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Mental Illness: The impact on the law enforcement community

In Law Enforcement by Beth

The law enforcement community deals with people from all walks of life for a host of reasons. One thing is for sure, they respond to people in all types of crises. When responding to a call for an individual in a mental illness crisis, the situation can have wide-ranging results. The nature of the mental illness is that varied diagnoses may lead to unpredictability. There is no blueprint for law enforcement officers to follow. When mental illness is not professionally treated and managed, the individual can behave erratically and disruptively. 

Mental Illness

According to the National Alliance on Mental Illness (NAMI), 1 in 5 adults in the US will experience some type of mental health issue in any given year. 

Complicating this fact is that 60% of these individuals had not received any treatment in a year. This figure is astounding when considering the number of community-based contacts that law enforcement officers respond to. Furthermore, it is also reported that 20% of the prison population and 21% of the jail population have a history of mental health issues. This is compounded by the fact that of the 20.2 million adults who have a substance use disorder, 50.5% (10.2 million adults) had a co-occurring mental illness. 

This data is an important factor when considering how to respond to an incident with the goal of a nonviolent resolution. Some individuals in crisis may have difficulty responding to directions. If police aren’t trained in mental health issues, they may interpret these actions as defiance or resisting arrest. Things can escalate quickly.

De-escalation Training

Police officers and correctional staff must know how to manage decisions that may require swift action or a prolonged response.  De-escalation techniques are beneficial training for officers that find themselves responding to a person experiencing a mental health crisis.

When an officer arrives on the scene with limited information, an assessment and decision of the next steps must be determined. The initial plan that is formulated is critical to a peaceful resolution. A few examples of questions that must be discussed by the responding officers would be, does the incident require additional support, should the scene be cleared of bystanders, is there a need for officers who may have additional training on negotiations. All may be needed at some point or perhaps none at all. Every situation is unique and thus must be treated as such.

The law enforcement community in recent years has found that training with mental health professionals has become key to understanding mental illness and how to appropriately respond to someone in crisis. Many police and correctional officers are participating in Critical Incident Training (CIT). 

Crisis Intervention Training established the desire and need of law enforcement officers to improve their response when dealing with mentally ill persons in crisis. 

Memphis, 1987

It was developed as a result of an incident that occurred in Memphis, Tennessee in September 1987. Police responded to a 911 call that involved a man with a history of mental illness who was cutting himself and threatening to commit suicide. Upon arrival, the police ordered the man to drop the knife. The man did not drop the knife and instead, he ran towards the Officers. The officers discharged their firearms, and the man was killed. 

A sergeant in the Memphis Police Department went to his superiors and requested to implement a Crisis Intervention Team (also known as CIT). The Memphis Police partnered with the National Alliance on Mental Illness (NAMI) and two Universities, the University of Memphis, and the University of Tennessee. The Memphis Model as it is referred to today is the cornerstone of the current program having been adopted in approximately 2,800 communities nationwide. 

CIT is training and ultimately a program that provides the foundation necessary to promote community and statewide solutions to assist individuals with a mental illness. The CIT Model reduces both stigma and hopefully the need for further involvement with the criminal justice system. CIT provides an opportunity for effective problem solving regarding the interaction between the justice and mental health care system and the community. 

First responders are most often the individuals that respond to a person in a mental health crisis. The term first responder refers to the police, law enforcement, correction officer, and any other staff member who is a front-line initial responder. Clearly, those who answer a call of a person in distress do not know the full situation until they arrive on the scene. The situation can develop into a negative consequence unless those responding understand and follow de-escalating techniques. 

CIT programs are designed to improve public safety response to mental health crises, help individuals with mental health and substance use disorders access behavioral health services, and promote safety for the individual and as well as the responding law enforcement officer.

The Goals of CIT

The goals of CIT are simple and straightforward; identity, assess, and intervene; return the individual to his/her prior level of functioning as quickly as possible, and lessen any negative impact on future mental health. Crisis Prevention Training focuses on crisis prevention and crisis management strategies, including aggressive behavior and physical intervention. From the law enforcement officer’s perspective, the focus on de-escalation techniques is critically important since the majority of mental illness crises occur in the community without the benefit of a controlled situation.

Other public safety staff may have a situation with some physical constraints and that is why correctional agencies have adopted the CIT model to establish a designated team from various disciplines within a facility to de-escalate the situation while assisting the individual in crisis. All involved in the crisis are working to ensure a nonviolent intervention with a positive outcome.

The benefits of CIT are numerous and here are a few.

  • CIT programs bring community leaders together.
  • Give police officers more tools to do their job safely and effectively. 
  • Keep law enforcement’s focus on crime.
  • Ensures that individuals with mental illness are provided the necessary and appropriate services.
  • Produce cost savings.

Mental Illness Break

A mental illness break occurs in all different manners and as previously stated, no two situations are alike. Some of the signs listed below may apply to only those managing individuals held in custody while others may be evident and occur during a community-based contact. With that being said, what should law enforcement and correctional officers be looking for when dealing with an individual in crisis. 

What are some of the signs and symptoms that the individual may be exhibiting?

  • Extreme mood changes, including uncontrollable “highs” or feelings of euphoria
  • Prolonged or strong feelings of irritability or anger
  • Avoiding friends and social activities
  • Difficulties understanding or relating to other people
  • Changes in sleeping habits or feeling tired and low energy
  • Changes in eating habits such as increased hunger or lack of appetite
  • Changes in sex drive
  • Difficulty perceiving reality (delusions or hallucinations, in which a person experiences and senses things that don’t exist in objective reality)
  • Inability to perceive changes in one’s own feelings, behavior, or personality 
  • Overuse of substances like alcohol or drugs (co-occurring disorder may be exhibited)
  • Multiple physical ailments without obvious causes (such as headaches, stomach aches, vague and ongoing “aches and pains”)
  • Thinking about suicide
  • Inability to carry out daily activities or handle daily problems and stress
  • Intense fear of weight gain or concern with appearance

It is important to note that the signs and symptoms listed may apply to anyone including family, friends, colleagues, and yourself. 

The risk of suicide is a major concern for people with mental health conditions, their family, and friends. The signs and symptoms of a potential mental illness break can also be signs of suicidal thoughts that may possibly lead to an attempt.

The combination may be exacerbated when the individual is using illicit substances that may alter clear thinking. People who attempt suicide typically use terms as feeling overwhelming emotional pain, frustration, as well as feeling lonely, hopeless, guilty, rage to describe how they felt at the time of the attempt. If someone has attempted suicide before, the risk of another attempt is even greater. 

Common signs of suicide:

  • Giving away possessions
  • Taking steps to tie up loose ends like organizing personal papers
  • Talking as if they’re saying goodbye
  • Making or changing a will
  • Saying things like “You’ll be better off without me” or “Nothing matters anymore”
  • Sudden cheerfulness or calm after a period of despondency
  • History of suicide attempts or other self-harming behaviors
  • History of family/friend suicide or attempts

When you are in a community contact with a person in a mental health crisis, always try to stress (whenever appropriate) to the person in a crisis that they should keep in mind.

  • You are not alone 
  • This is not your fault 
  • You deserve help and support 
  • There is support available for you

You should always defer to a colleague who has formal or additional training in CIT when responding to a person in a mental health crisis. If at all possible, request that your department send you to training so you can learn how to de-escalate a person in crisis. This training will be beneficial to not only you and your department but the local community as well.