Encountering The Mentally Ill: Modern Policing Issues and the Detention Crisis

The television shows light up our homes with visions of detectives who have mind boggling skills to extract confessions and the ability to read people better than the average civilian. It certainly leads us to believe in some metaphorically way that deceptive behavior is somehow only uncovered by Voodoo magic. Wow. That’s all very fascinating and certainly grabs us for entertainment value.

Hollywood might sensationalize it just a little bit. Not that it isn’t true, but it isn’t magic. The knack comes from years of education and experience with interpersonal communications.

Interpersonal communication skills are perhaps an officer’s greatest tools. Volatile interactions can often be deescalated rapidly by officers who are masters of communications. Those skills come in handy for every police contact. Dynamic situations can happen at random and law enforcement must be ready to react.

Police officers not only need to have the ability to recognize deception, but they also must be able to identify abnormal behavior. Reading people is extremely important. Law enforcement officials have to know a lot about human behavior and they must be able to best react, deescalate situations, and at times restrain physically and emotionally charged persons.

Mentally ill persons have a huge impact on our criminal justice system. It all starts at the street level where we might encounter them on duty as a police officer. Usually emotionally disturbed persons are contacted on a call derived from a complaint. The complaint can come from a neighbor, observing citizen, or family member. Usually the behavior is bizarre or aggressive and requires police intervention. Police assess the situation and evaluate the best solutions. Many times it results in an arrest. So are the police Band-Aiding a larger social problem?

Have you noticed the shift in prison reform and social programs to accommodate mentally ill offenders with re-entry programs, mental health care, substance treatment plans, and occupational rehabilitation methods? Why is that? We are seeing a large number of offenders also displaying disturbing behaviors or being diagnosed with mental illness. This is now a hot topic of scientific study and restorative justice reformation.

Defunding of mental health institutions began in the Kennedy era and continued with Reagan. These facilities became unsustainable and were a disposal place in a sense of our mentally ill citizens. As harsh as it sounds, it essentially was a locked housing facility (prison form) for unwanted and very unstable citizens displaying or diagnosed with severe mental illness. Prior to 1960, very unorthodox and cruel practices were common. Inhumane treatment and the overuse of psychotropic drugs were widely used.

Before the deinstitutionalization, little was done to rehabilitate them into society. The system was a poor housing program to be blunt. People were locked up and forgotten by family members and their irrational behaviors were shielded from the public. The thought processes of treating these patients in a more humane way and allowing them to be a part of the community began to take place in the 1960s and continues today. The Community Mental Health Act of 1963 was a part of legislative action which began this process.

I think we have all watched horror films depicting some sort of institution or asylum and the mistreatment of humans. Maybe these extreme images we gather from movies is all some of us can visualize about those with mental disorders. Perhaps it is all we think we know or is telling of how much television influences our thoughts because many people have never had an encounter with volatile persons. It isn’t the norm to run into a severely deranged person, but certainly can happen.

Police may encounter that type of behavior more often in a person exhibiting bizarre and dangerous behavior after taking certain illegal substances or “drug cocktails.” Drug cocktails are illegal substances laced with hallucinates, dangerous drug combinations or mixtures, or involve a person using multiple illegal substances. This state can be a temporary or permanent cycle of psychosis. Often mental disorders can be brought on by long term drug use.

Whether the disturbed person has behavior temporarily induced by drugs or a psychotic episode or suffers from an illness or disorder is not usually determined until the police do some investigation. The subject’s peculiar behavior starts a social reaction which can place them in the criminal justice system.

Our American society has been labeled as a very mentally ill nation when compared to other countries and criticized by outsiders. Perhaps this is actual and perhaps some of it has been assumed from our openness about mental health. The fact is we do have a social crisis.

After deregulations in mental health wards began, mentally ill citizens then were released into society and began to flood the criminal justice system. The concept itself of integrating them into regular life was much more humane, but what didn’t happen fast enough was a proper community design. When the funding for housing and treatment was stripped, as well as drug prices rose, it really gave those seeking mental health solutions little avenue for success.

Many became homeless or sought to medicate themselves with substances which led to more societal dysfunction. Substance abuse seems to follow or precede the cycles and mental breakdowns. Police officers faced an influx of problems with domestic issues and community disturbances. Because the United States did not have a proper plan in process, the mentally ill behaviors and incidents became a police problem. Complaints increased and domestic disturbances drew our attention to a much bigger issue. The behaviors emerged because of substance abuse, lack of treatment, lack of medications, or other factors. Police had to respond to the call. The behaviors were criminalized and impacted the criminal justice system. Prisons became de facto mental health hospitals.

Families did not know how to care for their loved ones and many domestic quarrels or violent episodes occurred. The mentally ill were driven out of homes or caught in the criminal justice system. Some took to the streets. Many bounced around from friend or family dwellings, often getting kicked out because of some disturbing episode or event.

Many homeless persons I ran across in law enforcement had been diagnosed with mental illness or a disorder of some kind, but stopped seeking treatment because of lack of support or funding, or both. It was not surprising to hear their story and that their move to the streets began with some type of fall out with family or a great loss in their life. The losses were various and differing among homeless persons whether it involved a career plummet or the loss of a loved one, or a combination of events. Some life event seemed to be a commonality in triggering the decline in their social and mental well-being. Additionally, several had no support system to give them structure and balance.

Jails and prisons have become the new “housing program” for the mentally ill. Lack of pre-release planning, inadequate numbers of mental healthcare design and facilities, and social system integration has caused a stress to communities. In the beginning, the magnitude was not realized. Police administrators introduced training which came in the late 90s. By the early 2000s for law enforcement and many police schools focused heavily on training and emphasized the importance officers how to identify and  interact with mentally ill citizens. The frequency of encountering mentally ill persons and the manic incidents were catalysts to training adjustments.

Disturbing behavior by citizens continues to be a majority of police responses. In response to the calls, law enforcement have incorporated training and best practices in this area of concern.  As part of law enforcement’s overall organizational design, administrators have integrated standard modules and core courses pertaining to best practices in dealing with the mentally ill. The first response may always begin with a police reaction, but it can end up as a medical focus. Sensitivity training as well as education toward recognition of the problem has helped identify and triage these incidents to treat the source of the health problem first rather than just jail the offender.

We have to recognize that major mental disorders and illnesses are accompanied by functional impairment and it affects the person’s thoughts, emotions, decision making skills, and ability to relate to others. There are many more facets, but these name a few impacts upon a person’s psyche and everyday functioning abilities.

Leaving the mentally ill untreated and ignoring the problems will make the situations and incidents worse in a community. Public safety would diminish. It has to be a commitment which we all manage collectively with community partnerships as a nation. Exploring progressive models and continuing education for law enforcement has been written into the policies and procedures for most all police departments. We still have a long way to go.

Fixing our mental health problem begins with ordinary people and changing attitudes, making mental health a priority in our country. It isn’t just a medical issue, it is a social issue with community responsibility. The police are just one component of the call to action. Collaborative efforts can make a difference in quality of life with sustainable models of first responder procedures, mental health treatment, and offender rehabilitation all while keeping public safety paramount.