Identifying Chicago’s High Users of Police-Involved Emergency Services

Abstract

Objectives. To identify individuals at risk for behavioral health (BH)–involved encounters with police in Chicago, Illinois. Methods. We linked Chicago Police Department (CPD) arrest and Fire Department (CFD) BH-involved ambulance event data. We identified at-risk individuals who accumulated at least 1 BH-involved ambulance and at least 1 arrest event between May 2016 and April 2017. We identified a high-use subgroup displaying most intensive services use. We identified high-use locations with highest volume of ambulance events with only CFD data. Results. Of 83 392 individuals and 116 105 events in the linked emergency events data, 1842 at-risk individuals accounted for 2.2% of individuals, 5.6% of all events, and 16% of BH-involved CFD events with police involvement. A total of 330 high-use individuals accounted for 0.4% of individuals, 2% of events, and 4.7% of CFD events with police involvement. Top-100 high-use locations accounted for 9% of CFD events, and individuals of high-use location events are largely distinct from high-use individuals. Conclusions. Integrated police and ambulance data hold promise to identify individuals at risk for BH-involved encounters with police and to support proactive interventions to prevent or improve response at these encounters.

Two-year prevalence rates of mental health and substance use disorder diagnoses among repeat arrestees

“…A recent study in Chicago used integrated administrative data from the police and fire departments to identify individuals and places most at risk for repeat behavioral health events. The findings demonstrate the utility of large administrative data to identify repeat users and places of emergency services; additionally, these processes can be automated and replicated to assist first responders in resource allocation and in designing proactive interventions (Tentner et al, 2019 ). Administrative data to identify individuals most at risk for repeat contact with the justice system, along with knowledge of co-occurring mental health and SUD diagnoses, may help guide police when responding to 911 calls.…”

“…Individuals with mental illness tend to cycle through the justice system rapidly (i.e., multiple arrests per year). Prior studies demonstrate repeat arrestees frequent hospital emergency rooms (Akins, Burkhardt, & Lanfear, 2016 ), are disproportionately homeless (Green, 1997 ; Harding & Roman, 2017 ; Tentner et al, 2019 ), and have co-occurring mental health and SUD diagnoses (White et al, 2006 ). For instance, nearly half of individuals arrested for a mental health protection hold were rearrested within 60 days, and nearly a quarter of those were rearrested within the first 14 days of release from incarceration (Akins et al, 2016 ).…”

Mental health and policing: Picking up the pieces in a broken system

“…3,10,11,13,17,23,24,49 Encountering these same people again and again overburdens law enforcement agencies, strains limited resources, and can be frustrating and demoralizing for officers who are unable to help the individual. 3,27,50…”

“…In most cases, programs were developed through collaboration between police, mental health service providers, and others invested in addressing the issues. 30,49,50,56,57 The range of programs highlighted in the literature review include the following: mobile teams of police and mental health professionals to respond to mental health crisis; one-stop-drop-off centres, which provide PwMI with immediate access to services such as assessments and referrals by specially trained care teams; and crisis intervention teams in each police catchment area to respond to mental health crises in addition to performing regular duties. 30,32,33,49,56 …”

“…Previous articles described fragmentation and silo services, and it has been suggested that more research was required given the lack of evidence for certain models. 30,36,49,50 For example, there is a significant need for research and systems analysis on integrating physical and mental healthcare, especially involving case management models for this population group. 3,30,46,47,50 The further research should examine service model implementation, intended outcomes, alignment and fit to community expectations, information system adequacy, and cost-effectiveness.…”