Changing the Mental Health Emergency Response System in Washington County, Oregon
On October 24, 2022 at 2 a.m., 27-year-old Joshua Wesley called a crisis help line from his home in Washington County, Oregon, just west of Portland. He was having suicidal thoughts and knew that he needed professional help. But instead of receiving a mental health provider as specifically requested, he encountered a group of armed police officers at his door. This response not only deprived Wesley of the immediate psychiatric care that he needed, but it also led to him being arrested and seriously injured by the responding officer. He ultimately spent two weeks in the hospital, and six months in jail.
Wesley told us that he felt that he needed qualified professionals to console him, talk him down, and give him solutions. But the officers that showed up made the situation worse by simply trying tried to put him in handcuffs and cart him off.
Joining forces with the ACLU, Disability Rights Oregon, the ACLU of Oregon, and the law firm Shepherd Mullin, Wesley is a plaintiff in a recently filed lawsuit against Washington County and the local 911 dispatch center. The lawsuit asserts that the county’s emergency response system discriminates against people with mental health disabilities and exposes them to risk of serious harm, including injury, arrest, and incarceration. Wesley said that he joined the case because he believes strongly in helping out others facing similar struggles.
A Life-or-Death Situation
Washington County has a history of inappropriately responding to mental health crises. In 2022, police officers were dispatched to 100 percent of the calls coded as “behavioral health incidents” in Washington County. The county does have mobile crisis teams comprised exclusively of mental health clinicians, the sole non-police response available there. But, while the mobile crisis teams are intended to be available 24/7, in practice, they’re underfunded, not connected with the emergency dispatch system, and often unavailable — especially at night, when many mental health crises occur.
Police response to mental health crises can be dangerous and even deadly. Police officers are not qualified mental health professionals and should not be expected to assess and treat people in crisis. Beyond that, police presence may actually make mental health symptoms worse, triggering anxiety and paranoia. Most alarming of all, it is that people with untreated mental illness are 16 times more likely than others to be killed by the police during an encounter.
911: Reimagining a System that Defaults to Dispatching Police
Emergency response systems must be revamped to equip 911 call-takers to dispatch non-police first responders.
Source: American Civil Liberties Union
That’s what nearly happened in Wesley’s case. Instead of being provided with the care he was seeking — on-site psychiatric assessment and treatment — he was placed under a “police officer hold,” a form of involuntary detention, and transported to a hospital via ambulance. Wesley was not treated or stabilized during transport and his symptoms worsened. At the hospital, Wesley was still suicidal and he attempted to take an officer’s firearm to use on himself. During the incident, the officer stabbed Wesley several times, resulting in serious injuries to his chest, stomach, and head.
The damage to Wesley’s body serves as a constant reminder of the incident. The scars left from the incident demonstrate that there could have been other ways to deal with the situation, Wesley told us.
Wesley then spent two weeks in the hospital recovering. During this time, his repeated requests for mental health assistance and therapy were denied. He remained handcuffed to his bed and kept under near-constant police surveillance. Wesley felt that the doctors stopped looking at him as a patient who needed help and treatment to heal, but rather, as a criminal.
After being released from the hospital, Wesley faced criminal charges arising from the altercation with the officer. He spent six months in jail, missing the birth of his first and only son. He also missed the holidays and time with his family at a time of great strife.
Ultimately, it took months for Wesley to receive the psychiatric help that he first sought in October.
A More Humane Emergency Response
When someone in Washington County experiences a physical health crisis, like a heart attack or a severe allergic reaction, they can call 911 and expect a response from a qualified medical professional, like an EMT or paramedic. The same cannot be said, however, for someone experiencing a mental health crisis.
The lawsuit explains how this discrepancy violates the Americans with Disabilities Act and Rehabilitation Act. Mental health crises demand a mental health response — not a police response — because they are, at their core, health emergencies.
Experts agree that mental health emergencies should be addressed by mental health professionals, not the police. As part of their the Substance Abuse and Mental Health Services Administration (SAMHSA) proposes a three-tiered system that includes a crisis call center, mobile crisis teams, and stabilization centers for walk-ins and drop-offs. SAMHSA also noted that responding with police is “unacceptable and unsafe,” a view that the shares.
As a result of Washington County’s inappropriate response to mental health crises, it discriminates against people with mental health disabilities on a daily basis. . This lawsuit seeks to improve its mental healthcare system. Possible solutions include fully funding mobile crisis response teams that can bring care and support to the people who need it, when they need it.
Washington County isn't the only jurisdiction with a system in need of reform. Justice Department investigations have found similar discrimination in Louisville and Minneapolis, stating that relying on police as mental health first responders causes “real harm in the form of trauma, injury, and death to people experiencing behavioral health issues.”
Wesley hopes that this case brings widespread attention to an issue that impacts many lives on a daily basis. People with mental health disabilities are harmed both because of a failed response to mental health crises , and because many people with mental health disabilities don’t want to call for help out of fear of an armed police response. Wesley sees a need nationwide for an important reckoning for how jurisdictions respond to mental health crises. Counties and other locales should be looking at their systems and asking, “Is our system for mental health crisis response fair? Is it safe? Is it right?”
How jurisdictions answer these questions could have a major impact on the care and support people with mental health disabilities receive while in crisis. We must not allow discriminatory practices that cause real harm and death to go unchecked.
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