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Keeping the Peace: Police Discretion and Mentally Ill Persons

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Keeping the Peace: Police Discretion and Mentally Ill Persons Keeping the Peace: Police Discretion and Mentally Ill Persons c is oD By Linda A. Teplin t ho is and P b or e: C c ur o o s t ho P about the author n many urban centers, respond- Linda A. Teplin is Professor of Psychiatry and Director of the Psycho-Legal Studies Program ing to mentally ill people has at Northwestern University Medical School. In addition to her work on the criminalization of Ibecome a large part of the mentally ill persons, she has conducted research on the epidemiologic characteristics of police peacekeeping function. adult jail detainees, delinquent youth, and the correlates of violence. Her current work involves Several factors have increased the the first large-scale, longitudinal study on psychiatric disorders, patterns of service use, likelihood of police encounters: and risky behaviors. deinstitutionalization in the 1960’s, cutbacks in Federal mental health funding, and changes in the legal code governing patient rights and ment with mentally ill persons and ment or treatment. In addition, affirming the right of a mentally ill instruct police to initiate a psychi- many psychiatric programs will not person to live in the community atric emergency apprehension accept everyone, particularly those without psychiatric treatment.1 whenever the person is either considered dangerous, those who dangerous to self or others or is also have substance abuse disorders, At the same time, society’s tolerance unable to provide for basic physical or those with numerous previous of mentally ill persons in the com- needs so as to protect him/herself hospitalizations.4 (See “Law munity is limited. Given the stereo- from serious harm. Enforcement Options for Handling type of mentally disordered people Mentally Ill Persons,” page 10.) as dangerous,2 citizens often call Although the law legitimizes the upon the police to “do something” police officer’s power to intervene, it in situations involving mentally does not—and cannot—dictate the Officer Decision ill individuals, particularly when officer’s response in any given situa- Making Regarding they exhibit the more frightening tion. As with all law enforcement Mentally Ill Persons and disturbing signs of mental decisions, the police must exercise disorder.3 discretion in choosing the most The seminal study of police officer appropriate disposition. decision making regarding encoun- ters with mentally ill citizens was Officers who encounter an irrational The Police Role in Egon Bittner’s in 1967.5 Bittner person creating a disturbance have Handling Mentally Ill found that the police reluctantly three choices: transport that person made psychiatric referrals and initi- Persons to a mental hospital, arrest the per- ated hospitalization only when the son, or resolve the matter informal- Police involvement with mentally individual was causing or might ly. In making these judgments and ill persons is grounded in two com- cause serious trouble. Even so, in trying to calm situations on their mon law principles: (1) The power officers resorted to a mental own, the police are called upon to and responsibility of the police to hospital only in the absence of act as “street-corner psychiatrists.” protect the safety and welfare of the other alternatives. public, and (2) parens patriae, which But their options are, in practice, Almost 15 years later, a study by dictates protection for disabled citi- limited. Initiating an emergency the author of this article found zens such as mentally ill persons. hospitalization often is fraught with that little had changed. In 1980, bureaucratic obstacles and the legal Most mental health codes specify researchers began recording first- difficulties of obtaining commit- the parameters of police involve- hand observations about how police officers handled mentally disordered persons in a large north- ern city and how these interactions Officers who encounter an irrational person differed from interactions with people who were not mentally creating a disturbance have three choices: disordered.6 They found that police resolved transport that person to a mental hospital, situations informally in 72 percent of the cases, made an arrest in 16 arrest the person, or resolve percent of the cases, and initiated emergency hospitalization in the matter informally. 