Ever since the United States Supreme Court’s 1974 and 1975 double remands in Lessard v Schmidt (414 U. S. 473 and 421 U.S. 957), the police have been in the front lines of our society’s struggle with mental illness. Lessard made it more difficult for family and mental health professionals to place individuals into treatment and has left this responsibility — by and large — to the police.
Though officers are not and should not be street-corner psychologists, the fact is that they come in daily contact with people who have a variety of emotional problems. Consequently, cops need to have at least a basic understanding of how to communicate with Emotionally Disturbed Persons (EDPs) in order to diffuse possible violent encounters.
Research suggests that persons with developmental disabilities and other mental issues are seven times more likely to come in contact with law enforcement than others. In some jurisdictions, EDP-related calls may be one of the largest number of non-criminal calls received by law enforcement. Law enforcement officers also provide a sizable number of mental health referrals because they are often the first to respond to EDP generated complaints.
The Numbers are Staggering
With more than 300 diagnosed mental disorders — the professionals aren’t even sure of the exact number — it’s not surprising that police often contact those with emotional or behavioral problems. Even with legitimate concerns about faddish over-diagnosis the numbers are staggering.
The National Alliance on Mental Illness maintains that:
• One in four adults experience a mental health disorder in a given year
• About 2.4 million Americans live with schizophrenia
• 2.6 percent of Americans have a bipolar disorder
• 5.2 million Americans have co-occurring mental health and addiction disorders
• One-half of all lifetime cases of mental illness begin by age 14, and three-quarters by age 24
• 90 percent of those who commit suicide have a diagnosable mental disorder
This doesn’t mean that these individuals have committed a crime when law enforcement officers contact them, an important distinction that Gary Klugiewicz pointed out in an article written by PoliceOne’s Doug Wyllie last May. In fact, it’s more likely they will be victims, not suspects. Estimates suggest only about 1 percent of those suffering from mental health issues are dangerous. However, in the most difficult of circumstances officers discover that these individuals can be a threat to themselves or others. Officers are rightly wary and have legitimate safety concerns every time they respond to EDP-related calls.
Front Lines of Mental Health Care
Ithaca, New York likely reflects the range of challenges faced in many jurisdictions. As early as 1998 calls from EDPs were the “largest number of non-criminal calls received by the Ithaca Police Department.” In response, the Department built a relationship between community policing officers and mental health professionals that successfully decreased the number of EDP calls and eliminated many of the chronic calls.
What prompted this partnership was the death of both an officer (Lieutenant Michael Padula) and his attacker (Deborah Stagg), in a 1996 barricaded suspect incident. According to reports, Stagg had a history of mental illness and hospitalization and, on the day of the tragedy, and been off her medication for nearly a month.
Despite an extensive effort at intervention in a community of 30,000 (the metro area is significantly larger), tragedy struck again in August 2011 when Keith Shumway, a 20-year old who had been unable to find immediate mental health assistance at the local clinic, attacked and shot a police officer. During the attack Shumway’s life-threatening behavior forced a second officer to shoot and kill him. Shumway’s aunt had it about right when she said in an interview that “...the police and the law are on the front lines of mental health care. And that is not their original job, not what they’re trained for.”
Though in the vast majority of instances law enforcement officers do a superb job handling EDP calls, they sometimes end in tragedy. Rarely does the mainstream media capture the success stories, such as Officer Rocco Cipriano of the Scranton, Pennsylvania Police Department who successfully defused a tense situation with a knife-wielding teenage girl. A quietly successful intervention doesn’t make the news.
Once on-scene, patrol officers may have no idea that the unresponsive, uncooperative, or even violent subject with whom they are dealing with on the street, in a dark alley, or the narrow confines of a small room has a diagnosed mental or emotional disability. Psychiatrists and psychologists spend years developing expertise in a few of these disorders, often in clinical settings. Expecting officers in tense circumstances to immediately recognize one of the myriad developmental, psychological or behavioral disorders is wishful thinking. In order to resolve clear public safety threats, officers sometimes must resort to force. Only afterwards do other facts emerge that may result in public censure. But that is only the beginning of the problem.
Because pre-booking mental health diversion programs or assertive community treatment regimen are often unavailable in smaller, rural jurisdictions, a local jail may be the only alternative to insure the individual’s and public safety. Should a jail facility prove unacceptable or unsuitable (no in-patient mental health program, for example), on-call mental health professionals may have no choice other than to release the individual, who has committed no criminal offense, back into the environment that contributed to the incident in the first place. Without proper mental health and substance abuse services, these people often become recurring problems for family and law enforcement until such time as their emotional or mental issues result in arrest and eventual detention.
However, this does not mean that law enforcement should neglect the need to understand EDP behavior. Many police academies provide instruction on EDPs, but post-employment in-service training may be more sporadic. Professional publications, universities and colleges, non-profits, and the private sector have helped fill the knowledge gap. Training on autism, one of the fastest growing diagnosed developmental disorders in the nation, is just one example.
How to ‘Speak’ Autism
PoliceOne has published a number of excellent articles on autism, some inspired by officers that have raised autistic children. Joel Lashley’s excellent two-part series, “How to ‘speak’ Autism” is but one example.
Another great resource is Kerry L. Brooks, a federal law enforcement officer and President of Autism-2-Awesome http://www.autism2awesome.com/. He offers a course to first responders to help them recognize and appropriately react to people with autism. Kerry recognizes that each encounter with a special needs person will be different. Therefore, he has designed the course so participants gain a broad understanding of autism and then works to help each attendee develop best-practices on how to approach people with special needs.
His intent is to increase both officer and the EDP’s safety and decrease liability in the process.
Supervisors should consider a number of options for roll-call or other training venues. Topics of interest for patrol, especially with limited training time and tight budgets, could include:
• an overview of mental health illnesses
• suicide risks and “suicide by cop”
• the status of the law on mental health and liability
• co-occurring mental health disorders
• working with mental health professionals
• general recognition and communication strategies
Now tired of Lessard’s unintended consequence of using jails as mental health facilities, some legal experts and mental health advocates want to reverse course. Changes are unlikely to come anytime soon and law enforcement will remain on the front-line of our society’s response to people with behavioral and emotional issues. A little bit of knowledge can go a long way in helping officers recognize and articulate what they see, gain confidence, and help shape a response that could de-escalate an otherwise tense and potentially violent confrontation.