Center for Problem-Oriented Policing

Summary of Responses

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.

General Considerations for an Effective Response Strategy
#ResponseHow It WorksWorks Best IfConsiderations
1Working with the mental health communityPolice develop partnerships and collaborate with mental health agencies and advocacy groupsthe collaboration is focused on identifying and solving specific problemsMental 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
2Working with emergency hospitalsPolice meet regularly with the staffs of emergency hospitals to address issues and problemsa sense of teamwork and shared responsibility can be developedProtocols 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
3 Appointing police liaison officersHelps police and other organizations maintain focus on and develop expertise in mental health issuesliaison officers have credibility within the police agency so that they quickly hear about complaints and problemsLiaison 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
Specific Responses to People with Mental Illness
#ResponseHow It WorksWorks Best IfConsiderations
Improving the Police Response to Incidents
4Training generalist police officersImproves police officers awareness and understanding of mental illness and thereby improves their responses to incidentsthe training is hands-on, realistic, and focused on making good decisions that protect the safety of the individual, the general public, and officersIt is important to demystify mental illness and help officers overcome stereotypes and prejudices
5Providing more information to patrol officersIncreases the likelihood that people with mental illnesses will be properly referred to treatment servicesadequate mental health services are available and the police data and communications system forewarns officers about previous incidents and encounters involving specific complainants, suspects, victims, subjects, and addressesStoring 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
6Using less-lethal weaponsReduces the likelihood of serious injury or death to people with mental illnessesless-lethal weapons are effective, noncontroversial, and immediately available to officers in the fieldLess-lethal weapons may affect a person in mental health crisis differently from other persons; agencies must assure that officers do not resort to less-lethal weapons before exhausting nonviolent alternatives
7Deploying specialized police officersImproves the police response to situations involving mental illness through the delivery of specialized knowledge, skills, and experiencemental health practitioners are included in the training so that familiarity, trust, and teamwork are developedDeploying 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
8Deploying specialized nonpolice respondersImproves the response to situations involving mental illness through the delivery of specialized knowledge, skills, and experiencesworn and non-sworn personnel work together as a teamIt is important to have clear guidelines about the differing roles of sworn and non-sworn responders and clarity about decision-making authority
Working With Stakeholders
#ResponseHow It WorksWorks Best IfConsiderations
9Initiating assisted outpatient treatmentIncreases the likelihood that people with mental illness will receive proper treatment and medication, thereby decreasing the likelihood of the need for police interventionmental health workers enforce court-ordered treatment complianceCompliance enforcement has been shown to reduce incidents, arrests, victimization, violent episodes, and homelessness
10Establishing crisis response sitesImproves the response to people in mental crisis through readily available specialized servicesintake procedures are streamlined, a no-refusal policy is in place, and both mental health and substance abuse services are availablePolice 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
11Establishing jail-based diversionImproves the mental health treatment of offenders and reduces the use of scarce jail resourceswhen screening occurs immediately after bookingImmediate diversion will generally be available only for minor offenders; more serious offenders may be considered for diversion at the prosecution or adjudication stages
12Establishing mental health courtsEnhances the special expertise of judges in adjudicating mentally ill offenderswhen specialized judges and courts work closely with mental health agencies and advocacy groupsSmall jurisdictions may not have the resources or volume of mental health cases to support specialized judges or courts
Protecting Victims
13Protecting repeat crime victimsIncreases the likelihood that people with mental illness who are repeat crime victims, as well as repeat victims of offenders with mental illness, receive special attentionrepeat victims are identified sooner rather than later in the course of their repeated victimizationsIt is important to try to identify guardians (official or unofficial) who can both protect vulnerable victims and influence them to change any risky behavior
14Providing services to victimsIncreases the likelihood that crime victims who have mental illness, as well as victims of offenders with mental illness, will recover from their victimization and successfully navigate the legal systemvictim services agencies, mental health agencies, and mental health advocacy groups collaboratePolice 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
Targeting Offenders
#ResponseHow It WorksWorks Best IfConsiderations
15Targeting repeat criminalsIncreases the likelihood that people with mental illness who commit repeated crimes, as well as offenders who commit repeated crimes against people with mental illness, are targeted for special attentionrepeat offenders are identified sooner rather than later for special enforcement, prosecution, and/or treatmentRepeat offenders often go unrecognized and fall through the cracks of the criminal justice system; concerted effort is required to keep this from happening
16Targeting those responsible for repeat or chronic disturbancesIncreases the likelihood that people with mental illness who repeatedly create disturbances are targeted for special attentionguardians and handlers (including family members and service providers) can be persuaded to exercise more supervision and influence over disorderly behaviorRestoring order and resolving disturbances are among the most challenging police responsibilities; particularly when these involve a person with mental illness, informal alternatives are preferred, and jail should be avoided
17Targeting those responsible for repeat calls for serviceIncreases the likelihood that people with mental illness who repeatedly call the police about trivial or imaginary problems are targeted for special attentionrepeat complainants receive follow-up visits to identify underlying issues and implement systematic responsesBecause 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
Targeting Locations
#ResponseHow It WorksWorks Best IfConsiderations
18Targeting hot spotsConcentrates attention on locations with multiple incidents and/or calls for service involving people with mental illness, thereby correcting conditions that create incidentsguardians and managers can be persuaded to exercise more supervision and authority over hot- spot locationsHot-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
19Regulating facilities more effectivelyCompels mental health service facilities to improve their practices, thereby reducing the likelihood that police will need to interveneliaison officers work with each facility to analyze problems, recommend solutions, and monitor complianceBecause 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
#ResponseHow It WorksWorks Best IfConsiderations
20Arresting people with mental illnessIntended to deter offenders through punishment and incapacitationarrested people are promptly diverted into the mental health, medical, or social service systemsPeople 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
21Incarcerating people with mental illnessIntended to deter offenders through punishment and incapacitationmental health services are available in the jailIncarceration 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
22Ignoring the needs of people with mental illnessDone in hopes that the problem will go awayproblems are minor and other stakeholders shoulder the responsibilityIgnoring people in need is an abdication of a basic police responsibility