The attitudes of Canadian police officers toward the mentally ill

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Introduction

When governments contemplate the deinstitutionalization and community integration of individuals with mental illnesses, a variety of community supports and services are considered essential and developed (to a greater or lesser extent). But one community agency that has been significantly affected by the downsizing of psychiatric hospitals is the police, rarely a group considered to be a community mental health service. The police have been described as de facto mental health providers (Patch & Arrigo, 1999) and “the frontline extension of the mental health system” (Chief Coroner of Ontario, 1994). There remains little doubt that contacts between the police and those with mental illnesses have increased significantly as more and more of individuals experiencing mental illnesses are residing outside the hospital and within the community Brown & Maywood, 2002, Heslop et al., 2002. The reasons are complex and not altogether clear. To some extent, of course, the mere presence of more individuals with mental illnesses in the community will increase contact. There is also evidence that the mentally ill is at significantly increased risk of being victims of crime, given their vulnerability (Marley & Buila, 2001). The question of increased risk of violent behavior among those with mental illnesses remains controversial to some extent, although it appears clear that individuals who are not properly treated and who abuse substances are indeed at increased risk. It has been noted that the arrest rate of those with mental illnesses is higher than that of others, but how much of this is attributable to an actual increase in criminal or violent behavior and how much is attributable to the phenomenon described as “the criminalization of the mentally ill” is not clear (see Borecki & Wormith, 1985, Hiday, 1991, Monahan et al., 2001, Patch & Arrigo, 1999, Steadman et al., 1978, Teplin, 1984, Teplin, 1985, for more complete discussions of this issue). However, regardless of whether the contacts between the police and individuals with mental illnesses are attributable to increased violence, increased victimization, or a tendency to criminalize, what is clear is that the numbers are going up.

In the present context, the term criminalization is used to describe the tendency to involve individuals with mental illnesses in the legal/criminal justice system, under circumstances in which other nonmentally ill individuals would not be involved. It may include circumstances such as arresting a mentally ill individual for a misdemeanor, such as disorderly conduct, to resolve an otherwise problematic situation. To criminalize something, quite literally, means to make something criminal, which was not previously criminal. In the case of individuals with mentally illnesses, the concern is that behaviors that might not be regarded as criminal in other people may be treated as criminal behavior to provide an avenue for the police to deal with a situation that does not present any other obvious solution.

The question of how to approach situations in which some low level activity is perceived as distressing to others, or as potentially leading to more significant criminal activity, or as repetitive in nature, or, indeed, simply as indicative of a major mental illness, is a question which is rarely addressed in policy and, generally, left to the discretion of the individual officer responding. Similarly, even in situations in which there is a clear indication of violence or significant criminal behavior, there is no ready agreement among police officers as to the best method of handling the situation (Trovato, 2000). Most police departments do not have formal policy around the handling of mentally ill individuals, and most do not have specialized mental health officers or teams to respond to such calls (Deane, Steadman, Borum, Veysey, & Morrissey, 1999). A recent Canadian survey (Cotton, 2001) indicated that only a small minority of Canadian police services had formal strategies in place to assist in dealing with mentally ill individuals, and that these programs tended to exist only in large urban centres. Thus, in most cases, incidents involving individuals with mental illnesses will be handled by the full range of frontline officers. Indeed, it does appear that most officers have fairly regular contact with the mentally ill. A variety of studies (e.g., Green, 1997, Holley & Arboleda-Florez, 1988, Kimhi et al., 1998, Teplin & Pruett, 1992) have all documented the frequency of calls to the police for assistance with mental health issues. A general estimate is that such calls make up at least 7% of police responses—on one hand, a relatively small percentage, but at the same time, an overrepresentation of those suffering from mental illnesses (Borum, Deane, Steadman, & Morrissey, 1998).

According to Green (1997), most of these calls do not result in formal charges being pursued and, indeed, some would argue that the police undercharge rather than overcharge these individuals, as well as actively avoid apprehension under mental health laws because of frustrating and, often, nonproductive relationships with the mental health system (Teplin & Pruett, 1992). Clearly, discretion is used liberally in managing these situations.

