The increased number of persons suffering from serious mental illness in the community today sharpens our focus on the rights of persons to not be held against their will in mental institutions without clear and convincing evidence to justify civil commitment. We have also learned from experience that the potential pitfalls of attempting to treat persons suffering from serious mental illness in the community includes the risk that many of them fall out of treatment, and the current system is too strained to accommodate the large numbers of people that need treatment. These factors, in turn, lead to an increased burden on the police who are called to respond to psychiatric emergencies in the community, which could be better resolved with adequate psychiatric care instead of incarceration.
An ever-increasing number of persons who have a serious mental illness are being treated in jails and prisons. To successfully achieve diversion, we should provide more training in mental health to first responders. We should employ more mental health professionals to work with the police and other first responders. These efforts would be a cost-effective way to divert persons suffering from serious mental illness from correctional systems into treatment.
Police officers should receive proper training, education, and services to interact with persons suffering from serious mental illness in a safe manner. A report by the US Department of Justice noted inconsistent research findings on the use of force by police when dealing with persons who have a mental illness. The authors of this report call on further research to investigate how training police can reduce use of force on persons who have a serious mental illness.6
What are the best law enforcement models for encountering a psychiatric emergency? Models include police officers with specialized training in mental health as first responders to a psychiatric emergency, civilian mental health professionals employed by police, and mobile community-based mental health teams that respond to police calls but are not employed by police.7
Dr Linda Teplin8 points out that police officers have 3 choices when they encounter a person who has a mental illness who is creating a disturbance: transport the person to a hospital, arrest the person, or attempt to resolve the crisis on the street. Police officers often serve as the gatekeepers who ensure that persons with serious mental illness receive treatment and are not simply punished for having a mental illness by being sent to the correctional system.
If we are to entrust police officers with the responsibility of making the correct decision about the need for transport to a treatment center versus no treatment, we must provide the proper services and training to make the process efficient and safe, for both the officers and the persons with the serious mental illness. Mental health professionals, state-run forensic services, and law enforcement agencies need to come together and discuss the most efficient and safe models when confronting psychiatric emergencies to improve and expand these practices across America.
