An economic evaluation of a police–mental health co-response program: data from a pragmatic randomized controlled trial

Background

Alternative responses to behavioral health emergencies are increasingly common interventions to address the overrepresentation of people with mental illness in the criminal legal and health systems. We compared costs associated with receiving a crisis response from police-as-usual versus a police-mental health co-response team that occurred as part of a randomized controlled trial.

Methods

Eligible 911 calls-for-service were randomized to receive a police-as-usual or a co-response. Next, we record-linked randomized events to emergency medical services, jail, outpatient services, and emergency department data to assess outcomes. We calculated per-person costs of service utilization following the randomized event from a public-sector perspective.

Results

Our analysis revealed no cost-savings from the co-response. Persons who received a co-response team response had greater 12-month post-randomized incident costs associated with outpatient behavioral health encounters and emergency department visits.

Conclusions

Rigorous evaluations and cost analyses are important for determining whether alternative police response interventions achieve community goals.