We Cannot Keep Waiting for Crisis: Why Mental Health Reform Is Public Safety Reform

A recent interview on Newsmax with former Congressman, mental health advocate, and NSSC Policy Advisor Dr. Tim Murphy put into words what families, clinicians, law enforcement officers, and advocates have long known: America's mental health system too often arrives only after tragedy.

The pattern is familiar. A person shows escalating signs of psychiatric crisis. Family members plead for help. Systems respond that intervention thresholds have not been met. And the public conversation begins only after an arrest, a hospitalization, a violent encounter, or a death.

We keep asking the wrong question.
Not: How did we miss the warning signs?
​But: Why do we keep building systems that require catastrophe before they respond?

A False Choice Between Liberty and Care

For decades, mental health policy has been shaped by a tension between civil liberties and intervention standards. Protecting individual rights matters — deeply and non-negotiably. But somewhere in that debate, America created a false choice between liberty and care.

Families describe the same cycle, in city after city. A loved one begins deteriorating. Paranoia sets in. They withdraw from treatment or lose insight into their condition. Family members call hospitals, crisis lines, providers, and law enforcement. The answer is almost always the same — nothing can be done until the person poses an imminent danger to themselves or others.

By then, the only systems available are the least therapeutic ones.
Emergency rooms. Jails. Police encounters. Courtrooms. Prisons.

That is not a treatment system. That is crisis containment. And crisis containment is extraordinarily expensive — financially, morally, and in human lives.

Systems That Inherited a Problem They Were Never Designed to Solve

Police departments did not volunteer to become the nation's primary mental health responders. Correctional facilities did not design themselves as treatment centers. These institutions inherited a role created by the collapse of every upstream system that should have acted first.

The consequences are predictable. Officers encounter people in acute psychiatric crisis under dangerous, high-pressure circumstances with few good options. Emergency departments cycle individuals through short-term stabilization with no continuity of care. Families exhaust themselves navigating fragmented systems while advocating for people who cannot always advocate for themselves. Communities watch the same crises repeat, year after year.

And then we act surprised when incidents like the shooting in Cambridge (MA) or the Subway Shoving (New York City) a few weeks ago happen.

This is not a failure of individuals. It is a failure of design.

Untreated severe mental illness frequently intersects with homelessness, repeated emergency room use, family destabilization, victimization, and justice-system involvement. Law enforcement officers increasingly function as de facto first responders for behavioral health emergencies — a role they never trained for and were never meant to carry. The downstream impact reaches every corner of society, and the cost is measured not only in dollars but in lives derailed, families fractured, and communities left managing preventable crises without adequate tools.

What Earlier Intervention Actually Requires

If the goal is genuinely reducing criminal justice involvement, focusing on what happens after police contact is far too late. Prevention requires moving intervention upstream — before psychiatric crisis becomes a criminal justice event.

That means rethinking several long-standing assumptions.

Treatment systems must prioritize earlier action rather than waiting for deterioration to cross emergency thresholds. Delayed care rarely produces easier recoveries. It produces more complicated ones, and more suffering along the way.

Families must be recognized as partners, not obstacles. Relatives who witness obvious decline are too often excluded from systems they are simultaneously expected to support. That exclusion is both clinically counterproductive and morally indefensible.

Continuity must replace the revolving door. Short-term stabilization without sustained treatment planning simply returns people to the same conditions that produced the crisis in the first place. Cycling individuals through emergency departments and inpatient units without long-term care coordination does not treat illness — it manages symptoms until the next crisis arrives.

Healthcare and public safety systems must stop operating as parallel structures that rarely communicate. Coordinated crisis response, diversion pathways, data-sharing, and community partnerships are not aspirational add-ons. They are preconditions for meaningful reform.

Every preventable psychiatric crisis that becomes a law enforcement incident reflects a missed opportunity somewhere upstream and closing that gap requires these systems to work together rather than in isolation.

Compassion Is Not Waiting

There is a persistent misconception that intervening earlier somehow threatens individual dignity or autonomy. It does not — if the intervention is built on care rather than control.

Compassion is not standing by while someone deteriorates to the point of homelessness, incarceration, or irreversible harm. Compassion is not waiting for a loved one to become a danger before the system will acknowledge their suffering.

​Compassion is building systems capable of recognizing pain before it becomes a catastrophe — and responding with treatment, support, and dignity rather than handcuffs and holding cells.

Public safety and mental health are routinely treated as separate policy conversations. They are not. Every family left without options represents a systems failure. Every justice-system encounter rooted in untreated illness should force the same question: what should have happened months or years earlier, and why didn't it?

The goal is not coercion for its own sake. The goal is a national standard of care that values timely treatment, family partnership, sustained recovery, and human dignity — one that measures success not by how efficiently we manage crisis, but by how rarely crisis becomes the only option left.
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Because if America keeps waiting for a crisis before offering care, we should not be surprised when a crisis is exactly what we continue to get.

WATCH TIM MURPHY'S INTERVIEW

Author

Carmen Facciolo, Senior Vice President of Clinical and External Affairs, National Shattering Silence Coalition