Deliberative, affective, and experiential risk in crisis response: Fears of responders and people in crisis

<p>Mental health crisis response is diverse and evolving, with ongoing debate about outcomes for people in crisis, the appropriateness of different responses, and the role of police. Crisis encounters combine three forms of risk assessment: reasoned judgments (deliberative), emotional responses (affective), and gut feelings (experiential). This qualitative knowledge-to-action study consisted of interviews with 33 Canadian and American key informants in crisis response (e.g., responders and people with lived experience of crisis encounters). Interpretive phenomenological analysis was employed by a large and diverse coding team on data pertaining to shifting dynamics and experiences of risk. Findings address: a) the governing logic of risk in crisis response, as risks are triaged and translated yet remain subjective and uncertain; b) constant perceptions of risk in crisis encounters that shift based on the scene and mental health discourses; and c) a double-bind to police involvement, where responders fear risks to themselves and others on scene and seek security and stability in police but people in crisis fear police involvement. Risk moves from deliberative to experiential via affective emotions on the scene. This study identified sustained reliance on police by responders, even within civilian-led, non-police alternative crisis response teams. Police remain a form of first response, co-response, and backup or escalation support, heightening risk for people in crisis, despite focused efforts to de-task police from crisis calls.</p>