A Disability Justice Approach to Mental Health Crisis Response: What True Alternatives Require
Part 3 in a Series on Mental Health Crisis Response
By Jordyn Jensen
When police respond to mental health crises, the consequences are well documented: force, restraint, involuntary detention, escalation, and in too many instances, death. These harms fall hardest on disabled people, people of color, and especially disabled people of color. In the United States, as many as half of all people killed by police are disabled, and people with serious mental health conditions are 16 times more likely to be killed during police encounters than those without such conditions. These are not accidents. They are the predictable outcomes of a system that sends armed police to respond to human need.
And yet, communities are building a different kind of response. Across the country, local governments and community-based organizations have launched mobile crisis teams, clinician-led units, and peer-based services, often described as “alternatives.” Our recently released joint report with Human Rights Watch and the New York Lawyers for the Public Interest, “Self-Determination is the Pathway to Liberation”: Alternative Mental Health Crisis Response in the United States (“Alternative Response Report”), documents this landscape. We identified more than 150 non-police crisis response programs nationwide and highlight eight programs that illustrate components of rights-based crisis response. The report identifies key elements of rights-respecting responses and shows how some non-police programs have carried those elements out in practice.
This matters now because growth has not meant transformation. Police-led and co-responder models still shape much of the crisis response landscape, while coercive legal frameworks continue to shape what happens once distress becomes visible. Governments continue to expand involuntary hospitalization, court-ordered treatment, and psychiatric confinement even as non-police alternatives remain underfunded. Alternatives are growing, but the systems that criminalize, confine, and coerce people in distress have not been displaced.
The first two blogs in this series set up the problem this piece addresses. The first blog argued that mental health crisis response operates as governing infrastructure, not a collection of services. More specifically, it described how the current landscape is organized through three models: police-led, co-responder, and non-police response. It also showed that police, emergency departments, and involuntary psychiatric systems remain structurally dominant, even as alternatives expand. The second blog turned to space, showing that crises do not unfold on neutral terrain. Factors such as segregation, disinvestment, clinic closures, housing instability, surveillance, dispatch protocols, and eligibility criteria shape how crisis is produced, interpreted, and routed. Geography matters because these conditions are not evenly distributed, and because place often shapes what systems are activated once distress becomes visible. In some communities, people may reach peer-led or community-based support. In others, distress is routed through police, emergency departments, or involuntary psychiatric systems. The cases of Jordan Neely and Win Rozario make the stakes concrete. Neely’s killing shows how racialized and ableist norms shape who is perceived as dangerous in public space, while Rozario’s killing shows how dispatch systems can make police the default even where alternatives nominally exist.
This third blog begins from that terrain. If crisis response is built through infrastructure, law, funding, geography, and institutional authority, then alternatives cannot be evaluated only as individual programs. They have to be understood as part of a broader system, including what they replace, what they remain connected to, and whether they actually move people away from surveillance, confinement, and force.
Beyond Reform: A Shift to the Core Question
Much of the current debate treats the central question as who should arrive instead of police. That question matters, but it is not enough. A response can remove police and still reproduce carceral power if clinicians, crisis workers, or other responders retain the authority to surveil, detain, institutionalize, or impose treatment without consent. In that scenario, coercion has not been eliminated. It has been moved into a different institutional form.
As Liat Ben-Moshe argues, incarceration “does not just happen in penal locales” but operates through a dispersed network that normalizes coercion as care. The Alternative Response Report draws from this understanding of the carceral to ask not only whether police are physically present, but whether a response preserves autonomy, consent, and self-determination.
The question, then, is what it would mean to center disability justice. Disability justice begins from the leadership of people most impacted, including those who have been psychiatrically incarcerated, criminalized, and institutionalized. Some of the most transformative models, including Project LETS, Fireweed Collective, Cambridge HEART, and Mental Health First (a project of the Anti Police-Terror Project), have emerged from grassroots organizing led by people most directly impacted.
As articulated by Patty Berne, co-founder of Sins Invalid and a foundational disability justice organizer, “all bodies [and minds] are unique and essential, all bodies [and minds] have strengths and needs that must be met… we are powerful not despite the complexities of our bodies [and minds], but because of them.”
In this disability justice frame, mental crisis is not simply a pathological event to be managed by professional authority. It is often produced through poverty, housing instability, criminalization, social abandonment, and the cumulative violence of racism and ableism. Disability justice is therefore both an analytic framework and a political vision of a world in which every body and mind is treated as valuable.
Healing justice reinforces this vision. The Fireweed Collective holds that harm is both individual and structural, and that healing must be collective, relational, and grounded in self-determination. We have similarly described disability justice as “a transformative framework for radically reimagining responses to harm and conflict that do not rely on incarceration” in An Intersectional Approach to Advocacy on Prison and Jail Conditions. Applied to mental health crisis response, this means shifting from managing risk to building the conditions under which care becomes possible, including consent, material support, community accountability, and self-determination.
