Troubled times: law enforcement, severe mental illness, and other disabilities

Susan Werner - Did Trouble Me on YouTube

As we experience the Covid-19 pandemic, political unrest, and economic uncertainty, we frequently hear the expression “During these troubled times…” or something equivalent. Whether it is used in an ad for anti-anxiety medication or to promote a candidate in a seemingly distant election, many people with severe mental illness and those with severe intellectual and developmental disabilities (IDD) and their families experience “troubled times” as the norm. Untroubled times are a welcome relief, while waiting for troubles that may be just around the corner. 

In the recent Black Lives Matter upheavals following the horrific video-recorded killing of George Floyd in Minneapolis, a demand to “Defund the Police” has been pushed to the forefront of news coverage. There are varying interpretations of what this means. However one interprets the phrase, there is a lot to be gained from examining the role of law enforcement in the lives of people with mental illness and other disabilities, the allocation of taxpayer funds in this regard, and whether there are more effective ways to use the money that might produce better results for everyone concerned. Police departments, like public schools, are often called on to solve societal problems that they have no control over, such as poverty, the lack of medical and mental health care, and homelessness. The neglect of these problems through years of de-funding programs that might have shored-up our system of care and services to people with with mental illness and intellectual and developmental disabilities (IDD), has led to law enforcement taking on responsibility for problems where others have failed to have an impact. It is hard to believe that most police officers want this responsibility, nor are they very good at solving these types of societal problems.

Severe mental illness often leads to police involvement when a person with untreated mental illness is perceived as acting irrationally or in a threatening manner toward others. People with severe IDD and their families experience similar situations to that of people with severe mental illness and their families. [See "Michigan’s mental health system is failing many with severe autism", 5/16/19 from The DD News Blog for some examples.]

The Treatment Advocacy Center (“Eliminating barriers to the Treatment of Mental Illness”), distributes a Research Weekly that recently looked at the “Role of Law Enforcement in Mental Illness Crisis Response". Its recommendations show how shifting funding from law enforcement to better care and treatment for people with severe mental illness would relieve law enforcement of taking on responsibilities better left to the mental health system and divert people who are unnecessarily forced into the criminal justice system into more appropriate and effective treatment.

Here are excerpts from from the Research Weekly: "Role of Law Enforcement in Mental Illness Crisis Response":
“The Treatment Advocacy Center has been calling attention to the need to transform law enforcement’s role in communities for more than 20 years, starting with the work of our founder Dr. E. Fuller Torrey. Our research expertise includes the role of law enforcement in mental illness crisis response and how people with severe mental illness are overrepresented in the criminal justice system.

"What follows is a compilation of data and information on these important topics: ..”
...
"Approximately one in four fatal police encounters involve an individual with severe mental illness, according to our 2015 report, Overlooked in the Undercounted. This means that people with mental illness are 16 times more likely to be shot and killed by police, compared to people without mental illness. Reducing the disproportionate volume of contacts between law enforcement officers and people with severe mental illness is the single most immediate, practical strategy to reduce fatal police encounters for individuals with mental illness. Furthermore, there is currently no national government database collecting information regarding arrest-related deaths, let alone the role of mental illness or race disparities in these encounters."

...
"The role of law enforcement in mental illness crisis response is an enormous portion of department resources and budgets. Responding to and transporting individuals with mental illness occupies more than one-fifth of law enforcement officers’ time, according to our 2019 report, Road Runners . This outsized role is a result of the overrepresentation of people with mental illness within the criminal justice system, the length of time mental health crisis service calls take, the long distances law enforcement must travel to find available mental health resources and the time officers must wait while transporting individuals in crisis to an emergency department."

...

"The lack of appropriate mental health treatment services in the community was the most prominent factor contributing to law enforcements’ outsized role in mental health crisis response, according to a thematic qualitative analysis of our 2019 law enforcement department survey results . Survey respondents felt that many of the time and resource issues surrounding psychiatric transports are due to an inadequate supply of beds in the community for individuals to receive treatment. As with any other illness, severe psychiatric diseases have a variable illness course, with waxing and waning symptomology and resulting needs for the individual suffering. Therefore, a full continuum of psychiatric care, including outpatient, crisis, and acute care, as well as longer-term and residential-type beds, is needed for a functioning psychiatric system. Few communities in the United States have such a robust mental health care system in place."
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"As municipalities continue to examine the role law enforcement plays in our society, these data and resources can serve to inform evidence-based policy decisions.

Elizabeth Sinclair Hancq
Director of Research
Treatment Advocacy Center