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Amnesty International (1999). United States of America
:
Race, rights and police brutality.
New York: Amnesty International
Reports. Link to article.
Borum, R. (2000). Improving high risk encounters
between people with mental illness and police. Journal of the American Academy of Psychiatry and the Law,
28, 332-337.
Borum, R., Deane, M.W., Steadman, H.J., &
Morrissey, J. (1998). Police perspectives on responding to mentally ill
people in crisis: Perceptions of program effectiveness. Behavioral
Sciences and the Law, 16, 393-405. Link to Article
In
this study, we sampled sworn police officers from three law enforcement
agencies (n=452), each of which had different system responses to
mentally ill people in crisis. One department relies on field assistance
from a mobile mental health crisis team, a second has a team of officers
specially trained in crisis intervention and management of mentally ill
people in crisis, and a third has a team of in-house social workers to
assist in responding to calls. Calls involving mentally ill people in
crisis appear to be frequent and are perceived by most of the officers to
pose a significant problem for the department; however, most officers
reported feeling well prepared to handle these calls. Generally, officers
from the jurisdiction with a specialized team of officers rated their
program as being highly effective in meeting the needs of mentally ill
people in crisis, keeping mentally ill people out of jail, minimizing the
amount of time officers spend on these calls, and maintaining community
safety. Officers from departments relying on a mobile crisis unit (MCU)
and on police-based social workers both rated their programs as being
moderately effective on each of these dimensions except for minimizing
officer time on these calls where the MCU had significantly lower
ratings.
Borum, R., Swanson, J., Swartz, M., Hiday, V. (1998).
Substance abuse, violent behavior and police encounters among people with
severe mental disorders. Journal of Contemporary Criminal Justice, 12,
236-250.*
In
this sample of 331 people with severe mental disorders, 20% reported
being arrested or picked up by police for a crime at some time
in the 4-month period before their hospital admission, most
commonly for alcohol or drug offenses or crimes of public disorder
(e.g., loitering or trespassing). Risk of a police encounter was
significantly related to (a) recent use of alcohol or drugs
and (b) recent violent behavior. However, substance use
appeared to be related to police encounters only when medication noncompliance
was also involved. Thus, violent behavior and the combination
of medication noncompliance and substance use significantly
increased the odds of a police encounter.
Bower, D.L. & Pettit, W.G. (2001). The Albuquerque
police
department’s crisis intervention team. FBI Law Enforcement Bulletin,
70(2), 1-6. Link to article.
Clay, R. (2000, Spring). Jail diversion programs
enhance care. SAMHSA News. VIII(2), 1-5.
Cochran, S., (2002). The Crisis Intervention Team
model in action. Community Mental Health Report. 2, 31.
Cochran, S., (2004). Fighting stigma in law
enforcement: The message has come from the heart. Address Discrimination
and
Stigma Center
. Retrieved August 3, 2006. Link to article.
Cochran, S., Deane, M.W., & Borum, R. (2000).
Improving police response to menatlly ill people. Psychiatric Services,
51, 1315-1316. Link to article.
Cochran, S., Dupont, R., Hopkins, T., Farrell, D.,
Boyette, D., & McDade, K. (1996). The Memphis Police Crisis Intervention
Team: More than just training. Presented at the annual meeting of the
National Alliance for the Mentally Ill, Nashville, Tennessee.*
Compton, M.T., Esterberg, M.L., McGee, R., Kotwicki, R.J.,
& Oliva, J.R. (2006). Brief reports: Crisis Intervention Team
Training: Changes in knowledge, attitudes, and stigma related to
schizophrenia. Psychiatric Services, 57, 1199-1202.
Crisis
intervention team (CIT) training provides police officers with
knowledge and skills to improve their responses to individuals
with mental illnesses. This study determined changes in
knowledge, attitudes, and social distance related to
schizophrenia among police officers after CIT training. METHODS:
A survey was administered to 159 officers immediately before and
after a 40-hour CIT training program in Georgia. Pre- and posttest
data were gathered from surveys taken between December 2004
and July 2005. RESULTS: After the training, officers reported improved
attitudes regarding aggressiveness among individuals with
schizophrenia, became more supportive of treatment programs for
schizophrenia, evidenced greater knowledge about schizophrenia, and
reported less social distance toward individuals with schizophrenia.
CONCLUSIONS: This study supports the hypothesis that an educational
program for law enforcement officers may reduce stigmatizing attitudes
toward persons with schizophrenia.
