Mental Health Professionals Together With Paramedic First Responders, Not Police, Decrease Nonviolent Crime Rates

Researchers looked at whether a program with health-focused first responders reduced less serious crimes.

A program with health-focused first responders reduced less serious crimes by over a third, according to results of a study published in Science Advances.

In Denver, Colorado, the Support Team Assistance Response (STAR) program was launched in June 2020 as a 6-month pilot study. Each STAR team comprised a mental health clinician and a paramedic in a specially equipped van.

They provided rapid, onsite support to individuals in crisis who were identified through 911 calls in 8 of the 36 Denver precincts. The program operated Monday to Friday, 10 am to 6 pm. The efficacy of the program was evaluated by comparing targeted crimes (eg, trespassing, public disorder, resisting arrest) before and after the program’s launch and during and outside the program’s operating hours and range.

The STAR program was associated with a 34% reduction in targeted crimes (β, -0.41; P <.001). The STAR program was not associated with a reduction in nontargeted crimes (β, -0.05; P =.245), indicating that more serious crimes did not increase when mental health professionals intercepted individuals in crisis rather than the police.

The investigators evaluated whether these effects were due to seasonal trends in crime rates. Comparing STAR trends with December 2016 to November 2017, December 2017 to November 2018, and December 2018 to November 2019 confirmed the significant drop in targeted crimes as a result of the STAR program intervention.

Furthermore, similar findings were observed in comparisons between STAR-active and STAR-inactive time periods and between STAR-active and STAR-inactive precincts.

Overall, the police categorization of crimes indicated the STAR program decreased overall crime by 14% during the 6-month pilot period.

These findings may be associated with some unique aspects of the study site and should be replicated in other urban and rural areas in the United States.

This study found that a pilot program of dispatching a mental health clinician and a paramedic in lieu of the police to targeted, less serious crimes resulted in a 34% decrease in these crimes and a 14% decrease in crimes overall. These findings have the potential to address the financial, social, and violent outcomes that come from dispatching police to low-priority, mental health crisis events.

We spoke with Thomas S. Dee, Senior Fellow at Stanford Institute for Economic Policy Research about this study.

Can you explain the motivation behind the STAR program?

This is really a common sense innovation. Most police officers report that they’d rather not deal with mental health and substance abuse calls in the field and don’t feel prepared to do so. Others agree that the presence of a police officer on such calls can unnecessarily escalate these incidents, sometimes tragically so.

Were you surprised by how effective STAR was at reducing targeted nonviolent crimes?

Given the sensible nature of the STAR program, I wasn’t surprised. But the fact that the effect was so large and so immediate was striking. These targeted crimes dropped dramatically in the first month the program began operations.

Why do you think the STAR program was so effective? What unmet needs does the STAR program tackle that police are not able to address?

The underlying need in these nonviolent emergency calls involves health care. So, sending health care professionals allows us to address the real need and, through that, to reduce future crimes.

Do you think the STAR program can be replicated to other cities or rural areas?

The successful replication of a promising pilot is always an open question. However, I think these findings should strongly encourage other communities to take this innovative approach.

How do you think the STAR program can be improved?

I can’t see how it is possible to have asked a pilot program to have performed much better. However, whether Denver is able to successfully take this program to scale across the city is an open question.

What are the important take-home messages from this pilot program?

There are 2: One is that the program is not just highly effective. It also appears to save money. The program has quite low costs. And directing these calls to health-based first responders and reducing crime rather than sending these cases through the criminal-justice system is highly cost-effective. Second, the future adoption of this innovation should also benefit from a rare political consensus. Whether you are “Back the Blue” or “Defund the Police” there is a lot for you to like about this first-responder approach.


Dee TS, Pyne J. A community response approach to mental health and substance abuse crises reduced crime. Sci Adv. 2022;8(23):eabm2106. doi:10.1126/sciadv.abm2106