Restructuring Crisis Response Programs as Civilian-Led: A Scoping Review

Civilian-led crisis response teams provide emergency mental healthcare for individuals in acute distress in community settings, often without the involvement of police as first responders. These models represent one of several emerging alternatives to police-led crisis response and have gained attention for their potential to improve safety, trust, and care outcomes. Reports included in this scoping review discussed: the development, need, potential, implementation, and outcomes of civilian-led crisis response models. Covidence software was utilized by two independent reviewers to search 11 databases, with a third reviewer resolving conflicts. A dataset of 46 reports were then analyzed with thematic content analysis by a multidisciplinary team using critical theories to offer an exploration of how civilian-led crisis teams have begun to address the harms of policing responses to mental health. In exploring the key processes for civilian-led crisis response teams, three themes emerged. The first theme, Decentering Police, explores the growing collective awareness of the harms associated with police-involved crisis intervention and the corresponding need for alternative approaches, alongside efforts to establish a team composition that is intentionally distinct. The second theme, Team Scope of Practice, explores the subthemes of dispatch logistics and defining criteria for response. Team Sustainability is the third theme and explores how social and political will shape the uptake and long-term operation of civilian-led crisis programs.