Cowell, A., Broner, N. & Dupont, R. (2004).The
cost-effectiveness of criminal justice diversion programs for people with
serious mental illness co-occurring with substance abuse: Four Case
Studies. Journal of Contemporary Criminal Justice, 20, 292-314. Link to article.
Many cities, counties, and states have criminal justice
diversion or jail diversion programs, in which those committing low-level
offenses and who have mental illness or substance abuse are diverted from
the criminal justice system into treatment. However, there is little
existing evidence on the cost and cost-effectiveness of such programs.
This article presents the first such estimates for four sites. Estimates
of the impact of diversion on both costs and effectiveness varied across
the sites. This variation likely reflects heterogeneity in the structure
and implementation of the programs across the sites. Directions for
future research are suggested.
Cordner, G. (2000). A Community policing approach to
persons with mental illness. The Journal of the American Academy
of Psychiatry and the Law, 28, 326-331.
Cordner, G. (2006). People with mental illness.
Retrieved June 30, 2006. Link to article.
Dank, N.R., & Kulishoff, M. (1993). An
alternative to the incarceration of the mentally ill. Journal of
Prison and Jail Health, 3, 95-100.*
Deane, M.W., Steadman, H.J., Borum, R., Veysey, B.M.,
& Morrissey, J.P. (1999). Emerging partnerships between mental health
and law enforcement. Psychiatric Services, 50,
99-101. Link to article.
Police
departments in the 194 U.S.
cities with a population of 100,000 or more were surveyed in
1996 to identify strategies they used to obtain input from the
mental health system about dealing with mentally ill persons.
A total of 174 departments responded (90 percent). Ninety-six
departments had no specialized response for dealing with mentally
ill persons. Among the 78 departments with special programs,
three basic strategies were found: a police-based specialized
police response, a police-based specialized mental health
response, and a mental-health-based specialized mental health
response. At least two-thirds of all departments, even those
with no specialized response program, rated themselves as
moderately or very effective in dealing with mentally ill
persons in crisis.
Dowd, J. (2004) Crossing the line: Formal training can
transform relations between the police and mental health services. Mental
Health Today, 4, 14-15.*
Draine, J., & Solomon, P. (1999). Describing and
evaluation jail diversion services for persons with serious mental
illness. Psychiatric Services, 50, 56-61.
Link to article.
Despite
efforts over the last 30 years to promote diversion from jail
for individuals with serious mental illness who have engaged
in criminal behavior, few jail diversion programs have been
adequately studied. To guide development of jail diversion services
and encourage empirical research on their effectiveness, the
authors describe the overall concept of jail diversion and the
basic operations of such a program. They also outline research issues
in evaluating the effectiveness of jail diversion programs, including
problems encountered in randomized field trials and quasi-experimental
designs. Implications of jail diversion services for mental
health professionals include learning how to collaborate with
law enforcement personnel, sufficiently integrating mental health
and substance abuse services into the criminal justice system
despite segregated funding streams, and ensuring that clients
who are intensively monitored are also provided with adequate
treatment to avoid jail recidivism.
Dupont, R (2001). How the Crisis Intervention Team
Model enhances policing and improves community mental health. Community
Health Report, 2(1), 3-4.
Dupont, R. & Cochran, S. (2001). Police and
mental health linked programs: Promising Practices-The CIT Model. In G.
Landsberg & A. Smiley (Eds.), Serving mentally ill offenders and
their victims.
New York,
Springer Publishing.
Dupont, R., & Cochran, S. (2000). Police response
to mental health emergencies: Barriers to change. The Journal of the American Academy of Psychiatry and the Law,
28, 338-344.
El-Mallakh, R.S., Wulfman, G., Smock, W. &
Blaser, E. (2003). Implementation of a Crisis Intervention Program for
police response to mentalHealth emergencies in Louisville. Journal of the Kentucky Medical
Association, 101(6), 241-243.
Engel, R.S., Silver, E. (2001). Policing mentally ill
disordered suspects: A reexamination of the criminalization hypothesis. Criminology,
39, 225-252.*
The
criminalization hypothesis is based on the assumption that police
inappropriately use arrest to resolve encounters with mentally disordered
suspects. The current study uses data collected from two large-scale,
multi-site field studies of police behavior-the Project on Policing
Neighborhoods (POPN) conducted in 1996–1997 and the Police Services Study
(PSS) conducted in 1977-to examine the relationship between suspect
mental health and use of arrest by police. Multivariate results show that
police are not more likely to arrest mentally disordered suspects.
Implications for future research on the criminalization hypothesis are
discussed.
