. It took years and years--it took about 15 
years before I ever put those shoes back on. They actually do 
not fit. I have about 20 pairs of Doc Martens, but I did not 
wear those shoes ever again. I was not willing to--I was not 
willing to accept treatment, especially when I was not at my 
best. Every hospitalization after was involuntary and did 
involve police coming to take me to the hospital, because I 
thought that is what it was like to go to a psychiatric 
hospital. I had not seen it done any other way. I did not want 
to have anything to do with that.
    You know, even talking about it, I am sorry, it is like my 
heart is super-duper racing, because it still brings up a lot 
of memories and trauma that, on top of having an illness in 
which you are trying to recover, no one should have to 
experience.
    Senator Padilla. You hit the exact right word that I was 
anticipating. It was ``traumatic.'' It was additional trauma, 
which does not help someone who is already, you know, working 
to cope with or overcome a mental health condition. There have 
got to be smarter ways to do this, and I appreciate you helping 
to make the points. You are right; in communities of color 
especially, we do not talk about this enough.
    I have a follow-up question for Major Bartness because 
there is also the flip side to this coin. As I have come to 
learn in recent years, correct me if I am wrong, but in law 
enforcement there are more sworn officers who die by suicide 
every year than lose their lives in the line of duty. Correct 
me if I am wrong. I just wanted to hear from you for a few 
minutes about the psychological toll that use of force and 
other first responder experiences has on law enforcement 
officers and suggestions and ideas on how to acknowledge that 
and build that into training and support for sworn officers.
    Major Bartness. Thank you, Senator Padilla. Secondary 
trauma in law enforcement is a very serious issue which you 
have highlighted, and it is incumbent upon police departments 
to develop very robust employee assistance programs and ensure 
that those resources, confidential, are available to law 
enforcement and their family members, because those family 
members also live with the baggage that our officers bring 
home. We very intentionally have to create a culture where we 
recognize that secondary trauma is going to occur and that 
officers need to talk about it and that there is a very well 
developed system that they know how to access in real time when 
they are struggling.
    Not every department, obviously, is doing very well with 
that. So it, too, is a responsibility, that as we assess the 
State of our profession at this moment in history, that has to 
be given attention. Thank you for your attention to it.
    Senator Padilla. Thank you. It is going to be a topic of 
ongoing conversation.
    Thank you, Mr. Chair.
    Chair Booker. Senator Padilla, I am grateful.
    I am going to now adjourn the hearing. QFRs--I am sorry. 
What is that? Oh, I am sorry. Senator Ossoff, I apologize. I am 
told you are online.
    Senator Ossoff. All good. No problem, my friend. Thank you, 
Mr. Chairman, for convening this hearing, and thank you to the 
panel. I know we have votes, so I will do my best to be 
concise.
    Major Bartness, thank you for being here and thank you for 
your service. In response to an increase in mental health-
related emergency calls during the pandemic, Brookhaven, 
Georgia, a small city, pioneered a co-responder crisis 
intervention system. The Mayor of Brookhaven, John Ernst, said 
that this has helped to de-escalate situations involving 
individuals suffering from mental illness who may be involved 
in contact with law enforcement or calls to 911. I would like, 
Major Bartness, for you to comment on how co-responder programs 
like the one in Brookhaven, Georgia, might help to de-escalate 
such interactions and ensure that neither public safety nor the 
safety and health of those suffering from mental illness is 
jeopardized when police and law enforcement and emergency 
services respond to such calls.
    Major Bartness. Thank you, Senator. I think the co-
responder model is outstanding. We have it here in Baltimore. 
The challenge we have is that it is not large enough. It is 
operational 7 days a week but only 8 hours a day, and it is one 
team responsible for the entire city of Baltimore during that 
8-hour shift. It is a licensed clinical social worker paired 
with a highly trained CIT officer, and they respond to some of 
these most acute calls for service.
    What it does allow us to do is what Ms. O'Connor rightly 
pointed out earlier, and that is, as these calls come in with 
an officer in the field able to immediately respond, they are 
able to get there quickly, they do not have to wait an 
indeterminate amount of time. In order to do that to scale, 
there has to be more funding for these teams. They are 
fantastic. They play off each other's skills. They de-escalate, 
and then they refer to community-based services and case 
management to get these consumers who need the help.
    Senator Ossoff. Thank you, Major Bartness.
    Ms. Myrick, I would like to ask you a couple of questions 
about necessary investments in mental health services in 
Georgia and across the country. First of all, to be clear, I 
have not seen any evidence that people suffering with mental 
illness are any more likely to commit violent crime than anyone 
else in the population. In fact, according to the National 
Alliance on Mental Health, they are not, and, indeed, studies 
have shown that those suffering from mental illness are, in 
fact, much more likely to be victims of violent crime.
    We also know, at least according to some research, that 
individuals with untreated mental illness in particular who do 
come in contact with law enforcement in emergency situations 
are more likely to be killed in the encounter. I would like to 
hear from you your view on the importance of increasing our 
