By Frank Lewis
Portsmouth Police Chief Robert Ware was reading an article in the FBI Law Enforcement Bulletin when – “the first paragraph really jumped out at me.” The article was titled, “The Importance of Mental Health Training in Law Enforcement,” by Nicholas Wilcox, M.S.
That first paragraph read, “As mental health problems within communities have increased over the past 40 years, inpatient services have decreased. Therefore, police departments have had to meet the growing needs of individuals suffering mental health emergencies. Police officers not only are the first responders to these crises but often are the only source of immediate service for urgent mental health activities. Various efforts to address mental illness in communities have been instituted by police agencies; however, the implementation rate is incongruent with the number of mental health-related service calls.”
According to Wilcox, “In 1955, 75 percent of individuals who experienced mental health episodes were treated in inpatient settings; by 1977 only 7 percent received inpatient care. This process, termed ‘deinstitutionalization’ by the mental health community, describes the removal of essential patient services in favor of more decentralized approaches. Deinstitutionalization has occurred over time since the mid 1950s and was implemented to reduce the costs incurred by mental hospitals and shift the care away from state institutions that had negative societal perceptions.”
Ware referred to the often knee-jerk reaction to incidents and takes exception to some of those reactions.
“Gun control is not the answer to our problems,” Ware said. “It’s the lack of available mental health treatment options.”
Police officers not only are the first responders to (mental health) crises but often are the only source of immediate service for urgent mental health activities.
“This is why I put officers through CIT training,” Ware said, “but when are our nation’s leaders going to wake up to the root cause?”
In May, members of the Portsmouth Police Department and other law enforcement officers received training as to how to deal with mentally ill individuals they might encounter. The Crisis Intervention Team (CIT) training was a collaborative effort between law enforcement and the mental health community.
The effects of deinstitutionalization can be explained through a fictional example. In 1950, John Doe, Sr., suffered his first schizophrenic break. He was arrested by a police officer during the occurrence and formally diagnosed while incarcerated. He spent the next 2 years in a state mental hospital, where he suffered 20 subsequent episodes that promptly were managed. John was released from the hospital, but was voluntarily readmitted 6 months later. He remained there for 18 months, during which he suffered another 8 episodes. Between 1950 and 1954 John experienced 28 episodes during inpatient care.
“Typically, when people are in mental health crisis, it’s a law enforcement officer that has the first contact. Someone experiencing a mental health crisis may be incoherent, emotionally excited, thinking or behaving irrationally or experiencing a variety of other emotions and thoughts,” Ware said the week of the CIT training. “More often than not, these contacts start out as a noncriminal encounter. It is only through a great deal of recognition, understanding and communication skills that an officer is able to bring the situation under control without escalating into a criminal encounter or use of force situation.”
Reach Frank Lewis at 740-353-3101, ext. 1928, or on Twitter @franklewis.