Finn, P.E., & Sullivan, M. (1989). Police
handling of the mentally ill: sharing responsibility with the mental
health system. Journal of Criminal Justice, 17, 1-14.*
The public
repeatedly calls on law enforcement officers for emergency assistance
with the mentally ill because police officers and deputy sheriffs provide
free, around-the-clock service and are required to respond. However, law
enforcement agencies are typically ill equipped to handle this
population. On the one hand, arrest is usually an inappropriate
disposition. On the other hand, mental health facilities frequently
refuse to accept police referrals due to lack of bed space. As a result,
police often lose substantial time and experience considerable
frustration trying to resolve incidents involving this population. In a
few communities, however, law enforcement agencies and the social service
system have developed formal arrangements to coordinate responsibility
for handling the mentally ill. These networks relieve police officers and
deputy sheriffs of handling individuals whose problems are primarily
psychiatric; however, when dealing with cases that do require law
enforcement intervention, officers can get quick assistance from the
appropriate human service provider. Each mental health facility, in turn,
can expect law enforcement officers to refer only those types of mentally
ill persons whom the staff are qualified to assist; at the same time,
facility staff can obtain prompt help from officers in emergencies
involving dangerous clients. At the least, the mentally ill benefit by
avoiding unnecessary involvement with the criminal justice system; at
best, they receive assistance from mental health professionals to begin
to solve their problems
Fyfe, J. (2000). Policing the emotionally disturbed. The
Journal of the AmericanAcademy of Psychiatry and the Law, 28,
345-347.
Gentz, D., & Goree, W. (2003). Moving past what
to how: The next step in responding to individuals with mental illness. FBI
Law Enforcement Bulletin, 72(11), 14-18. Link to article.
Green, T. (1997).Police as frontline mental health workers:
the decision to arrest or refer to mental health agencies. International
Journal of Law and Psychiatry, 20, 469-486. Link to article.
Hails, J., & Borum R. (2003). Police training and
specialized approaches to respond to people with mental illness. Crime
and Delinquency, 49, 52-61. Link to article.
Eighty-four
medium and large law enforcement agencies reported the amount of training
provided on mental-health-related issues and the use of specialized responses
for calls involving people with mental illnesses. Departments varied
widely in the amount of training provided on mental-health-related
topics, with a median of 6.5 hours for basic recruits and 1 hour for
in-service training. Approximately one third of the agencies (32%) had
some specialized response for dealing with calls involving people with
mental illnesses. Twenty-one percent had a special unit or bureau within
the department to assist in responding to these calls; 8% had access to a
mental health mobile crisis team.
Hill, R. (2001). Civil liability and mental illness:
A proactive model to mitigate claims. The Police Chief.
Husted, J.R., Charter, R.A., & Perrou, B. (1995).
California
law enforcement agencies and the mentally ill offender. Bulletin if
the American
Academy of
Psychiatry and the Law, 23, 315-329.*
This article reviews the
results of a survey of California
law enforcement agencies, designed to assess the experience of these
agencies with mentally ill offenders (MIOs) and the training of their
officers to interact with this population. The results suggest that most
law enforcement officers are given insufficient training to identify,
manage, and appropriately refer the MIOs they are increasingly likely to
encounter. The data indicate that, in contrast to their training and
expectations, peace officers are as likely to be called to a mental
illness crisis as to a robbery. The MIO is likely to be arrested for
nonviolent misdemeanors and to be screened by officers with little of the
training or knowledge needed to divert them to appropriate mental health
treatment. Respondents report that increased communication and
cooperation between law enforcement and mental health professionals is
the single greatest improvement needed for handling mental illness
crises.
Jazbec, C. A. (n.d.). Shared Concerns: Family Members
and Law Enforcement. Link to Article
Lamb, H., Weinberger, L., & DeCuir, W. (2002).
The police and mental health. Psychiatric Services, 53, 1266-1271. Link to article.
With
deinstitutionalization and the influx into the community of
persons with severe mental illness, the police have become frontline
professionals who manage these persons when they are in
crisis. This article examines and comments on the issues raised
by this phenomenon as it affects both the law enforcement and mental
health systems. Two common-law principles provide the
rationale for the police to take responsibility for persons with
mental illness: their power and authority to protect the safety
and welfare of the community, and their parens patriae obligations
to protect individuals with disabilities. The police often
fulfill the role of gatekeeper in deciding whether a person with
mental illness who has come to their attention should enter the
mental health system or the criminal justice system. Criminalization may result if this role is not performed appropriately. The authors
describe a variety of mobile crisis teams composed of police,
mental health professionals, or both. The need for police officers
to have training in recognizing mental illness and knowing how
to access mental health resources is emphasized. Collaboration
between the law enforcement and mental health systems is
crucial, and the very different areas of expertise of each
should be recognized and should not be confused.
