Guest post by Jennie Simpson, a Public Health Analyst in the Office of Policy, Planning, and Innovation at the Substance Abuse and Mental Health Services Administration, the US Department of Health and Human Services, where she supports the coordination of SAMHSA’s agency-wide criminal justice portfolio and provides subject matter expertise. This post is the third installment of Border Criminologies’ themed week on the Anthropology of Police organised by Paul Mutsaers.

There are two DCs: the gritty city―the side of DC that most people don’t know amidst the clamor and loudness of politics and posturing―and the city as capital of the United States. Stark inequality separates these two DCs: the Washington, DC of politics and deadlines and the city of Washington, DC, where I’ve spent near the last decade working between the borders of a fractured behavioral health system and an ever expanding criminal justice system.

In my liminal DC, which is both field and home, my work fits now in the realm of policy. As I’ve done over the last decade, I cross boundaries daily: now as an anthropologist and policy analyst as well as in my work that focuses on the macro-level intersections between behavioral health and criminal justice. Crossing these borders entails understanding how gatekeepers, collaborators, and policymakers drive decisions made at the federal, state, local, and individual levels.

© Jennie Simpson
In fieldwork conducted in Washington, DC from 2008 to 2010, I explored how homeless individuals with mental health and substance use disorders entered the criminal justice system via their interactions with police officers. These interactions were situated in the context of history, the political economy of Washington, DC, and the current wave of gentrification. What emerged was a complex architecture of gatekeepers who facilitated the entry of individuals into the behavioral health and/or the criminal justice systems; collaborators that mediated, supported, or contested the decisions of gatekeepers; and policymakers that smoothed the routes taken into either system. As I’ve moved professionally from researcher to expert technical assistance provider to policy analyst, these roles continue to be found in my work, in different forms, at different levels, but still infused with power, inequality, and social stratification. In this post, I explore how borders between research, policy, and practice are crossed, contested, and guarded.

Gatekeepers: Policing the New Downtown

One of the most painful recountings in my research came from a guest at the [mental health] drop-in center who had his morning breakfast at So Others Might Eat (SOME), an organization serving the poor and homeless, many with mental and substance use disorders. He described how one officer regularly sat outside SOME. ‘Sometimes he’ll come in and ask for ID, punch it into the computer and see if someone has warrants. People are scared to eat in the morning.’ – Personal fieldnotes

Sometimes the police know you in the neighborhood as being homeless and they know you’re mentally ill, most of them will take you to detox and CPEP [District of Columbia Comprehensive Psychiatric Emergency Program]. Like, instead of taking you to jail. – Research participant

Opportunities and outcomes are the purview of gatekeepers. Who goes home, who goes to jail, and who gets sent to a hospital or emergency psychiatric program falls in the discretion of police officers. Are these decisions fair or informed? And what influences these decisions?

In Washington, DC, homeless individuals first started to appear in large numbers in the late 1970s due to the loss of affordable housing, gentrification, and the lack of employment opportunities. Significant numbers of individuals with mental illnesses were also showing up in shelters and on the streets, linked to the court-mandated depopulation of St. Elizabeths Hospital, a then federally-run mental hospital in southeast DC, inadequate community outpatient care, lack of social support programs and benefits, and a shortage of low-cost rental units and transitional housing. This mirrored similar happenings in cities across the United States, as a confluence of economic and sociopolitical forces in the late 1970s and early 1980s created a context amenable to an increase in the number of people with mental illnesses―many often homeless―in contact with law enforcement and subsequently, the criminal justice system.

For police officers in the downtown core of Washington, DC, demands from the business community, new residents, and city elite were considerations in the execution of their daily activities, including their interactions with homeless individuals. Officers articulated the pressure they felt from these groups to ‘move-along’ or ‘do something’ about the homeless, yet recognized they had a responsibility to all members of the community. As one officer noted:

It’s a tough situation. You have to make two worlds happy at the same time and you end up choosing the lesser of two evils. So you just make the person move. It’s a catch 22- we have to solve their [businesses or residents] problem because that’s the problem the chief of police will listen to.

Homeless outreach workers and behavioral health providers in the downtown began to partner with police officers as mediators in these demands. They became key conduits through which officers could divert individuals from official police actions into the behavioral health system. But these partnerships were informal and not officially recognized. They operated as a simple bridge and safe passage between the criminal justice and behavioral health systems.

Collaborators: Supporting BH/LE Collaboration

Where is home? Today, it is a town spun off a highway that continues across state lines; last week, an expansive city that stretches for miles. The problems are the same here as they always are: how can a police department, with less than a hundred officers, reduce the number of individuals with behavioral health issues from entering the criminal justice system? How do all the pieces fit: police, behavioral health providers, local agencies and state laws? How can these entities collaborate in their community? What I know is that no matter the place, issues of public space, inequality, transience, underfunded services and scarce resources dominate the conversation. – Personal fieldnotes

© Jennie Simpson

From 2011 to 2013, I provided technical assistance to police agencies implementing a specialized model to respond to individuals with mental and substance use disorders in communities throughout the United States. In every town or city I visited, I sat with police and behavioral health treatment providers to explore the needs of their communities, problem solve, and create plans that would bring together two systems―with divergent policies, practices, and missions―in an effort to reduce the number of individuals crossing their borders. Community to court to jail or prison to community. With housing, without housing. With treatment resources, and without. The crossings are exacerbated by a lack of rights―to housing, to health care, to food. And always, the goals and outcomes of these systems will never be the same, although they serve the same individuals. Although individuals with mental health and substance use disorders have complex behavioral health needs that should be addressed by health care and supportive services, the criminal justice system shores up the lack of resources to address those needs. And so, people with mental and substance use disorders continue to cross back and forth, between systems, between communities and carceral institutions, across the chasms of needs and resources.

Policymakers: Crossing the Borders of Analysis

Knowing the gatekeepers and collaborators―and those crossing the borders―has led me to work in policy. At the macro-level, I see how movements in one system cause reverberations in the other. And each system is interconnected with many other systems. The web becomes complex. It challenges me to think concretely and yet expansively, because mental illness, substance use, homelessness, race and poverty cross so many borders: structurally, systemically, and socially. It is here that a public anthropology of policing informs my work in policy. Understanding the role of history, community relations, political economies of localities, the frontline practices of police officers and behavioral health providers, and the interconnectedness of these forces underlying the operations of systems are key analytical lenses that move forward policy activities on criminal justice, law enforcement, and behavioral health forward. Scaling up from the micro to macro level allows the intimacy of qualitative data from my fieldwork and the multi-site experiences of technical assistance to think holistically of the borders, boundaries, and crossings undertaken everyday by a multiplicity of actors working in the criminal justice and behavioral health systems.

Note: The opinions expressed in this piece are the author’s own and do not necessarily reflect the views of the Substance Abuse and Mental Health Services Administration, the Department of Health and Human Services, or the United States government.

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How to cite this blog post (Harvard style):

Simpson, J. (2016) Gatekeepers, Collaborators, and Policymakers: Crossing the Borders of the Criminal Justice and Behavioral Health Systems in the United States. Available at: (Accessed [date]).