Mental Illness Responses

Feb. 24, 2014
When mental health became ‘decriminalized’ years ago, the floodgates of institutions poured many into the mean streets. Most became victims of the system. All too often most became pharmaceutically institutionalized leaving them trapped to take their meds.

There is a reoccurring event that keeps playing out on the streets and often on the television news of a person in a mental health crisis and the local law enforcement becomes involved. Some of these are good outcomes and some are tragic. Some make law enforcement responders heroes and others make them the defendants in civil litigation. There comes a time when you need to step back and view the issue from the 50,000 foot view, what are we doing correctly and where do we need to improve in our service delivery? Are we in law enforcement doing all we can do?

Several years ago, I was appointed to a state training committee and one of our tasks was that we were to meet with a lady who wanted to champion a mental health cause to law enforcement. Her child had an extremely rare diagnosis. She had spent years with several doctors, clinics and countless evaluations to garner the exact diagnosis, yes it was that rare. She was proposing that all first responders take a course in recognizing this malady and how to best respond to it. It would have been nearly a week long course. Granted this was a problem, but only one out of hundreds of mental diagnoses that we face in the streets daily. As much as I wanted to help her, the probability of having a contact with a victim of this was lottery winning probabilities. I felt sorry for her but then explored this some more.

When mental health became ‘decriminalized’ years ago, the floodgates of institutions poured many into the mean streets. Most became victims of the system. All too often most became pharmaceutically institutionalized leaving them trapped to take their meds. How many times have you responded to a person that are off their medications or mixed with recreational drugs or alcohol? Some of us got good at handling this and others did not. Most all of the state law enforcement training commissions have recommended and/or offered classes on mental health and its response. If you are seeking some help go to The National Alliance on Mental Illness (http://www.nami.org) for some information.

Another trend that is emerging is the creation of multidisciplinary teams to respond to mental health crisis calls. The training of mental health professionals/para-professionals along with emergency medical and law enforcement for a team approach is one of the best practices we are seeing. These Crisis Intervention Team (CIT) programs are local initiatives designed to improve the way law enforcement and the community respond to people experiencing mental health crises. They are built on strong partnerships between law enforcement, mental health provider agencies and individuals and families affected by mental illness.

The problem with this is availability and response times. The small agency covering a vast rural area may only have one officer or deputy working with a state trooper off the interstate as the closest back-up. A mental health patient in crisis may need assistance before a team can be assembled or respond from the county seat. Still what can we do? I firmly believe that all officers need to be updated on the law enforcement’s role in this call for service. If you add to this the epidemic of Post Traumatic Stress Disorder (PTSD) our military veterans, we are increasing our chances of having to respond to calls for help. Go to the US Department of Veterans Affairs (http://www.va.gov) for more information and another good information source is Active Hero’s (http://activeheroes.org) for helping PTSD victims.

I do not desire to see my law enforcement brothers and sisters respond to a situation where they do not have the best tools and skills made available to them any longer. Nor do I want to see a person having a mental crisis be misdiagnosed or improperly treated due to lack of training on our end. Yes, there have been gaps in our responses in the past. There are current cases in litigation where training may have avoided a tragedy. Training is not the great salvation to this but it will assist in the understanding and proper service delivery. Today’s law enforcement leaders and supervisors must view this as an important topic requiring attention. The reduction of and total avoidance of liability exposure should make the naysayers sit up and pay attention.

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