Cameron Miranda
Policing the mentally ill has become a major responsibility for law enforcement, and officers must be well-prepared to recognize and appropriately respond to indicators of mental illness. The ability of police officers to correctly identify mental health symptoms can make a substantial difference in many aspects of the encounter, including the level of force used and whether an individual is arrested. While there is a proven track record of success, only 10% of the US's 25,000 police departments require crisis intervention training regarding the mentally ill. The challenge of assessing mental illness is further complicated by the fact that signs of mental illness can resemble those of substance use, even for experienced psychiatrists.
| Characteristics | Values |
|---|---|
| Police officers' ability to identify mental health symptoms | Substantially impacts the level of force used, whether an individual is connected to an emergency mental health evaluation, and whether the individual is arrested |
| Police dispatch | Can use the program to reference the individual’s health history and send help immediately |
| Police officers' commonsense element | Officers believe that they know mental illness when they see it |
| Screening checklists | Can aid law enforcement in identifying mental illness |
| Crisis Intervention Training (CIT) | CIT officers have 40 hours of training and experience in responding to emotional disturbance crisis calls, in addition to making regular police services calls |
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What You'll Learn
Recognising mental health symptoms
Officers can utilise three key sources of information to assess mental health symptoms: information from police dispatch, collateral contacts during the encounter, and their own behavioural observations. For example, if an individual calls 911 and is incoherent, the dispatcher can reference their health history and forward this information to responding officers. Frontline officers can also follow screening checklists to quickly identify various mental disorders and determine the appropriate course of action.
CIT officers, or "generalist-specialist" law enforcement officers, receive specialised training in responding to emotional disturbance crisis calls. This training fosters a partnership between law enforcement and the community and equips officers with de-escalation techniques. CIT officers can divert individuals to mental health treatment facilities instead of jail when appropriate, significantly improving outcomes.
However, a lack of training in dealing with the mentally ill can have deadly consequences. Only a small percentage of police departments require crisis intervention training. Improving access to mental health treatment and reporting fatal law enforcement encounters involving individuals with mental illness are also crucial steps in addressing this complex issue.
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Police training and preparation
Police officers are increasingly becoming front-line responders to mental health crises. They often must address situations involving mentally ill persons who may be suspects, victims, or individuals in need of assistance. Therefore, police training and preparation are essential to recognizing and responding appropriately to indicators of mental illness.
One crucial aspect of police training is providing officers with practical tools to identify mental health issues. This includes teaching officers about the signs and symptoms of various mental illnesses and how they may present in different individuals. For example, officers should be able to recognize that signs of mental illness can sometimes be similar to those of substance use, as evidenced by research showing even experienced psychiatrists frequently confusing the two in emergency rooms. Thus, training should emphasize the importance of accurate identification and the potential consequences of misidentification.
Another critical component of police training is de-escalation techniques. Officers should be taught to prioritize de-escalation strategies when interacting with individuals in mental health crises. This includes using verbal cues to calm and communicate with the individual, as well as employing tactics that do not immediately involve the use of force. For instance, CIT (Crisis Intervention Team) officers are trained to respond to emotional disturbance crisis calls and learn to de-escalate tense situations. This approach has shown to reduce officer injury rates significantly.
Police departments should also implement screening checklists as a practical tool to aid officers in quickly screening for various mental disorders. These checklists can be used by frontline officers and dispatchers to identify mental health issues and determine appropriate responses. Checklists can include questions or indicators to assess for specific mental health concerns, such as risk of self-harm or harm to others, presence of psychotic symptoms, or substance use.
Additionally, training should emphasize the importance of collaboration and partnership with mental health professionals. Officers should be encouraged to divert individuals to mental health treatment facilities rather than jail when appropriate. This requires knowledge of local mental health resources and established partnerships with treatment providers to ensure individuals receive the necessary care.
Finally, police departments should ensure that training is ongoing and periodic. Mental health training should not be a one-time event but rather a continuous process of learning and improvement. This includes providing resources for officers to seek additional training and specialized roles, such as CIT officers, for those interested in further developing their skills in this area.
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Police interaction with the mentally ill
Officers may struggle to articulate how they identify mental illness, with some relying on a "look" or "commonsense element". However, the ability to recognize mental health symptoms is crucial and can significantly impact the outcome of police encounters. For example, recognizing mental illness can reduce the likelihood of arrest, while recognizing substance use can increase it.
