Mental Health Training for Law Enforcement Professionals

Methods

Results

Of the 150 surveys distributed, 126 were returned, representing a response rate of 84 percent. According to a census taken in 2000, this sample represents less than 1 percent of the total number of local police officers (n = 16,718) in Massachusetts.¹³ Over half (55.4%) of the police officers attending the training volunteered to attend. The majority (73.4%) of police officers reported they had previously attended post-academy mental health training. Regarding highest level of education, 28.8 percent had taken some college classes, 32 percent had graduated from college, 9.6 percent had some post-graduate training, and 19.2 percent had completed post-graduate training. Regarding experience, 19.2 percent had 1 to 5 years, 22.4 percent had 6 to 10 years, 20.8 percent had 11 to 15 years, 14.4 percent had 16 to 20 years, and 14.4 percent had over 20 years of law enforcement experience.

Over 90 percent of respondents reported that the topic of mental illness was either fairly or very important. Interest in particular topics varied, although all topics were rated by a majority of respondents as fairly or very important. Table 1 identifies those topics ranked as of significantly greater and lesser interest, along with an intermediate group. The topics of Dangerousness, Suicide by Cop, Decreasing Suicide Risk, Mental Health Law, and Your Potential Liability for Bad Outcomes were rated significantly higher (repeated-measures ANOVA, p < .05) than the topics of Management of Problem Behaviors, Mental Health Resources in Your Area/Institution, Personality Disorders, Overview of Specific Types of Mental Illness, and Types of Medication and Their Side Effects, which, although considered important, were ranked lower in an overall preference list. The topics of Effective Communication With Persons With Mental Illness, Drug and Alcohol Abuse, and Stress Management received intermediate ratings (Table 1). Level of education did not have a significant effect on the ratings, but police officers with more law enforcement experience rated the importance of learning about mental illness significantly higher (repeated-measures ANOVA, p < .05) than officers with less experience. Subjects who volunteered to attend the training rated Importance of Mental Illness as a training subject and the topics of Overview of Specific Types of Mental Illness, Personality Disorders, Mental Health Resources in Your Area/Institution, Suicide by Cop, Management of Problem Behaviors, and Stress Management significantly higher (t test, p < .05) than those who were required to attend.

With the exception of Role-playing, which was rated significantly lower (based on repeated-measures ANOVA with p < .05), there were no significant differences among training modalities. Responses ranking presentation formats as very effective were 37.7 percent for Video, 29.9 percent for Small Group Discussion, 29.0 percent for Handout, 25.0 percent for Lecture, 22.7 percent for Role-playing, 22.3 percent for Slides, and 22.5 percent for Panel Discussion. Responses ranking presentation formats as completely ineffective were 0 percent for Video, 1.7 percent for Small Group Discussion, 0.8 percent for Handout, 0.8 percent for Lecture, 5.0 percent for Role-playing, 0.8 percent for Slides, and 1.7 percent for Panel Discussion. The average ratings for teaching formats were 3.34 for Video, 3.21 for Small Group Discussion, 3.17 for Handout, 3.15 for Lecture, 2.87 for Role-playing, 3.21 for Slides, and 3.12 for Panel Discussion.

Regarding training frequency, 68.3 percent of respondents preferred yearly training, 18.7 percent preferred training once every five years, 11.4 percent wanted training every six months, and 1.6 percent wanted training on a monthly basis. Regarding training length, 55.7 percent preferred a half day of training, 22.1 percent wanted a full day of training, 19.7 percent wanted two hours of training, and 2.5 percent wanted one hour of training.

There were 12 written comments about additional topics for training. Three respondents requested more information about civil commitment laws. Other requested topics included jail diversion, feedback from mental health professionals regarding performance, juvenile issues, death in police station “lock-ups,” dealing with family members of mentally ill persons, dispatcher's role in suicide attempts, mental health issues within police departments, video examples of persons with mental illness, how to communicate with mental health professionals, and visiting community mental health facilities.

