Recently I did a post expressing my concern about learning that a local police force routinely handcuffs people that they are taking to hospital under a Mental Health Act apprehension. That got me thinking about what it should look like to help people in mental health crisis.
Police-mental health partnership
The police force in the city where I live (not where I work) has a partnership with the local health authority to operate “car 87/88”. This involves an unmarked police car, a plainclothes police officer, and a mental health nurse. They attend mental health emergency situations, and track down people who have been certified under the Mental Health Act in the community but left before they could be taken to hospital.
If they’re attending a call and someone needs to be taken to hospital involuntarily, either the police officer will do a Mental Health Act apprehension or the on-call psychiatrist will be called to assess the person and do a Mental Health Act medical certificate if appropriate. An ambulance then transports the person to hospital The car 87/88 police officer can accompany as needed and the nurse following behind in the police car.
Benefits of this type of partnership
I really like this system; the biggest problem I see is that there’s only one car per shift for a large urban centre. It seems much more civilized to have a more subtle police presence (unmarked car, no uniform), a highly experienced mental health nurse, and transportation in an ambulance (what with mental illness being a medical issue).
I understand why police need to be involved sometimes if someone is being taken to hospital on an involuntary basis, but I don’t think that’s any excuse to take the health out of mental health care. Mental illness crisis is an emergency medical issue, and I strongly police should be involved in a primarily supportive role unless there’s an imminent safety risk.
Less lethal options
Speaking of which, I think it’s crucial that police attending situations where a mentally ill person poses an imminent threat have training in the use of less lethal force options, such as weapons that fire rubber bullets or bean bags. Several years ago at a mental health clinic where I worked, a client had come in who was highly suicidal and wished to commit “suicide by cop” (i.e. goad police into shooting and killing him). The team of police officers involved handled the situation extremely well and were able to utilize these less lethal options to make sure that nobody got hurt, including the client.
Because mental illness is unpredictable, mental health crisis situations are equally unpredictable. However, I think having a well-designed crisis response system can go a long way in both promoting safety and preserving dignity of the mentally ill person in crisis. A system that further traumatizes mentally ill individuals does no one any favours, and we need to do better than that.
You may also be interested in a more recent post on how defunding the police could be beneficial for people with mental illness.