Police undertake America's mental health crisis
By Sierra Martin
sierramartin1997@gmail.com
A lack of funding for mental health care in the United States has led to insufficient training by first responders, increased number of prison inmates with mental health issues and inadequate treatment of the growing mental health crisis.
The National Council for Behavioral Health completed a study which shows the number of Americans who have a mental illness increases yearly, with access to affordable healthcare and proper treatment getting more difficult to obtain. Expansive budget cuts to mental health funding in cities across the nation has caused the already limited resources to dwindle.
Because of this, police departments throughout the country are being tasked with responding to the mental health crisis. According to an audit completed by the City of Austin, since 2008 the Austin Police Department has reported a 95% increase in mental health related calls.
The audit outlines that as of 2016 there were 158 officers serving in the Crisis Intervention Team for the Austin Police Department. The team is comprised of officers who are trained to respond to mental health related calls. This includes wellness checks, suicide prevention, transporting patients to an inpatient facility or detaining those with mental illness. Crisis intervention officers are taught to use de-escalation techniques and communicate that they are not there to make an arrest.
All APD officers receive 40 hours of mental health training, which is equal to one college course. Officers who choose to be a Mental Health Officer on the CIT team take an additional 80 hours of training, equivalent to a total of three college courses throughout their career.
But CIT officers are only on call from 6 a.m. to 9 p.m. leaving eight hours of officers not specifically trained for mental health related calls to respond to 400-600 calls an hour.
After evaluating APD, the audit conducted by the city of Austin determined that APD does not track and review crisis intervention incidents effectively.
According to the report, “APD does not dispatch crisis intervention-certified officers to lead crisis incidents, these resources are not always available when needed, and officers may not have all relevant information when responding to these calls.”
Howard Williams had experience as an APD officer for 25 years and was the Chief of Police for the San Marcos Police Department for 11 years before retiring and becoming a lecturer in the School of Criminal Justice at Texas State University.
Lack of Mental Health Training
Williams does not think police officers should be solely responsible for responding to mental health related calls and thinks that police are undertrained and unqualified throughout the county.
“We do the best we can. But we're not adequately educated. We're not adequately trained or equipped to deal with real mental health issues,” Williams said. “We're just not. This takes years of education and training, not the hours of training we get.”
Surveys show that 22% of fatal police encounters followed calls directly tied to a person’s mental illness. According to a survey by the Federal Bureau of Justice Statistics, 64% of people in jail and more than half of all prison inmates have a mental health problem.
Ariel Dulitzky is a clinical professor of law and director of the Human Rights Clinic at the University of Texas Law School.
The Human Rights Clinic was approached by a local organization representing families of people who died during encounters with the police. They asked the clinic to look into the incidents with APD from a human right’s perspective.
Led by Dulitzky, the Human Rights Clinic collaborated with the Austin Community Law Clinic reviewed excising data and analyzed an audit published by the City of Austin in 2018. The two groups published their research, stating the main takeaway from the study is that APD’s current practices violate human rights norms and standards.
In the forward of their published research, Brian McGiverin, civil rights attorney for the Austin Community Law Center, discussed how he hopes the city council’s new initiatives will reduce lethal force during mental health calls.
“This report explains that the rate with which people are injured and killed because friends and family have sought help for someone during a mental health crisis is a human rights catastrophe,” said McGiverin. “They deserve better.”
In the study they found that of the 15 most populated U.S. cities, Austin has the largest number of shootings involving police and people with mental health problems. A third of the 24 people killed in Austin police shootings from 2010 to 2016 had confirmed mental health conditions.
“For me the most surprising thing was that the Austin police department has the highest per capita for fatal encounters with people with mental disabilities in the country,” said Dulitzky.
According to Dulitzky, APD doesn’t properly train its police force in crisis intervention and de-escalation.
“It is very clear that police cannot replace mental health providers to deal with mental health issues,” said Dulitzky. “The problem in Austin in particular, is that all the resources to deal with mental health problems have been removed through the decades and now the justice system is the main provider to deal with mental health problems.”
Along with offering educational classes and support for mentally ill individuals and their families, the National Alliance for Mental Illness helps to train APD’s Crisis Intervention Team.
Valerie Millburn is a retired teacher and has been volunteering for NAMI for seven years. For the past two years she has been involved in the mental health training for law enforcement officers in Central Texas.
Millburn lives in recovery with bipolar disorder and substance use disorder and recently
celebrated 21 years of sobriety. She has interacted with law enforcement during a personal mental health crisis twice and is encouraged to help train officers so they can see it is possible to recover from mental illness.
“The power we bring, and what they tell us in their evaluations is, ‘Oh my gosh we just don't see recovery,’ and we give them the hope that the person really is a person with the disease, not just the disease,” said Millburn. “And that's why I do it so that they can see the face of recovery."
Based on her personal experiences, Millburn says she focuses on teaching the officers to speak slowly and calmly, give the person space and ask simple yes or no questions.
Throughout the two years Millburn has been training police, what surprises her most is officers reaching out to her for help.
