Emerging Partnerships Between Mental Health and Law Enforcement

A survey of urban police departments in the 194 U.S. cities with populations of 100,000 or more was conducted in 1996. Completed surveys were received from 174 departments (90 percent) in 42 states. Besides background information on the police department and locale, the survey requested information about interactions between police and mental health professionals—specifically whether the police department had any policies or procedures designed to divert into treatment or provide crisis assistance to persons thought to be mentally ill who might otherwise be arrested. Also requested was information about the availability to all line officers of departmental training in managing mentally ill persons and whether the department employed specially trained mental health officers or deputies.

Departments were asked to rate on a 5-point Likert scale the perceived overall effectiveness of the department to respond to a person with a mental illness who is in crisis. This perceived effectiveness scale was used as a "first-cut" and cost-effectiveness measure to identify exceptional programs. Steadman and colleagues (10) reported that program ratings of perceived effectiveness correlate highly with program characteristics and objective measures of program success.

To identify existing response strategies, we asked departments three questions: "does your department have special mental health officers or deputies who are employees of your department?" "does your department provide on-site emergency psychiatric evaluation of mentally ill persons?" and "does your department have other collaborations with emergency mental health services? If yes, specify." The open-ended question provided more specific accounts of the departments' crisis response. We then examined the responses for similarities across departments and combined the similar strategies into categories. This procedure yielded three primary police-mental health professional response strategies.

A majority of police departments in U.S. cities with populations of 100,000 or more do not have a specialized strategy to respond to persons in crisis who may have a mental illness. Among those that do, three primary approaches can be identified: a police-based specialized police response, a police-based specialized mental health response, and a mental-health-based specialized mental health response.

A very small percentage of departments (3 percent) indicated that they had a specialized unit of officers who were trained to handle crisis calls involving mentally ill persons. This innovative strategy appears to be a relatively new type of police response developed under community policing initiatives. The use of a police-based unit of mental health professionals also appears to be an innovative response; such units range from a team of specially trained social workers to staff psychologists who do consultations with officers in the field. The most widely used method of response is a mobile crisis team, based in the mental health system, that provides assistance on the scene.

One note of caution is that the survey reflected only urban police departments, and it is possible that the typology would be quite different if specialized mental health responses in rural areas were taken into account.

This classification of three types of the various police-mental health collaborations can provide a framework for further research, preferably with an objective evaluation as opposed to a self-perceived rating of the effectiveness of these strategies.

This study was jointly supported by grant 96-IJ-CX-0082 from the National Institute of Justice and by the University of North Carolina at Chapel Hill (UNC-CH)-Duke University Program on Services Research for People With Severe Mental Disorders. The authors thank Matthew Johnsen, Ph.D., for comments on the draft, as well as the program participants at the UNC-CH meeting on police-mental health crisis response who helped refine the typology: the Birmingham, Alabama, police department community service officer program; the police-mobile crisis teams of Albany, New York, Charleston, South Carolina, Knoxville, Tennessee, and Richmond, Virginia; and the Memphis, Tennessee, police department crisis intervention team.

Ms. Deane, Dr. Steadman, and Dr. Veysey are affiliated with Policy Research Associates, Inc., 262 Delaware Avenue, Delmar, New York 12054 (e-mail, [email protected]). Dr. Borum is with Duke University Medical Center in Durham, North Carolina. Dr. Morrissey is with the Cecil G. Sheps Center for Mental Health Services Research at the University of North Carolina at Chapel Hill.