To aid officers, screening checklists have been proposed, which can help quickly identify various mental disorders. These checklists, coupled with in-service training, can help officers select the most effective tactics when dealing with suspects who may have mental disorders. One example of this training in practice is Crisis Intervention Training (CIT), which teaches officers to de-escalate tense situations and divert individuals to mental health treatment facilities rather than jail when appropriate.
Despite proven benefits, only 10% of police departments in the US require CIT or similar training. This lack of training can lead to deadly consequences, as evidenced by several fatal encounters between police and individuals with mental illnesses. To reduce these incidents, improved mental health treatment systems are needed, as well as better data collection on the role of mental illness in fatal law enforcement encounters.
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Screening checklists
One example of a screening checklist is the one used by CIT officers. CIT officers are "generalist-specialist" law enforcement officers who have received specialized training in responding to emotional disturbance crisis calls. They learn to de-escalate tense situations and divert individuals to mental health treatment facilities instead of jail when appropriate. This approach has been shown to reduce officer injury rates significantly.
Frontline officers can also benefit from using brief mental health screening checklists previously used by criminal justice professionals. These checklists can help officers select the most effective tactics when dealing with suspects who may have mental disorders. For example, when an individual calls 911 and is incoherent or inaudible, the dispatcher can use the checklist to reference the person's health history and send immediate assistance. The information can also be forwarded to responding officers to help them handle the situation appropriately.
While screening checklists can be valuable tools, it is important to note that officers often have difficulty articulating how they identify mental illness. This suggests that more comprehensive training is needed to ensure that law enforcement can effectively recognize and respond to mental health issues.
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Treatment laws
In the United States, there are several laws and regulations in place that pertain to the treatment of individuals with mental illness. These laws aim to protect the rights of individuals with mental illness, ensure equal opportunities, and provide access to necessary treatment and services. Here is an overview of some key treatment laws:
The Americans with Disabilities Act (ADA) of 1990, as amended in 2008, is a federal law that establishes requirements for equal opportunities in various aspects of life for individuals with disabilities, including those with mental illnesses. The ADA mandates equal opportunities in employment, state and local government services, public accommodations, commercial facilities, transportation, and telecommunications.
The Mental Health Parity and Addiction Equity Act of 2008 require insurance groups offering coverage for mental health or substance use disorders to provide benefits that are comparable to those offered for general medical coverage. This means that deductibles, copays, out-of-pocket maximums, and treatment limitations for mental health or substance use disorders must be no more restrictive than those for other types of medical care.
The Insanity Defense Reform Act (18 U.S.C. § 17), passed in 1984, addresses the role of mental health considerations in the criminal justice system. This act placed the burden of proving criminal insanity on the defendant and limited the use of mental illness as a defense strategy.
The Consolidated Appropriations Act, 2023 (CAA, 23) included provisions that reauthorized, strengthened, and expanded mental health and substance use disorder programs administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). This law built upon previous legislation aimed at addressing substance use disorders and promoting recovery and treatment.
Additionally, there are specific laws and regulations that pertain to the rights of individuals receiving treatment for mental illness. For example, 42 U.S.C. § 9501 outlines the Bill of Rights for individuals admitted to a program or facility for mental health services. This includes the right to an individualized, written treatment plan, the right to periodic review and reassessment of treatment needs, the right to confidentiality and access to records, and the right to referral to other providers upon discharge.
While not specifically a treatment law, it is also important to note that there have been calls for improved training for law enforcement and criminal justice professionals on how to interact with individuals with mental illness. Organizations such as the National Association for the Advancement of Colored People (NAACP) have advocated for mandatory and ongoing periodic mental health training for law enforcement agencies to better equip them to handle situations involving individuals with mental illness.
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Frequently asked questions
One of the challenges is that the signs of mental illness can be similar to those of substance use, even for experienced psychiatrists. Another challenge is the lack of training provided to law enforcement on dealing with the mentally ill, which can lead to deadly consequences.
Information from police dispatch, collateral contacts during the encounter, and the officer's behavioural observations during the encounter.
By implementing screening checklists, increasing training on interacting with the mentally ill, and fostering partnerships between law enforcement and the community through CIT officers.
