Читать книгу Police in America - Steven G. Brandl - Страница 147

Along with enforcing the law, controlling crime, and handling situations where force may need to be used, another reason for the police is to respond to people in need. In particular, the police have frequent contacts with people who are mentally ill, more now than ever before. It is estimated that between 7% to 10% of police encounters involve people with mental illness.²⁴ These contacts may be with people in crisis (e.g., out-of-control, bizarre behaviors, suicide attempts) or because of serious but more chronic (e.g., homelessness) mental health issues or because of other more “nuisance” or disorderly type behaviors (e.g., a person walking on a roadway). Most police contacts with persons with mental illness do not involve major crimes or violence.²⁵

There are at least two reasons for the frequent contact between the police and persons with mental illness. First, even though the concerning behaviors may not be criminal, the police have responsibilities for maintaining peace and safety. Since citizens have quick and easy access to the police to deal with such situations, it is much easier and quicker to summon the police than other social services. As in other situations, the police have these responsibilities simply because they are designated as first responders.

The second reason for more contacts between the police and people with mental illness is that there are more persons with mental illness now living in communities. Decades ago, persons with serious mental illness were more likely to be institutionalized and required to receive treatment. Today, involuntary institutionalization is reserved for only the most extreme of instances. Mental illness is most frequently managed through prescribed drugs for people who live in the community. Indeed, police officers often hear from relatives of people who are experiencing a mental health crisis that “he was fine until he stopped taking his medication.”

There are potential problems and difficulties when the police intervene in situations that involve persons with mental illness. First, traditionally the police have not received training on recognizing mental illness or its various symptoms. Complicating matters is that sometimes substance abuse and physical, cognitive, or other emotional problems can masquerade as mental illness. How can police officers be expected to provide “psychiatric first aid”²⁶ without being trained on this complex phenomenon?

Second, interactions with people with certain mental illnesses can be dangerous for officers and well as the individual, especially when mental illness is not accurately recognized or properly handled. The third problem when intervening in situations that involve persons with mental illness is that there are limited options available to the police to resolve the situation. Depending on the situation, police officers may transport the individual to a psychiatric facility for immediate treatment; try to diffuse the situation on-scene, often with a warning; or arrest the person. These options are not a solution to the problem but are simply ways for the police to manage the situation and resolve immediate concerns.

The best police practice when it comes to interactions with persons with mental illness is using crisis intervention teams (CIT).²⁷ Crisis intervention teams consist of police officers who have received extensive training on how to recognize mental illness and how to effectively respond to it. Officers receive training in such topics as post-traumatic stress disorder (PTSD), traumatic brain injury, psychotropic medications, suicide prevention, personality disorders, and the law relating to mental illness, to name a few. Skills such as verbal de-escalation are also a critical part of the training. The logic of CITs is that, with mental health expertise, officers will be in a better position to more effectively and safely resolve such situations. CIT also represents a more systematic and informed approach to dealing with mental health issues in the community. CIT requires the creation of relationships between the police and mental health resources and treatment options. CIT requires an entirely more systematic approach to mental health related calls for service. Police dispatchers need to send CIT officers to calls, police supervisors need to schedule adequate numbers of CIT officers to each shift, and partnerships and processes with mental health service providers need to be created, formalized, and used. Police services are recognized as the front-end of much larger process. CIT is a more holistic versus haphazard approach to effectively managing mental health needs in the community. The CIT approach is much more congruent with a service-oriented role than one focused on law enforcement.

Photo 4.5 Some of the many responsibilities of the police have very little to do with law enforcement or crime control. Some, such as directing traffic, are provided as a public service.

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