MH@H Mental Health

Police Partnerships in Mental Health Crisis Response

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Recently, I did a post about a local police force that routinely handcuffs people being apprehended to hospital under the Mental Health Act. 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 work) has a partnered 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’ve been certified under the Mental Health Act in the community but couldn’t be taken to hospital.  

If they’re attending a call and someone needs to be taken to hospital involuntarily, the police officer may do a Mental Health Act apprehension. Alternately, the on-call psychiatrist will be called to assess the person for certification under Mental Health Act.  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 involuntarily. However, 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 believe the police should be primarily supportive unless there’s an imminent safety risk. There’s no reason for them to be doing “wellness checks” routinely.

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. We need to do better than that.

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The Straight Talk on Suicide page covers a variety of topics related to suicide, including getting help and safety planning, from the perspective of someone who’s been there.

21 thoughts on “Police Partnerships in Mental Health Crisis Response”

  1. 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 🙁

  2. too bad we americans
    do not do this
    eg brian cardall
    had a seizure
    and sat in the road naked
    the cops tazed him
    and his heart stopped
    good post
    any words?

  3. 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.

    1. I think all health professionals have a professional responsibility to check whatever their judgments may be at the door and treat all patients with respect.

  4. 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

  5. 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.

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