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Counties Examine Police Training in Encounters with Mentally Ill

May 6, 2015

By Kimberly Leonard
U.S. News & World Report

At a time when excessive use of force by police is taking center stage in the national conversation, another concern is gaining traction: how to train officers to recognize and interact with people who have a mental illness, and how to divert people with medical needs from jails to places where they can receive treatment.

Even before the deaths of Eric Garner in New York City and Michael Brown in Ferguson, Missouri, last summer, police in Dallas faced criticism for the handling of a call that led to the death of a mentally ill 38-year-old man. The mother of Jason Harrison asked police in June for help in taking her son, who had been diagnosed with bipolar disorder and schizophrenia, to a local hospital. He was holding a screwdriver when the officers arrived, and when he wouldn’t drop it the officers fired several shots and killed him. Harrison’s family in March released a chilling video of the incident taken by a police camera that raises disturbing questions about whether the officers acted appropriately in their handling of the confrontation.

In another case in January, Kristiana Coignard, who was 17 and had bipolar disorder and depression, entered a police station in Longview, Texas. On her hand she wrote, “I have a gun” and she had a knife on her. She provoked a confrontation, eventually charging at an officer with her knife, and she was fatally shot.

The episodes, while extreme, are emblematic of what law enforcement and health professionals say is an increasing need for police to more effectively relate to people who might be acting out or misunderstood because of mental disorders – and to make informed decisions about whether they are better suited to jails or to hospitals.

“Police officers are public servants; they interact with people in dire times of need,” says Toni Carter, a commissioner in Minnesota’s Ramsey County, where officials are poised to pass a resolution that would support changes to how the corrections system handles mental illness.

Too often, law enforcement may use force when they don’t need to, says Paton Blough, a member of the National Alliance on Mental Illness, who has bipolar type 1 disorder. He described an incident in which he was in a paranoid and delusional state of mind and police used a Taser to subdue him after they had already hit him with batons and handcuffed him. Blough said he doesn’t blame the officers because they lacked training.

“They were trying to get me calm,” he said. “I believed they were there to kill me, not to help me.”

Often after confrontations with police, people with mental illness are incarcerated. Because of this, and because of a lack of training programs or even access to treatment, 10 times more people with mental illness are in prisons and jails than in state psychiatric hospitals, according to the Treatment Advocacy Center, a group that works to increase treatment for mental health.

A new initiative introduced on Capitol Hill on Tuesday by the National Association of Counties, the Council of State Governments Justice Center and the American Psychiatric Foundation calls on counties to provide alternative programs for people with mental illness instead of taking them to jail. The initiative, “Stepping Up,” would have counties assess how many people with mental illness are in jails and track the progress those people make in treatment.

In Loudoun County, Virginia, work to change the system has already started. At the Capitol Hill event, Sheriff Mike Chapman spoke of how a third of the county’s deputies receive training to participate in Crisis Intervention Teams (CIT). The program offers specialized training for such things as talking someone out of suicide or appropriately managing a psychotic episode that may be caused by schizophrenia or by drug use. Afterward, team members help follow up to link those people with mental health professionals.

Some staff originally may have dismissed the program as “hugs for thugs,” Chapman said. But now, they tell him it is the best program they have ever had.

“I think it’s picking up steam,” he says of the possibilities of similar programs around the country.

Linda Langston from the Linn County Board of Supervisors in Cedar Rapids, Iowa, and past president of the National Association of Counties, says that when law enforcement members get CIT training, they are able to make different choices about how to approach people with mental illness.

In 2012, the latest year in which the the National Institute of Mental Health reported data, an estimated 9.6 million adults suffered from a serious mental illness. Though 18.6 percent of adults have some form of mental illness, like depression or anxiety, more serious conditions like bipolar disorder, schizophrenia or post-traumatic stress disorder, affect 4.1 percent of Americans.

An estimated 8.9 million adults in the U.S. have co-occurring mental illness and substance use disorders, yet only 7.4 percent receive treatment for both conditions and more than half get no treatment at all.

When persons with mental illness do run afoul of the law, the charges they most commonly face are not for violent crimes, according to the National Alliance on Mental Illness.

“People, through no fault of their own, have a biologically based illness,” said Patrick Kennedy, a former member of Congress from Rhode Island and mental health care advocate. “They are discriminated against in every form. We arrest them for not treating them.”

The corrections system became the main gatekeepers for people with mental illness and substance abuse disorders after President John F. Kennedy signed the Community Mental Health Act in 1963. The law’s vision was to shut down mental asylums in favor of shifting patients to one of 1,500 outpatient community mental health centers, so people could receive treatment in the neighborhoods where they and their families lived.

The legislation never met its full intention, however. Only half of the community centers were built, and budget cuts hit the ones that were.

“We are using our criminal justice system as a substitute for a fully functioning mental health system,” said Sen. Al Franken, D-Minn.

Franken, along with Rep. Doug Collins, R-Ga., on the House side, introduced the Comprehensive Justice and Mental Health Act, which instructs the Justice Department to provide information to local law enforcement, increase services for veterans and set up accountability measures.

“We have 5 percent of the world’s population but 25 percent of the world’s prison population,” Franken said. “That’s in large part because we have criminalized mental illness.”

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