What True Alternatives Grounded in Disability Justice Require
The Alternative Response Report identifies key components of rights-based mental health crisis response, including removing police as primary or default responders, avoiding involuntary services, centering consent, integrating peers across all levels, providing accessible services and follow-up, offering alternatives to 911, minimizing power imbalances, and maintaining transparent data. The principles below are not exhaustive. They move this series from diagnosis to design, building from the landscape described in the first blog, to the spatial inequities analyzed in the second, to what true alternatives require.
Non-Coercive Response and Carceral Decoupling
To see what this looks like in practice, picture the police-led model described in the first blog. A 911 call triggers law enforcement, or police initiate contact based on how they interpret someone’s behavior. Officers arrive armed and uniformed. They may detain, restrain, or transport someone to a locked facility. As Jamelia Morgan has written, this pattern often begins when someone calls for help during a perceived mental health crisis and armed officers are dispatched instead. Civil commitment laws and psychiatric holds authorize detention based on perceived dangerousness and risk, reproducing racial and ethnic disparities in psychiatric detention.
The Alternative Response Report treats non-coercion as a core rights-based requirement: no involuntary services, consent-centered care, and removal of police as primary or default responders. This matters because coercive psychiatric practices function as forms of social control, and evidence undermines the assumption that coercion reliably produces safety or recovery. For example, research has linked perceived coercion during psychiatric hospitalization with worse post-discharge outcomes, including suicide attempts. The World Health Organization has also called for a faster transition away from coercive mental health services and toward holistic, rights-based, person-centered support.
Now picture something different. The report describes HEART as operating without police involvement or other carceral responders, and as not calling police or emergency medical services unless a community member asks for it. HEART explains that it would “never involuntarily hospitalize somebody or put them in our van against their will. It all has to be totally consent-driven.” In Oakland, Mental Health First rejects forced treatment and works from the belief that even when someone is “not sharing our version of reality,” they still know what they want and need. These examples show what non-coercion looks like when consent is treated as a baseline, not a preference to be overridden.
But non-coercion at the point of contact is not enough if the surrounding infrastructure still funnels people toward force. This is why decoupling is crucial. Decoupling means severing crisis response from the infrastructures that authorize and reproduce coercion, including police dispatch, emergency departments, and pathways into involuntary intervention. Many “alternative” crisis response programs still operate alongside police, depend on police-controlled dispatch systems, or preserve pathways into involuntary treatment, functioning as additional layers within carceral systems rather than replacing them. As Interrupting Criminalization (see pp. 9–10) cautions, a system is not non-carceral simply because it is medicalized; many programs described as “alternatives” continue to rely on clinical authority and pathways into involuntary intervention, reproducing forms of control even in the absence of police.
A disability justice approach requires crisis response that is structurally independent from policing and involuntary intervention. It must be a genuine exit from coercion, not a softer entry point into it.
Voluntary Care Pathways
A disability justice framework requires not only non-coercive response, but systems that people can access voluntarily, without being routed through police or conditioned on compliance. As Nev Jones and I wrote in an op-ed last year, “Supporting voluntary, rights-based care is not a denial of the seriousness of mental health conditions. It is precisely because people with psychiatric disabilities may experience profound distress and vulnerability that we must reject simplistic, punitive responses.” Support must be something people can choose at entry and throughout care.
The reality is that voluntary options remain scarce. This is the spatial problem the second blog named: availability depends on geography, operating hours, staffing, funding, dispatch protocols, and eligibility criteria. In many places, crisis response still runs through 911 systems that position law enforcement as the default. Even where non-police teams exist, the landscape of crisis services is limited, and dispatch systems shape whether someone has a meaningful choice in how support reaches them.
The programs profiled in the Alternative Response Report illustrate what stronger voluntary access can look like. Mobile Crisis Response Teams (MCRT) in San Diego County operate 24/7 and are guided by the principle of “serve anyone, anywhere, anytime.” HEART offers a confidential support line built around consent and trust. Mental Health First runs a dedicated phone and text line separate from 911. MACRO in Oakland and Netcare in Franklin County also maintain access points that do not require a direct call to police. Together, these models show why access should be free, confidential, available, and reachable without forcing people through law enforcement.
Peer respite programs and warm lines extend this further. Peer respites create voluntary, home-like spaces where people can seek support without fear of being routed into psychiatric confinement. Warm lines offer a way to reach out early, before distress escalates into crisis or police contact. Voluntary access is not a gap-filling measure. It is a different way of organizing care.
