Why Crisis Response Lives Between Crime and Care

Stephanie Schilling and her Sacramento Sheriff's Office partner, as part of the Co-response Crisis Intervention Team, 2022

Every day, across communities, there is a quiet volume of calls for service that don’t fit neatly into any single category. They are not always crimes. They are not always medical emergencies. They are not always “mental health calls” in the way systems like to define them.

They are people.

A person standing on a freeway overpass, debating whether today is the day. A Medi-Cal–contracted provider meeting a client in the field and realizing something has shifted — that this client needs more support than planned. A welfare check that starts as “just a concern” and unfolds into something far more complex.

These are the calls that happen every day. And they are the calls that most clearly show why crisis response lives between crime and care.

The limits of a crime-only lens

When law enforcement responds alone to these calls, they are often placed in an impossible position. Without a clear crime, their options narrow quickly. “No crime, no action” becomes the default — not because officers don’t care, but because systems have trained them to operate within strict legal thresholds.

This binary approach forces officers to assess human suffering through a criminal lens: Is there a law broken? Is there probable cause? Is there enough risk to justify involuntary action?

If the answer is no, intervention often ends — even when it is obvious that someone is struggling and unsafe.

The result is a system that unintentionally teaches people that they must become sicker, more escalated, more dangerous, or more disabled before help is available. That is not prevention. That is delayed response.

What changes when a clinician is present

When a licensed mental health clinician responds alongside law enforcement, the entire spectrum of support changes.

Suddenly, the call is no longer confined to crime or no crime.

The response can include:

• Voluntary transport to mental health clinics instead of emergency departments or jail

• Access to medical and mental health records that provide context, history, and continuity

• The ability to identify whether a person already has a provider — and to contact and collaborate with that provider in real time

• Clinical assessment that does not rely on arrest or involuntary hold as the only options

Just as importantly, the presence of a clinician often de-escalates the scene before words are even exchanged.

Law enforcement slows down. Clients slow down. The tone changes.

Officers know a counselor is present. That knowledge alone reduces the likelihood of escalation to force. Clients recognize that someone there understands mental health symptoms, not just behavior. The interaction becomes less adversarial and more human.

This is not theoretical. It is observable, repeatable, and consistent across jurisdictions that implement true co-response models.

The danger of false categories

One of the most harmful aspects of traditional crisis response is the way systems force people into false categories:

• Criminal or not criminal

• Sick enough or not sick enough

• Eligible for help or not yet

These categories are administrative conveniences — not reflections of real human experience.

Mental health symptoms do not wait for legal thresholds. Disability does not announce itself neatly. Crisis does not unfold on a policy timeline.

When systems insist on rigid definitions, they unintentionally create harm. People are denied support until their situation deteriorates. Law enforcement is left holding responsibility without appropriate tools. Communities experience preventable tragedies and burnout among responders.

Protection means more than enforcement

If law enforcement is truly about ensuring the welfare of the community — all of the community — then that responsibility must include people with disabilities, including mental health conditions.

Crime or no crime, officers swear an oath to protect. Sometimes that protection means intervening not against a person, but for them — even when the threat is internal, psychological, or rooted in trauma.

Co-response models honor that oath by expanding what protection can look like. They acknowledge that safety is not always created through enforcement. Often, it is created through presence, assessment, collaboration, and timely support.

Living in the middle — intentionally

Crisis response does not belong solely to law enforcement or to mental health. It lives in the space between them — where human behavior, legal authority, clinical judgment, and ethical responsibility intersect.

That middle space is uncomfortable. It requires coordination. It requires trust. It requires systems to admit that no single discipline can do this work alone.

But it is also where the best outcomes happen.

This is the space I have worked in for years — and the reason I wrote Between Crime and Care. Not to criticize responders, but to illuminate what actually works when we stop forcing people into boxes they were never meant to fit.

Because the truth is simple: When we expand the response, we reduce harm. When we collaborate, we create safety. And when we meet people where they are — between crime and care — we finally begin to do this work well.