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An analysis of community health, its history, successes and failures, depends on an understanding of its scope, but there is little consensus as to precisely what the discipline entails. Some view it as a strict scientific discipline, others see it as a social movement, and still others conceive of it as a conglomerate of various disciplines. It is useful initially to identify the medical components of community health, and then to approach its interdisciplinary aspects. Community health, strictly defined, includes such fields as disease control, environmental sanitation, maternal and child care, dental health, nutrition, school health, geriatrics, occupational health, and the treatment of drug and alcohol abuse. This limited definition, though accurate, does not differentiate the field from the much older area of public health. Within community health, the disease focus of traditional public health epidemiology, the total health focus of community medicine, and the outcome focus of health services research are interconnected. Community health combines the public health concern for health issues of defined populations with the preventive therapeutic approach of clinical medicine. An emphasis on personal health care is the result of this combination. Robert Kane describes the field accurately and succinctly: “We envision community medicine as a general organizational framework which draws upon a number of disciplines for its tools. In this sense, it is an applied discipline which adopts the knowledge and skills of other areas in its effort to solve community health problems. The tools described here include community diagnosis (which draws upon such diverse fields as sociology, political science, economics, biostatistics, and epidemiology), epidemiology itself, and health services research (the application of epidemiologic techniques on analyzing the effects of medical care on health).”

The paper examines the historical shifts in policing strategies towards individuals with SMI and vulnerable populations, highlighting the development of co-response models, introducing the concept of “untethered” co-response.

This paper conducts a review of literature to trace the evolution of police responses to individuals with serious mental illness (SMI) and vulnerable populations. It categorizes four generations of police approaches—zero-policing, over-policing, crisis intervention and co-response—and introduces a fifth generation, the “untethered” co-response model exemplified by Project SCOPE in Philadelphia.

The review identifies historical patterns of police response to SMI individuals, emphasizing the challenges and consequences associated with over-policing. It outlines the evolution from crisis intervention teams to co-response models and introduces Project SCOPE as an innovative “untethered” co-response approach.

The research acknowledges the challenges in evaluating the effectiveness of crisis intervention teams and co-response models due to variations in implementation and limited standardized models. It emphasizes the need for more rigorous research, including randomized controlled trials, to substantiate claims about the effectiveness of these models.

The paper suggests that the “untethered” co-response model, exemplified by Project SCOPE, has the potential to positively impact criminal justice and social service outcomes for vulnerable populations. It encourages ongoing policy and evaluative research to inform evidence-based practice and mitigate collateral harms associated with policing responses.

Given the rising interactions between police and individuals with mental health issues, exacerbated by the COVID-19 pandemic, the paper highlights the urgency for innovative, non-policing-driven responses to vulnerable persons.

The paper contributes to the literature by proposing a fifth generation of police response to vulnerable persons, the “untethered” co-response model and presenting Project SCOPE as a practical example.

It is customary these days to denounce our society for its unconscionable neglect of the elderly, while we look back romantically to some indeterminate past when the elderly were respected and well cared for. Contrary to this popular view, old people historically have enjoyed neither respect nor security. As Simone de Beauvoir so effectively demonstrates in The Coming of Age (New York: Putnam, 1972), the elderly have been almost universally ill‐treated by societies throughout the world. Even the Hebrew patriarchs admonished their children to remember them as they grew older: “Cast me not off in time of old age; when my strength fails, forsake me not” (Psalms 71:1). Primitive agrarian cultures, whose very existence depended upon the knowledge gleaned from experience, valued their elders, but even they were often moved by the harsh conditions of subsistence living to eliminate by ritual killing those who were no longer productive members of society. There was a softening of societal attitudes toward the elderly during the period of nineteenth century industrial capitalism, which again valued experience and entrepreneurial skills. Modern technocratic society, however, discredits the idea that knowledge accumulates with age and prefers to think that it grows out‐of‐date. “The vast majority of mankind,” writes de Beauvoir, “look upon the coming of old age with sorrow and rebellion. It fills them with more aversion than death itself.” That the United States in the twentieth century is not alone in its poor treatment of the aged does not excuse or explain this neglect. Rather, the pervasiveness of prejudice against the old makes it even more imperative that we now develop programs to end age discrimination and its vicious effects.