Service User Perceptions of Mental Health Emergency Response in New York City.

Mental health emergency response (initiated after calling centralized phone systems such as 911 in the United States and Canada) is a highly impactful, but understudied, component of the mental health service system. The present study used qualitative methods to examine the experience of receiving mental health emergency services and explore recommendations to improve future response. Twenty-three persons from New York City who self-identified as having interacted with mental health emergency services completed in-depth interviews and detailed 40 incidents of receiving mental health emergency services; interviews were analyzed using a deductive analytic approach. Major themes included participants perceiving responders as aggressive and using some type of force (including the act of putting on handcuffs). Participants typically reported being hospitalized, with roughly half of participants reporting dissatisfaction with the outcome. Prominent themes included experiencing aggression from police and feeling stigmatized by responders, while others experienced fair treatment from police officers and experienced them as professional and non-threatening. Participants felt that emergency mental health responders should be curious, conversational, non-judgmental and not aggressive, and that responders should primarily be comprised of mental health professionals and peers. Findings have important implications for how the mental health service system responds to perceived emergencies, and suggest that alternatives to traditional police-based responses need to be more widely implemented.