Late one night, while riding along with a police officer on patrol, the mayor of Fishers, Ind., asked the officer what kinds of calls most concerned him. He got an unexpected answer: mental health situations. They were occurring almost once a shift.
Mental illness isn’t readily visible in a place like Fishers, an affluent suburb of Indianapolis with just under 90,000 residents. “In our community,” Mayor Scott Fadness says, “there are a lot of people living in quiet despair and suffering from mental health issues, but they’re not being addressed in a systemic way.”
In the country as a whole, mental health situations are responsible for about 1 in 10 police calls. Many stem from undiagnosed conditions unknown to police and first responders. The consequences can be tragic. While about 3 percent of U.S. adults suffer from a severe mental illness, they make up a quarter to one-half of all fatal law enforcement encounters, according to the nonprofit Treatment Advocacy Center. Similarly, a recent internal review by the Los Angeles Police Department reported that 37 percent of police shootings last year involved suspects with documented signs of mental illness.
Municipalities like Fishers are seeking ways for public safety personnel to better assist the mentally ill and respond more effectively to potentially dangerous situations. Fadness noticed last year that suicide attempts and similar crises in Fishers appeared time and time again on weekly police summaries, so he convened a mental health task force.
One of the resulting recommendations was a call for additional training. All police patrol officers in Fishers will soon complete a 40-hour Crisis Intervention Team (CIT) training module covering de-escalation techniques and how to spot mental health symptoms. It’s not brand-new -- the model was first implemented in Memphis in the late 1980s and has spread to over 3,000 departments. But the majority of agencies and officers nationwide still lack the necessary training to implement it. Michael Woody, president of CIT International, says incident reports are often misclassified because officers are not aware that mental illness is involved.
Even when they are aware and mentally ill individuals threaten to harm themselves or others, police often are left with no choice other than to contact a family member or take the person to jail. The nation’s largest individual mental health providers are now, in fact, correctional facilities, like the Cook County, Ill., jail. “When I became a police officer in 1977, we had health facilities,” Woody says. “Now, there’s no place to take them to.”
In Fishers, police are encouraged to identify mental illnesses and transport individuals to a mental health facility, if necessary. They did so 211 times last year.
Police responding to mental health situations frequently face a conflict between what they feel they should do and what they’re legally able to do. They must act on what individuals are willing to tell them. Seeing a house in disarray may indicate a person needs help, but officers may not be authorized to intervene.
The proliferation of community policing hasn’t helped, either. John Snook, executive director of the Treatment Advocacy Center, says it places officers in more frequent contact with the mentally ill, but gives them no real treatment options. “This isn’t a law enforcement problem,” he says. “Police are forced to be the first responders for mental health calls, something that they aren’t suited to do.”
Traumatic mental health episodes pose serious safety risks for police. Departments that have implemented CIT training report reductions in officer injuries. After an Indianapolis officer was gunned down, the Indiana General Assembly passed a law allowing police to seize and retain firearms from mentally ill persons considered dangerous.
Nationally, reliable information on the role of mental illness in fatal police encounters is scarce, according to the Treatment Advocacy Center, which compiled its estimates from a review of academic studies and media reports. Several federal databases track officer-involved fatalities, but all suffer from a limited number of participating agencies, reports that aren’t standardized or other shortcomings. “There isn’t a good carrot or stick for states to report this information,” says Snook.
Mental health advocates say comprehensive solutions are needed. In Fishers, fire and emergency personnel will work with local hospitals to follow up with patients to make sure they’re taking prescribed medications after they’re discharged from hospitals, helping to cut costs from frequent emergency room visits. The citywide initiative also includes partnerships with behavioral health providers and efforts to better treat mental illness within the school system. “Our goal is to ultimately help people before they get to a crisis situation in the first place,” says Mitch Thompson, an assistant city police chief who served on the task force.
One practice that research has found to be particularly promising is assisted outpatient treatment, which permits judges to order treatment plans for offenders suffering from severe mental illnesses as a condition for remaining in their communities. Such treatment programs offer addiction services, housing, job opportunities and a range of other assistance.
While the Fishers initiative isn’t yet fully implemented, one early result has been greater empathy on the part of law enforcement, Thompson says. Officers aren’t used to interacting with the mentally ill unless they’re going through a crisis, so part of the CIT training aims to help police understand the types of everyday conditions people are suffering from. “Just coming to the table and talking about it,” Thompson says, “is quite sobering.”