Lamb, H., Weinberger, L., & Gross, B. (2004).
Mentally ill persons in the criminal justice system: Some perspectives.
Psychiatric Quarterly, 75, 107-126.*
There
is an increasing number of severely mentally ill persons in the criminal
justice system. This article first discusses the criminalization of
persons with severe mental illness and its causes, the role of the police
and mental health, and the treatment of mentally ill offenders and its
difficulties. The authors then offer recommendations to reduce
criminalization by increased coordination between police and mental
health professionals, to increase mental health training for police
officers, to enhance mental health services after arrest, and to develop
more and better community treatment of mentally ill offenders. The necessary
components of such treatment are having a treatment philosophy of both
theory and practice; having clear goals of treatment; establishing a
close liaison between treatment staff and the justice system;
understanding the need for structure; having a focus on managing
violence; and appreciating the crucial role of case management,
appropriate living arrangements, and the role of family members.
Lattimore, P. K., Broner, N., Sherman, R., Frisman,
L., & Shafer, M. S. (2003). A comparison of prebooking and
postbooking diversion programs for mentally ill substance-using
individuals with justice involvement. Journal of Contemporary Criminal
Justice, 19, 30-64. Link to article.
Eight programs are described representing a variety of
approaches to diversion in terms of point of criminal justice
intervention (prebooking or postbooking), degree of criminal justice
coercion, type of linkages provided to community-based treatment, and
approaches to treatment retention. The authors also describe the
characteristics of almost 1000 study participants who were diverted into
these programs over an 18-month period and examine the extent to which
systematic
differences are observed between prebooking and postbooking subjects,
as well as
among sites in each of the diversion types. Results suggest
that prebooking and postbooking diversion subjects were similar on most
mental health indicators, but differed substantially on measures of
social functioning and substance use and criminality, with postbooking
subjects scoring worse on social functioning and reporting more serious
substance use and criminal histories. Variability among sites was also
observed, indicating differences in local preferences for the types of
individuals deemed appropriate for diversion.
Murphy, G. (1986). Improving the police response to
the mentally disabled. Washington,
DC: Police Executive
Research Forum.*
Murphy, G. R. (1989). Managing persons with mental
disabilities: A curriculum guide for police trainers. Washington, D.C: Police Executive
Research Forum.*
Munetz, M. R., & Griffin, P. A. (2006, April).
Use of the Sequential Intercept Model as an approach to decriminalization
of people with serious mental illness. Psychiatric Services, Vol. 57, No.
4, 544-549. Link to Article
Munetz, M. R., Fitzgerald, A., & Woody, M. (2006,
June). Police use of the taser with
people
with mental illness in crisis. Psychiatric Services, Vol. 57,
No. 6, 883-884. Link to Article
Munetz, M. R., Morrison, A., Krake, J., Young, B., &
Woody, M. (2006, November). Statewide implementation of the Crisis
Intervention Team Program: The Ohio Model. Psychiatric Services,
Vol. 57, No. 11, 1569-1571. Link to Article
This column discusses ways that states can implement
community-based best practices statewide, by using the crisis
intervention team (CIT) model as an example. Although state mental health
authorities may want to use a top-down approach to ensure uniform,
high-quality implementation, programs may be more likely to succeed if
they arise as bottom-up, grassroots innovations. Programs like CIT are
especially challenging to implement because they involve collaboration
between complex systems and affect multiple stakeholders. The column
describes lessons learned in Ohio in hopes of assisting other states in
implementing this and other innovations.
Panzarella, R., & Alicea, J., (1997). Police tactics
in incidents with mentally disturbed persons.Policing: An
International Journal of Police Strategies and Management, 20,
326-338. Link to article.
In
recent years police departments have responded to increasing numbers of
incidents involving mentally disturbed people. Data for this study were
drawn from a survey of 90 officers in a special unit mandated to respond to
such situations and from their detailed descriptions of 90 specific
incidents. Explores the types of incidents, their relative frequency, the
characteristics of such incidents, and especially police tactics
considered to be effective or ineffective. The articles discusses the
findings in terms of police department organizational structure as well
as individual officers' beliefs about the mentally disturbed and tactical
choices.
Patch, P.C., & Arrigo, B.A. (1999). Police
officer attitudes and use of discretion in situations involving the
mentally ill. International Journal of Law and Psychiatry, 22,
23-35. Link to article.
