This chapter examines mental health and policing by focusing on deaths after police contact in the US and UK. It considers how the policing of people with mental health issues leads to them being disproportionately more likely to die after police contact than almost any other group in society. The chapter begins by examining the circumstances that have led to police in the US and UK becoming the de facto emergency response to persons experiencing mental health crises. It discusses the differing organisational dynamics and policies that shape police responses to mental health crises in the US and UK. It considers how innovative programmes such as Crisis Intervention Teams in the US and Street Triage in the UK might enable police to have fewer lethal outcomes with citizens. The chapter further examines issues such as the disproportionate use of police force on people with mental health issues and the relative lack of training for officers about mental health conditions.