The Role and Impact of Law Enforcement in Transporting Individuals with Severe Mental Illness, A National Survey

From Treatment Advocacy Center, May, 2019

(NOTE: “We received 355 unduplicated responses from law enforcement agencies throughout the country. Of those responses … all states were represented except Alaska, Connecticut and Hawaii.”)

Approximately 8.3 million Americans have a severe mental illness such as schizophrenia, severe bipolar disorder or major depression with psychotic features.1 Almost half of these people are untreated on any given day.2 Without proper treatment, people with severe mental illness are at risk of experiencing negative outcomes that seriously impact them and the people around them.

Faced with limited community treatment options and a dire shortage of psychiatric inpatient beds, those in need of mental health treatment may not receive it until a crisis occurs and law enforcement intervenes. Approximately one-third of individuals with severe mental illness have their first contact with mental health treatment through a law enforcement encounter.3

Law enforcement officers are thus often on the front lines of psychiatric care, charged with responding to, handling and even preventing mental illness crisis situations.

The predictable results have been criminalization of severe mental illness and extreme overrepresentation of people with mental illness in jails and prisons.4 Research indicates that persons with serious mental illness are most often arrested for misdemeanor crimes.5 They are also four times more likely to be incarcerated for low-level charges than individuals without psychiatric disease.6

People with mental illness are more likely to be arrested if they live in communities with limited treatment options.7 Officers sometimes even resort to “mercy bookings” (using low-level misdemeanor charges) to get individuals in psychiatric crisis off the street and into treatment.8 Studies have found that in some parts of the country psychiatric treatment is more accessible in jail than in the community.9

Police officers and sheriffs’ deputies with little or no medical or mental health training are now regularly required to recognize conduct as symptomatic of psychiatric illness while in the midst of a chaotic encounter and to strike a balance between upholding public safety and serving the needs of the person in crisis.

Once an individual is taken into custody, it is law enforcement’s responsibility to transport him or her to the appropriate service. Law enforcement agencies throughout the country are feeling the strain of this responsibility on their budgets. Even when statistically controlling for type of response, law enforcement encounters with people with mental illness have been shown to use at least 90% more resources than encounters not involving mental illness.10

Diverting people in psychiatric crisis away from the criminal justice system and into treatment may be undermined by delegating the transportation function to law enforcement. Officers frequently find treatment-focused response options difficult to access or non-existent;11 unsurprisingly, they adhere to the arrest procedures they have been trained to carry out.

In addition to serving as street-corner psychiatrists, law enforcement officers have become road runners, responding to mental health emergencies and traveling long distances to shuttle people with mental illness from one facility to another.

Members of law enforcement do not serve as treatment providers for any other illness. It is difficult to imagine subjecting someone having a heart attack to arrest, or someone with cancer being transferred to a specialty center, in handcuffs, in the back of a police cruiser.

But regardless of the fact that severe mental illnesses are brain diseases, we persist in treating their behavioral manifestations as criminal acts.

The Treatment Advocacy Center set out to develop a national picture of the outsized role law enforcement plays in psychiatric crisis response and transportation. Road Runners: The Role and Impact of Law Enforcement in Transporting Individuals with Severe Mental Illness, A National Survey represents the first-ever national survey of sheriffs’ offices and police departments on these issues. It provides a glimpse into the burdens being shouldered by law enforcement, and the fiscal and societal implications of that reality.

read … Full Report

CB: Hawaii Ignores National Survey On Police Burden To Transport Psychiatric Patients