Peck, L. Jr. (2003). Law enforcement interaction with
persons with mental illness. TELEMASP Bulletin, 10(1), 1-12.
Perez, A., Leifman, S., & Estrada, A. (2003).
Reversing the criminalization of mental illness. Crime and Delinquency,
49, 62-78. Link to article.
In
1972, a federal court reinforced the deinstitutionalization of state
psychiatric hospitals when they held that people with mental illness have
a constitutional right to treatment (Wyatt v. Stickney, 1972). Although
many states released patients and closed hospitals in response to this
decision, they neglected to provide adequate community-based treatment
resulting in the unintended reinstitutionalization of this population
into our state and local jails. Recently, many state and local
stakeholders have come together to address this situation. This article
will discuss how the criminal justice system has become a primary mental
health provider and strategies being utilized to reform the current
system.
Redlich, A. D. (2004).
Mental Illness, Police Interrogations, and the Potential for False
Confession. Psychiatric Services, Vol. 55, No. 1, 19-21. Link to Article .
Reuland, M. (2004). A guide to implementing
police-based diversion programs for people with mental illness.Delmar,
NY: Technical Assistance and Policy
Analysis Center
for Jail Diversion.Link to article.
Reuland,
M., and Margolis, G. (2003). Police approaches that improve the response topeople
with mental illnesses: A focus on victims [Electronic Version]. The
Police Chief 70(11), 35-39. Link to article.
Ruiz, J. (1993). An interactive analysis between
uniformed law enforcement officers and the mentally ill. American
Journal of Police, 4, 149-177.*
Steadman, H.J., Barbera, S., & Dennis, D. (1994).
A national survey of jail diversion programs for mentally ill detainees. Hospital
and Community Psychiatry, 45, 1109-1113.*
Steadman, H.J., Braff, J., & Morrissey, J.
(1988). Profiling psychiatric cases evaluated in the general hospital
emergency room. Psychiatric Quarterly, 59, 10-22.*
Steadman, H.J., Cocozza, J.J., & Veysey, B.M.
(1999). Comparing outcomes for diverted and nondiverted jail detainees
with mental illness. Law and Human Behavior, 23, 615-627. Link to article.
Jail
diversion programs have been proposed for use with persons with mental
illnesses. While much support exists for these programs in theory, little
is known about their characteristics, the individuals they divert, or
their effectiveness. The current study focuses on identifying the
characteristics of persons diverted through a court-based program in one
midwestern city and their outcomes during the first 2 months after
diversion. Information on participants (n = 80) was gathered through
detainee interviews, staff interviews, and record abstracts. Two factors
appear to be important in diversion: (1) community risk and (2)
availability of specialized programs for diverted offenders. Demographic,
clinical, and social context variables appear to influence diversion
decisions. Overall, the diverted and nondiverted groups did approximately
the same upon release, but one third of the nondiverted group never got
released during the follow-up
Steadman, H.J., Deane, M.W., Borum, R. &
Morrissey, J.P. (2000). Comparing outcomes of major models of police
responses to mental health emergencies. Psychiatric Services, 51,
645-649. Link to article.
The study compared three
models of police responses to incidents involving people
thought to have mental illnesses to determine how often
specialized professionals responded and how often they were
able to resolve cases without arrest. METHODS: Three
study sites representing distinct approaches to police handling
of incidents involving persons with mental illness were
examined-
Birmingham, Alabama;
and Knoxville and Memphis, Tennessee.
At each site, records were examined for approximately 100
police dispatch calls for "emotionally disturbed persons" to
examine the extent to which the specially trained professionals responded.
To determine differences in case dispositions, records were
also examined for 100 incidents at each site that involved a
specialized response. RESULTS: Large differences were found across
sites in the proportion of calls that resulted in a specialized response-28
percent for
Birmingham, 40 percent for Knoxville, and 95 percent for Memphis. One reason
for the differences was the availability in Memphis of a crisis drop-off center for persons with mental illness that had a no-refusal policy for police
cases. All three programs had relatively low arrest rates when
a specialized response was made, 13 percent for Birmingham,
5 percent for Knoxville, and 2
percent for Memphis.
Birmingham's program was most
likely to resolve an incident on the scene, whereas Knoxville's program
predominantly referred individuals to mental health
specialists. CONCLUSIONS: Our data strongly suggest
that collaborations between the criminal justice system, the
mental health system, and the advocacy community plus essential services
reduce the inappropriate use of U.S. jails to house persons
with acute symptoms of mental illness.