national investment in mental health care services and what 
kinds of social services in particular you think are neglected 
or lacking, generally speaking, across the country.
    Ms. Myrick. Sure, thank you. You know, definitely since the 
institutionalization of mental health care services and 
community-based services have never been fully funded, they are 
woefully underfunded. In order to kind of bring up, I would 
say, an ecosystem of support for people that move through the 
continuum of their health and wellness, which includes times 
when people are in crisis, we need to look at the system as a 
whole system that also interacts with other social services and 
systems such as housing, employment, physical health care, 
mental health care.
    Most people with mental health conditions, especially 
serious mental illness, want everything that anybody else 
wants. Most importantly, they want to work. Many are told, like 
myself, to go on disability which impedes sometimes your 
ability to go to work because of how the system of SSI and SSDI 
work.
    If we had to fund--like if we could fully fund a system, I 
think the system would include well-trained behavioral health 
professionals. It would include peer support and family 
support. Family support for adults with serious mental illness 
is not fully funded. It is funded for parents who are peers to 
other parents. It would include things like peer respite as 
well as family respite. We have not even talked about family 
respite. Those do not even exist, but families sometimes also 
need a respite and a place to go where they can get support 24/
7 to help support their loved ones.
    Other things, I think, that are critically important are 
mobile crisis teams that do include a behavioral health 
professional and a peer supporter in order to be in the 
community and also community supports that are sometimes not 
even part of the system because sometimes people will not go to 
the mental health system, but they may go to their church or 
their barber shop. How do we place people there that can be 
helpful?
    The other things that people need, as Kevin Martone pointed 
out, most importantly, if you do not have a home, how can you 
participate in treatment and do that with any kind of 
consistency? Housing is critical, housing is first for people 
with both mental health and substance use disorders. I think 
there need to be better partnerships across jurisdictions, 
including criminal justice and police systems, in order for 
mental health, criminal justice, and police to work far better 
together.
    Last--oh, I had another one, and I forgot it. There are so 
many. I think that will give you your list. Thank you.
    Senator Ossoff. Thank you, Ms. Myrick.
    Major Bartness, my time is up. I am going to ask you for 
the record to respond to a more general inquiry. I have asked 
this of the FBI Director, I have asked this of nominees for 
senior positions at DOJ as well as in discussions with leaders 
in Georgia about the increase in violent crime that we have 
seen nationally over the last year, particularly during this 
COVID-19 pandemic, and its causes, how you have responded in 
Baltimore, what you assess to be the factors driving the 
increase in crime. We have seen a significant increase in the 
murder rate in Atlanta. We have seen a higher rate of violent 
crime in Columbus and in other parts of my State. I know it is 
a national dynamic, and so I will be submitting to you for the 
record, Major Bartness, an opportunity to present your analysis 
to this Committee of what is causing this increase in violent 
crime.
    Senator Ossoff. I thank you for being here. I thank all of 
our witnesses for your testimony.
    Mr. Chairman, I yield.
    Chair Booker. Thank you very much. I agree. I want to give 
a lot of gratitude to all the witnesses who have been here, who 
have shared such essentially important testimony. This is a 
crisis in our country, and this is a great hearing where we 
have talked about solutions.
    I apologize. The floor vote is expiring, so I am going to 
sprint and run, but I will remind everybody that questions for 
the record are due in 1 week. The hearing record will be open 
for 1 week for statements and letters or any other contribution 
that the incredible witnesses want to make to the constructive 
work that the U.S. Senate and especially the Judiciary 
Committee has before it.
    Thank you very much, everyone. I appreciate it, and have a 
good day.
    [Whereupon, at 12:04 p.m., the hearing was adjourned.]
    [Additional material submitted for the record follows.]

                            A P P E N D I X

Miscellaneous submissions:

 Ayesha Delany-Brumsey Testimony..................................   146

 City of Charlottesville Police Department........................   210

 Contact Between Police and People with Mental Disorders..........   162

 Crime Science, Policing and public health calls for service in 
    Philadelphia..................................................   191

 Defending the Police (LELDF).....................................   160

 Effectiveness of Police Crisis Intervention Training Programs....   201

 IACP Law Enforcement Policy Center...............................   151

 Madison Police Department........................................   145

 New York Post, Can't Replace Policing with Social Services That 
    Don't Do What They're Supposed to by Stephen Eide.............   186

 Police, Treatment and Community (PTACC)..........................   189

 Potential for violence in arrest of persons with mental illness 
    by Philip Mulvey and Michael White............................   170

 RealClear Policy, Police De-escalation and its Discontents.......   197

 USA Today, Fewer than 1 in 5 support `defund the police' movement   212

 Washtenaw County, Office of the Sheriff..........................   209
 
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