The police encounter people with mental illness of all ages in five general situations: as a victim of a crime; as a witness to a crime; as the subject of a nuisance call; as a possible offender; and as a danger to themselves or others. It is also true that the person with a mental illness may fall into more than one category at a time.  It is critical for the officer who responds to the scene to recognize whether mental illness may be a factor in the incident, and to what extent, before deciding which response is best.

Several different approaches have been developed to enable officers to effectively assess situations involving people with mental illnesses that both reduce their contacts with the criminal justice system and ensure on-scene safety. The safety of all involved parties - the victim, person with mental illness, family members, bystanders and, police - is of paramount importance.  The desired outcome of these contacts should be problem resolution that entails fair and dignified treatment of people with mental illness.

The first step for law enforcement in developing protocols is to learn about successful approaches adopted by other law enforcement agencies. A group of key stakeholders should be designated as a planning group to investigate and assess the different responses so that community leaders can develop response protocols that meet the unique needs of the community. (For more information on these committees, see the discussion in this report's Introduction as well as Chapter VI: Improving Collaboration.) Planning groups can accomplish this research and investigation using a variety of sources, including reviewing the literature; speaking with other law enforcement agencies about their promising approaches and any barriers to their success; or attending the training of a department that employs a response that could be effective in their community.

Approaches to consider include the following.  They may be adapted to the specific needs of a community.

• Crisis Intervention Team (CIT).  The CIT approach employs specially trained uniformed officers to act as primary or secondary responders to every call in which mental illness is a factor. Ideally, officers are chosen to participate based on their willingness to enhance services to people with mental illness within the community. CIT officers are available for each shift to provide assistance to consumers and their families and to facilitate emergency mental health assessments.
• Comprehensive Advanced Response.  This response model can be described as a traditional response modified by mandating advanced, 40-hour training for all officers within the department. Some of the departments that use this approach address responses to people with mental illness as part of their training and responses to "special populations."
• Mental health professionals who co-respond. Some law enforcement agencies hire licensed mental health workers as secondary responders. These civilians serve in units that are either located in the police department - where civilian workers are under the chief's supervision - or reside outside the department because staffing is shared with other county or city mental health providers. These civilian workers may either ride along with officers in special teams or respond when called by an officer after the scene has been secured for various crisis calls, including those involving people with mental illness. The civilian employees are responsible for developing relationships with community-based organizations and finding available services within the community.
• Mobile Crisis Team (MCT) co-responders.  Generally, Mobile Crisis Teams are composed of civilian personnel employed by mental health organizations, who are licensed mental health professionals.  For an effective, safe response, MCTs should act only as secondary responders who are called out once the scene has been secured by law enforcement.  Law enforcement officers call MCTs if it is believed that there is a person involved who may be a danger to him- or herself or others, or if the person needs services. Also, in some jurisdictions, if no crime has been committed, MCTs can provide transport to a mental health facility (if it appears the person might meet the criteria for civil commitment) or other services (such as counseling or drug treatment).  MCT personnel are knowledgeable about criteria for involuntary commitment, bring extensive information to the scene, and are able to provide follow-up services.

Regardless of the particular approach chosen, the officers must ensure the following: stabilize the scene; recognize signs or symptoms of mental illness; determine whether a serious crime has been committed; consult with personnel who have mental health expertise; and, when indicated, determine whether the person might meet the criteria for emergency evaluation. Once these determinations have been made, the responders must decide what, if any, action should follow. (see Policy Statement 4: On-Scene Response; also Policy Statement 28: Training for Law Enforcement Personnel).

Recommendations:

a.

Stabilize the scene using deescalation techniques appropriate for people with mental illness.

b.

Recognize signs or symptoms that may indicate that mental illness is a factor in the incident.

c.

Determine whether a serious crime has been committed.

d.

Consult personnel with expertise in mental illness to enhance successful incident management.

e.

Determine, when warranted, whether the person may meet the state criteria for emergency evaluation.