“What surprised me the most is the number of (officers) who come up to me afterwards and share the fact that they have a family member in crisis, and they don't know what to do,” said Millburn. “Or that they themselves live with a mental health condition and can't share it with anyone. One in five people suffer from a mental health condition, and the police are no different, and they're not even trained to take care of it themselves how do we expect them to take care of it for others.”
Karen Ranus is the Executive Director of the National Alliance of Mental Illness for Central Texas and was encouraged to join their staff after taking one of their courses after almost losing her daughter to suicide, saying the class was transformative for her family.
Jails are becoming the new psychiatric hospitals
The US department of justice published a special report estimating that over half of all prison and jail inmates have a mental health problem.
According to the study by the Human Rights Clinic, an increase in de-institutionalization over the years has contributed to the increase in inmates with a mental illness.
De-institutionalization is the trend of closing psychiatric hospitals and integrating people with psychosocial disabilities into society.
The US department of justice report found a large number of individuals with mental health issues in jail because there is nowhere else for police officers to take them. If the individual is violent, cannot afford psychiatric care or psychiatric hospitals are full, they are taken to jail to be monitored.
According to Ranus, the largest number of calls to request police help for a mental health crisis is hospital emergency rooms.
Williams came across the scenario many times in his career where the responding officers knew the suspect who committed a crime was not criminally responsible because of their mental illness but had no other option than to take them to jail.
“We can't just let him out of jail the next day because they're not prepared to go take care of themselves,” Williams said. “So you hold them for a few days and hope a bed eventually opens, so that you can take them to a mental health facility somewhere. And in the meantime, you just lock them up in jail, which is an absolutely horrific and horrible solution. But it's all we've got.”
Based on a survey sent to prisons across the country by the Treatment Advocacy Center, state prisons and county jails hold as many as ten times more individuals with severe mental illness than state psychiatric hospitals.
“Because individuals with serious mental illnesses are predisposed to committing minor crimes due to their illnesses, many end up being detained in county jails with limited or no mental health treatment until a state hospital bed becomes available for them,” according to a survey of jail staff’s perspectives. “Some have even been jailed in the absence of any criminal charges.”
Solutions for the mental health crisis
Ranus is part of the Travis County Behavioral Health and Criminal Justice Advisory Committee, which focuses on discussing ways to improve response and treatment to individuals with mental health in the Central Texas area.
One positive change the committee has been able to accomplish is placing clinicians in the 911 call center to direct the call to a licensed social worker who can triage and determine what the individual needs.
According to Ranus, the main goal of the Advisory Committee is to model programs similar to San Francisco’s Street Crisis Response Team and Dallas’s RIGHT CARES, where a team of emergency medical technicians, fire department and peer support counselors respond to mental health calls. Unless there is a concern for violence, police will not be the first on the scene.
“You know it's interesting this notion that empathy can coexist with accountability,” Ranus said. “I can have great empathy for law enforcement and truly understand how difficult their jobs are and how they are doing their jobs in the midst of a great deal of challenge because we have a flawed system of care when it comes to mental health. I can have great empathy for that, and yet still hold them accountable to partner with us in creating change and to come up with solutions.”
Millburn thinks that a solution for the mental health crisis would be Americans having better access to treatment, noting that of the 254 counties in Texas, 185 have no psychiatrist. The National Council for Behavioral Health notes that, “key contributors to this lack of access include cost, limited resources, funding, social stigma and distance/ability to secure an appointment.” And that 74% of Americans do not think mental health services are accessible to the general public.
Defunding the police
Due to nationwide protests against police brutality, a conversation to defund the police has erupted across the country. Ranus thinks that the term “defund” is misleading and makes people view the movement as a way to shut police departments down. In reality, defund the police means reducing police department budgets and redistributing those funds to essential social services that are often underfunded such as housing, education, unemployment and mental health care.
On Aug 13, Austin’s City Council unanimously voted on defunding the Austin Police Department by $150 million, a vote that was met with mixed response by the Austin community. According to the American Civil Liberties Union, defunding the police may have a positive impact on redistributing funds to social services and alternative public safety programs that can benefit people diagnosed with a mental illness and may be part of a long-term solution.
Ranus supports defunding the police so it can bring more financial support to underfunded community projects and relief to police officers who are stretched thin throughout the community.
“I think we owe it to APD to create a system which allows the right people to respond to the situation at the right time,” Ranus said. “And sometimes it will have to be a law enforcement officer but sometimes maybe you could be a paramedic and a social worker.”
Williams thinks the idea to provide more aid to mental health care is one of the positive outcomes of the protests to defund the police.
“It took riots and things like that, to bring this to people's attention and get them to honestly discuss these issues,” Williams said. “And we can come to the conclusion as a society that this is a much larger problem than dealing with police and the mental health field, we need to revamp the system here. It's broken.”
If you or someone you know may be experiencing a mental illness that is harmful to themselves or others, please contact Integral Care’s Crisis Helpline at 512-472-HELP (4357).
Thank you to everyone who helped me with this project!
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