Healthcare’s role in the police reform debate

In recent weeks, many healthcare leaders have spoken eloquently about the need to address the social and economic conditions that shorten lives in America’s minority and poor communities. That idea also belongs in the police reform debate.

If you listen carefully to most of the organizations demanding “defund the police” (a terrible slogan), you won’t hear a call to abolish police departments. What they seek are limits on the police role in dealing with some of the nation’s biggest social problems.

“Defunding the police means … investing more in mental-health care and housing, and expanding the use of community mediation and violence interruption programs,” wrote Christy E. Lopez, co-director of the Innovative Policing Program at Georgetown Law School.

“Municipalities can begin by changing policies or statutes, so police officers never respond to certain kinds of emergencies, including ones that involve substance abuse, domestic violence, homelessness or mental health,” wrote Ph.D. candidate Philip V. McHarris and Thenjiwe McHarris, a strategist for the Movement for Black Lives.

There’s a compelling logic to decriminalizing many police functions. Homelessness is not a crime. Nor are the mental disorders that cause individuals to act out in public.

Yet for most the first response to seeing people with these problems is to call 911, which usually brings ill-equipped police officers to the scene. What if the 911 operators could summon organizations whose mission is dealing with homelessness, behavioral health disorders, spousal abuse, child abuse, substance abuse and juvenile delinquency?

Someone with a badge and a gun is not the ideal first responder in most of those situations. People from organizations with the skills and resources to tackle the social determinants of health (another terrible slogan) are far more appropriate.

Budgets are boring, but budgets reveal priorities. States and municipalities spend significantly more on policing than they do on social services. Minneapolis, where George Floyd was murdered, has a police budget of $193 million this year, while affordable housing gets $31 million and the health department gets $24 million.

That skew in local priorities looks even worse when you realize most police funding comes from local taxes, while housing, health and other human services are heavily dependent on federal grants. Municipal budgets in every section of the country have a similar slant.

Cities’ reform efforts have focused on better police training. The Houston Police Department set up a special division to deal with people in mental health crises. Colorado has pilot projects that send out behavioral health clinicians with the police on 911 calls.

But these approaches will never address the core problems, which are inextricably linked to the poverty and the economic desperation that remain endemic in low-income communities. Even as the nation neared full employment, child abuse rose to 3.5 million cases in 2018.

An estimated 12 million people, 85% of whom are women, suffer from spousal abuse each year. Intimate partner rape and other assaults account for 15% of all violent criminal acts.

The U.S. systematically underfunds social service approaches to dealing with these and other problems. Until the federal government reverses its own misshapen priorities, states and municipalities must take the lead in showing there’s a better way.

This doesn’t mean getting rid of the police. Indeed, polls show minorities want more police in their neighborhoods. But they want good cops, not racists who consider every black person a criminal. They resent that most murders in their communities never get solved, and that guns continue to flood their streets.

The leaders of institutions that tend to the dead and wounded need to speak more forcefully on these issues. And they must also ask governments to invest more in improving the social conditions that make our society so violent in the first place.

The viewpoints expressed by the author do not necessarily reflect the opinions, viewpoints and official policies of Modern Healthcare and its staff.


Tags: covid-19, pandemic

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