Bridging the Gap: A Discussion on Reforming Law Enforcement Interactions with the Mentally Disabled

Written by: Savanna Payne

Edited by: Shruti

What makes a heart attack and a panic attack different? While both have very similar physiological symptoms, the help that individuals may receive if they experience one of these conditions is likely very different. While an individual experiencing a heart attack is immediately met with medical assistance focused on support and treatment, an individual experiencing a severe panic attack or other mental health crisis may find themselves confronted by law enforcement that may be ill-equipped to provide proper care (Design, 2024). Even though both may be health concerns, the discrepancy between emergency response care exposes a much broader issue with society’s perspectives and treatment of mental health and physical health. 

Interactions between law enforcement and individuals with mental disabilities (i.e. autism spectrum disorders, intellectual disabilities, etc.), have long been a concern. There has been a growing call for change regarding law enforcement involvement in mental health crises due to high potential of a violent outcome occurring. Individuals, with untreated mental health conditions, are 16 times more likely to be killed during an encounter with law enforcement than other civilians (Treatment Advocacy Center, 2015).  Unlike medical health professionals, first responders like police officers are not always trained to properly assist individuals experiencing a severe mental health crisis and may unintentionally escalate the situation. Encounters with law enforcement can be particularly intimidating for individuals in a mental health crisis and may worsen the individual’s condition rather than ease it. 

A report by the U.S. Department of Justice takes it a step further and argues that the current emergency response system for mental disabilities is a discriminatory act. The New York Lawyers for Public Interest (NYLPI) challenged the City’s defense, stating that singling out communities with mental disabilities denies individuals their rights to equal health care under The American with Disabilities Act (Design, 2024). Specifically, the DOJ has raised concerns that communities with mental disabilities are more likely to be perceived through a criminal lens rather than a health-centered one. This may result in a mental health framework that blames the individual in crisis instead of prioritizing their care and treatment. While police intervention is still critical in mental health crises, especially in cases where violence is involved, the mental and physical well-being of the person should be better prioritized. 

While the current approach to a mental health crisis intervention may alleviate some concerns over violence prevention, it does not address the concerns over the health and safety of individuals with mental disabilities. A significant contributor to this issue is the lack of specialized training of first responders–especially police officers–that is needed to appropriately assist individuals in a mental health crisis. While police officers may receive some training for engaging individuals with mental disabilities, the information can be varying in quality, are not standardized, and are not easily accessible (Coleman & Cotton, 2014).

In response to these concerns, one program that has already been implemented is the “Serving Safety” program; it is a national initiative by the Institute of Justice that aims to improve interactions between police and people with mental disabilities. It intends to improve collaborative responses between these two communities by building a more standardized mental health crisis response, and expanding research and resources in this critical area (Watson et al., 2019). The program implemented nine models that can serve as local solutions. These models can be further categorized into 3 main categories: educational training, collaborative initiatives, and individual specialized teams. 

For the first method, highly specialized educational programs for first responders, also known as crisis intervention trainings (CIT) have begun to be implemented nationwide. This training provides law enforcement with the knowledge and application skills to engage individuals in a mental health crisis in a safe and respectful way. While localized trainings do exist in certain police departments, they are typically are voluntary sessions and require considerable funding, which many law enforcement departments do not have the available resources. However, their ability to provide standardized education and practice to a broad audience attests to their effectiveness. Research shows that many CIT programs that have already been implemented have reported as high as an 80% lower detention rate of individuals with mental health disabilities (Watson et al., 2019, p. 23). 

The second method involves programs that include collaboration efforts of two or more separate, skilled departments. This may include co-responder teams that pair an officer with a mental health professional or a trained professional for support. A recent study examined the Crisis-Response Team (CRT) in Seattle. It was concluded that not only has the interaction between police and people experiencing a mental health crisis improved, but it also made better use of police resources. Many patrol officers were able to focus more on traditional criminal investigation now that medical professionals were able to support them with the skills they lacked. (Watson et al., 2019, p. 17). 

The final method is the use of specialized teams that work independently of law enforcement rather than in collaboration with them. For an example, mobile crisis teams (MCTs) can be used. MCTs typically consist of a team of mental health professionals (i.e. typically includes social workers, nurses, etc.) that will respond to mental health crisis situations in the community. Researchers at Vera Institute of Justice found that compared to patients at hospital-based emergency services, patients that were treated by an MCT were 17% more likely to receive additional community services within 90 days of the crisis (Watson et al., 2019, p. 42).

While there are many different methods to providing better instructional resources within the emergency response system, all of these solutions intend to foster a greater sense of safety and inclusivity for the mental health community. Educating law enforcement is not simply about improving immediate outcomes, but is also a powerful tool for reducing stigma surrounding the mental health community. Although it is important for first responders and medical professionals alike to be equipped with the knowledge and skill set to treat people in a mental health crisis, it is just as important for professionals to handle these situations with empathy. By understanding different perspectives, individuals are forced to see a whole person, rather than just an illness (Fischer, 2023). With the help of programs like Serving Safety, we can create a well-informed and compassionate emergency response system that not only establishes the safety and well-being of all individuals, but also actively counters harmful behaviors that criminalize mental disabilities. 

References 

Coleman, T., & Cotton, D. (2014). TEMPO: A contemporary model for police education and training about mental illness. International Journal of Law and Psychiatry, 37(4), 325–333. https://doi.org/10.1016/j.ijlp.2014.02.002

Design, S. S. (2024, October 4). Press Release: U.S. Department of Justice Weighs in for Advocates in Lawsuit Against NYC’s Discriminatory Use of Police to Respond to Mental Health Crises - New York Lawyers for the Public Interest. New York Lawyers for the Public Interest. https://www.nylpi.org/press-release-u-s-department-of-justice-weighs-in-for-advocates-in-lawsuit-against-nycs-discriminatory-use-of-police-to-respond-to-mental-health-crises/

Fischer, B. (2023, October 31) Importance of a Stigma-Free Approach to Mental Illness Among Law Enforcement First Responders. (2023, October 31). Aspyre Wellness. https://aspyrewellness.com/importance-of-a-stigma-free-approach-to-mental-illness-among-law-enforcement-first-responders/

Treatment Advocacy Center. (2015, December). Overlooked in the Undercounted: The Role of Mental Illness in Fatal Law Enforcement Encounters - Treatment Advocacy Center. Treatment Advocacy Center -. https://www.tac.org/reports_publications/overlooked-in-the-undercounted-the-role-of-mental-illness-in-fatal-law-enforcement-encounters/

Watson, A. C., Compton, M. T., & Pope, L. G. (2019). Crisis Response Services for People with Mental Illnesses Or Intellectual and Developmental Disabilities.