Improving Police Response to Persons With Mental Illness: A Progressive Approach

Psychiatrists who work with law enforcement professionals seek resources that examine how collaborative interventions between the disciplines can improve outcomes for citizens and officers during mental health crises. Improving Police Response to Persons With Mental Illness is one such resource.

The editors are nationally recognized leaders in the law enforcement community. They participated in two 21st-century projects designed to ameliorate how law enforcement officers respond to individuals with acute mental illness, after incidents in Illinois and Texas resulted in fatal outcomes. The book is the collaborative effort of the editors and other experts, including attorneys and academic professionals who are involved with such incidents.

The text has three sections. Part I, which contains three chapters, describes the “Origins of the Problem.” The authors of this section review challenges police officers face when they interact with persons in mental health crisis. The chapter entitled “Atypical Situations-Atypical Responses,” describes how these encounters differ from routine police work. Vignettes describe situations in which citizens with mental illness are victimized and need the protection that is provided by police officers, as well as ones in which individuals who are in emotional crisis are restrained by police to protect other citizens. Although the most extreme of these encounters result in fatalities, the descriptions span the spectrum with regard to types of interactions and outcomes. The broad scope of the case examples enhances the author's discussion of the perceived roles of law enforcement officers.

The second and third chapters are entitled “Community Treatment and the Police” and “Nature of Police Contact With Persons With Mental Illness.” The latter chapter, written by Leonard Peck, Jr, summarizes findings from surveys of Illinois and Texas police and sheriffs' departments that examined factors affecting how law enforcement officials functioned during mental health crises. The surveys included questions about the frequency and types of interactions, transportation to hospitals or court, types of offenses, the perceived likelihood that the affected persons would become victims of crime, the degree of disruption caused by the affected person's behavior, the availability of community mental health resources, and the importance of various types of training.

Part II, “Issues for Law Enforcement,” also consists of three chapters. “Law Enforcement Policy Recommendations” examines policy considerations that affect persons with acute mental illness, including the initial call received by the police department dispatcher, the police officer's response to the call, and the officer's assessment of the situation at the scene. Different models of cooperation between police and mental health agencies are described.

The second and third chapters, “Realistic Expectations of Police” and “Legal Authority and Limitations,” describe what law enforcement might do to refine interactions with persons with acute mental disorders. The authors' recommendations include providing adequate training, developing clear policies, and increasing communication with mental health agencies. The third chapter explains the process for involuntary hospitalization.

Part III of the book is labeled “Successful Police Responses.” It has four chapters that describe how to ameliorate police responses to mental health emergencies. One chapter describes various law enforcement training models. Another offers practical advice about how police departments can craft collaboration agreements with mental health agencies. Gary W. Cordner, an expert in police operations and administration, examines community policing in the third chapter.

The final chapter, “Creating Effective Law Enforcement and Mental Health Partnerships,” examines the cultures and goals of law enforcement and mental health agencies. The author provides guidelines for establishing collaborative models that can be successful.

In summary, Improving Police Response to Persons With Mental Illness is an informative guide for law enforcement officers and mental health professionals, including those professionals seeking to under-stand the pressures law enforcement officers experience when they are required to assist citizens during mental health crises. The authors provide an excellent discussion of the topics that should be addressed by law enforcement administrators who want to develop protocols that improve police competence and effectiveness during mental health emergencies, including collaborative partnerships with mental health agencies.

• American Academy of Psychiatry and the Law