How can we help those in mental health crisis?

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 shoulds look like to help people in mental health crisis.

The police force in the city where I live (different from the one referred to in my previous post) has a partnership with the local health authority to operate what’s referred to as 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 is then called, and the person is transported to hospital in the ambulance, with the car 87/88 police officer accompanying as needed and the nurse following behind in the police car.

I really like this system, and the biggest problem I see is that there is only one car for afternoon shift and one for night shift in 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 health care.  Mental illness crisis is an emergency medical issue, and I strongly police should be involved in a primarily supportive role unless there is an imminent safety risk.

Speaking of which, I think it’s crucial that police attending situations where a mentally ill person poses an imminent threat be well trained in the use of less lethal force options, such as weapons that fire rubber bullets or bean bags.  A number of 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 that attended handled the situation extremely well trained 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 illness crisis situations are equally unpredictable.  However, I think having a well-designed crisis response system can go a long in 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.

23 thoughts on “How can we help those in mental health crisis?

  1. demmiecynic says:

    I agree, and I work for the police. I’m in the UK so guns aren’t carried routinely, only by special armed forces units for unique situations. Police presence can add an element that isn’t corresponding to what mental health is all about. However having said that, the work our negotiators do is remarkable, and is the part of the force I want to progress to eventually. Missing people in mental health crisis are taken as seriously as any other emergency. If anything now I am writing this I wish there was something else, something not quite police but a bit different to a MH professional, for some types of situations. Austerity is not helpful either 😦

    Liked by 3 people

  2. Meg says:

    I agree. There needs to be compassion, too. I appreciate your raising awareness for this! I also wish nurses wouldn’t act all “holier than thou” when dealing with an overdose or cutting, etc. It caused me to develop a nurse phobia for years that I overcame when I got pneumonia, and all of a sudden the nurses were nice again. [Rolling my eyes.] It’s not as if they have any complaint: they’re being paid for their time in the ER, so there’s no reason to be all judgey.

    As I type this, I’m realizing I’d probably be judgey of people who keep ODing on street drugs due to being addicts, so maybe I’m a hypocrite. I like to think I’d try to hide my bias, though. It’s hardly something I’m proud of.

    Liked by 3 people

  3. Marie Abanga says:

    I bookmarked this post to get back to it when I could leave a comment. Hmm, in my country Cameroon – Africa, we do not even have police get involved o. The family have to try their best period. If the distressed person runs off to the streets, the family either goes after them, or abandon them to their wanderings and doings. It’s a bit different here and I don’t know why, but people are still more ‘family members receptive’ even in extreme crisis and I remember a day my brother in his mania held my 10 months old son up side down threatening to throw him down if anyone dared him. I did dare him gently and soothingly until he gave me the baby and went locked himself in the loo for a couple of hours. He broke some stuffs and raged until he calmed down a few hours later and slept on the floor. The door was locked from inside and mum had to have it spoiled to get to him. We took him to the hospital thereafter and he was hospitalized. Many families here figure out what works best for them but police are rarely if ever involved. I will personally dread and loathe their involvement especially in uniform/siren/threatening etc way. Thank you for this post and all the other Ashley

    Liked by 3 people

  4. skinkittin says:

    Great article Friend. What an interesting topic. Mental health in America is so dysfunctional. Lady Liberty needs mood stabilizers STAT. Your area sounds great. I bet you have reasonable access to medications as well. We’re not jealous or anything.

    Liked by 1 person

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