Wednesday, March 16, 2016

A Deadly Dance: The Police and the Mentally Ill

by B. Lana Guggenheim

Police brutality against citizens, particularly minorities, has been much discussed these past few years. However, one minority group has been ignored: the mentally ill. Across the USA, and beyond, police are frequently the first responders to situations involving the mentally ill, usually with dire consequences for the latter. Reliable statistics on police interaction are difficult to find, but anywhere from one-tenth to a quarter of all police interactions involve the mentally ill, approximately 15-20% of those in jail suffer mental illness, and about one quarter to one half of those shot by police struggled with mental illness. Estimates are that people with mental illness are sixteen times more likely to be killed by the police. While being ill is not a crime, being mentally ill is often criminalized, and problems involving or associated with people with mental illness often involve police, who are often not properly trained to handle such situations.

It is commonly but inaccurately thought that people with mental illness are likely to be violent or engaged in violent crime. While a small percentage are indeed more violent than the general population, this is not true for the majority. Most people with mental illnesses are not criminals, and of those who are, most are not violent. That these non-violent people in need of help often end up in jail or worse is an avoidable tragedy. After all, nurses and other medical staff are unarmed, unarmored, and they aid mentally ill patients every day, with no fatalities on either side.

Part of the problem is that our gutted health system cannot handle the burden of caring for the people who need it most. Many mental health clinics are closing, leaving their patients without the care they need, and they often end up on the streets as a result. And the top mental health institutions in the nation? They are found inside jails like in New York City’s Riker’s Island, Cook’s County, and Los Angeles County. Because the existing system withholds treatment until a mentally ill person becomes dangerous to themselves or others, police officers are forced to act as the front line in mental health work. Instead of treating the illness, people call the police and if things go relatively well, the ill person is arrested for things like loitering, shoplifting, or public urinating. Too often though, they get shot instead.
Riker's Island Correctional Facility

The lack of services is exacerbated by the lack of training. Many officers are ambivalent about being the front-line of mental health services, seeing it as outside their mandate to protect the safety of the public, and that caring for the mentally ill is properly the mandate of the healthcare system. This attitude is reinforced by the lack of training available to police officers about recognizing mental illness, mental health crisis intervention, and lack of contact or cooperation from mental health and emergency services. Police are trained to respond to criminal threats with shows of force and authority, which can escalate a crisis for a person suffering a breakdown. The resulting injuries and deaths are traumatic both for the officers, but especially for the victim, their friends and family, and the wider community as a whole.

The Washington Post reports that most of the mentally ill killed by police are men, and over half of them white. Most of them died close to home. Often, the police are called by family members who are overwhelmed and worried about their relative’s erratic behavior. For example, Yvonne Mote of Alabama dialed 911 in March of last year hoping the police could help her schizophrenic brother, Shane Watkins. He was shot and killed by police instead. While an average of nine out of ten of the mentally ill confronted by police were armed with some kind of weapon, they were mostly less lethal than firearms, including toy guns, or knives, or even pens. A percentage of these people are military or police veterans suffering PTSD as well. And according to the data maintained by the FBI and other organizations, only three officers have been killed by edged weapons in the past decade. However, of the thousands killed by police over the years, only a few officers have been prosecuted. For example, Dallas police officers John Rogers and Andrew Hutchins were not indicted for killing mentally ill Jason Harrison for holding a screwdriver in Dallas in 2014.

Jason Harrison

Some police departments have changed their policies. One such is the Las Vegas police department, who adopted a use-of-force policy in 2009 that put the highest premium on the “sanctity of human life,” which stresses proportionality as a guiding principle to limit the use of force. Four years in, the police shootings have fallen by nearly half. However, restrictive policies are not a panacea, as while they lead to fewer injuries for officer and civilian alike, they also lead to more crime.

