The evolution of municipal emergency response has shifted toward a multidisciplinary paradigm, specifically within the City of Tucson, Arizona. Facing a population of 548,073 residents across a jurisdiction of 226.71 square miles, the city has moved away from traditional enforcement-only models toward a sophisticated, integrated system of behavioral health crisis response. Central to this transformation is the Mental Health Investigative Support Team (MHIST), a specialized unit designed to bridge the gap between law enforcement and clinical psychiatric care. The framework is built upon the principles of Crisis Intervention Training (CIT) and a guardian mindset, prioritizing the least harm resolutions over traditional punitive measures. This systemic shift was accelerated following the 2011 shooting of U.S. Rep. Gabrielle Giffords, which served as a catalyst for the Tucson Police Department (TPD) to fundamentally re-evaluate its approach to mental health-related calls, leading to the formal creation of the MHIST in 2013.
The Structural Framework of the Mental Health Investigative Support Team
The Mental Health Investigative Support Team operates as a specialized arm of the Tucson Police Department, designed to function as a central resource for patrol officers who encounter individuals experiencing behavioral health crises. The team's operational philosophy is rooted in the "guardian" model of policing, which emphasizes protection and service over control and arrest.
Operational Logistics and Visual De-escalation
A critical component of the MHIST strategy involves the psychological impact of police presence. To mitigate the stigma associated with mental illness and reduce the potential for escalation, MHIST officers utilize specific tactical adjustments: - Use of civilian clothing: By removing the traditional police uniform, officers reduce the visual triggers that can cause anxiety or fear in individuals experiencing psychosis or severe trauma. - Unmarked vehicles: The use of unmarked cars prevents the immediate associative alarm response often triggered by police cruisers, facilitating a more approachable environment for the individual in crisis.
Administrative and Staffing Composition
The MHIST has evolved from a small, self-funded pilot program into a robust multidisciplinary unit. Initially launched by the Chief of Police with a single sergeant and two officers, the program has expanded significantly to its current scale.
| Staffing Component | Current Quantity | Role and Function |
|---|---|---|
| Sergeants | 3 | Unit leadership and operational oversight |
| Officers | 21 | Specialized crisis response and investigation |
| Clinical Co-responders | 11-12 | Licensed mental health professional integration |
| Total Units | 3 | Dedicated team structures for city coverage |
The staffing model is characterized by a collaborative, holistic approach. All teams are housed within the same program to ensure that communication is seamless and that the transition from police contact to clinical care is immediate.
The Co-Responder and Deflection Models
Tucson employs a sophisticated layering of response teams to ensure that the level of intervention matches the specific needs of the individual.
Clinical Co-Responder Integration
The co-responder program pairs MHIST officers directly with mental health clinicians. This pairing allows for an immediate clinical assessment on-scene, which reduces the likelihood of unnecessary hospitalizations or arrests. The goal is to proactively and compassionately connect individuals to services before, during, and after the crisis event.
The Deflection Model and Peer Support
Beyond clinical professionals, Tucson has implemented a deflection model. This involves the use of peers—individuals who possess both Certified Peer Specialist (CPS) credentials and lived experience with mental health challenges. - Peer Integration: Peers co-respond with deflection officers to provide a relatable human connection that clinical professionals or officers may not be able to provide. - Housing First Model: Certain peers are specifically trained in the Housing First model and work in tandem with homeless outreach officers to address the intersection of homelessness and mental illness. - Professional Evolution: The program transitioned from a purely clinical co-responder model to include peers, acknowledging that the supervision and training requirements for peers differ significantly from those of licensed clinicians.
Training Requirements and Professional Qualifications
The efficacy of the Tucson model is dependent upon a rigorous, multi-tiered training infrastructure that extends across various departments.
Crisis Intervention Training (CIT)
The Tucson Police Department utilizes an immersion model for CIT, which is the gold standard for crisis response. - Duration: The training consists of a 40-hour intensive program. - Accessibility: CIT training is available to officers on a voluntary basis, though its principles have been instilled throughout the entire department by Chief Chris Magnus. - Co-responder Participation: Clinical co-responders are required to attend CIT training alongside officers to ensure a shared language and understanding of crisis management.
Specialized Training Tiers
Training is not limited to a single group but is distributed across the entire emergency response spectrum. - General Training: Mental Health First Aid (MHFA) and basic crisis mitigation training are mandatory for all officers and are also open to the general community. - Multi-tiered Access: Training is extended to call takers, dispatchers, emergency medical technicians (EMTs), paramedics, and firefighters. - Advanced Specializations: High-level training is provided for specialized units, including the MHST and SWAT Negotiators, to ensure that even high-risk tactical situations are handled with a mental health-informed perspective.