Conclusions

In this study, we conducted a preliminary analysis of the topics, presentation formats, and frequency of mental health training preferred by police officers. Although the officers were from police departments across Massachusetts, only a small percentage of Massachusetts police officers were surveyed. Because of the small sample size and potential bias of the study population, it is not clear whether the findings from this survey can be generalized to all police officers; thus, the results must be interpreted with caution. Although just over half of respondents volunteered to attend the training, over 90 percent of respondents reported that the topic of mental illness was either fairly or very important to their work. In addition, the responses for interest in topics and lecture modalities were compressed in the three to four range. When taken together, these data suggest that many police officers are interested in learning more about working with persons with mental illness and view it as an important aspect of their job.

In this survey, over 70 percent of officers reported receiving post-academy mental health training. It is possible that the high percentage of officers who received post-academy mental health training reflects a self-selected population, in that officers with pre-existing interest in mental health training may have chosen to attend the training sessions where the survey was administered. Similarly, the officers who were mandated to attend the training may have been sent from individual police departments that emphasized mental health in-service training for their officers. Officers may be receiving such mental health training as a consequence of recent litigation related to officer performance in crisis situations (see for example, Palmquist v. Selvik and the Village of Bensenville¹⁴) or based on a recognition of the frequency with which officers encounter persons with mental illness in the course of their work.

Police officers are not asked to oversee the management of persons with mental illness on a long-term basis. This may explain why the topics of Management of Problem Behaviors, Mental Health Resources in Your Area/Institution, Personality Disorders, Overview of Specific Types of Mental Illness, and Types of Medication and Their Side Effects, although still desired by respondents, were not rated as high as the other topics. Although correctional officers were not included in this survey, they may have more interest in these particular areas.

Given the current interest in mental health training, it is likely that many mental health professionals will be asked to speak to law enforcement professionals about mental illness. When time is limited for training, this study suggests that officers would choose the topics of Dangerousness, Suicide by Cop, Decreasing Suicide Risk, Mental Health Law, and Your Potential Liability for Bad Outcomes as topics of interest. Additional topics could include Effective Communication With Persons With Mental Illness, Drug and Alcohol Abuse, and Stress Management. Based on the written comments from this study, there may also be a need for less formal, more specific discussions on topics such as how to communicate with mental health professionals or jail diversion. Training in some of these areas may warrant the addition of legal professionals to the training team. Regarding the topics selected by study subjects, however, these personal preferences must be balanced with the mental health topics that training and commanding officers would select for their departments. For example, for the training programs attended by study respondents, police chiefs and training coordinators were specifically asked to design curricula that included education about types and manifestations of mental disorders. Although the individual officers in this study did not rank the topic of Overview of Specific Types of Mental Illness as high as other topics, teaching officers to understand basic differences between specific mental illnesses may be useful in improving communication and understanding of the persons whom they encounter. In this regard, police departments could also solicit advice from mental health professionals and local agencies in selecting prioritized topics. Although attitudes of police officers may be more difficult to change,^9,12 providing training topics aimed at increasing knowledge may be a first step. Further study is needed to identify the effectiveness of such training in improving outcomes in law enforcement encounters with persons with mental illness.

Regarding training modalities, Role-playing was rated significantly lower than the others, but the percentage of respondents rating it as extremely effective was similar to that for both Slides and Panel Discussion. The percentage of respondents rating Role-playing as completely ineffective, however, was higher. This most likely reflects extreme views toward Role-playing, with fewer respondents giving mid-range ratings. For some officers, role-playing may be considered a very useful training modality, but other officers may not prefer this training technique. Thus, when considering role-playing as a training modality, we recommend asking about the level of comfort with it prior to including it as a part of the training.

Regardless of the method, when developing training for police officers, it is important to keep in mind that many police officers may have completed college and engaged in post-graduate studies. Therefore, the level of the information should be presented to suit their needs. Officers and mental health professionals come from different vantage points in their exposure to persons with mental illness. In our experience, using mental health and law enforcement professional co-trainers allowed the officers to learn from the perspective of each discipline. It has been noted that, in working together, police and mental health providers must be mindful of the limits of their expertise.¹¹ By collaborative teaching or by having a designated law enforcement leader in attendance, mental health professionals in the instructor role can defer questions related to police procedure to someone with expertise in that area, and vice versa. This approach to teaching may also serve as a model for effective communication between a law enforcement officer and a mental health professional.¹⁵ Such efforts may assist mental health professionals in joining forces with law enforcement to provide the most effective means of managing persons with mental illness in crisis.