Steadman, H.J., Deane, M.W., Morrissey, J.P.,
Salasin, S. & Shapiro, S. (1999). A SAMHSA research initiative
assessing the effectiveness of jail diversion programs for mentally ill
persons. Psychiatric Services, 50, 1620-1623. Link to article.
For nearly 30 years jail
diversion programs have had wide support as a way to prevent
people with mental illnesses and substance use disorders from
unnecessarily entering the criminal justice system by
providing more appropriate community-based treatment. Although
these programs have had wide support, very few systematic outcomes
studies have examined their effectiveness. This paper discusses
findings on rates of incarceration of persons with serious
mental illness and co-occurring substance use disorders in
U.S. jails, summarizes recently completed research on jail diversion
programs, and describes a three-year research initiative begun
in 1997 by the Substance Abuse and Mental Health Services Administration
that uses a standardized protocol to examine the characteristics
and outcomes of various types of jail diversion programs in
nine sites throughout the U.S.
Steadman, H.J., Morris, S.M., & Dennis, D.L.
(1995). The diversion of mentally ill persons from jails to
community-based services: A profile of programs. American Journal
of Public Health, 85, 1630-1635. Link to article.
A major
proposal for appropriately treating persons with mental illnesses who
have been arrested is to divert them from jail to community-based mental
health programs. However, there are few available definitions,
guidelines, and principles for developing effective diversion programs.
The goal of this research was to determine the number and kinds of jail
diversion programs that exist, how they are set up, and which types of
programs are effective. Methods. On the basis of information gathered
during a national mail survey (n = 1263) and follow-up telephone survey
of 115 responding jails, 18 sites were selected for on-site interviews
based on perceived effectiveness and presence of a formal diversion
program. Results. Data are presented from a national sample of jail
diversion programs (n = 18). Key factors for developing diversion
programs and descriptors of effective programs are presented.
Conclusions. It is clear that controlled, longitudinal studies of these
programs' effectiveness, using client-based and organizational outcome
measures, are badly needed.
Steadman, H.J., Stainbrook, K.A., Griffin
, P., Draine, J., Dupont, R.,
& Horey, C. (2001). A specialized crisis response site as a core
element of police-based diversion programs. Psychiatric Services, 52,
219-222. Link to article.
Transporting
an individual in psychiatric crisis to an emergency department
is often frustrating for both law enforcement and mental
health professionals. To facilitate collaboration between police
and mental heath professionals in crisis cases, some communities
have developed prebooking diversion programs that rely on
specialized crisis response sites where police can drop off
individuals in psychiatric crisis and return to their regular patrol
duties. These programs identify detainees with mental disorders
and work with diversion staff, community-based providers, and
the courts to produce a mental health disposition in lieu of
jail. This paper describes three of the diversion programs participating
in the Substance Abuse and Mental Health Services Administration
jail diversion knowledge development application initiative
that demonstrate the importance of specialized crisis response
sites. The three programs are in Memphis, Tennessee; Montgomery
County, Pennsylvania; and Multnomah County, Oregon. The authors
describe important principles in the operation of these
programs: being a highly visible, single point of entry; having
a no-refusal policy and streamlined intake for police cases;
establishing legal foundations to detain certain individuals; ensuring
innovative, intensive cross-training; and linking clients to
community services.
Strauss, G., Glenn, M., Reddi P., Afaq, I.
, Podolskaya, A., Rybakova, T., et al. (2005).
Psychiatric disposition of patients brought in by crisis intervention
team police officers. Community Mental Health Journal, 41,
223-228. Link to article.
Background:
As part of an effort to improve police interactions with mentally ill
citizens, and improve mental health care delivery to subjects in acute
distress, the University
of Louisville, in
conjunction with the Louisville Metro Police, established the crisis
intervention team (CIT). CIT is composed of uniformed officers who
receive extensive training in crisis intervention and psychiatric issues
and who are preferentially called to investigate police calls that may
involve a mentally ill individual. Methods: In an effort to determine the
characteristics of the individuals brought to the emergency psychiatric
service (EPS) by CIT officers, a comparative (CIT vs. mental inquest
warrant [MIW, a citizen-initiated court order to bring someone for
psychiatric evaluation because of concerns regarding dangerousness] vs
non-CIT/non-MIW), descriptive evaluation was performed. Results: With the
exception of a higher rate of schizophrenic subjects brought in by CIT
(43.0% vs. 22.1, non-CIT, P=.002), the demographics, diagnosis, and
disposition of CIT-referred subjects were not different in any way from
non-CIT patients. Subjects referred on MIWs were more likely to be
admitted to a psychiatric hospital than non-MIW patients (71.6 vs. 34.8,
P <.0001), but CIT-referred hospitalization rates were not different
from hospitalization rates of self-referred subjects (20.7 vs. 33.3, ns).
