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In 2007, Lynn Moore broke into someones home looking for Osama Bin Laden. Moore is a paranoid schizophrenic with a long history of drug and alcohol abuse. It has been over twenty times that he has been arrested and put in jail four times. When he gets out of jail he goes into a homeless shelter but a month into his good behavior he fails a breathalyzer and has to leave. As a result, being homeless and having no supervision, he stops taking his medication. He then begins to search for Bin Laden and gets sent back to jail. A week after he is released he gets re-arrested (Frontline). "According to the Federal Bureau of Justice Statistics, there are currently 1.25 million inmates (Stephey)" like Moore, with mental illnesses.
"A three-city study found that 92% of patrol officers had at least one encounter with a mentally ill person in crisis in the previous month,Â and officers averaged six such encounters per month. The Lincoln Police Department found that it handled over 1,500 mental health investigation cases in 2002.Â The New York City Police Department responds to about 150,000 "emotionally disturbed persons" calls per year (Cordner)".
Even though a mental illness is technically not a police problem, an offense caused by a person with a mental illness becomes a police problem. Offenses include minor crimes and disturbances. The way a police officer delivers their services to someone with a mental illness is very important. The traditional reaction to those with mental illnesses has repeatedly been ineffective and seldom tragic (Cordner). This is because police do not know how to neither handle a mentally ill person nor be able to confirm whether a person has a mental disorder or not. There is a powerful need for police officers to have education in identifying a mental illness and knowing how to get access to mental health resources. The delivery of police services to the mentally ill is a big issue.
An increase presence of people with mental illness in our jails is one of the major problems in the criminal justice system today. "Mental illness is a term that describes a broad range of mental and emotional conditions (Boston University)". There are many types of mental conditions and each one makes a person act out in different ways. The purpose of the police is to deliver public safety as well as peace for the community they serve. They are also there to deliver assistance during emergency or danger situations.
Police officers are the first source called upon to respond to urgent situations which include persons with a mental illness. They come across people with a mental illness in a variety of ways and in a variety of situations. The situation can be citizen initiated where a family member may call upon the police for help during a psychotic episode. Another example would be a citizen may call the police because they feel they are in danger by someone who is acting bizarre and dangerous. On the other hand, the situation can be police initiated where an officer comes across a person with a mental illness behaving unacceptably or committing a petty crime in public.
All of these interactions between officer and mentally ill, usually occur when the person is having a mental health emergency. Therefore, they need medical attention instead of officers coming to try to stop the situation or arrest them. Due to their condition, the person is not going to act rational by any standards. Their symptoms are going to make them act inappropriately even towards the police officer which will in turn make the officer respond by arresting them. As a result, the mentally ill "offender" will end up with a broad criminal record for trivial crimes when they really need treatment for their illness.
Most arrests dealing with people with a mental illness is for minor crimes that are directly related to their illness. However, they are more likely to get arrested for these minor crimes compared to the general population. One may ask why that is. This is because of their behavior. Mentally ill people are not rational people and when they are not on their medication they will continue to act irrationally. From personal experience for living with someone with a mental illness, this is true. Yet for the person I live with, she has constant care to get the medication that she needs. When the medication is not given, the outrageous behavior can get out of control where you need to call the cops. In contrast, most mentally ill persons are homeless and don't have that stability of a family or friend. Thus, officers will arrest them in order to give immediate safety to themselves and to the community. This is also a mercy booking where the officer arrests the person with a mental illness for a minor offense because they know that the jail will give them the mental health care needed.
Police officers have a large amount of discretion when it comes to implementing their responsibilities as a cop. Their discretion includes making decisions on what to do when they come across someone who has a mental illness. As mentioned before, interactions between the police and the person with a mental illness could be police initiated or citizen initiated. When the contact is police initiated then the officer's discretion becomes very widespread. This is due to the fact that there is knowing supervising or observing what the officer is doing or what the situation is. As a result, the officer can deal with situation any way they want. They can handle the situation in a good way (be calm and talk to them), bad way (use of force) or by not doing anything at all. Contrast to that, when the interaction is citizen initiated, police discretion becomes limited. For example, if a person with a mental illness breaks into someone's home, that citizen does not care if the offender has an illness; they want them arrested and sent to jail (Lamb, Weinberger, & DeCuir, 2002). Lastly, there are circumstances where the police don't have any discretion because of laws. If a person with a mental illness committed a major crime like murder then the position of the police is clear; arrest and take the person to jail. A Los Angeles Police captain said "You arrest somebody for a crime because you know at least they'll be put in some kind of facility where they'll get food and shelter. You don't invent a crime, but it's a discretionary decision. You might not arrest everybody for it, but you know that way they'll be safe and fed (John Wiley & Sons)".