Material Supports: Housing, Income, and Care Infrastructure
A crisis does not begin in the moment someone calls for help. As the second blog in this series documented, “crisis is not an isolated incident. It is a trajectory unfolding across environments, infrastructures, and governing logics over time.” What gets labeled a mental health crisis is often inseparable from housing instability, poverty, trauma, lack of healthcare, and the cumulative effects of racialized disinvestment.
No crisis team, no matter how well designed, can substitute for stable housing, accessible healthcare, a living income, or community-based support. Without those conditions, crisis response intervenes at the point of breakdown instead of preventing the conditions that make breakdown predictable.
The Alternative Response Report names follow-up and connections to community-based resources as essential components of rights-based crisis response. For instance, Netcare provides up to 14 days of follow-up, helping people reconnect with voluntary treatment, housing, and social services. STAR partners with community organizations through its Community Partner Network to provide case management, follow-up, wraparound services, and culturally responsive referrals. COMPASS conducts outreach, connects people to showers, meals, and shelter, and works with a 90-day emergency housing program that accommodates families and pets. These examples show that de-escalation is the beginning of the work, not the end.
As healing justice emphasizes, and as the Fireweed Collective argues, healing depends on basic needs, relationships, and community. Disability justice treats these conditions as central, not ancillary. A system that ignores them responds only to the most visible symptoms of much deeper failures.
Peer Leadership and Community Governance
The Alternative Response Report identifies diverse participation of peers with lived mental health or substance use experience across all levels, from program design to frontline response to oversight, as a core component of rights-based crisis response. Disability justice pushes this further. Peer involvement is not only about adding people with lived experience to existing systems. It is about shifting power.
The research supports the importance of peer and lived experience workforces, which are associated with recovery-oriented and person-centered care. The Bazelon Center reports that peer-led crisis response can reduce reliance on hospitalization and law enforcement while increasing engagement with community-based care. But peer leadership is not only about outcomes. It is about expertise, authority, and governance. People who have navigated crisis and coercive systems hold critical knowledge that traditional systems routinely sideline in favor of clinical and legal authority.
The programs highlighted in the report reflect this shift in different ways. HEART responders all have lived experience with a carceral system, including psychiatric incarceration, the child welfare system, or prison. Mental Health First was designed and is led by people with experience of substance use, mental health crisis, and intimate partner violence, rooted in the conviction that those closest to the problem have the greatest solutions. COMPASS includes peers on response teams and a Community Advisory Board that includes people with lived mental health experience, people from diverse racial and ethnic backgrounds, and formerly incarcerated people. Netcare integrates Certified Peer Recovery Specialists into both frontline response and follow-up.
Peer inclusion without institutional change is not enough. Project LETS offers one example of non-carceral, peer-led support rooted in mutual aid. Mental Health First also offers a model grounded in abolition, disability justice, and healing justice, connecting people to resources that address the broader conditions shaping their distress rather than routing them into confinement or surveillance. Community governance means accountability flows to the people most affected, rather than only to police departments, hospitals, or state agencies.
The Conditions Under Which Care Becomes Possible
These principles are not hypothetical. Communities across the country are already building peer-run services, community-led mobile teams, consent-centered models, and crisis response programs that treat self-determination as central. Their work shows that another response is possible, not as an abstract ideal, but as something already being practiced.
The question is whether these alternatives will be protected, resourced, and allowed to grow. Disability justice reframes crisis response as part of a broader system of collective care. It asks who controls the system, where support is available, whether people in crisis retain autonomy and choice, and whether the response moves people toward care or back into surveillance, confinement, and force.
That is what connects this piece to the first two blogs in this series. The first showed that crisis response is infrastructure, not simply service delivery. The second showed that this infrastructure is spatially uneven, with care and control distributed differently across communities. This third piece asks what must be built instead.
What distinguishes a disability justice approach is not only the absence of police. It is the presence of justice, including non-coercive support, voluntary pathways, material resources, peer leadership, and community governance. These are the conditions under which care becomes possible.
Getting there requires more than pilot programs or partial reforms. It requires sustained investment in the systems communities are already building, along with a reallocation of resources away from policing, confinement, and coercion. The distance between the system we have and the care people deserve is not inevitable. It is a political choice.
The Alternative Response Report identifies key elements of rights-respecting crisis response and highlights programs already putting pieces of that future into practice. The work of creating a world where people experiencing crisis are met with care rather than force is already underway. We must support and sustain it.
The Center for Racial and Disability Justice (CRDJ), based at UCLA School of Law, is a first-of-its-kind center dedicated to promoting justice for people of color, people with disabilities, and individuals at the intersection of race and disability.
Learn more about CRDJ by visiting the Center for Racial and Disability Justice webpage.
