A Department of Community Safety: Theory Meets Practice

Walking through Penn Station last year with my kids, I had an experience that captured exactly what Mamdani’s proposed Department of Community Safety could address — and what it could easily miss.

A disheveled man who had been sitting near a pile of dirty belongings and empty White Claw bottles stood and began weaving unsteadily down the concourse, then collapsed onto the floor. As fast as a school of fish, the commuters and tourists opened a wide circle around him. Many stopped to watch, uncertain of what to do, looking towards a nearby MTA employee in a vest who managed with admirable economy of gesture to convey the twin messages “I’ll call someone” and “this is not my job.” I felt that uneasy mix of recoil and concern that so often haunts you in New York, followed by a sense of relief, because I did have something I could do. We happened to be at Penn Station with Ben, a family member who is a psychiatrist with emergency medicine training who specializes in working with very high need patients at a mental health hospital. He was farther down the platform, so I called him and asked him to come back. He cut quickly through the circle of onlookers, knelt down at the man’s side, and began gently asking him questions. Ben had helped him into a seated position by the time the police arrived. 

The moment I remember most clearly is when the police began questioning the man: Where had he been last? Had he had treatment somewhere? Stayed somewhere? Blurrily, the man began unclasping his pack. Stop, the officers snapped, voices hardening. Put your hands up NOW. Don’t touch your bag. Confused, he mumbled and tugged at the clasp. The officers’ hands went to their belts, and the circle of tourists tensed and shuffled back. 

Then Ben said very calmly, “Can I get it for him?” An officer nodded tersely. Ben leaned over, voice steady and warm. “Sir, can I get something from your bag for you? I’m going to open it, ok? I’m going to reach in — is it this piece of paper? Yes? Ok, I’m showing it to them. I’m putting your bag down over here.” 

The crumpled paper had the name of a clinic scrawled on it — the answer to one of the officer’s earlier questions. Then the encounter diffused into routine and the tourists drifted away. Ben stayed until the EMTs arrived with a stretcher, said goodbye to the man, and handed a brief synopsis of his observations over to the medical team. (Heavily intoxicated. Notice the scars and wounds on the back of his head. He’s fallen many times before. Possibly seizures that he’s self-medicating for or that the alcohol use is triggering, a deadly cycle to be caught in.)  

This type of interaction — where someone with training in mental health and substance use disorders resolves a situation where the traditional tools of policing are not the right fit — is the heart of the vision for alternative emergency response, which sends teams of unarmed civilian responders to a subset of 911 calls in lieu of police. Mamdani has proposed creating a new Department of Community Safety that would house a set of new and expanded services, including a citywide expansion of the city’s alternative response B-HEARD program, mobile response teams and service provision in subways. He has argued that it would make it so that “no longer must police respond to every single failure of the social safety net.” This will be better for the cops, he says, who are now burdened with problems far beyond their remit — and it’ll be better for mentally unstable individuals, who need the help of clinicians and social workers, not people who carry guns.

He’s not wrong, but if these programs are going to be more than another add-on to an already fragmented service array, he’ll need to design a department that provides something existing ones don’t.

My organization, the Government Performance Lab at Harvard, works with dozens of cities across the U.S. that are establishing or expanding alternative response programs and runs a community of practice with over 400 government practitioners across the country, from 911 call center directors to fire chiefs, police chiefs and alternative response team leads. We have helped cities design and launch alternative response programs from Texas to Pennsylvania to Los Angeles. Mamdani is right that these programs can divert thousands of calls, that the calls can be safely answered by community responder teams and that the best evidence we currently have suggests that civilian response can decrease criminal legal system contact, possibly by replacing arrests with pathways to mental health and substance use treatment. 

But alternative response programs like the ones that the mayor-elect is describing are not a stand-alone solution to mental health and homelessness. They are simply a type of emergency response, one that ideally provides compassionate, trained care to help ensure that a moment of urgent need is less likely to escalate further. In Vital City’s public safety mayoral candidate event and in his debates, Mamdani has focused his descriptions of a new Department of Community Safety “that tackles the mental health crisis and homelessness crises head on” on alternative response programs such as CAHOOTS (Eugene, Ore.) and B-HEARD (in New York). But community responder teams do not provide long-term treatment for mental health and homelessness any more than EMTs provide ongoing care for cardiac health after responding to a heart attack. To address deeper underlying concerns, crisis responders must be able to bridge folks in crisis through to intensive case management and ultimately to services — benefits, housing with supports for people with acute needs, inpatient or outpatient care, supports for obtaining and staying on medication. 

