Law enforcement agents are trained to handle a variety of life-threatening situations, from talking down a suspect wielding a weapon to evacuating large areas following a natural disaster. Even when officers are well prepared, certain situations may require the assistance of other professionals. These professionals become especially important when law enforcement agents engage people with severe mental illness (SMI).
In the U.S., one in four adults experiences mental illness. For 9.3 million Americans the problems can be severe enough to impede their ability to act rationally. Most people suffering a mental illness are not violent, criminal or dangerous. Yet, they are ten times more likely to be incarcerated than committed to a state psychiatric hospital. Increasingly, police officers serve as the first line of contact when those living with mental illness are at their most disoriented.
Survival depends on mental health partnerships
In their 2013 report, researchers from the National Sheriff’s Association and Treatment Advocacy Center (TAC) agreed with earlier analysis that claimed half of the people shot and killed by police each year have mental health problems. While the number of justifiable homicides between 1980 and 2012 decreased by 5 percent, TAC noted that deaths attributed to attacks on police officers increased 67 percent during that same time period . About one-third of shootings by law enforcement officers is the result of “suicide by cop,” when the victim has no intention of surviving the encounter.
Law enforcement needs guidance and participation from mental health agencies to shepherd struggling individuals to professional care before an encounter turns fatal. According to the TAC report, this cannot be accomplished without mental health expertise, and this knowledge falls outside of law enforcement:
The transfer of responsibility for mentally ill persons from mental health professionals to law enforcement officers is patently illogical. Law enforcement officers self-select and are trained to do traditional police work. If they had wanted to become mental health professionals, they would have done so. To take people trained in law enforcement and use them as mental health professionals is a grossly inappropriate use of their skills.
To help those suffering SMI to weather their confrontations with police, TAC recommends greater implementation of assisted outpatient treatment (AOT), which specifies that individuals with SMI who might be a danger may be court-ordered to take medication for their psychiatric disorder as a condition for living in the community. The Department of Justice considers AOT to be evidence-based and effective: studies show AOT decreases homelessness, psychiatric hospitalizations, arrests, days incarcerated and financial costs to a community. Researchers predict that widespread use of AOT could reduce the number of SMI-related justifiable homicides by half.
Training helps mitigate violent outcomes
While there are no universally-adopted criteria for mental health training in law enforcement, crisis intervention training is available in the majority of U.S. states. Crisis Intervention Team (CIT) programs are local initiatives designed to improve the way law enforcement and their communities respond to people experiencing mental health crises.
Officers enrolled in these courses undergo 40 hours of comprehensive mental health training, learning the best tactics for engaging suspects experiencing SMI. But Major Sam Cochran, the first coordinator of the Memphis program, believes program goals extend far beyond training. CIT is more concerned with changing the way people understand and react to mental illness. The strong partnerships between local law enforcement, mental health providers and families impacted by mental illness comprise the foundation of CIT.
However, few states require officers to participate. The Atlantic noted that many states offer local CIT classes in only a few counties. Of the 3,144 counties and county equivalents in the U.S., about 23 percent have CIT training available. A survey reported by Michael Woody, president of CIT International, showed that most states required officers to receive no more than 8 hours of training.
Since the programs began in 1988, CIT-trained officers are less likely to use force or suffer injuries when responding to mental health calls. Laura Usher, the CIT program manager at National Alliance on Mental Illness (NAMI), recognizes that law enforcement agencies typically can’t afford to train everyone. Crises involving mental illness represent a significant 10 percent of emergency calls, but departments could become over-resourced after investing in comprehensive CIT training.
“What most communities want to do is develop a group of officers who are highly trained, and they’re the ones who are called in a crisis,” Usher told The Atlantic.
Clinicians join officers in the field
To prepare officers to engage these citizens, CIT programs provide background knowledge and teach empathy critical for de-escalating a situation involving mental illness. However, having mental health professionals on the scene can greatly improve the service provided to troubled individuals.
Some communities are asking mental health professionals to provide that assistance to officers in the field, where their expertise is most likely to make a difference. According to The Sacramento Bee, California’s Yolo County was granted nearly $2 million from the state to strengthen its community response to suspects in crisis. Officers who answer crisis calls will now be accompanied by a clinician. The county hopes to reduce the overall number of deaths and hospitalizations among mentally ill suspects.
“We had been dismayed by the number of hospitalizations,” Karen Larsen, the Yolo County mental health director, told The Sacramento Bee. “Law enforcement was spending a significant amount of time dedicated to mental health. The message was loud and clear that we needed to do better.”
The Yolo County initiative is part of California’s Mental Health Wellness Act of 2013, which aimed to expand officer access to crisis intervention and assistance. As more states across the U.S. look into improve their response to mental illness, Yolo County may serve as an excellent model for advanced intervention.
By working with mental health agencies, police officers help ensure that people experiencing mental illness are receiving the best and most effective treatment. Mental health professionals contribute critical insights aimed at helping the officer connect with a troubled individual and then guide that person toward appropriate care. Enlisting the assistance of professionals for officer training can save department resources, as well as lives.
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