Conclusions: CIT officers appear to do a good job at identifying patients
in need of psychiatric care.
Teller, J.L.S., Munetz, M.R., Gil, K.M., &
Ritter, C. (2006). Crisis Intervention Team training for police officers
responding to mental disturbance calls. Psychiatric Services, 57,
232-237. Link to article.
OBJECTIVE:
OBJECTIVE:In recognition of the fact that police are often the
first responders for individuals who are experiencing a mental
illness crisis, police departments nationally are incorporating specialized
training for officers in collaboration with local mental
health systems. This study examined police dispatch data before
and after implementation of a crisis intervention team (CIT) program
to assess the effect of the training on officers' disposition
of calls. METHODS: The authors analyzed police dispatch logs
for two years before and four years after implementation of
the CIT program in Akron, Ohio, to determine monthly average rates
of mental disturbance calls compared with the overall rate of
calls to the police, disposition of mental disturbance calls
by time and training, and the effects of techniques on voluntariness
of disposition. RESULTS: Since the training program was implemented,
there has been an increase in the number and proportion of
calls involving possible mental illness, an increased rate of
transport by CIT-trained officers of persons experiencing mental
illness crises to emergency treatment facilities, an increase
in transport on a voluntary status, and no significant changes
in the rate of arrests by time or training. CONCLUSIONS: The
results of this study suggest that a CIT partnership between the
police department, the mental health system, consumers of services,
and their family members can help in efforts to assist persons
who are experiencing a mental illness crisis to gain access to
the treatment system, where such individuals most often are
best served.
Teplin, L. (2000). Keeping the peace: Police
discretion and mentally ill persons. National Institute of Justice
Journal, 244, 9-15. Link to article.
Teplin, L. ( 2001). Police discretion and persons
with mental illness. Community Mental Health Report, 1,
37-38, 45-46.*
Teplin, L. & Pruett, N. (1992). Police as
streetcorner psychiatrist: managing the mentally ill. International
Journal of Law and Psychiatry, 15, 139-156. *
Thompson, M.D., Reuland, M, & Souweine, D.
(2003). Criminal Justice/Mental Health Consensus: Improving responses to
people with mental illness. Crime and Delinquency, 49, 30-51. Link to article.
This
article summarizes the impetus for and findings of the Criminal
Justice/Mental Health Consensus Project. This project has been a 2-year
effort to develop recommendations, which reflect a bipartisan agreement
among the stakeholders in the criminal justice and mental health systems
to improve the response to people with mental illness who are involved
with--or are at risk of involvement with--the criminal justice system.
Stakeholders involved in consultations for the project included state
lawmakers, police chiefs, officers, sheriffs, district attorneys, public
defenders, judges, court administrators, state corrections directors,
community corrections officials, victim advocates, consumers of mental
health services, family members and other mental health advocates, county
commissioners, state mental health directors, behavioral health care
providers, and substance abuse experts. The success of the project will
hinge largely on how effectively these flexible guidelines are shaped and
molded to meet the particular needs within various jurisdictions
throughout the country.
Thorward, S. R. (2003). Crisis Intervention team
(CIT) Training sees immediate results. Link to Article
Torres, C. & Valdes, G. (2002, June 12).
Collaborative crisis intervention and alternatives to incarceration for
persons with mental illness. The
Council. Link to Article
Torrey, E.F., Steiber, J., Ezekiel, J., Wolfe, S.M.,
Sharfstein, J., & Flynn, L.M. (1992). Criminalizing the seriously
mentally ill: The abuse of jails as mental hopspitals. Innovations
& Research, 2, 11-14. Washington
, DC : Public Citizen’s
Health Research Group.
Treatment Advocacy Center
(2005). Briefing paper: Law enforcement and people
with severe mental illnesses. Link to article.
Turnbaugh, D. (1999). Crisis Intervention Teams:
Curing Police Problems with the Mentally Ill. The Police Chief, 52(2),
52-54. Link to article.
Vermette, H. S., Pinals, D. A., & Appelbaum, P. S.
(2005). Mental health training for law enforcement professionals. The
Journal of the American Academy of Psychiatry and the Law, 33,
42- 46. Link to Article
The purpose of this pilot study was to determine topics of interest and
preferred modalities of training for police officers in their work with
persons with mental illness. Police officers across Massachusetts
attending in-service mental health training were asked to rate the
importance of potential mental health topics and the effectiveness of
potential training modalities on a Likert-type scale. Additional data
collected included the officer's experience, level of education,
motivation for attendance, previous attendance of post-academy mental
health training, and preferences for length, frequency, training site,
and trainer qualifications. A t test was used to determine if
there were significant differences (p < .05) between those
who volunteered and those who were mandated to attend the training.
