Ideally, any person brought to a mental health provider by police officers will be someone already known to the system or will be able to easily fit into existing services. Unfortunately, such cases appear to be more the exception than the rule. Perhaps because people who are not already engaged in the system come into contact with the police more frequently than others who are successfully engaged in treatment, they face a number of obstacles in entering the system. Because contact with police may, in fact, turn out to be a person's introduction to the mental health system, it is important that the system's door be open at this critical juncture and engagement not be made more difficult by bureaucratic concerns. Establishing protocols that allow a case to be opened or reopened smoothly can help with this process.

An important test of the partnership between police and mental health providers is the ability of officers and providers to agree on who needs mental health services. If police officers bring an individual they perceive to be in need to a provider, they expect the provider to offer appropriate services to that individual. Mental health providers must respect the observations and judgments of police officers charged with making quick decisions in the field. By the same token, police officers must respect the assessment of mental health providers about which cases they are able to address and which cases are beyond their capacities. If the law enforcement and provider agencies have not worked together before, it may take a period of trial and error for a balance to be struck. The important thing is for police and providers to ensure that they will learn as they go along and that every effort will be made to meet each individual's needs in the process. There must also be an understanding that if an individual's needs cannot be met, there is a shared plan for getting those resources established.

Even with appropriate training, police officers will occasionally seek services for someone who cannot be helped by the local mental health provider. It is important in such instances, however, that providers not simply turn the individual away or leave him or her under the responsibility of the police. Protocols should be developed that delineate how police and providers should work together to find some assistance for the individual, even if it is not in the mental health system.

One source of assistance for people with mental illness is peer support programs.  Several types of peer groups exist to help consumers, including Drop-In Centers, Warmlines, and Clubhouses.  "Drop-in centers" are informal social and recreational programs that serve as information clearinghouses and meeting locations for other peer support groups, including 12-step groups. Traditionally, people with mental illness fill staff positions.  "Warmlines" are telephone support systems staffed by consumers trained to listen empathetically, provide information about appropriate resources, and act as a link to needed or desired supports and services.  Warmline staff does not provide suicide intervention or crisis intervention, but they are trained to recognize the need to engage the more critical support offered by a suicide hotline.  The staff also makes outgoing calls, contacting consumers who have asked to be called regularly to stay connected to a support system.  "Clubhouses" are collaborative efforts between professionally trained staff and consumers who provide vocational support and prepare consumers to enter into or return to the workforce.

In many instances, law enforcement officers may deliver a person with a mental illness to a mental health provider only to discover that any of a number of complicating factors may make it difficult to connect that person with appropriate services. For example, the provider will want to determine whether the person has insurance or qualifies for Medicaid or other benefits or entitlements. Similarly, the person may have more than one diagnosis or display no interest in receiving services. In these instances, too, protocols must be in place to ensure the delivery of appropriate services or responses.

In some communities, ACT programs have been put in place or adapted to provide or arrange for comprehensive treatment and supports for people with mental illness whose behavior has brought them to the attention of law enforcement. The concentrated individual attention that characterizes the ACT model can provide assurance that a person in need will receive appropriate services. In other instances, it may be that clinical services aren't needed, and the most effective connection can be made with peer services, either at a drop-in center or through individual contact with a peer counselor who is trusted because of the shared experience of mental illness.   

Regardless of the model used, mental health providers should take steps to ensure thorough follow-up for any individual who is brought to them under mutually agreed conditions by law enforcement authorities. Follow up may help stop the cycle of repeated involvement with the criminal justice system, while offering mental health providers a ready barometer of conditions and situations that receive police attention. "Follow-up" in this case means, at a minimum, a thorough examination, which may result in a referral to a more appropriate provider. The protocols developed to ensure services must also include a component that allows providers and police to regularly assess the appropriateness of referrals.  In addition, each participating agency should designate a liaison to work with counterparts to resolve problems.