Project Summary
The research team is investigating whether and how alternative emergency response programs (AERPs) are successful in transforming state responses to crises in ways that move away from systems of policing and punishment and toward racial health equity and meaningful community participation. To do so, they are studying three interlinked decision points: the initial emergency dispatch of AERPs as opposed to police; the design and implementation of the AERP crisis intervention; and the changes in health service utilization, including connection with behavioral health care and diversion from criminal legal institutions.
Research Questions/Aims
- What impact does professional decision-making during an emergency call have on the deployment of AERPs?
- How does policy responsiveness (in an institutional context) affect AERPs’ design as non-police and non-carceral interventions?
- What is the impact of AERPs on behavioral health service utilization?
Actionability
- Inform local policy and program implementation, including coordination between community-based and government efforts to improve health and racial equity and reduce criminalization
- Partner with a network of municipalities and local community organizations that have or plan to implement AERPs to share insights around which mechanisms/components of the AERPs contributed most to advancing health and racial equity
Racial Equity Implications
Local governments across the United States have increasingly implemented AERPs in response to protest demands following George Floyd’s murder at the hands of Minneapolis police because they promise to help curb racially disparate arrests, incarceration, and other harms resulting from police responses. Populations benefitting from this research include those disproportionately impacted by state-based harms, particularly Black, Latinx, and Indigenous and other people of color and people with mental health and/or substance use concerns and disabilities.
Outcomes
Health and Wellbeing: time-varying trends in individual behavioral health measures typically associated with crisis response services, including emergency room admissions, opioid overdoses, and medications for opioid use disorder; and service provision outcomes, including Medicaid coverage and housing services.
Other: community involvement and participation; integration and leadership of directly impacted communities; diversion and deflection of emergency calls to non-police; legal and jurisdictional dynamics; arrests and bookings; and jail incarceration.
Methodology
To answer RQ1, the project team is deploying a survey to emergency communications personnel. The approach to RQ2 involves in-depth interviews and observations over two years with AERP partners and stakeholders in Oakland, CA; Madison, WI; and Dayton, OH. Research at each site includes roughly 25 initial interviews and 25 follow-ups with AERP service users, 30 interviews with staff and community stakeholders, 100 hours of participant observation, and access to administrative health and policing data. To answer RQ3, the team will use a difference-in-differences design based on all-payer claims data from the California Department of Health Care Services to compare behavioral health service utilization and outcomes in counties that have implemented AERPs versus those that rely on police for crisis interventions.
Columbia University
Edmond & Lily Safra Center for Ethics (Harvard University)
Justice, Health, and Democracy Initiative
Harvard T.H. Chan School of Public Health and Law School
RTI International’s Transformative Research Unity for Equity
Mobile Assistance Community Responders of Oakland
Dane County Public Safety Communications
Community Alternative Response Emergency Services
An advisory board of service providers, researchers, and advocates
Dayton Mediation Response Unit