Results indicate that State laws that make it possible for people in psychiatric crisis to be hospitalized involuntarily in an emergency are poorly understood or perceived as too complicated to use; mental illness is seen as a significant factor in the injury or death of on-duty law enforcement officers; the transportation and hospital security demands associated with incidents involving severe mental illness are perceived a major consumer of law enforcement resources nationally, requiring increasing amounts of time and manpower; and officials see growing numbers of mentally ill persons in the general population, in jails and prisons, and among the homeless over their career. Senior law enforcement respondents overwhelmingly believe that issues arising from untreated severe mental illness are substantial and increasing. Among the most critical policy changes suggested is the need for better training of law enforcement agencies about criteria for intervention when individuals are in acute psychiatric crisis. It is critical that first responders are knowledgeable about the statutory options available to them in dealing with these vulnerable populations and the means of exercising them. Federal agencies such as the Department of Justice that track crime, police shootings and other law enforcement activities need to add mental illness to their statistical monitoring. This report was developed from an online survey of more than 2,400 senior law enforcement officials from every State, most of them with 20 years of experience or more in their field. 12 figures