The family of a NSW man who died in a police siege has called for a royal commission into responses to mental health crises, saying it is "abundantly clear" the system is broken.
In a letter to state Mental Health Minister Rose Jackson, the stepfather of Todd McKenzie said the death toll from how police handled mental health responses was considered "collateral damage" by the government.
Mr McKenzie, who had been diagnosed with schizophrenia, was shot three times by police at his home on the NSW mid-north coast in July 2019 after officers were called due to concerns for his welfare.
A coronial inquest was held into his death, but stepfather Neil Wilkins wrote that the state needed to "wipe the slate clean" with a royal commission rather than waiting for more people to die.
"One thing which is abundantly clear is that police are not adequately trained in the area of mental health ... to deal with a mentally unwell person in crisis," he wrote.
"They do not possess the skills to de-escalate."
Mr Wilkins called the Police, Ambulance and Clinical Early Response Program "useless as udders on a bull", questioning the value of the service.
The program is a $6.1 million NSW Health-led government initiative in which mental health clinicians attend emergencies in the Sydney metropolitan area alongside first responders.
The Minns Labor government has cited the program as part of the solution to dealing with mental health crises, however it has been criticised as the clinicians do not attend when police respond to situations where people are armed.
"Why have a specialised service which cannot respond to any mentally unwell person carrying a weapon?" Mr Wilkins said.
Several people have been killed following interactions with police in recent months, including Krista Kach, who was shot with a police "beanbag" round following a stand-off in the Hunter region last month.
"Unfortunately what appears ... is that previous governments including your own have endorsed the actions of police officers carrying out their duties, if a mentally unwell person is killed then this is merely collateral damage," Mr Wilkins wrote.
A May report from the Law Enforcement Conduct Commission found nearly half of all NSW police-involved deaths or serious injuries involved a person experiencing a mental health crisis.
Despite the high rate, officers received "extremely limited" training on how to respond to those incidents, the police watchdog said.
While the force had introduced a four-day mental health intervention program for officers, only 300 of 16,000 sworn officers were trained each year.
NSW Police are conducting a three-month review into mental health responses with a report due in November.
AAP has contacted Ms Jackson's office for comment.
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