Co-responder Onboarding
Regardless of their clinical employment status, all co-responders must undergo a comprehensive orientation process to function within a police environment: - Police Academy Exposure: Co-responders attend orientation at the academy. - Technical Training: They are trained in the use of police radios, firearms, and emergency driving. - Clinical Integration: They complete the 40-hour CIT training to align their clinical skills with police protocols.
The Comprehensive Crisis Continuum
The MHIST does not operate in a vacuum; it is part of a broader ecosystem of care that includes immediate crisis lines, mobile teams, and stabilization centers.
Immediate Access Points (Crisis Lines)
Tucson provides multiple avenues for individuals to seek help without immediately involving law enforcement.
- Community Wide Crisis Line: (520) 622-6000 or 988 (Suicide Prevention Lifeline).
- LGBTQ+ Support: 1-888-843-4564 (LGBT National Hotline) and 1-866-488-7386 (The Trevor Project for those under 25).
- Domestic and Sexual Violence: (520) 795-4266 or 1-888-428-0101 (Emerge Crisis Line).
- Peer Recovery Support: (520) 770-9909 or (844) 733-9912 (HOPE, Inc. Warm Line, available 8am-10pm, 7 days a week).
Mobile and Facility-Based Interventions
The city maintains a physical and mobile infrastructure to ensure that once a person is identified as needing help, there is a place for them to go.
- Crisis Mobile Teams (CMT): These teams work in tandem with the crisis lines to provide continuous access to services, moving the point of care from the phone to the physical location of the individual.
- Crisis Response Center (CRC): Located at 2802 E District St., Tucson, AZ 85714, this center provides 24/7 emergency psychiatric and substance addiction treatment. It accepts both voluntary and involuntary admissions.
- Secondary Medical Facilities:
- University Medical Center (Main): 1501 N Campbell Ave, (520) 874-2000.
- University Medical Center (South Campus): 2800 E Ajo Way, (520) 469-8700.
- Sonora Behavioral Health (Northwest Hospital): 6050 N Corona Rd, (520) 873-3884.
Integration of Law Enforcement and the Justice System
A defining characteristic of the MHIST approach is the intentional overlap between criminal investigations and mental health support.
Diversion and Legal Protocols
The MHIST recognizes that mental health investigations often dovetail with criminal investigations. Rather than treating these as mutually exclusive, the team utilizes mental health diversions. This allows individuals to enter treatment programs instead of the traditional carceral system, provided the circumstances meet the criteria for diversion.
Special Population Protocols
The Tucson Police Department maintains specific General Operating Policies that cover investigative protocols for vulnerable groups. These policies ensure that when officers interact with special populations, the approach is governed by specific mandates designed to protect the rights and well-being of the individual.
Analysis of the Holistic Response Model
The Tucson model represents a transition from a reactive "intercept" model to a proactive "deflection" model. By integrating 21 officers, 12 co-responders, and a network of peers and social workers (including 8 additional social workers being embedded in the PD), the city is creating a safety net that prioritizes stabilization over incarceration.
The critical success factor in this system is the 24-hour treatment center. Without the existence of the Crisis Response Center (CRC) to take both voluntary and involuntary patients, the efforts of the MHIST and the co-responders would be negated, as there would be no clinical destination for the individuals they encounter. This synergy between the "street" (MHIST/Co-responders) and the "facility" (CRC/Medical Centers) creates a closed-loop system of care.
Furthermore, the move toward non-police-based responses is an ongoing objective for the city and state of Arizona. While current operations rely on the MHIST, the long-term strategy involves further decoupling mental health crises from law enforcement entirely, using the current co-responder model as a bridge to a fully clinician-led response system.
Conclusion
The Tucson Police Department's approach to mental health crisis response is a sophisticated integration of clinical psychology and law enforcement. By utilizing the Mental Health Investigative Support Team, the city has effectively operationalized the "guardian" mindset, shifting the focus from apprehension to diversion and stabilization. The success of this model is not attributed to any single component but rather to the intersection of several critical layers: the 40-hour CIT immersion training, the use of civilian-clothed officers to reduce stigma, the inclusion of peers with lived experience, and the existence of a 24/7 Crisis Response Center. Through this multidisciplinary community team approach, Tucson is advancing 21st-century policing by treating behavioral health crises as medical emergencies rather than criminal disturbances, thereby reducing the harm caused to vulnerable populations and improving the overall safety of the community.