A Brief History of Mental Health Crisis Intervention Efforts

By Sarah Ahmed-Alsaggaf, Social Work Intern

In 1981, president Ronald Reagan decided to cut hospitals' federal budget for treatment of mental illness. That decision has complicated the process for finding a designated institution to go to when an individual encounters a mental health crisis. Therefore, they would have to call 911 and request police involvement with these kinds of crises. Some police personnel are not trained or educated to interact with people with mental illnesses - some don’t have enough knowledge or practical experience to respond and deal with severe mental illness (Position statement 59: Responding to behavioral health crises).  Assigning those missions to the police could turn the situation into confrontations between law enforcement and the mentally ill, which could lead to catastrophic and tragic outcomes.

 Moreover, these confrontations would result in sending sick people to jail or the ER because there are no appropriate facilities that are equipped and prepared to manage those types of crises; this would be harmful and would make the situation even worse. Unfortunately, even a country as wealthy as the United States can be faced with both a social problem and a public health crisis at the same time because for years, the country could not find a practical solution to the mental health situation (Devylder, Fedina, & Link, 2020).

A recent study by the Treatment Advocacy Center concluded that individuals with untreated mental illness are 16 times more likely to be killed during a police encounter. Also, the study found out that although less than 1 in 50 U.S. adults has an untreated severe mental illness, 1 in 4 fatal police shootings involves an individual with a mental illness (People with untreated mental illness 16 times more likely to be killed by law enforcement). The Washington Post has reported that in 2015 at least 25% of people who were killed in police shootings suffered from mental illnesses; and in 2018 the police killed more than 200 individuals with mental illness (How Mental Illness Affects Police Shooting Fatalities).  

In 1988, The Crisis Intervention Team training program was developed in Memphis, after the police killed a 27-year-old man who was suffering from a severe mental illness. The purpose of this program is to train law enforcement on how to deal with mental health crises, understand the signs and symptoms of mental illness and to divert people to mental health treatments instead of putting them in jails. This program is a partnership between law enforcement, mental health specialists and the community stakeholders in order to ensure the safety of society and avoid unnecessary use of force that could result in tragedy.  This training is beneficial for the police officers; it gives them more understanding of mental illness and it hones their intervention skills. Also, it is more beneficial for people with mental health issues as it ensures that they get the treatment they deserve, doesn’t make their situations worse and more importantly, it saves their lives. The CIT is mostly organized by community organizations where they host speakers who volunteer to train these officers (CIT History ​course and guide). In Dane County, the CIT program is funded by a contract with the County. Last year $87,500 was set aside to fund the CIT program in Dane County. According to the University of Memphis CIT Center, there were 2,700 CIT program conducted within the U.S in 2019 ( Rogers, McNiel , & Bin, 2019).  

Another program developed to reduce this issue is the Co-Responder Model. This program's goal is to train police officers to work alongside with mental health professionals when responding to mental health crises, whether it is a phone call or on the scene. This program was founded to prevent injuries, prevent the criminal justice system's involvement and avoid unnecessary arrests or use of force. When the police and mental health professionals work together, there is a positive effect on the services that can be provided to the mentally ill and their caregivers; Moreover, it can prevent unwanted outcomes and enable the response team to better manage the situation. People can get a co-responder team upon request when they call local police departments or 911. Most of the co-responders are funded from tax money (Co-Responder Programs). 

Both of these programs were established to ensure that people with mental health issues get better treatment in which their lives are not threatened due to their illness. Applying those programs within our societies would make a difference; it would help to preserve lives and dignity for people with mental illness and prevent deadly outcomes. 

NAMI Dane County partners with local law enforcement agencies to hold Crisis Intervention Team (CIT) trainings in Dane County. To learn more about CIT trainings, check out our CIT webpage.

References:

Rogers, M., McNiel , D., & Bin, R. (2019). Effectiveness of police crisis intervention training programs. Retrieved from Journal of the American Academy of Psychiatry and the Law: http://jaapl.org/content/early/2019/09/24/JAAPL.003863-19

CIT History ​course and guide. (n.d.). Retrieved from CIT: http://www.gocit.org/crisis-intervention-team-history.html

Co-Responder Programs. (n.d.). Retrieved from Colorado Department of Human Services: https://cdhs.colorado.gov/behavioral-health/co-responder

Devylder, J., Fedina, L., & Link, B. (2020, October 07). Impact of police violence on mental health: A theoretical framework. Retrieved from American Public Health Association: https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2020.305874?journalCode=ajph

How Mental Illness Affects Police Shooting Fatalities. (n.d.). Retrieved from International Bipolar Foundation : https://ibpf.org/how-mental-illness-affects-police-shooting-fatalities/

People with untreated mental illness 16 times more likely to be killed by law enforcemen. (n.d.). Retrieved from Treatment Advocacy Center: https://www.treatmentadvocacycenter.org/key-issues/criminalization-of-mental-illness/2976-people-with-untreated-mental-illness-16-times-more-likely-to-be-killed-by-law-enforcement-

Position statement 59: Responding to behavioral health crises. (n.d.). Retrieved from Mental Health America : https://www.mhanational.org/issues/position-statement-59-responding-behavioral-health-crises

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