Additionally, there are four main factors that contribute to the mentally ill becoming a police problem. The first and biggest cause affecting the police is deinstitutionalization. This policy moved mentally ill people out-of-state institutions/psychiatric hospitals as well as closing part of all those large institutions/psychiatric hospitals. Ever since the introductions of medicines that controlled symptoms like hallucinations, it was said that many patients could function without continuous care. This is where things gone terribly wrong because just because there are medications to stabilize a person, they still need constant care to make sure they take those medications. Similarly, if there was still health programs/hospitals that accommodate people with mental illness than police intervention would work better. Police would redirect people with mental disorders to mental health systems and not than the criminal justice system.
After deinstitutionalization criminalization arises as the second cause to this problem. With no place to go in the community and no community-based/mental health services accessible, the mentally ill can't keep up proper treatment. Without proper treatment, the mentally ill end up in jail and are given a criminal record. "About 16% of the inmates in jails and prisons in this country have a serious mental illness. There are more mentally ill persons in jails and prisons than in hospitals in this country. Jail cells have become substitutes for hospital beds for the mentally ill. Almost a third of the mentally ill who are incarcerated are locked up not for committing serious crimes (Criss)". More calls about disorderly conduct, trespassing, alcohol and drugs, and robbery are made to the police involving people with mental illness. As predicted, those calls led to the police to arrest and send them to jail to solve a direct problem. Sometimes, this is due to the lack of knowledge on the police officers part. They may not know this person is mentally ill or they just want that problem gone. Additionally, this criminalizes mental illness and re-institutionalizing them in jail or prison instead of a psychiatric facility where they could be getting the care they need.
The third cause is medicalization. When mentally ill people are in jail they are receiving treatment and their medication. However, when they are out of jail these non-institutionalized mentally ill persons need to take their medication but have no place to go to receive it. Although, when they are released from jail they have a two-week supply of medication, they still need to figure out how to keep up their medication on their own. These mentally ill persons are homeless and have no job, money, family or friends. The problem with medicalization makes the police come in contact with the mentally ill more. Lack of monitoring, abuse of alcohol and drugs, and the high cost of medication is what leads the mentally ill to go off their medications and do minor crimes.
The last cause is privatization of mental health facilities. Privatization becomes an issue because expenses are cut drastically. There are not many staffing on call because it is too expensive to pay for all of them. Therefore, police get calls to help with the person with a mental illness who is acting up (Cordner). The person with a mental illness is not getting the correct and proper treatment they need and law enforcement officers are still be called to take care of a group that they don't know how to handle.
To bring up the earlier question: "Why is it that when minor offenses occur, do police officers arrest the person with mental illness and not take them to a hospital or a health facility?" The answer to this was that the police officer may not know this person has a mental disorder. Someone who seems like they have a mental illness to a mental health professional may not seem so to police officers. This is due to the fact that they don't have adequate training in dealing with this specific type of population. In some cases a mental illness could be seen by the police as homelessness, alcohol or drug intoxication, especially if at the time of arrest the person with the mental illness was using drugs or alcohol. This is the result of law enforcement lack of training about mental disorders. It is very clear that officers do not have training to prepare them to recognize whether a person has a mental illness. For example, the police are trained to use certain tactics when enclosing on a suspect. However, what they don't know is that using those tactics on someone with a mental illness, or during a mental breakdown, they will be creating a worse situation and potentially violent (NAMI).
Training should involve law enforcement along with mental health professionals. Mental health professionals can be advisable associates with law enforcement. Police officer training could be provided by the mental health professionals since their job is to work with mental patients. Mental health professionals could teach officers basic knowledge, facts, and awareness of mental disorders, how to manage a person with a mental illness and how to gain access to mental health facilities and resources. Additionally, police officers should learn information about health and community-based services in their community such as clinics and shelters (Cordner). This is crucial to a police officer's education towards the mentally ill. Officers could effectively and efficiently refer people with mental illness to organizations that are capable of treating and caring for the mentally ill. Law enforcement would not have to bring in every mentally ill person to jail knowing that when they get out they will just end up back in the same spot.