The “mental health” section of Mamdani’s Department of Community Safety proposal also name checks expanding the city’s network of community mental health workers, mobile crisis units and some voluntary programs, including peer clubhouses and respite centers. But the City already spends billions of dollars a year on mental health and homelessness services that are administered by large, established agencies. In order to justify the monetary and bureaucratic costs of adding another agency, a newly formed Department of Community Safety would need to offer more than duplication of existing efforts under a new name. It would need to bridge three siloed domains — criminal justice, housing and homelessness, and mental health — and provide consistent cross-agency accountability for outcomes for individuals experiencing severe mental illness and homelessness. A Department of Community Safety would offer something new and needed only if it could take responsibility for the highest-need individuals in the city, create stronger accountability for outcomes using frontline data from 911 and other sources and create a unified pathway across currently disconnected systems. 

For one example of how a new community safety department could align its programs to address mental health and homelessness, look to Durham, N.C. Durham is, of course, much smaller than New York City, but is one of the few jurisdictions in the country that has established a Community Safety Department that functions as a peer to its law enforcement agency and is funded through general funds rather than short-term grants. What can New York City learn from its experience? 

In most jurisdictions, there are three types of emergency response: for fires, the fire department; for medical emergencies and transport to the hospital, EMS (and sometimes fire); and for all else, police. Alternative response takes the “for all else” category and breaks it down more granularly, saving police for calls that have a closer nexus to public safety, calls that involve violence or high risk of violence, weapons and so on. In July 2021, Durham created its Community Safety Department (DCSD) as a distinct municipal entity designed to rethink how the city responds to public safety and wellness needs that fall outside the traditional “police/fire/EMS” buckets. Structurally, DCSD sits alongside the city’s police and fire departments as a co-equal part of the city’s safety infrastructure that reports directly to city leadership. Its 911 response, stabilization programs and housing resources work in concert to provide both an immediate safety net and a feedback loop to inform broader system reform. Deep investment in data gathering and continuous learning enable DCSD to track patterns in emergency service utilization, recurring crises and unmet behavioral health needs.

DCSD’s core program is called Holistic Empathetic Assistance Response Teams (HEART). Launched in 2022, HEART comprises multiple units: a Crisis Call Diversion unit placing mental health clinicians in the 911 call center; unarmed Community Response Teams dispatched to nonviolent behavioral health and quality-of-life calls (similar to B-HEARD); and co-response teams pairing clinicians with specially trained police officers for higher-risk situations. These solutions are seen as different tools in the city’s toolkit, allowing the city more nuanced and tailored responses to crises. 911 call dispatchers are trained to differentiate whether a call merits hand-off to a clinician over the phone, a co-response team (officer and behavioral health specialist) or the Community Responder Team. Critically, these crisis teams then hand off to in-house follow up teams that help connect residents to longer-term help. 

Over time, DCSD began to notice that a disproportionate number of 911 calls were about a small subset of especially acute individuals in the city. These are residents struggling with chronic homelessness and severe mental illness or substance use disorders. Ryan Smith, the founder and director of Durham’s Community Safety Department, says that working with this group of residents in need has revealed how fragmented traditional care systems are and how the current system of services can fail the most vulnerable residents. “Because we take the 911 calls, we know what’s actually happening on the street and we take responsibility. A lot of these systems of care and support — they have an out. If someone is too hard to work with, they kick them out of their program, discontinue them for being non-compliant. A community safety department is a structure that realizes that government shouldn’t do that, can’t do that. We’re going to keep showing up. We’re not going to give up on you.” The hardest people to serve bounce in and out of city services, showing up in jails, shelters and emergency rooms. These are the individuals most likely to be dropped in the complex coordination and handoffs between existing city services, or to be discontinued by a provider for failing to show up or comply with program requirements. 

Mamdani shouldn’t lose sight of this. A Department of Community Safety can reorient government to better address the problems of people who are struggling on the streets and subways only if it has a relentless ownership for the individuals it serves and has the mandate and ability to improve the way criminal justice interventions, homelessness and housing services and mental health resources are dispensed. 

