Methods: We analyzed clinician reports from 4,252 co-responder encounters between January 1 and December 31, 2023. After each encounter, clinicians indicated one of the following primary outcomes: recommended/referred to involuntary services (e.g. psychiatric hospitalization), recommended/referred to voluntary services, provided information about mental health services, or resolved on-scene. Individuals serviced were 33.1% non-Hispanic Black, 22.7% non-Hispanic White, 13.2% Hispanic, 4.8% another race or ethnicity, and 26.3% unknown.

Results: Approximately half of co-responder encounters resulted in a recommendation/referral for involuntary (20%) or voluntary psychiatric services (27%). One-third of encounters ended with clinicians providing information about mental health services, and 19.6% were resolved on-scene. White and Hispanic individuals were less likely than Black individuals to be recommended to involuntary services (OR=0.73, 95% CI: 0.69, 0.90; OR=0.65, 95% CI: 0.51, 0.83). Additionally, Hispanic individuals were more likely than Black individuals to be recommended or referred to voluntary care (OR=1.41, 95% CI: 1.13, 1.76). Encounters with White individuals were more likely to result in the provision of information than encounters with Black individuals (OR=1.22, 95% CI: 1.02, 1.44).

Conclusions: We found significant racial and ethnic differences in primary mental health treatment outcomes in co-response. These findings may reflect differing population needs within one urban area, police or clinician bias during evaluation and decision making, or individual factors including socioeconomic status and health insurance. Further research is needed to understand the cause of racial and ethnic differences and whether intervention efforts toward racial equity are warranted.