Leesa Topic has spent more than a decade campaigning for changes to Australia’s mental health response system after her daughter, Courtney, was shot dead by police during a mental health crisis in 2015. “Our family’s forever broken,” she told Farrago, arguing the consequences of police-led responses to such crises are ongoing for families like hers and for others who continue to encounter the same system.

Eight years later, Jesse Deacon, a 43-year-old man in public housing in Glebe, was in the grip of an acute mental health breakdown when his neighbour called triple zero and asked for an ambulance. Police arrived first, forcibly entered his home and shot him dead.

In January 2026, a 49-year-old man on the New South Wales Central Coast was shot dead by police after a welfare check escalated into a six-hour siege. Officers had attended over concerns for his wellbeing, but the situation deteriorated and he was shot during a confrontation.

Mental health crises are both common and increasing in Australia. One in five Australians experiences a mental health episode each year and demand for acute services has consistently exceeded capacity.

Victorian police are responding to roughly one mental health crisis every 10 minutes, having received 54,400 callouts in 2023 – 24, an increase from 43,000 or a call every 12 minutes in 2017 – 18. 

In the absence of a dedicated mental health pathway within the triple zero system, crises are routinely routed through law enforcement. This places distressed individuals in contact with responders primarily trained in control and public order rather than clinical support and de-escalation. 

At the same time, chronic underfunding of community-based services limits early intervention, meaning many individuals only enter the healthcare system once they reach crisis point. 

Failures Upstream are Causing Consequences Downstream

Leesa Topic’s experience illustrates the human consequences of a system shaped by access barriers common to families without private health insurance. Her daughter, Courtney, had lived with anxiety, depression, ADHD and Asperger syndrome since childhood. 

Lessa explained that her time navigating the healthcare system to find treatment and support for Courtney—who was experiencing mental health distress, but not yet a crisis point—was extremely frustrating.

“You've got to wait three to six months for a hospital or a psychiatrist, or you get admitted to hospital and they keep you there for a day and say, ‘All right out on your own then,’” she said. 

A recent study published by The BMJ found that the average wait time for teens to see a treatment provider for anxiety and depression is 99.6 days. 

On 10 February 2015, police responded to a call-out made by community members concerned for Courtney’s welfare as she was seen walking with a kitchen knife in hand near a fast food outlet. 41 seconds after officers arrived, she was shot in the heart.

“There was no assessment, no de-escalation, nothing,” Leesa said. “41 seconds. That’s all her life was worth.” Her account reflects a broader trend in which rapid escalation replaces clinical engagement, often with fatal consequences.

At the inquest, she was told the officer who pulled the trigger would make the same decision again. “That breaks my heart as a human being,” she said.

Officers with specialist mental health training were seconds away but had not yet reached the scene. 

The subsequent coronial inquest into her death found errors were made by the officers that day and the coroner made 10 recommendations to the NSW Police Commissioner, including that mental health trained officers handle cases like Courtney’s where possible.

An inquiry into Jesse Deacon’s death found that fear of police involvement is now deterring some people in acute distress from seeking help at all. These accounts show that when responses fail in the moment, they reshape public trust and discourage future help-seeking.

Since her son Jesse was killed, Judy has advocated for a dedicated fourth option within the triple zero system, a round-the-clock mental health response.

Image supplied: Courtney Topic (left) Leesa Topic (right)

Causes: Policy, Practice and System Pressures

Emma, a Melbourne paramedic with five years’ experience in mental health call-outs, provides a frontline perspective on why these outcomes occur. She avoids generalising about individual officers, noting that some interactions are handled well, but identifies a broader pattern of escalation. 

She said the visible presence of police equipment—firearms, tasers and protective gear—can “derail” the tone of an interaction, making it feel more threatening than a paramedic-led response.

This difference is not just symbolic but practical. Emma describes cases where situations that were initially stable deteriorated after police became involved. She attributes this to a tendency toward “reactiveness,” which can quickly escalate into use of force.

In lower-risk situations, such as minor self-harm, her approach prioritises communication and avoids restraint unless absolutely necessary. By contrast, she has observed police responses that escalate “from zero to 100 so quickly”.

She links these differences to institutional pressures. Paramedics operate under strict clinical scrutiny, particularly around sedation, which incentivises de-escalation. 

Police, however, are accountable for maintaining control and safety, which can encourage faster and more assertive intervention. These competing pressures shape how each service responds on the ground.

This view is echoed at senior levels. Police Association of Victoria secretary Wayne Gatt told The Age that: “the Police Association has long said that its members are not the most appropriate or qualified to act as the first response to incidents of mental health crises.”

The legal framework also plays a role. Under section 232 of the Mental Health and Wellbeing Act 2022 (Vic), the power to take into care and control a person in a mental health crisis sits with police and authorised mental health clinicians, not paramedics. 

Paramedics may transport and care for patients who are voluntarily seeking treatment, but they do not have the authority to detain someone involuntarily. In those situations, they must rely on police or authorised clinicians to exercise that power.

In practice, this often results in a more enforcement-oriented response, particularly in situations where risk is uncertain or evolving. The structure of 232 therefore both defines legal responsibility and shapes which professional lens—clinical or coercive—dominates at the point of intervention.