Rather than simply creating another layer of navigators whose job was to conduct hand-offs to other program, DCSD built Familiar Neighbors, a team responsible for seeing these high-needs individuals through their entire journey from street contact to placement in housing and care. With caseloads as low as three to four clients per caseworker, the Familiar Neighbors team takes a persistent, relational approach, meeting people daily or even multiple times per day, accompanying them to appointments, securing IDs or benefits, working to build the trust to move towards housing and treatment.They do not disconnect once they enroll them with a social services provider, ensuring continuity across multiple handoffs. This relentless (and time intensive) engagement, while still small in scope, has helped some of Durham’s most troubled residents move from years of homelessness in the downtown business district into permanent supportive housing. But the persistent focus and ownership of the problem has also revealed structural gaps that prevent people from moving from the streets into housing and care — document processes that take over 50 days, missing referral pathways into housing or hospital services. Ryan notes that because DCSD is on the frontline of responding to 911 calls and then trying to move neighbors from crisis through stabilization and into treatment and housing, its work generates insights that can reshape how an entire city organizes care for its most vulnerable residents. 

This shows up in the way that DSCD designed a new involuntary committal team that can do involuntary committal assessments in the field. In North Carolina, any individual, including family members and clinicians, can petition a magistrate to initiate an involuntary commitment if someone appears to be at risk due to mental illness. Typically, the police are tasked with finding the individual and transporting them to the hospital, often in restraints, where they will be examined. However, these examinations often result in denials of involuntary committal, meaning that the transport was a waste of police officer and medical specialist time as well as traumatizing to the resident. To improve the process and experience with involuntary committals, DCSD created an in-house Involuntary Commitment Response Team. The DCSD involuntary committal team is staffed with certified first examiners who can conduct the initial steps of the assessment in the field. This approach has allowed the city to reduce the use of restraints and police transport when unnecessary and provide a more specialized, compassionate approach when a committal is merited. While Mamdani’s goals to minimize the use of involuntary committals are laudable, he still needs a plan for how to support and integrate those types of intensive interventions alongside crisis response and long-term supports.

Ryan told me, “One of the most touching things I’ve received in this role has been emails from parents who are in the heartbreaking position of having to make multiple involuntary commitment calls on their child. They’ve told me, ‘This is always a devastating thing to do, but this was the best experience we’ve ever had. The way your team responded, their knowledge and compassion made a huge difference in an experience that is usually terrifying and traumatic. One mother wrote to us recently, saying, ‘This is the seventh IVC experience for my son and myself and it was, by leaps and bounds, the best IVC experience I have had. This program has been so needed for so very long (my son and I have been navigating the system for 15 years) and I am so appreciative of your presence in our community! You all fill a vital need in this community.’”

DCSD leaders saw this shift in perspectives not only from residents but also from officers. When I asked what he’d want a mayor building a new department to know, Ryan said, “People are going to talk about resistance and skepticism from law enforcement, But I’d want a mayor to know that can change, even faster than you think possible. We partnered with law enforcement from the beginning. There was a lot of skepticism. One of our sergeants described the feeling in the police department as ‘darn close to 100% that this was a bad idea.’ We did surveys of our law enforcement partners. Just 37% of officers thought HEART would be helpful on mental health calls initially. But that number had risen to 67% after one year. I thought that kind of mindset shift would have taken longer, but we saw significant shifts in just a year. We were on the radios together, they saw our teams going out, taking work off of them, being active in the community. Increasingly, officers are asking for us to go to more calls. They see it’s something that’s making their job better.” Is the program perfect? Of course not. But when launching an ambitious new department, New York should learn from others who have done similar work. Much of Durham’s success in establishing and expanding its Community Safety Department has come from creating a strong through-line between its crisis response teams, follow up care navigators and intensive case managers for its highest acuity individuals; working in close collaboration with its community, law enforcement and 911 call dispatchers; and building in real-time data-driven improvement. 

One vision for better crisis response could be what I experienced in Penn Station: a responder with training in mental and behavioral health averting a potentially disastrous encounter with law enforcement and enabling a smooth handoff to care. But unless that man we met in Penn Station was connected to intensive follow-up, he may have ended up right back in Penn Station the next day. Mamdani should invest not only in the front door of compassionate crisis response, but, more importantly, in the clear ownership and accountability to stick with someone after crisis through stabilization, treatment and housing placement.