Responding to persons with mental illnesses: police perspectives on specialized and traditional practices (original) (raw)
Related papers
A new look at an old issue: People with mental illness and the law enforcement system
The Journal of Mental Health Administration, 1997
Most research on encounters between persons with mental illness and the law enforcement system has focused on the extent to which persons with mental illness are shifted between the mental health and law enforcement systems. This article focuses instead on the interplay between the mental health and law enforcement systems for a group of persons with severe mental illness who continue to be actively treated by an Assertive Community Treatment (ACT) program. To better understand the connection between these two systems, profiles were constructed for 100 ACT clients, including data about arrests, other contacts with the law enforcement system, and mental health treatment. Results indicate that although the majority of A CTclients had some contact with the law enforcement system, most police encounters and arrests were for minor infractions. Those clients with the most frequent and serious contacts also received more expensive and intensive mental health treatment. Implications for future research and program design are discussed. Research suggests that a growing number of persons with serious mental illness have become the responsibility of the law enforcement system rather than the mental health system?-3 Although much attention has been focused on the movement of persons with mental illness between these two public systems, relatively little attention has been given to understanding the patterns of interactions between the mental health and law enforcement systems for people who are actively involved in effective treatment programs. This article offers a preliminary look at the overlap and connections between these two systems by studying a group of persons with mental illness who are enrolled in an Assertive Community Treatment (ACT) program. This type of mental health program is being increasingly used around the country, especially for persons who have frequent contacts with the police. Although ACT programs have been studied extensively, 4,5 surprisingly little is known about whether this form of treatment affects the interplay between the law enforcement and mental health systems. The present case study was undertaken to provide a deeper understanding of the extent and nature of the use of the law enforcement system by persons who are being treated within ACT programs.
This article examines the historical and contextual factors that are related to the growing numbers of persons with mental illness who are processed through the criminal justice system. The paper discuss five major mental health and criminal justice policies that frame the challenges associated with the mentally ill in the criminal justice system: deinstitutionalization (a shift in the locus of care from the state hospital to community-based treatment agencies); mental health law reform (notably more stringent criteria for involuntary admission to a psychiatric facility); fragmented care (little coordination between mental health and other treatment providers); drug enforcement (the war on drugs that resulted in the arrests of the mentally ill who use illicit substances); and public-order policing (the enforcement of arrest policies that target nuisance crimes). The article also presents recommendations for responding more effectively to the problems of the mentally ill in the crimi...
Criminal justice, 2000
Major changes in mental health policies and laws have placed untold numbers of persons with serious mental illness (PSMIs) in the community, where they receive inadequate or intermittent care, or no care at all. These changes have caused criminal justice professionals to become involved with PSMIs at every stage of the justice process. In this chapter, we explore the blurred boundaries between the criminal justice and mental health systems in the United States. We focus on the arrest, incarceration, and community supervision of PSMIs. We review research on the relationship between serious mental illness and violent crime and trace the historical developments that have apparently produced growth in the numbers of PSMIs in the criminal justice system. We also examine how the increased numbers of PSMIs have compelled criminal justice organizations to alter their policies, procedures, and relationships with mental health providers and to confront the difficulties that arise in initiating and sustaining those relationships.
Mentally Ill Persons in the Criminal Justice System: Some Perspectives
Psychiatric Quarterly, 2000
There is an increasing number of severely mentally ill persons in the criminal justice system. This article first discusses the criminalization of persons with severe mental illness and its causes, the role of the police and mental health, and the treatment of mentally ill offenders and its difficulties. The authors then offer recommendations to reduce criminalization by increased coordination between police and mental health professionals, to increase mental health training for police officers, to enhance mental health services after arrest, and to develop more and better community treatment of mentally ill offenders. The necessary components of such treatment are having a treatment philosophy of both theory and practice; having clear goals of treatment; establishing a close
Psychiatric Services, 2002
With deinstitutionalization and the influx into the community of persons with severe mental illness, the police have become frontline professionals who manage these persons when they are in crisis. This article examines and comments on the issues raised by this phenomenon as it affects both the law enforcement and mental health systems. Two common-law principles provide the rationale for the police to take responsibility for persons with mental illness: their power and authority to protect the safety and welfare of the community, and their parens patriae obligations to protect individuals with disabilities. The police often fulfill the role of gatekeeper in deciding whether a person with mental illness who has come to their attention should enter the mental health system or the criminal justice system. Criminalization may result if this role is not performed appropriately. The authors describe a variety of mobile crisis teams composed of police, mental health professionals, or both. The need for police officers to have training in recognizing mental illness and knowing how to access mental health resources is emphasized. Collaboration between the law enforcement and mental health systems is crucial, and the very different areas of expertise of each should be recognized and should not be confused.
