• Center for Problem oriented policing

POP Center Problems People with Mental Illness, 2nd Ed. Appendix

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Appendix: Summary of Responses to People with Mental Illness 

The table below summarizes the responses to people with mental illness, the mechanism by which they are intended to work, the conditions under which they ought to work best, and some factors you should consider before implementing a particular response. It is critical that you tailor responses to local circumstances, and that you can justify each response based on reliable analysis. In most cases, an effective strategy will involve implementing several different responses. Law enforcement responses alone are seldom effective in reducing or solving the problem.

Response No.

Page No.


How It Works

Works Best If…


General Considerations for an Effective Response Strategy



Developing an integrated response model

Enables early recognition of mental illness and facilitates diversion to mental health care, when appropriate

…police are able to make timely referrals to a range of social and mental health services

Requires considerable high-level coordination among police and service-providing agencies



Working with the mental health community

Police develop partnerships and collaborate with mental health agencies and advocacy groups

…the collaboration is focused on identifying and solving specific problems

Mental health agencies are typically underfunded and overwhelmed; police may want to help support and empower advocacy groups to increase their influence on legislation and funding



Working with emergency hospitals

Police meet regularly with the staffs of emergency hospitals to address issues and problems

…a sense of teamwork and shared responsibility can be developed

Protocols must be developed in advance and effectively implemented so that patrol officers are not faced with debating doctors and nurses in the middle of the night



Appointing police liaison officers

Helps police and other organizations maintain focus on and develop expertise in mental health issues

…liaison officers have credibility within the police agency so that they quickly hear about complaints and problems

Liaison officers to the entire mental health system should have sufficient rank to represent the whole police agency and establish standing with doctors, psychiatrists, etc.; liaison officers to specific facilities can be area specialists (beat officers) or mental health specialists



Establishing detailed policies and procedures

Clarifies procedures and expectations for officers

…line-level officers have input into policies and procedures

Requires ensuring that police policies and procedures are compatible with those of mental health service providers



Proactively addressing chronic mental illness-related problems

Addresses underlying conditions driving chronic problems

…police officers are both trained and expected to engage in proactive problem solving

Partner mental health and criminal justice agencies must also be amenable to proactive and preventive interventions to chronic problems

Specific Responses to People with Mental Illness

Improving the Police Response to Incidents



Deploying specialized police officers

Improves the police response to situations involving mental illness through the delivery of specialized knowledge, skills, and experience

…mental health practitioners are included in the training so that familiarity, trust, and teamwork are developed; officers volunteer for the special assignment

Deploying around-the-clock specialists and developing a team approach with mental health practitioners may be difficult for small/rural police agencies and in jurisdictions that lack their own mental health facilities



Deploying specialized nonpolice responders

Improves the response to situations involving

mental illness through the delivery of specialized knowledge, skills, and experience

…sworn and non- sworn personnel work together as a team

It is important to have clear guidelines about the differing roles of sworn and non-sworn responders and clarity about decision-making authority; a blended approach of generalist and specialist officers is also viable



Training public-safety call takers

Leads to earlier recognition of the need for mental health expertise to address the incident

…call takers are able to mobilize mental health resources quickly and reliably

Call takers will not always be able to accurately identify a mental illness dimension in calls for service



Training generalist police officers

Improves police officers’ awareness and understanding of mental illness and thereby improves their responses to incidents

…the training is hands-on, realistic, and focused on making good decisions that protect the safety of the individual, the general public, and officers

It is important to demystify mental illness and help officers overcome stereotypes and prejudices; training alone will not suffice to change police encounters with people with mental illness



Providing more information to patrol officers

Increases the likelihood that people with mental illnesses will be properly referred to treatment services

…adequate mental health services are available, and the police data and communications system forewarn officers about previous incidents and encounters involving specific complainants, suspects, victims, subjects, and addresses

Storing and communicating information about individual histories of mental illness and mental health crises raises significant privacy issues; legal restrictions may vary from state to state



Using less- lethal weapons

Reduces the likelihood of serious injury or death to people with mental illnesses

…less-lethal weapons are effective, noncontroversial, and immediately available to officers in the field

Less-lethal weapons may affect a person in mental a health crisis differently from other persons; agencies must assure that officers

do not resort to less-lethal weapons before exhausting nonviolent alternatives



Withdrawing police from some incident scenes

Can reduce anxiety in the person with mental illness; eliminates opportunity for “suicides by cop”

…police are assured that no innocent other persons are put at risk by removing police from the scene; mental health resources can be offered to those in need

