Abstract
Demands for alternatives to police responses to mental health crises have driven significant transformations in the frontlines of emergency care. This ethnographic study (2022-2025) analyzes how the boundaries between policing and behavioral health have been negotiated, contested, and reconstructed during the implementation of a large-scale crisis response initiative in California, USA. Taking an ethnographic approach, we demonstrate how boundary work among law enforcement, behavioral health professionals, and organizational leaders unfolds through intertwined dynamics of competition, collaboration, and reconfiguration. Our findings highlight how boundary work is embedded within broader socio-political contexts shaped by advocacy for racial justice, critiques of police violence, and demands for systemic reform. Specifically, we reveal how the frontline enactment of crisis response is characterized by ongoing negotiations around authority, legitimacy, safety, and care, reflecting and reshaping political and ethical debates on criminalization and police reform. This paper contributes to boundary work theory by illustrating how professional and institutional boundaries are dynamic sites of dialectical engagement that both respond to and actively shape contemporary struggles around race, violence, mental health, and justice.
| Original language | English |
|---|---|
| Article number | 118982 |
| Number of pages | 9 |
| Journal | Social Science & Medicine |
| Volume | 393 |
| Early online date | 17 Jan 2026 |
| DOIs | |
| Publication status | Published - Mar 2026 |
Bibliographical note
Copyright © 2026, Elsevier Ltd. This accepted manuscript version is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International https://creativecommons.org/licenses/by-nc-nd/4.0/Funding
This research was supported by grants from Blue Shield of California Foundation (##COV-2206-18200), the UC Berkeley Society of Hellman Fellows Fund, and grant number K01HS027648 from the Agency for Healthcare Research and Quality.
| Funders | Funder number |
|---|---|
| Agency for Healthcare Research and Quality | K01HS027648 |
| Blue Shield of California Foundation | COV-2206-18200 |
| UC Berkeley Society of Hellman Fellows Fund |
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