Repeated-measures ANOVAs were used to determine if there were significant
differences (p < .05) between mental health topics and
lecture formats and to determine the effect of education and experience
on the results. Although all topics suggested were rated, primarily, as
fairly important, the topics of Dangerousness, Suicide by Cop, Decreasing
Suicide Risk, Mental Health Law, and Your Potential Liability for Bad
Outcomes were given the highest ratings. Role-playing was rated
significantly lower than other training modalities, while Videos and
Small Group Discussion had the highest mean scores. Level of prior
education had no significant effect on the ratings, but officers with
more experience rated the importance of mental illness as a training
topic significantly higher than officers with less experience. This
survey suggests that police officers are interested in learning more
about working with persons with mental illness and view it as an
important aspect of the job.
Vickers, B. (2000). Memphis, Tennessee
, Police Department's Crisis InterventionTeam, Bulletin
From the Field Practitioner Perspectives. Link to article.
Waldman, W., Gilmore, K., & Maschi, T. (2004,
September 20). Individuals with mental illness in the Camden County
Criminal Justice System: An analysis of the implications of a tragedy and
recommendations for cross systems improvements. The Camden Mental
Health and Criminal Justice Report, 1-36.
Walsh, J. & Holt, D. (1999). Jail diversion for
people with psychiatric disabilities: The sheriffs’ perspective.
Psychiatric Rehabilitation Journal, 23, 153-160. Link to artcle.
The
limited availability of community treatment for people with psychiatric
disabilities bas led to an increase in their rates of arrest. Mental
health treatment is not part of the mission of jails, and the specific
needs of these people may go unserved, with a consequent risk of symptom
relapse. The present study was undertaken to solicit the perspectives of Virginia sheriffs,
who regularly intervene with this group, on the potential for diversion
programs to reduce the jailing and recidivism of people with psychiatric
disabilities. The results indicate that sheriffs have many constructive
suggestions for diversion strategies and, in partnership with mental
health professionals, could develop programs that better facilitate the
rehabilitation of people and contain costs for both systems.
Watson, A.C., Corrigan, P.W., Ottati, V. (2004).
Police officers' attitudes toward anddecisions about persons with mental
illness. Psychiatric Services, 55, 49-53. Link to article.
A
significant portion of police work involves contact with
persons who have mental illness. This study examined how knowledge
that a person has a mental illness influences police officers'
perceptions, attitudes, and responses. METHODS: A total
of 382 police officers who were taking a variety of in-service training
courses were randomly assigned one of eight hypothetical vignettes
describing a person in need of assistance, a victim, a
witness, or a suspect who either was labeled as having schizophrenia or for whom no information about mental was provided. These officers
completed measures that evaluated their perceptions and
attitudes about the person described in the vignette. RESULTS: A
4x 2 multivariate analysis of variance (vignette role
by label) examining main and interaction effects on all
subscales of the Attribution Questionnaire (AQ) indicated
significant main effects for schizophrenia label, vignette
role, and the interaction between the two. Subsequent
univariate analyses of variance indicated significant main
effects for role on all seven subscales of the AQ and for
label on all but the anger and credibility subscales.
Significant role-by-label interaction effects were found for
the responsibility, pity, and credibility subscales.
CONCLUSION: Police officers viewed persons with
schizophrenia as being less responsible for their situation,
more worthy of help, and more dangerous than persons for whom
no mental illness information was provided.
Wolff, N. (1998). Interactions between mental health
and law enforcement systems: Problems and prospects for cooperation. Journal
of Health and Politics, Policy, and Law, 23, 133-174. Link to article.
The article focuses on the
difficulties of coordinating the roles of the mental health and law
enforcement agencies, working with people with severe mental illness,
while examining the challenges posed by system specialization in the United States.
Factors which make these agencies seem ineffective and inefficient; How
specialization and mutual interdependency can undermine the effectiveness
of the community service network.
Woody, M. (2005, Summer). The art of de-escalation.
The Jounal, 26-62. Retrieved July 17, 2006, from Northeastern Ohio
University College of Medicine Division of Clinical Sciences. The
Jounal, 26-62. Link
to article.
Woody, M. S. (2003, January 6). Dutiful Minds-Dealing
with mental illness. Link to article.
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