The question of what drives officer discretion in the handling of any situation is complex. The primary determinants will of course be specific to the individual encounter: the nature of the action, the type of complaint, who complained, the history of the involved parties, the context, and a variety of other situational issues. Patch and Arrigo (1999) describe two types of factors in particular that might be relevant to the analysis of discretionary behavior. The first of these is the nature of police–citizen encounter. Calls may be initiated by either the police or by a citizen, and as well, the call may be for either law enforcement or order maintenance.

The second factor is that of “officer type,” a term these authors use to represent the personality and attitudinal attributes of individual officers that may influence their behavior in specific situations. It is of course unlikely that attitudes will be the sole determinant of behavior in officers, but attitudes are no doubt an influencing factor. Attitudes are, by definition, behavioral tendencies or dispositions to act in a certain way. In the case of dealing with the mentally ill, there is particularly good reason to be concerned about attitude because the generally negative opinion of the public toward individuals with mental illnesses is well documented, and it is widely accepted that stigma remains one of the biggest barriers to successful community integration of those with mental illnesses. There is no shortage of literature decrying the effects of stigma and the negative expectation on the plight of those suffering from psychiatric illnesses (cf. Green, 2000). Phelan, Link, Stueve, and Pescosolido (2000) provide distressing support to the suspicion that attitudes are not necessarily improving over time. They report data that suggests that the general public in 1996 expressed more concerns about the dangerousness of the mentally ill than was the case in the 1950s.

There is, in fact, little known about the attitudes of police officers toward the mentally ill and the mental health system. Lester (1978) looked at attitudes of a limited and nonrepresentative sample of police officers, but was only able to make a general observation that they tended to be slightly authoritarian and less benevolent than health care workers.

Kimhi et al. (1998) observed that only a small minority (14.3%) of Israeli police officers felt that those with psychiatric disorders should be isolated from society. Trovato (2000) assessed attitudes toward the mentally ill in a large sample of 374 Toronto police officers. Their scores on an adapted version of the Opinions About Mental Illness Scale (OMI; Cohen & Struening, 1962) indicated a high degree of benevolence, which is described as representing a view of mental patients as a societal obligation and a belief in advocacy for persons with mental illnesses. Generally, Trovato's results indicated police holding a positive orientation toward individuals with mental illness, but at the same time, a relatively socially restricted view of the mentally ill. In addition, he found that while officers ascribed, in theory, to principles of benevolence and a mental hygiene ideology, their behavior was more consistent with authoritarian and socially restrictive views. One particularly intriguing aspect of Trovato's work was the inclusion of copious comments and observations by the police about other aspects of their attitudes toward working with the mentally ill, especially in reference to how they viewed their role as police officers and to what they attributed the increasing amount of contact. There were some general themes that emerged. Some officers clearly thought that there were serious flaws in the mental health system. Others made observations about the appropriateness of the role of police in this type of work. Because these comments were not structured, it was not possible to determine to what extent they were singular opinions and to what extent they were widespread attitudes. It is not known how Trovato's sample of police officers compared with other occupational groups on the dimensions measured.

The purpose of the present study was to identify and quantify those attitudes that may influence the discretionary behavior of police. In particular, the present study sought information about the attitudes of police officers toward the maintenance of the mentally ill in the community, about how much control the mentally ill should be subject to, the extent to which the community should tolerate or interact with those with mental illnesses, the need for public resources and funding, and the role of the police in the care of the mentally ill.

Section snippets

Participants

Officers were recruited from three police forces: the Kingston City Police Department, which has approximately 150 sworn members and is located in a medium-sized city (population 120,000) in Eastern Ontario; the Port Moody Police Department, with 31 sworn members, located in the city of Port Moody, British Columbia (population 25,000); and selected detachments of the Ontario Provincial Police (OPP) within Eastern Ontario. The OPP is a large provincial police force, which holds mandates for

Results

The overall participation rate was 34%, with approximately equal proportions of each police force responding. It is not possible to comment on the representativeness of this sample in general, but demographic data suggested that those who responded were roughly comparable to the overall pool of subjects in terms of age, gender, years of service, and rank. For surveys that the respondents did not actively solicit themselves, response rates are known to vary over a significant range, from about

Discussion

The gradual shift in care for individuals with mental illnesses from institutions to the community has created an expanding role for police officers. Little, however, is known about how the police feel about individuals with mental illnesses or how they feel about their role in caring for these individuals. Members of the three police services surveyed in the present study did not display high levels of authoritarianism or significantly socially restrictive attitudes toward individuals with

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