Police and Mental Illness: Increased Interactions

1 And Mental illness : Increased InteractionsReasons for Increased InteractionsAcross North America, a number of changes have led to increasing interactionbetween Police and persons with Mental illness . A shift from institutionalized careto community-based care has resulted in more persons with Mental illness in thecommunity. Unfortunately, community support systems have not received suffi-cient funding to grow proportionately to the Increased need. Existing crisis re-sponse services (crisis lines, Mental health teams, hospital emergency wards, forexample) are limited in scope and are often not well integrated. Reductions inhospital beds and services result in hospital admission only for those in acute crisis,and, even then, only for very short periods of factors and the general lack of understanding and awareness about men-tal illness result in many people with Mental illness in crisis coming into contactwith Police .

2 A Canadian Mental Health Association, BC Division study foundthat over 30% of persons with serious Mental illness interviewed had contact withpolice while making, or trying to make, their first contact with the Mental healthsystem. Police officers are, by default, becoming the first point of access to mentalhealth services for persons with Mental illness , earning them the nickname psy-chiatrists in blue. But is this an appropriate role for Police ? Are they trained andgiven the proper resources and support to fulfill this role? What are the impacts ofthis situation for persons with Mental illness , for the Police , for the public?Impact of Increasing InteractionThere is an ambivalence among Police officers about whether they should infact be dealing with Mental health issues. The Police mandate is generally toensure safety and to provide protection to the public, but some Police officersdo not consider this mandate to include protecting or providing safety forpeople with Mental illness in crisis this being the responsibility of the mentalhealth system.

3 This ambivalence is reinforced if there is a lack of comprehen-sive, ongoing training of Police officers in the recognition of Mental illnessand in Mental health crisis intervention, and a lack of contact and supportfrom Mental health and emergency services. The results for persons with Mental illness can be serious : long delays inreceiving necessary diagnosis and treatment, unnecessary and damaging trauma,criminalization of illness -induced behaviour. The estimates of untreated men-tal illness in the criminal justice system range from 15 40% of the incarcer-ated population. When Police respond to a person in Mental health crisis asthey are trained to respond to a typical criminal emergency situation with ashow of force and authority they may in fact escalate the crisis to a point ofrisking injury or death for Police or the public, but most often for the personin Mental health impact on Police can be traumatic: Police officers have been trauma-tized by the Police shooting deaths of persons in Mental health crisis, deathswhich might well have been prevented if officers had received appropriatetraining.

4 As well, Police suffer frustration at long wait times at emergencydepartments, refusals to admit persons to hospital, a lack of Mental healthservice alternatives, and a lack of coordinated general public suffers also. Family and friends of persons with mentalillness experience the trauma and frustrations of such Interactions , as well as theimpact of the criminalization of Mental illness . The general public experiences theloss of Police response when hours of Police time are spent waiting for a person incrisis to be admitted to hospital. The public also receives reinforcement for theNo. 1 Building Capacity: MentalHealth and Police Project(BC:MHAPP) is a project ofthe Canadian Mental HealthAssociation s BC Division,with a goal of improvinginteractions between Police ,emergency services, andpeople with Mental fact sheet is produced aspart of the BC:MHAP fact sheets have beensupported by gamingrevenue from the Province ofBritish Columbia.

5 This projectis supported by theVancouver Foundation andthe Provincial Health ServicesAuthority. This fact sheet isone in a series of eight: Police and Mental Illness: Increased Interactions Criminalization ofMental illness Violence and Mental Illness: Unpacking the Myths Police and Mental Illness: Models that Work Mental Health Crises:Frequently Asked Questions Hallucinations andDelusions: How to Respond Mental illness andSubstance Use Disorders:Key Issues Suicidal Behaviour:How to RespondFor more information on thisproject, please contactCamia Weaver, ProvincialCo-ordinator for BC:MHAPP,CMHA BC Division, March 2005BC DIVISION false perception that Mental illness is a crime rather than an illness , and thatpersons with Mental illness are a public danger a common and erroneous beliefwhich hurts both persons with Mental illness and the number of communities, recognizing the need to improve the response topersons in Mental health crisis, have developed special programs for interven-ing with persons who have a Mental illness .

