Psychiatric hospitals, mental institutions, asylums, psych wards—call them what you will—they’ve had a checkered history and their future seems to be at risk. Since the 1950s, deinstitutionalizing has been the practice and community based treatment centers have been the expectation. The reality? Law enforcement has had to close the gap.
Institutions nationwide now hold about 35,000 patients, down from their peak of over 500,000 just 60 years ago. While the number of hospital beds continues to decline, the number of prisoners with mental illness continues to climb. It’s estimated that as much as 20% of the prison system population is mentally ill. According the Chief Louis Dekmar, Third Vice President of the International Association of Chiefs of Police (IACP): “The saddest commentary in this situation is that the largest provider of mental health care is corrections. County jails are second.”
Unfortunately, the public doesn’t often see, and therefore can’t comprehend, these statistics and the realities they reflect. The public doesn’t realize that prisons have effectively become the new psych wards. Instead, instances of shootings, hands-on interactions, and arrests of the mentally ill go viral. Cries for police to become more understanding and aware of mental illness and the need for a different approach to the mentally ill continue to proliferate.
The public often forgets that we should be focusing on expanding care for the mentally ill so that law enforcement doesn’t need to be involved in a public health issue. It’s convenient and easy to blame law enforcement. They are who we call. But to place the burden on law enforcement officers for the mental health crisis is unfair and inhumane—both to police and the mentally ill.
In 2016, seeing the growing health care crisis and concerned about responsibility falling on the shoulder of law enforcement, Chief Dekmar helped establish the One Mind Campaign (OMC) through IACP. It’s one of many in a movement toward helping law enforcement better understand mental illness and assist in a manner which protects the officer and the public.
Why the sudden need for these programs?
“The nation has criminalized mental health—[the mentally ill] live in the woods, eat out of trash cans and are largely ignored until they cause a problem. Then the police have to intervene,” Dekmar said.
Research has shown that people with severe mental illness are 16 times more likely to be killed by police and account for one-fourth of those killed in officer involved shootings. The OMC hopes to change that. By asking departments to take a pledge, they encourage training, development and amplification of policies that will assist officers in reducing negative outcomes and building community trust.
The have laid out four strategies, and ways to implement/maintain them: 1) Establish a clearly defined and sustainable partnership with one or more community mental health organization(s); 2) develop and implement a model policy addressing police response to persons affected by mental illness; 3) train and certify 100% of an agency’s sworn officers (and selected non-sworn staff, such as dispatchers) in Mental Health First Aid for Public Safety; and 4) provide Crisis Intervention Team training to a minimum of 20% of an agency’s sworn officers (and selected non-sworn staff, such as dispatchers).
Crisis Intervention Teams are a key part of keeping the mentally ill out of jail. They provide a bridge between law enforcement and behavioral health specialists to ensure proper placement and follow-up care for those experiencing a mental health crisis.
Law enforcement also needs to be able to identify when they are dealing with someone who is mentally ill, if they have not been informed prior to arriving on scene. To do that, OMC recommends Mental Health First Aid training, this course trains officers to recognize the signs of mental health and ways in which the officer can provide on scene support.
Whether or not we believe that law enforcement should be responsible for diffusing situations with the mentally ill, the fact is that many families call 9-1-1 when a situation spirals out of control. They hope an officer will bring a mixture of negotiation skills, an authoritative presence, and compassion, which will allow the family to regain control of the situation. For this to happen, officers must be trained to provide the kind of intervention needed without arresting and/or injuring the families that have called for help.
It’s not an easy task and some will not be resolved as well as we’d like, but we’ve got to better prepare for the situations so that the latter become less frequent.