The American journal of psychiatry, 2017
Psychiatric interventions have moved toward the criminal justice system. Every large jail and prison in the United States must offer psychiatric services to inmates in order to comply with the Eighth Amendment and established case law (1). Nearly all sizable emergency departments have access to psychiatric consultation. Very few psychiatrists in the United States are employed by a law enforcement agency and work alongside detectives, conduct evaluations in the field, assist with training, and participate in community outreach (2, 3). The need for collaboration between psychiatry and law enforcement is stronger than ever. Over the past 20 years, the number of hospital beds has been cut, and interactions between psychiatric patients and law enforcement have increased (4-6). Partnerships between law enforcement and psychiatry can augment the efforts of psychologists and other clinicians who are more prevalent within law enforcement. See related features: Clinical Guidance (Table of Contents) and AJP Audio (online)
Mentally Ill Individuals in Jails and Prisons
Crime and Justice, 2017
Both targeted programs and wholesale changes are sorely needed in how individuals with mental illness are processed in the criminal justice system. Mental illness is not as directly related to criminal involvement or violence as is often assumed. Mentally ill individuals are nonetheless disproportionately present in jails and prisons. Efforts to reduce their numbers must take account of the heterogeneity of mental conditions and their changing nature. Understanding of the complex ways in which mental illness and involvement in crime and violence are related is a precondition for formulating realistic policies. The disproportionate presence of mentally ill individuals in jails and prisons will not be substantially ameliorated by new programs alone; these have limited reach and effect. Doing better in five respects is key: expand the reach of standard and innovative mental health services, divert mentally ill individuals early in the criminal justice process, enrich training of criminal justice personnel, use data more effectively, and promote interdisciplinary aftercare programs for people with mental illness when they are released from jails and prisons.
Patterns and Prevalence of Arrest in a Statewide Cohort of Mental Health Care Consumers
Psychiatric Services, 2006
Objective-Although criminal justice involvement among persons with severe mental illness is a much discussed topic, few large-scale studies systematically describe the patterns and prevalence of arrest in this population. This study examined rates, patterns, offenses, and sociodemographic correlates of arrest in a large cohort of mental health service recipients. Methods-The arrest records of 13,816 individuals receiving services from the Massachusetts Department of Mental Health from 1991 to 1992 were examined over roughly a ten-year period. Bivariate relationships between sociodemographic factors and arrest were also examined. Results-About 28 percent of the cohort experienced at least one arrest. The most common charges were crimes against public order followed by serious violent offenses and minor property crime. The number of arrests per individual ranged from one to 71. Five percent of arrestees (roughly 1.5 percent of the cohort) accounted for roughly 17 percent of arrests. The proportion of men arrested was double that of women. Persons 18 to 25 years of age had a 50 percent chance of at least one arrest. This rate declined with age but did so unevenly across offense types. Conclusions-The likelihood of arrest appeared substantial among persons with severe mental illness, but the bulk of offending appeared concentrated in a small group of persons and among persons with sociodemographic features similar to those of offenders in the general population. Data such as these could provide a platform for designing jail diversion and other services to reduce both initial and repeat offending among persons with serious mental illness. Minimizing criminal justice involvement among persons with severe mental illness has become a major focus of policy makers and officials from both the mental health and criminal justice systems. From the collaboration of these systems various interventions have evolved over the past ten to 15 years to help divert arrestees with mental illness to an appropriate array of mental health services (1). These mechanisms, which target primarily low-level offenders, have been introduced at several points within the criminal justice process-from the street to the courthouse. Such interventions include specialized training for police officers (2,3), pre-and postbooking jail diversion programs (4,5), mental health courts (6,7), and reentry programs for individuals with serious mental illness who have been released from correctional settings (8). Support for these programs has been forthcoming from local, state, and federal agencies and was the focus of the Mentally Ill Offender Treatment and Crime Reduction Act of 2004 (S.1194), which passed both houses of Congress and was signed into law by President George W. Bush. Empirical evidence marshaled to contextualize these interventions comes from various sources and settings. Among the most frequently cited are data on the considerable