Policing and care in mental health crisis response: boundary work and the politics of safety and authority

  • Mark D. Fleming*
  • , Dani MacVicar
  • , Aoife M. McDermott
  • , Amanda L. Brewster
  • *Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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 languageEnglish
Article number118982
Number of pages9
JournalSocial Science & Medicine
Volume393
Early online date17 Jan 2026
DOIs
Publication statusPublished - 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.

FundersFunder number
Agency for Healthcare Research and QualityK01HS027648
Blue Shield of California FoundationCOV-2206-18200
UC Berkeley Society of Hellman Fellows Fund

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