6 In most cases, the programs weredeveloped through collaboration between Police and Mental health serviceproviders, and others involved or invested in the issue. The range of programsincludes: mobile teams of Police and Mental health professionals to respond tomental health crises Police reception centre where Police can take persons suspected ofhaving a Mental illness for further assessment and referral by speciallytrained Police officers crisis intervention teams located in each Police catchment area torespond to Mental health crises as well as perform regular duties joint protocols between Police and a Mental health centre or hospital,with continued joint assessment and problem-solvingA number of factors have been found to contribute to the success of among these are: training ongoing Mental health awareness training for all officers andspecialized crisis intervention skills training for specialized officers information systems an information system which tracks crisis interven-tions and outcomes ( what works and what doesn t), trains dispatchers inrecognition of Mental health issues, and a system of dispatch which relaysall relevant information on Mental illness and crisis issues accessibility accessible 24 hours a day, 7 days a week throughout the areaserved collaboration protocols for close collaboration with Mental health serv-ices and dispute resolution mechanism for collaborators evaluation measuring outcomes and disseminating results to make neces-sary changes for a more complete analysis of these issues, please see Study in Blue and Grey.

7 Police Interventions with People with Mental illness (2003) on our CMHA BCwebsite at of Mental IllnessThe IssueThe long-term trend of deinstitutionalizing people with Mental illness thatis, releasing people from psychiatric hospitals to reside and be treated in thecommunity has been heralded by many as a step forward in the social ac-ceptance and respectful treatment of people with Mental illness . With the ad-vent of new, more effective medications and better understanding of the rangeand types of community supports people with Mental illness require, manypeople with Mental illness live successfully in the a minority of people, usually those with multiple complex needs,deinstitutionalization combined with a lack of comprehensive community sup-port systems has resulted in another type of institutionalization, within pris-ons and jails rather than is only one of the factors leading to an increase in what is generallyknown as the criminalization of Mental illness , , where a criminal, legalresponse overtakes a medical response to behaviour related to Mental is a distressing trend, with a number of contributing Mental illness is CriminalizedResearch consistently shows us that a person with Mental illness is more likelyto be arrested for a minor criminal offence than a non-ill person.

8 The majorityof these arrests are for crimes such as causing a disturbance, mischief, minortheft, failure to appear in court directly or indirectly related to the mentalillness. The majority of these arrests are also initiated by a report from a mem-ber of the public, rather than the range of mentally disordered offenders ( persons with Mental ill-ness convicted of an offence) currently in jails and prisons is somewhere be-tween 15 to 40%; highly disproportionate to the occurrence of Mental illnessin the population at number of factors contributing to the disproportionate incarceration ofpersons with Mental illness have been identified in research literature: Lack of sufficient community support including housing, income, andmental health services. persons with Mental illness have a harder timefinding employment and housing, and maintaining consistent contactwith friends, relatives and treatment providers. It is estimated that 30% 35% of Canada s homeless population have a Mental illness .

9 Many be-come isolated, homeless , hungry, and poor due to the symptoms oftheir illness . High rate of substance abuse. Over 50% of people with Mental illnesshave a co-occurring substance use disorder. Co-occurring disorders( Mental illness and substance use disorder) are more difficult to treatthan either Mental illness or substance abuse alone, and there are insuf-ficient treatment programs for the growing demand. The Forensic label. Treatment is sometimes refused to persons whohave committed a criminal offence or have been previously staff may refuse admission because it is considered a criminalmatter, or the person may be considered too dangerous or disruptive fortreatment by community resources even if the offence for which theperson was arrested or convicted does not involve 2 Building Capacity: MentalHealth and Police Project(BC:MHAPP) is a project ofthe Canadian Mental HealthAssociation s BC Division,with a goal of improvinginteractions between Police ,emergency services, andpeople with Mental fact sheet is produced aspart of the BC:MHAP fact sheets have beensupported by gamingrevenue from the Province ofBritish Columbia.

10 This projectis supported by theVancouver Foundation andthe Provincial Health ServicesAuthority. This fact sheet isone in a series of eight: Police and Mental Illness: Increased Interactions Criminalization ofMental illness Violence and Mental Illness: Unpacking the Myths Police and Mental Illness: Models that Work Mental Health Crises:Frequently Asked Questions Hallucinations andDelusions: How to Respond Mental illness andSubstance Use Disorders:Key Issues Suicidal Behaviour:How to RespondFor more information on thisproject, please contactCamia Weaver, ProvincialCo-ordinator for BC:MHAPP,CMHA BC Division, March 2005BC DIVISION Problems with treatment. Some persons with Mental illness try nu-merous treatments without success. Others refuse treatment becausethey cannot accept that they have an illness , they dislike medicationside-effects, or due to symptoms of the illness itself. Lack of sufficienthousing, income, and support also interfere with the ability to main-tain treatment.