Withdrawal can conflict with the police occupational norm to act

Improving the Efficiency and Effectiveness of Mental Health Care



Initiating assisted outpatient treatment

Increases the likelihood that people with mental illness will receive proper treatment and medication, thereby decreasing

the likelihood of the need for police intervention

…mental health workers enforce court-ordered treatment compliance

Compliance enforcement has been shown to reduce incidents, arrests, victimization, violent

episodes, and homelessness



Establishing crisis response sites

Improves the response to people in mental crisis

through readily available specialized services

…intake procedures are streamlined, a no-refusal policy is in place, and both mental health and substance abuse services are available

Police should understand that a no-refusal policy does not guarantee extended or inpatient stays, just a guarantee that the facility will accept the person for evaluation



Establishing jail-based diversion

Improves the mental health treatment of offenders and reduces the use of scarce jail resources

… when screening occurs immediately after booking; adequate mental health treatment is available

Immediate diversion will generally be available only for minor offenders; more serious offenders may be considered for diversion at the prosecution or adjudication stages



Establishing alternatives for transporting non-violent mentally ill persons to mental health facilities

Reduces police time spent on relatively unproductive tasks

…non-police transporters have some training in self-defense and transport vehicles are designed for this purpose

Transferring this responsibility requires some cost shifting; police are more likely to make mental health referrals if doing so does not commit them to lengthy custodial and transportation tasks



Establishing mental health courts

Enhances the special expertise of judges in adjudicating mentally ill offenders

… when specialized judges and courts work closely with mental health agencies and advocacy groups

Small jurisdictions may not have the resources or volume of mental health cases to support specialized judges or courts

Concentrating and Customizing Interventions for Those Who Repeatedly Come into Contact with Police



Protecting repeat victims

Increases the likelihood that people with mental illness who are repeat crime victims, as well as repeat victims of offenders with mental illness, receive special attention; increases the likelihood that victims with mental illness, as well as victims of

offenders with mental illness, will recover from their victimization and successfully navigate the legal system

… repeat victims are identified sooner rather than later in the course of their repeated victimizations; victim services agencies, mental health agencies, and mental health advocacy groups collaborate

It is important to try to identify guardians (official or unofficial) who can both protect vulnerable victims and influence them to change any risky behavior; police must be careful not to dismiss victimization claims by people with mental illness; while false reports are common, so is victimization of people with mental illness by family members, unprofessional service providers, and others



Focusing on repeat offenders

Increases the likelihood that people with mental illness who commit repeated offenses, as well as offenders who commit repeated crimes against people with mental illness, are targeted for special attention

… repeat offenders are identified sooner rather than later for special enforcement, prosecution, and/or treatment; guardians and handlers (including family members and service providers) can be persuaded

to exercise more supervision and influence over disorderly behavior

Repeat offenders often go unrecognized and fall through the cracks of the criminal justice system; concerted effort is required to keep this from happening



Focusing on complainants responsible for repeat calls for service

Increases the likelihood that people with mental illness who repeatedly call the police about trivial

or imaginary problems receive special attention

… repeat complainants receive follow-up visits to identify underlying issues and implement systematic responses; police develop a trusting relationship with the chronic complainant

Because chronic complainants may initiate calls from various locations, it is necessary to analyze calls for service to identify repeat complainants as well as repeat addresses



Focusing on places where police frequently have contact with people with mental illness

Concentrates attention on locations with multiple incidents and/or calls for service involving people with mental illness, thereby correcting

conditions that create incidents

… guardians and managers can be persuaded to exercise more supervision and authority over hot- spot locations

Hot-spot analysis related to calls and crimes involving people with mental illness is challenging because police data systems often do not include categories or flags indicating mental illness



Regulating facilities more effectively

Compels mental health service facilities to improve their practices, thereby reducing the likelihood that police will need to intervene

… liaison officers work with each facility to analyze problems, recommend solutions, and monitor compliance

Because mental health facilities are often profit- making businesses that are poorly regulated by governing authorities, they frequently arise as hot spots; these facilities typically account for a disproportionate share of calls and crimes involving people with mental illness and should be a principal target of problem-oriented policing

Responses With Limited Effectiveness



Arresting people with mental illness

Intended to deter offenders through punishment and incapacitation

… arrested people are promptly diverted

into the mental health, medical, or social service systems

People with mental illness who commit serious crimes should be arrested, leaving decisions about criminal liability to the courts; minor offenders, however, are

not likely to be prosecuted, adjudicated, or incarcerated, making arrest an ineffective response from every perspective



Incarcerating people with mental illness

Intended to deter offenders through punishment and incapacitation

… mental health services are available in the jail

Incarceration of people with mental illness is never beneficial for the individual or the jail; it harms the individual, creates risks for other detainees, and greatly complicates the operation of the jail



Ignoring the needs of people with mental illness

Done in hopes that the

problem will go away

… problems are minor and other stakeholders shoulder the responsibility

Ignoring people in need is an abdication of a basic police responsibility

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