From Care to Coercion: Service User and Carer Experiences of Police-Involved Mental Health Crisis Responses.

Abstract

Police and specialised police teams are frequently called to respond to mental health crises, often becoming de facto gatekeepers to care. Yet the perspectives of people in crisis and their carers remain underrepresented in the literature. The aim of this review is to explore the lived experiences of people, including carers, who encounter police or specialised police teams during a mental health crisis. A narrative review was conducted following Sukhera's five-step approach. Searches across CINAHL, MEDLINE, PsycInfo, and Sociological Abstracts identified 33 qualitative studies from eight countries. Data were analysed thematically. Results reveal nuanced experiences, ranging from trust in police and crisis services to refusals to ever call them again; from successful de-escalation to rapid escalation; and from encounters that preserved life to those that ended it. Five themes were identified: (1) Initiating and navigating the crisis response; (2) Interacting and communicating during the response; (3) Perceptions of safety, risk, and coercion during the response; (4) The harms of the response; and (5) Improving police and specialised police team response. The review clearly lists the types of coercion that can be experienced during these responses, whether they involve only police officers or a co-responder model. The findings highlight that positive crisis response experiences depend on whether interactions are perceived as fair, respectful, humane, and non-coercive. While some encounters are supportive and lifesaving, negative experiences often carry disproportionate weight, eroding trust and deterring future help-seeking. More approaches grounded in procedural justice theory are needed to reduce coercion and rebuild trust.