Police are not clinicians. That single sentence — it appears in slightly different language in the Royal Commission into Victoria’s Mental Health System final report, in the published PACER evaluations and in the policy positions of the Police Association of Victoria — is the centre of the mental health and policing conversation in Victoria. Our newsroom has been working through the published reform documents and the implementation monitoring to give readers a clear picture of where the system has moved, where it has stalled and what is on the table through 2026.
This piece follows the Mindframe guidelines on reporting mental ill-health and suicide. We do not describe specific incidents in identifying detail and we frame the issue as a system question, because that is what the published evidence shows it to be.
The scale of police involvement
Mental health-related contacts make up a substantial proportion of all calls to Victoria Police. The published estimates — across the Royal Commission’s evidence base, the Police Association’s submissions and the agency’s own internal reporting — sit in the order of one in ten calls for service, with significantly higher proportions in some metropolitan command areas. Many of those contacts relate to a person in distress rather than to a person committing an offence, and a smaller subset involves people detained under the Mental Health and Wellbeing Act for assessment.
The structural problem the Royal Commission identified is that police are frequently the only government service available 24/7 with the capacity to physically attend a crisis, which has resulted in police absorbing a workload that the health system is better placed to lead.
The Royal Commission’s Recommendation 10
The Royal Commission into Victoria’s Mental Health System delivered its final report on 3 February 2021. Recommendation 10 is the one that bears most directly on the police-health interface. It calls for the establishment of a health-based response to people in mental health crisis, with police involvement reserved for cases where there is genuine risk to safety that requires a policing response.
The 2026 picture against that recommendation, on the published evidence:
- The Department of Health has continued to develop the Mental Health and Wellbeing Connect and Crisis Care arms of the reform program.
- The Victorian Government has acknowledged through the Implementation Monitor process that the work is behind schedule.
- The PACER (Police, Ambulance and Clinical Early Response) co-response model has continued to operate and expand, although it remains a co-response model rather than the health-led model the Royal Commission envisaged.
How PACER actually works
PACER pairs a Victoria Police member with an emergency mental health clinician, usually from the local Area Mental Health Service. The team responds together to defined calls for service that are flagged as likely to involve mental health distress. The presence of a clinician on scene allows for direct clinical assessment, de-escalation guided by clinical practice, referral to community-based mental health teams and, where necessary, transport to a health setting rather than a custody setting.
The published PACER evaluations report better outcomes against several measures: reduced use of force, reduced detention under the Mental Health and Wellbeing Act, lower emergency-department presentation rates and improved follow-up care. Those evaluations come with the usual caveats about the populations they cover and the comparison groups available, but the direction is consistent across the available evidence.
What PACER doesn’t solve is the underlying call volume. The model is operational in selected command areas, not statewide, and it operates within defined hours rather than 24/7. The expansion question — whether to scale PACER, to replace it with a health-led model or to operate both in parallel — is the policy question that has been live through 2025 and 2026.
The Lorne crisis-care model and other alternatives
Several smaller-scale alternative response models have been piloted in Victoria, and our newsroom has tracked the results where they are publicly reported. The Lorne crisis-care arrangement, which integrates ambulance, mental health clinical and community-services capacity in a small-town setting, is one example of how the response can be reorganised in a defined geographic area. The translatability of those models to higher-volume metropolitan command areas is the open question.
The “Beyond Crisis” community-based response work, the Hospital in the Home arrangements, the expansion of crisis-respite beds and the new Mental Health and Wellbeing Hubs all sit in the same broader policy frame. The reform direction is to move first response away from custody-and-emergency-department defaults and toward community-based, clinically-led responses.
Police use of force in mental health-related contacts
Use of force in mental health-related contacts is one of the issues that drove the Royal Commission’s framing. The published evidence — including the Coroner’s findings into several deaths over recent years and the IBAC reports on use of force more generally — has consistently identified mental health distress as a context in which adverse outcomes are over-represented.
The Victoria Police response has included revised training, the rollout of body-worn cameras as a routine part of frontline deployment, and updated Operating Procedures around de-escalation, crisis intervention and the use of less-lethal options. Those measures have produced measurable changes in some metrics. The harder question — whether the underlying mismatch between the call type and the responder type can be reduced through training rather than through the broader reform of who answers the call — is the one Recommendation 10 was attempting to address.
Custody and the mental health system
The intersection between custody and mental health continues to produce poor outcomes. The Coroner’s findings in several recent matters have repeatedly identified mental health screening, clinical handover and information-sharing as the system points where things go wrong. The Justice Health framework has been the subject of ongoing reform work, and the Victorian Aboriginal Legal Service, the Mental Health Legal Centre and other advocacy bodies have continued to press for stronger arrangements.
The 24-hour custody window after arrest is the highest-risk period. The Royal Commission’s recommendations, the Veronica Nelson coronial findings (which addressed both Aboriginal-specific and general clinical-handover questions) and the Implementation Monitor’s reporting all converge on the same point: clinical-quality assessment at the front of custody is the single most important intervention.
The Police Association perspective
The Police Association of Victoria has been consistent in its public position that the mental health response is not core police business, that the workload it generates is unsustainable on the current officer numbers, and that the health system needs to be resourced to take primary responsibility. That position aligns, broadly, with the Royal Commission’s framing — which is itself an unusual alignment between a workforce body and a reform process.
Where the conversation goes from here
Three things our team is watching through the rest of 2026:
- The Department of Health’s progress against Recommendation 10, including the staged commencement of the health-based response infrastructure.
- The PACER expansion decisions, including which command areas receive funded teams and whether hours are extended.
- The next iteration of the Mental Health and Policing Plan and the published implementation monitoring.
The conversation is real, the evidence base is now substantial, and the institutional alignment between the health sector, the policing sector, the workforce body and the reform monitor is unusual. The hard part is the resourcing decisions that have to follow.
If you or someone close to you is in mental health crisis
If you are in immediate danger or there is risk to life, dial 000. Lifeline operates a 24/7 crisis line on 13 11 14. Suicide Call Back Service is on 1300 659 467. Beyond Blue is on 1300 22 4636. 13YARN is the 24/7 Aboriginal and Torres Strait Islander crisis support line on 13 92 76. Kids Helpline is on 1800 55 1800. The Victorian Mental Health and Wellbeing Connect line provides connection to local services on 1300 375 330. SuicideLine Victoria is on 1300 651 251. If you are looking for support around the police interaction, the Mental Health Legal Centre runs a community legal service that can advise on the law around assessment, custody and interactions with police.
If you are worried about a friend, neighbour or family member, you do not need to wait until things are at crisis point to reach out. The services above will speak with you confidentially.
Mei Calloway covers community safety, family violence and road safety for Victoria Crime News.
