A call for better access for those in mental health crisis


To the Editor:

We have something on Martha’s Vineyard that people around the country have been clamoring for since spring of 2020: a police force ready, willing, and able to introduce a co-responder program, allowing mental health professionals to join the police on mental health calls. What we lack are mental health professionals ready, willing, and able to join them. Martha’s Vineyard Community Services has repeatedly declined requests to join police on calls, citing the housing crisis and a lack of staffing. People are falling through the massive cracks between the criminal justice system and the mental health system, and we have the power to change this.

As a defense attorney on the Island, I have seen officers (most notably from the Edgartown Police) doing what they can to try to de-escalate situations where someone is in crisis. Generally, even when there is probable cause that someone has committed a crime, officers will opt to bring suspects to the hospital instead of the jail, recognizing that mental health intervention will serve the individual and the community far more than incarceration. When someone is so mentally ill that they are a danger to themselves or others, the hospital has the ability to issue a “Section 12 hold”: an involuntary mental health hold until the individual can be transported to a locked psychiatric hospital. Though this process is far from perfect, it is the best option we currently have in situations like this. It is also dangerously underutilized.

I have lost count of the number of police reports I have received, starting with an individual clearly not in a right state of mind, and ending with “suspect was transported to the Martha’s Vineyard Hospital, where he underwent a mental health evaluation. It was determined he did not meet their standard for a Section 12 hold.” The underlying issue unaddressed, the person usually winds up back in court facing additional charges.

Though a Section 12 hold is involuntary, individuals can consent to them, and even alert healthcare professionals that they believe they are in need of such a hold. Even these individuals, begging for help, are often turned away, being told that they do not meet the hospital’s standard for a Section 12 hold.

I join the cry of many asking for increased resources on the Island: in this case, increased mental health services. It is my understanding that the current process at the hospital to evaluate individuals for a Section 12 hold involves a short Zoom call with a clinician off-Island. The hospital has minimal space to hold individuals pursuant to Section 12, and even fewer staff specializing in working with individuals in active psychosis. The end result is unfair to the hospital staff, unfair to the patient, and unfair to the community: In the event someone actually is held pursuant to Section 12, emergency room nurses are expected to do the job of a psychiatric nurse while an off-Island bed is found, leading to dangerous situations for staff and an increase in criminal prosecution of the severely mentally ill who seek help from the hospital.

Massachusetts has long been a leader in social justice. It is not often that the goals of police departments and defense attorneys align, but on this I join Edgartown Chief Bruce McNamee, who has been sounding the alarm on this problem for years: I urge everyone to support a co-responder program for police and mental health professionals, and I urge everyone to support an increase in mental health staff and services at the hospital. When people in crisis receive necessary treatment and are stabilized, it creates a safer and better community for all. We have some wonderful Island healthcare professionals who respond to calls when there is a substance abuse crisis; we need similar professionals who will respond when there is a mental health crisis.

There are of course many challenges to achieving this, most glaringly the lack of attainable housing on the Island. But this must be a top priority for the Martha’s Vineyard Hospital and Martha’s Vineyard Community Services. It already is for the Edgartown Police. I urge everyone to voice support for a co-responder program and increased mental health staffing and resources for the Island.


Casey J. Dobel