Life Saving Alternatives

Dr Panos Karanikolas and Hamilton Kennedy, researchers from the University of La Trobe who specialise in Victoria’s mental health system, told Farrago that paramedic-led responses represent the most practical first step toward a care-first model.

Their views were echoed by recommendation 10 of the 2021 Royal Commission into Victoria's Mental Health System, which called for emergency services’ responses to people experiencing time-critical mental health crises to be led by health professionals rather than police. 

A component of this recommendation was to see paramedics assume the role of being the first responders to triple zero calls relating to such crises by 2023, “wherever possible and safe,” but the reform was delayed until 2027. Reports from The Age claimed that the state's justice and health departments had received the required funding to initiate the transfer, and the reason for the delay was “unclear”.

Hamilton believes that such clinical responses are an improvement but critiqued them as still “so integrally linked with the public mental health and psychiatric system, which places them at arm's reach from police.”

Emma explained that some small-scale programs that partially resemble a clinical based response recommended by the Royal Commission do exist in Victoria. She believes The PACER model (Police, Ambulance, and Clinical Early Response), is “superior” to only an Ambulance Victoria response, as it has a trained mental health clinician who can provide nuanced support and assessment aboard. However, the model is limited in scope. At her branch, only two clinicians cover a large team, and the service is not available 24/7. As a result, most incidents still default to standard police-led responses.

From their research, Panos stressed they found these incidents are often for self-harm or suicidal distress and most are not deemed to be of risk to others, which they believe can be better handled without the involvement of emergency services. 

“There are lots of examples of grassroots, community, bottom up, non-clinical mental health responses that the government could fund … and they could be scaled up,” said Panos.

The National Justice Project, a human rights organisation campaigning for alternative first responses, is attempting to integrate these community-led, non-police, first responders.

Campaign leader Chloe Fragos explained their ethos is underpinned by the notion that there should be no single approach to dealing with the wide range of situations that prompt mental health-related triple zero calls. 

One of the possible alternative models Chloe detailed would see triple zero operators assess in-coming calls and then transfer the call to the most appropriate response team, which would then be mobilised. 

This is known as a triage system, which “keeps the emphasis and focus on how we can connect people to the right support they need.”

These Australian advocates are not working in isolation, they are a part of an international movement reinforced by concrete evidence that such alternatives provide successful and appropriate health-led care for people experiencing a mental health crisis or some type of distress. 

To explore how some of these international programs could be implemented in Australia, Farrago spoke to Alexander Heaton, the technical advisor for reimagining public safety at the New York University, School of Law policing project. 

Alexander has worked across Chicago and Minneapolis in arrest diversion and alternative response initiatives and recently launched a campaign to divert 12 million annual U.S. police calls to community-based, unarmed professionals by 2030. He detailed the importance of de-escalation and support. 

“I did a bunch of ride-alongs in Minneapolis for their behavioral Crisis Response Unit. Their first priority is to de-escalate the situation, to bring everything back down to a calmer level and then decide, what is the best intervention here?” 

Durham’s Approach

Alexander pointed towards a model often cited as a potential blueprint in Durham, North Carolina, where he claims “arrests of people with mental health concerns have dropped. But interestingly, the use of 911 has increased because people trust the system more.” 

In practice, the model operates as follows:

1. Crisis Call Diversion: Mental health clinicians are embedded in 911 call centres to provide phone-based support, assess risk, create safety plans and if an in-person response in necessary, these clinicians will mobilise one of the following teams: 
2. Community Response Team: A trained healthcare professional, peer support worker and emergency medical technician respond on-site to non-violent incidents, delivering trauma-informed care and linking individuals to community-based support.
3. Co-Response: A trained healthcare professional and a specially trained police officer attend higher-risk situations involving potential violence, focusing on support and de-escalation.
4. Involuntary Commitment Response Team: Clinicians conduct in-field mental health assessments where involuntary commitment (a legal process that places someone in a treatment facility even if they do not want to go) may be required.

Since 2021, these teams have responded to more than 28,000 calls to 911 with a consistently low rate of requests for backup from other public safety departments and no major injuries to their responders. 

What Comes After Moments of Crisis 

Changing who responds is only part of the solution. What happens after is equally important, where a person is taken and if they receive ongoing support, can determine whether a crisis is resolved or repeated.

When asked to draw on his experience working with alternative initiatives and how they should be replicated in other countries, Alexander noted how important holistic care is, “if they don't have a system, they don't have a place to divert these folks experiencing these concerns to, It's not going to be helpful.”

“You're going to see the same person over and over again.”

Whilst conducting interviews with people who have had police respond to their mental health crises, Panos consistently heard that, “there is an absolute [lack] of places people can go that are not fundamentally coercive.”

Panos critiqued that options beyond emergency departments or jail are a rarity. 

For Leesa Topic, the consequences of these gaps are deeply personal. She is calling for greater investment in a system that supports, rather than isolates, those experiencing mental ill health. 

“My Courtney is not coming home,” she said, “where are we headed?”

“If it’s just going to keep going as it is, more innocent people are going to lose their lives, whether it be at the hands of the police, [or] whether it be at their own hand… We must do better.” 

Image Source: RACV