Care, not cuffs - Advocating mental health awareness to prevent police abuse

Too many adolescents and adults with mental illnesses have potentially dangerous contact with the police. That contact comes in a number of forms, such as the person with mental illness being a victim or a witness of a crime, being the subject of a nuisance call, committing a crime themselves, or having a mental health crisis and being in danger of hurting themselves or others.

All too often they end up in the criminal justice system. As a result, approximately 25% of the U.S. prison and 60% of the jail population has a serious mental illness. In cities with a population of 100,000 or more, approximately 7% of all police contact involves people with a mental illness. People with a mental illness are twice as likely to be arrested for repeated behavior.

The increased contact is due to the fact that people’s behaviors, which are symptoms of their illness, are more likely to trigger a police response rather than a mental health response. Unfortunately, the only easy way to obtain help for a mental health crisis is to call 911. Typically, police are then sent out to deal with the mental health crisis, resulting in a possible arrest rather than an appropriate intervention.

Thus it is critical that police officers understand the biological nature of mental illness and know how to quickly assess and if possible de-escalate the situation. Poor understanding and ineffective responses often lead to an escalation of the crisis and the person ending up in jail instead of an appropriate mental health care setting.

In response to some very tragic incidents, relatively new models to educate police officers have emerged. One of the best is CIT (Crisis Intervention Team), Developed by Major Sam Cochran in 1988, the CIT program is a community collaboration, not just a training program, where officers are taught about mental illness and are trained both to prevent and de-escalate crises.

Studies have repeatedly shown that specialized training for police results in better outcomes for everyone. CIT produces the lowest rates of arrest and the highest rates for bringing people in for treatment. There are also decreased rates in officer injuries for mental-health related calls. Minneapolis has a CIT program and the police department has encouraged officers from around the state to participate in their training.

Yet CIT is only effective when law enforcement, the mental health system and various advocates collaborate to make sure that when officers divert someone, the treatment system is willing and able to provide appropriate treatment. This means that in order to reduce the criminalization of mental illness, we also need to build up our community mental health system.

Minnesota is currently developing mental health crisis teams which can respond to people in their own homes. Each regional team can provide stabilization services, consultation by phone or in person, and assessment and intervention. Currently, there are multiple phone numbers to call, making these important new services potentially difficult to access – especially in a crisis.

Legislation introduced this year could make more funding available for CIT. In addition, knowing that for some communities, particularly in rural areas, a 40-hour training session is very difficult, the legislation could also fund a four-hour training that would cover basics of the CIT program, including: types and forms of mental illness, including their symptoms; the impact that mental illnesses have on individuals, families, and communities; and legal issues pertaining to the mentally ill, including civil commitment and data practices.

Other legislation would require the Department of Human Services to create a task force to determine if one mental health crisis number could be developed and used throughout the state. Funding the development of more Mental Health Courts would also serve to divert people away from jails and into treatment.

The Consensus Project, which is the premiere report from the Council on State Governments on how to “decriminalize” mental illness, points out the importance of providing a user-friendly entry to the mental health system. In the end, the best way to prevent a criminal justice response is still to reduce the stigma surrounding mental illness, eliminate any barriers to accessing treatment, fully develop crisis services and community supports, and ensure that our first responders (police, EMTs, etc.) understand mental illness and how to de-escalate a crisis.

We have much to do in Minnesota to prevent a criminal justice response, but we are making progress.