Another Way to Raise Police Crisis Competency

Seriously mentally ill individuals often have police contact. The outcome of such contacts is largely determined by police actions, which can result in mentally ill individuals being arrested, imprisoned, physically injured, or worse. Negative dealings with police and the criminal justice system greatly weaken long-term recovery prospects of the affected individuals.

Every month there seem to be reports in the media of unfortunate, sometimes fatal, encounters between police and individuals with mental illness. Each account ends with a call for actions to prevent such incidents. Nonetheless these tragedies seem to continue.

In Philadelphia, for example, the beating of a homeless man in April 2005 raised concern about how the police should resolve calls involving individuals who may be a danger to themselves or others because of a possible psychiatric disorder. A dialog involving police, mental health officials, and advocates followed to a find mutually acceptable crisis response strategy (see A. Twyman, “Police policy on mentally ill questioned” Philadelphia Inquirer 4/18/05).

As has been the case elsewhere, discussion centered on the Crisis Intervention Team (CIT) pioneered by the Memphis Police Department in 1988. This model is based on teams of officers specially trained to handle “mental health calls” in addition to other duties.

The “Memphis Model” has many strong features and it has been adopted by a number of municipalities. However, it is not the only way to minimize adverse outcomes to mental health emergencies. An alternative approach is to disperse rather than centralize police crisis expertise.

Since 1974, Montgomery County, Pennsylvania, has rarely seen situations like those that trouble neighboring Philadelphia. Interactions between police and those with mental illness end without the use of force or only the minimum necessary for the safety of all parties. Police can call on mental health crisis specialists 24/7 and even a psychiatric emergency medical service (EMS).

For over 30 years, Montgomery County Emergency Service, Inc. (MCES), has built a system that works for law enforcement, and for mental health providers and sufferers. Help with mental health cases is available and accessible to the criminal justice system from the officer on patrol to the county prison staff. The “MCES Model” has been widely recognized over the years (e.g., see Psychiatric Services 51(November 2000).

MCES established the first police mental health crisis intervention training program in 1975. In the last two years alone, hundreds of police officers, probation and parole, and correctional personnel have completed an intensive 3-day course that enables them to recognize a psychiatric emergency and intervene in a manner that minimizes risk and expedites professional treatment.

The MCES training includes both classroom and field segments. NAMI-Pennsylvania, Montgomery County volunteers give trainees insight to their personal struggles with serious mental illness and experiences with the police related to their illnesses. MCES even offers “roll call trainings” to serve small departments that cannot spare staff for off-site training.

The MCES philosophy is to give practical crisis intervention training to as many police officers and other criminal justice personnel as possible. This raises mental illness literacy system-wide. Mental health situations are more promptly and safely addressed. Fewer mentally ill persons are stigmatized by arrest and detention. There is far less chance of overreaction or abuse.

Education is at the core of the MCES model but there is more than training. MCES offers a fully integrated crisis center to all county residents. It can dispatch a mobile crisis team or an ambulance, offer telephonic or walk-in crisis counseling, provide psychiatric evaluations, and arrange voluntary or involuntary psychiatric hospitalization.

MCES has streamlined its procedures and paperwork to reduce the police downtime involved in taking a mentally ill individual to its facility for evaluation and help. Over the years, MCES has distributed thousands of wallet-sized “cop cards” which outline its services and the criteria for an involuntary hospitalization. Police, in turn, account for over 50% of all MCES admissions.

Despite treatment advances and growing self-help resources, there will still be mental illness-related crises. Other communities may benefit from the lessons learned in Montgomery County, PA. The MCES model increases the odds that the responding officers will act in a manner that minimizes risk and facilitates recovery.

More information about MCES’s police training and related programs is available by contacting Donald Kline, PhD, Director, MCES Criminal Justice Department at dkline@mces.org or 610-279-6100. MCES is most grateful to the Pew Charitable Trusts and the Patricia Kind Family Foundation for financial support that enabled us to significantly expand our training.

Posted 5/1/05