Mental health professionals could provide police with methods on how to divert a situation that is leading to deadly force away. If mental health professionals fail to deliver assistance to police officers and law enforcement agencies, then police officers and the mentally ill can be in danger. When a person who has a mental illness is not on their medication they can act dangerously towards themselves or others (officer, citizen). However, a small group of mentally ill, those who are experiencing a psychotic break, are more violent than others. Therefore, by having mental health professionals by your side, they could assist officers during mental health crisis. Police officers can be trained to use less threatening ways of communication when it comes to people with a mental illness. Using a calm behavior and less threatening communication can drive the situation away from deadly alternatives.
In the past, when police officers came in contact with a mentally ill person, they used poor tactics and turned to deadly force to resolve the situation.
"In the United States, 982 of 58,066 police officers assaulted in 2002, and 15 of 636 police officers feloniously killed from 1993 to 2002, had "mentally deranged" assailants. Encounters with police are more likely to be dangerous for people with mental illness than for the police. An early study found that an average of nine New York City police shootings per year between 1971 and 1975 involved emotionally disturbed people. Between 1994 and 1999, Los Angeles officers shot 37 people during encounters with people with mental illness, killing 25.Â A review of shootings by the police from 1998 to 2001 in the United Kingdom indicated that almost half (11 out of 24) involved someone with a known history of mental health problems.Â It is estimated that people with severe mental illness are four times more likely to be killed by police.Â Serious injury and death of people with mental illness at the hands of the police are especially tragic, for obvious reasons" (Cordner).
Given the unpredictable nature of the mentally ill, officers should have backup understanding on how to deal with them. They need the skills and abilities to productively avoid violence and fatality. Most officers and most people in general don't realize that people with a mental disorder are easily excited. They need constant reassurance that the police will not hurt them and they are there to help. Communication with mental health professionals can help in telling them what to say to keep them calm and not agitated. Most fatalities will happen when officers do not realize a person is mentally ill but rather someone on drugs or alcohol causing a riot. Officers will just stick to the rules they know because they think this "crazy person" is just a crazy person without realizing there's an illness behind that crazy behavior.
The goal of training an officer on mental disorders is to increase their awareness of mental disabilities and their symptoms, develop basic emergency communication skills and increase information about available community facilities (Cordner). New less-lethal police tactics have developed today such as stun guns, Tasers and pepper spray. Police should obtain these along with their new knowledge of mental illnesses when they come in contact with a person with a mental illness. Their attitude will no longer need to use deadly force as a defense. As a result, police officers will approach and handle situations a lot better when it comes to the mentally ill by using better techniques and tactics.
There has been one advancement that law enforcement agencies made as a result of the growing population of mentally ill in jail; the implementation of Crisis Intervention Teams.
Â A number of officers in a department get trained to deal with persons with a mental disorder. CIT normally consist of dispatchers, since they play a crucial part in delivering vital information to responding officers (NAMI). A large amount of jurisdictions use sworn police officers for their Crisis teams. These sworn officers have special and broad mental health training in the delivery of emergencies (NAMI). The members of the Crisis Intervention Team are directly connected to their community mental health system (NAMI).
The objectives and goals of CIT programs are to expand an officers' ability to effectively and carefully collaborate with persons with mental illness; resolve crisis and then decrease criminalization by redirecting them away from the criminal justice system and to mental health services. The trained officers are still normal patrol officers but when a mental health crisis arises, they are the ones that go to help with the problem. A benefit of CIT is that they are flexible. The specially trained officers can deal with the mental health emergency directly on site by going to the scene, or they can act as advisors to the officers at the scene. CIT is being widely executed in medium to large cities across the United States enhance accessibility to mental illness (Watson, Morabito, Draine, & Ottati 2008).