While it is tempting to advocate rebuilding both the law enforcement and healthcare systems from the ground up, it isn’t practical advice. A number of communities have recognized the terrible situation for what it is, and developed programs that foster collaboration between police and mental health service providers, with noticeable success. These programs can take a variety of forms, such as mobile teams of police and mental health professionals to respond to crisis events, reception centers where specially trained officers can address persons suspected of having mental illness, crisis intervention teams, and joint protocols between police and mental health clinics or hospitals. Police are trained to de-escalate a situation and increase meaningful communication, including nonverbal communication skills, such as recognizing body language and active listening, alongside verbal communication skills that focused on tone of voice, portrayed empathy, and establishing rapport, rather than the opposite. It is a drastic shift in culture and behavior of traditional policing.

Mental Health Liaison officer Grant Humerickhouse (right) assists
 training with the Madison Police Department
In communities where such programs have been instituted, such as in Houston, Texas, Memphis, Tennessee, and Akron, Ohio, results of implementing these programs have been positive. Results have included getting those in need access to the support they lack, including crisis centers. Individuals referred to mental health services experienced less frequent contact with the police, and in cases where police transported people in need to crisis centers and hospitals, an increased percentage of those transportations were voluntary rather than involuntary, and family members have reported greater comfort in calling the police to request help for a loved one, as well as openly acknowledge the mental illness of their relative. And the police department incurred fewer costs, including less frequent mobilization of high-cost SWAT teams. Interestingly enough, the average number of mental health calls also tended to increase, but the amount of time spent on each call decreased, along with a decreased use of force. This shows that trained officers were better able to both recognize and handle calls that involved individuals with mental illness.

However, relatively few officers have received crisis intervention training, nor is this policy pursued across the country. Combined with the cutbacks in mental health service, the future of more such collaborations looks shaky. That leaves too many people dangerously vulnerable, with nowhere else to turn.

Images courtesy of Daily Mail, Yelp, and the Madison, Wisconsin Police Department

Works Cited
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Corey, E. Fuller, Dr. "Law Enforcement Interactions with Mentally Ill." Law Enforcement Interactions with Mentally Ill. Mental Illness Policy, 2011. Web. 16 Mar. 2016.
Kindy, Kimberly, Marc Fisher, Julie Tate, and Jennifer Jenkins. "A Year of Reckoning: Police Fatally Shoot Nearly 1,000." Washington Post. The Washington Post, 26 Dec. 2015. Web. 16 Mar. 2016.
King, Shaun. "American Tragedy: At Least 50% of Police Shooting Victims Struggled with Mental Illness." Daily Kos. Daily Kos, 5 Apr. 2015. Web. 16 Mar. 2016.
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Landsberg, Gerald. "Neglected Issues -- Police Killings of the Mentally Ill and the Lack of Police and Mental Health Relations." The Huffington Post., 14 Apr. 2013. Web. 16 Mar. 2016.
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Lowery, Wesley, Kimberly Kindy, Keith L. Alexander, Julie Tate, Jennifer Jenkins, and Steven Rich. "Distraught People, Deadly Results: Fatal Shootings by On-duty Police Officers." Washington Post. The Washington Post, 30 June 2015. Web. 16 Mar. 2016.
"Mental Health Liaison/Officer Programs." Special Units. City of Madison Police Department, 2015. Web. 16 Mar. 2016.
"Of All U.S. Police Shootings, One-Quarter Reportedly Involve The Mentally Ill." NPR. NPR, 04 July 2015. Web. 16 Mar. 2016.
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Reuland, Melissa, Matthew Schwarzfeld, and Laura Draper. "Law Enforcement Responses to People with Mental Illnesses: A GUIDE TO RESEARCH-INFORMED POLICY AND PRACTICE." Council of State Governments Justice Center (2009): n. pag. Council of State Governments Justice Center. Web. 16 Mar. 2016.
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  1. So the police are qualified to diagnose a mentally ill person now?

    hmm interestingly bridging the gap of mercenaries and licensed doctors..

    is this the new "Merdoc"?

    What other licenses do private contractors have? Dental, Podiatrist, Phlebotomist, Nero brain surgeons?


    1. So....killing us is okay instead ? There is nothing wrong with education. Dealt with police myself, and I am alive due to this training. It was a nonviolent offense by the way.