Handling Police Encounters with People with Mental Illnesses

"Sheriff's Department, open the door!"

At first I thought it was a joke, but then I heard the sound of a struggle and someone screaming. I opened my door, only for a staff member to wave me back into my apartment. She was on the phone. "He's psychotic. He's seeing things. He was cooperating but they took him down when he tried to run. What do you want to do?" I posted the details of the confrontation on my Facebook page with the hashtag #PsychPatientsLivesMatter and soon received comments on my bravery.

Bravery? No, this is a fact of life for people with mental illnesses. Sometimes an encounter with law enforcement goes very badly. Which is a shame, because with the right kind of training, police encounters with people with mental illnesses don't have to end with violence.

Crisis Intervention Team Training

I don't know why the sheriff's department was called. Had it been the Indianapolis Metropolitan Police Department, chances are a Crisis Intervention Team (CIT) officer would have responded. CIT officers have three goals, according to their web site:

1. To reduce the number of individuals with mental illness in the criminal justice system
2. To decrease the risk of injury or death to the person in crisis, the law enforcement officers and people in the community
3. To increase the number of people with severe mental illness that are in treatment

CIT police officers are trained about mental health issues, medications, addictions, suicide, legal processes, available resources, de-escalation techniques and alternatives to arrest such as immediate detention. I remember one CIT officer told a newspaper that in one case, he would have used force if he hadn't had the CIT training.

I believe every law enforcement officer should have this training. Sadly, Indy is the exception, with a goal of 20% of street police officers receiving this kind of training.

In other words, if you're in a mental health crisis in Indianapolis, you have a one-in-five chance of getting someone who can actually help.

This has ended sadly. Once, a man was put on quetiapine (Seroquel) and had a psychotic break. His family called the hospital, but the call went unanswered. Someone called the police to report a suicidal man with a gun. A SWAT officer responded and fatally shot the man.

How to Handle Calling the Police for a Mentally Ill Person in Crisis

The National Alliance on Mental Illness (NAMI) reports: "Every time a crisis is prevented through proactive intervention and assistance, it reduces the likelihood of contact with law enforcement and an arrest. Every time that an individual goes into a crisis, the odds of an assault, injury or arrest are increased."

So how to avoid negative outcomes? Prepare.

NAMI has an article called Ask A Cop: What Should I Say When I Call 911 for a Loved One? The advice: gather information before a crisis occurs, get advice from law enforcement officers before a crisis occurs and train for a crisis. For example, if your loved one is a veteran with posttraumatic stress disorder, keep a record of their diagnosis, medication regimen, symptoms of a crisis and potential triggers. The officer needs to know that your loved one has a reaction to certain tones of voice or that they think they're in Tikrit. Practice this preparation until you know it by heart. Then, if a crisis occurs, you'll know what to do.

NAMI's Family-to-Family has a crisis file you can use to prepare for emergencies. Your local affiliate will be able to help you. The national office can be reached at 1-800-950-NAMI.

NAMI reports:

Law enforcement and our jails and prisons have become the major providers for the mental health care in our country. While this is not an acceptable situation, it is a fact and we need to do what we can to respond in a way that leads to a good outcome for everyone. Doctors in the psychiatric emergency rooms have told us that they can tell the difference between officers who have received the training and those who have not by listening to the interactions between officer and the patient. When the officer is trained in CIT, they become part of the treatment team and the recovery actually starts when the individual with mental illness makes contact with police.

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