INFORMATION TO USERS This manuscript ,has been reproduced from the microfilmmaster. UMI films the text directly from the original or copy submitted. Thus, some thesis and dissenation copies are in typewriter face, while others may be from any type ofcomputer printer. The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrougb, substandard margins, and improper alignment can adversely affectreproduction. In the unlikely event that the author did not send UMI a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. Oversize materials (e.g., maps, drawings, charts) are reproduced by sectioning the original, beginning at the upper left-hand comer and contimJing from left to right in equal sectionswith smalloverlaps. Each original is also photographed in one exposure and is included in reduced form at the back ofthe book. Photographs included in the original manuscript have been reproduced xerographically in this copy. Higher quality 6" x 9" black and white photographic prints are available for any photographs or illustrations appearing in this copy for an additional charge. Contact UMI directly to order. UMl • A Bell & Howell Information Company 300 North Zeeb Road. Ann Arbor. MI48106-1346 USA 313/761-4700 800:521·0600 POLICE AS FRONTLINE MENTAL HEALTH WORKERS: THE DECISION TO ARREST OR REFER TO MENTAL HEALTH AGENCIES A DISSERTATION SUBMITTED TO THE GRADUATE DIVISION OF THE UNIVERSITY OF HAWAn IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN SOCIOLOGY AUGUST 1995 By Thomas M. Green Dissertation Committee: Gene Kassebaum, Chairperson Harry Ball Karen Joe Susan Meyers Chandler Kim Marie Thorburn UMI Number: 9604152 OMI Microform 9604152 Copyright 1995, by OMI Company. All rights reserved. This microform edition is protected against una~thorized copying under Title 17, United States Code. UMI 300 North Zeeb Road Ann Arbor, MI 48103 (I) Copyright by Thomas M. Green 1995 All Rights Reserved iii DEDICATION One of the qualities that makes the United States an economic and political world leader is our highly competitive nature. We have structured a society that generously rewards hard work and success. However, the mark of a truly great nation is one that values all its citizens, including those who cannot compete; in this, the United States falls short of greatness. This research is dedicated to those individuals whose daily struggle to survive is met with disgust and hostility. Those persons who have a mental illness and are living on the streets of "paradise" are a reflection of who we are as a society. I sincerely hope that we can learn to view our reflection with compassion and understanding. • iv ACKNOWLEDGEMENTS I am deeply indebted to the Honolulu Police Department for their cooperation and support in conducting this research. Without exception, all of my interactions with the department have been courteous and accomodating. I truly believe that all of the department's personnel with whom I dealt in the course of this research are dedicated to protecting and serving the public, including those persons who have mental illness. I am especially to indebted to Chief Michael Nakamura, Major Robert Au, Major Herbert Okemura, Captain Mike Chastain, Major Richard Fuji, Major Steven Watarai, Major Jerold Brown, Major Boisse Correa, Major Charles Duncan, the watch commanders from each of the eight police districts, and the patrol officers who participated in this research. The same debt of gratitude is owed to Sharon Black, director of Project Outreach, whose dedication and efforts on behalf of the homeless and homeless mentally ill is an inspiration. I had an exceptional dissertation committee. For the past seven years, Gene Kassebaum has served as not only chair of my thesis and dissertation committees, but has been a willing mentor. I was fortunate to benefit from Harry Ball's expertise concerning the legal system and wealth of knowledge about Hawaii's history of law enforcement; Karen Joe's knowledge of qualitative methods, theory, and tremendous support; Susan Meyers Chandler's profound understanding of the issues concerning persons who have a mental illness and society's response to those issues; and Kim Marie Thorburn's perspective of the problems associated with incarcerating persons who have a mental illness, and her passion for social justice. During the course of this research many friends had words of encouragement and support, but no more so than my supervisor, Alan Shimabukuro. Alan is the most gifted v manager I have ever known: he empowers his staff and leads by example. His guidance was critical to the successful completion of this research. I can honestly say that I could not have completed this research and all that preceeded it withoutthe love, support, and meticulous editing of my wife and best friend, Trish Riley. Not only do lowe her more than a few nights of not doing the dishes whileI studied, or lost weekends in reading or writing, or blurry vision from reading and re-reading my work, but the greatest gift was the knowledge that pursuing this goal was as important for her as it was for me. I am truly blessed. • vi ABSTRACT Most large cities in the United States are currently faced with an array of problems associated with a growing number of individuals who have a mental illness and who are often living on the streets, or at least are no longer confined in closed mental institutions. Whenever behavior in public violates community standards or laws, such behavior becomes subjectto law enforcement. The police are increasingly required to intervene in behaviors of individuals with diagnosed mental illness, being placed in a role which requires them to mediate the interests of local politicians, their own departmental policies, merchants, private service providers, hospitals, the general public, and individuals who may need mental health services. Police officers have a limited number of dispositional options but a great deal of discretion concerning which options to invoke. Research on police discretion has examined the degreeto which police "criminalize" the mentally ill, act as gatekeepers to the mental health system, and, in a broader sense, invoke police sanctions rather than clinical authority. The purposes of this research are threefold: to measure the distribution of the dispositional options which police select in dealing with persons with a mental illness who commit an act for which they could be cited or arrested; to measure why police make the decisions they do; and to measure police workload involved in invoking the various options for dealing with persons with a mental illness. Over half of the encounters between police officers and those with a mental illness resulted in an informal disposition, 20 percent resulted in the officertaking no action (a heretofore unmeasured outcome in studies of police discretion), and 15 percent resulted in arrest. During the study period, officer-suspect encounters ranged from 0 to 500 minutes in • vii duration, with an average of 36 minutes per encounter. Multivariate logistic regression analysis specifies models which best predict these three dispositional outcomes. Explanatory variables which appear in each model include the number of years an officer has served on the police force and the severity of the offense; other significant variables include whether the suspect was known on sight or known to have a criminal history. Qualitative analysis offers additional insights into the factors which influence the decision making processes of law enforcement officers. viii TABLE OF CONTENTS Acknowledgements v Abstract vii List of Tables x List of Figures xi Preface xii Chapter 1: Introduction.................................................................................... 1 A. Background of the Study 1 B. Police Discretion 4 C. Theoretical Framework.......................................................................... 12 D. Research Hypotheses 17 Chapter2: Law Related Issues Regarding Police Interaction With Persons Who Have A Mental Illness 19 A. Powers and Duties of the Police 19 B. Policy-Related Factors That Influence Police Discretion With Regard To Arrest 23 C. Liability............................................................................................. 27 D. Emergency Apprehension, Emergency Hospitalization, and Involuntary Hospitalization...................................................................... 34 Chapter3: Methodology 54 A. Setting 1 •••••••••••• ...... .. .. .. ................... 54 B. Methodology............ 59 Chapter 4: Quantitative Analysis...................................................................... 69 A. Univariate Statistics 69 B. Bivariate Statistics................................................................................ 84 C. Mulitivariate Statistics.... 101 D. Endnotes 109 Chapter 5: Qualitative Analysis III Chapter 6: Conclusions and Recommendations 139 A. Conclusions 139 B. Recommendations ~....... 147 C. Endnote 159 Appendix A: Incident Coding Form 160 Appendix B: Interview Questions 161 Appendix C: Variable List 164 References 166 , ix LIST OF TABLES 1. Basic Information ~.............................................. 70 2. Suspect Characteristics 77 3. Officer Characteristics 82 4. Relationship Between Known Criminal History and