Results were found that Crisis Intervention Teams worked effectively in Memphis (Steadman, Deane, Borum, &Morrissey 2000). CIT officers handle 95 percent of all mental disturbance calls, response times are under ten minutes, officer injuries are reduced, injuries caused to the mentally ill reduced, reducing arrests and re-arrests and referrals to treatments are high (Cordner). Mental health training should be used for all officers rather than a specialized crisis team. All officers should have the knowledge and training because you never know whether an officer part of a specialized team is unavailable or cannot be reached. People should not have to rely on "specific" officers when a crisis breaks out but all officers.
Most mentally ill people who come in contact with law enforcement are habitually poor and often homeless. "They cycle in and out of homeless shelters, hospitals, and jails, occasionally receiving mental health, but most likely receiving no services at all" (Denmark, 2009). They have only committed minor crimes and do not belong in jail or prison. Jail is counterproductive to the mentally ill who could be rehabilitated and reintegrated. Being able to execute effective substitutions to confinement will offer restoration and attention to the mentally ill. When police arrest people with mental illness for minor crimes it is often because they are looking for a short-term solution.
The documentary Frontline produced showed that the prison systems only rehabilitate until they feel the person with a mental illness becomes stabilized. However, they are only stabilized because they are receiving that care constantly. Once they are back out in the public that constant care is gone and they are going to end up back in jail. Imprisonment only rehabilitates for a short-term not a long-term like this group of people need. As a result, police officers will have to keep dealing with the same mentally ill people over and over.
The police are going to constantly be in contact with the mentally ill until psychiatric hospitals and mental health services are back for the long-term. The mentally ill are going to keep cycling in and out of jails and prisons until they have their twenty-four hour care back for them. Without these facilities our officers in this country are going to have to start being trained better in dealing with the mentally ill. Collaboration between them and mental health professionals has to exist. Police need to be capable of distinguishing when a person is mentally ill person and how to use the mental health resources and not jail. Neither the mental health system nor the law enforcement system can handle a mental health crisis in the community successfully without each other's help. Mental health resources need to be quickly available and easily accessible, and that police officers receive better training. With that, the problem the police have to their delivery of services to the mentally ill can work exceedingly better.
TALK ABOUT THE MOVIE- 76% of these inmates required and received psychiatric inpatient care or its equivalent for part of their time in jail during the current offense. A large number of people with serious mental illness are receiving their acute psychiatric inpatient treatment in the criminal justice system rather than the mental health system.
With respect to these inmates' history before the current arrest, at least 92% were known to be non-adherent to psychiatric medications, 94% had prior arrests, 72% had prior arrests for violent crimes, and 76% were known to have a history of substance abuse. Given these data, in addition to the fact that three-quarters required inpatient psychiatric care in the jail, it would appear that the jail had acquired the responsibility to manage and treat many of the most difficult and expensive to treat persons with serious mental illness.
This year alone, more than 700,000 people will leave prison, more than half of them mentally ill. Typically, these offenders leave prison with a bus ticket, $75 in cash, and two weeks' worth of medication. Studies show that within 18 months, nearly two-thirds of mentally ill offender-often poor and cut off from friends and family-are re-arrested.
FRONTLINE also tracks downÂ Keith Williams, a paranoid schizophrenic who had been arrested more than 10 times since producers first met him in 2004. Now at Northcoast Behavioral Healthcare, a state psychiatric hospital in Toledo, Ohio, Williams has been stabilized on forced medications. But Northcoast, like all other state psychiatric hospitals, now provides only short-term crisis care. A nurse says that Keith is doing good but it is also bad news because since he's doing good, he will be sent back into the community and he'll be back within three months.. Probably very psychotic, and hopefully not having hurt somebody."Once released, Williams will be responsible for taking his own medication. Asked how he'll know when to take his pills, Williams tells FRONTLINE: "I would know when to take them because ... if I feel like kaboo-ka-kaboojaning, I mean groovy or foamy or something, ... that's when I know I already took them." Four days after being discharged from NorthCOAST, Williams assaults a police officer. He is facing 10 years in prison.
(Mentally ill are not going to be in the state of mind to figure out how to get more medication. Most are homeless and don't even have a phone or anything to search for a place to get medication. Their mindset is not of a normal person who thinks oh I have to take my pill today. People who are mentally ill have to be told. They need places to go where they will get help. When they are released they should be given pamphlets on places to go and so on so at least they have some lead. Or the prison people can call an institution to come get this person and take them in once released.)
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