12 percent of the cases. (continued on page 12) National Institute of Justice Journal ■ July 2000 9 Law Enforcement Options for Handling Mentally Ill Persons Law enforcement officers have two around in circles.... The officer him into the mental health center basic ways to respond in situations and the sergeant got the man to because his behavior wasn’t that involving mentally ill people who stop spinning. They attempted to severe for the hospital to accept are causing a disturbance: formally question him, but the man was him. (either hospitalization or arrest) or completely out of it. He gave no Likewise, when an individual was informally. indication that he understood what defined as “too dangerous” by the was going on. He didn’t talk at all Officers’ decisions to hospitalize, hospital, arrest was the only alterna- during the encounter. The officer arrest, or deal with a mentally ill tive available to the officer: called for a wagon to take the man person informally are based less on to the hospital. A young man was banging on the degree of symptomatology than his mother’s door with a meat on the demands and constraints of Arrest. While arrest was not a fre- cleaver.... He was threatening to the situation. Officers’ first choice is quent disposition, the arrest rate for kill someone else and wanted to usually informal disposition. persons exhibiting signs of mental get into his mother’s home for a illness was greater than that of other gun. She wouldn’t let him in and Formal Options citizens involved in similar types of had called the police to get rid of incidents. Arrest often was the only Hospitalization. Police use of hos- him and/or to calm him down. step available to the officer in situa- pitals is limited by the number of When the police got there, officer tions where individuals were not suf- psychiatric beds in the community II decided the man needed to be ficiently disturbed to be accepted by and by the criteria for admission. hospitalized as he was dangerous the hospital, but were too public in Virtually every officer in the study to himself and others. So they their deviance to be ignored. was aware of the stringent require- called for a wagon to take the man ments for admission into the local It was common for an officer to to the mental health facility...but psychiatric hospital: Individuals had obtain a signed complaint in situa- they also wanted a complaint to be seriously ill—for example, tions where he or she thought an signed by the mother for disorderly be actively delusional or suicidal. individual required hospitalization. in case [the hospital wouldn’t take Police knew that persons who were The aim was to ensure the ready him]. It turned out that the hospital mentally retarded, alcoholic, or availability of an alternative disposi- would indeed not take the man, so categorized by hospital staff as tion—arrest—in the event that the he ended up being locked up for “dangerous” often were not wel- hospital found the individual unac- disorderly. come at the hospital, nor were ceptable for admission. The officers’ Ironically, it was precisely the persons with criminal charges apparent ingenuity was borne out of requirements for emergency psychi- pending, no matter how minor. necessity since hospital admission atric detention set forth in most criteria were so stringent. A typical Furthermore, handling mentally ill mental health codes—“dangerous example: persons was not regarded by officers to self and others”—that rendered as a “good pinch” and was largely The officer said this man had mentally disordered citizens unde- unrewarded by the department, fur- been on the street calling women sirable to hospitals and resulted in ther deterring psychiatric referrals. names, calling them whores, and their arrest. In addition, officers perceived the shouting at black people, calling Persons whose symptoms crossed rapid deinstitutionalization of men- them names and chasing them.... the boundaries of the caretaking tally ill persons as a personal slight A woman had signed a complaint systems met a similar fate. Mental on their judgment and a sign of the for his arrest because he was both- health programs found persons with hospital’s unwillingness to “do ering her. The man sounded like a alcohol problems disruptive to the something.” paranoid schizophrenic.... He was patient environment and often would very vague about himself and who Still, occasionally the police did not accept them for treatment. he was and felt that people were take someone to the hospital, as Conversely, detoxification facilities out to get him.... When he was shown in the following scenario: felt they were not equipped to deal taken to his cell, he began with persons exhibiting signs of We were on the scene in less than shouting to be let out and he kept mental disorder and would turn away a minute. The citizen in question shouting.... He was charged with persons with such mixed symptoms. was a black male, about 45 years disorderly conduct. The officer In general, jail became the place of old, standing on the sidewalk with said there wasn’t enough to take his arms outstretched, spinning last resort. Because mental health Keeping the Peace: Police Discretion and Mentally Ill Persons 10 and substance abuse systems symptoms is only one of the a “troublemaker,” hospitalization or tended to design their programs determining factors. arrest is very unlikely. Intervention as though clients were “pure in such cases is considered not types,” a number of people were Informal Options worth the trouble.
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