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Sun May 25, 2014, 01:48 PM

Why do we expect our police officers to be intake personnel for the mentally ill?

We expect people with minimal if any training to talk to someone for a few minutes and decide whether or not they should be forcibly committed to psychiatric care. Add to the mix that often the law requires that the person be an immediate threat to himself and/or others.

I guess this matches up with the rest of our current policies which see more mentally ill people in prisons than hospitals!

http://www.motherjones.com/mojo/2014/04/record-numbers-mentally-ill-prisons-and-jails

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Reply Why do we expect our police officers to be intake personnel for the mentally ill? (Original post)
hedgehog May 2014 OP
treestar May 2014 #1
phil89 May 2014 #5
Throd May 2014 #8
phil89 May 2014 #13
hedgehog May 2014 #17
bluestateguy May 2014 #2
hedgehog May 2014 #18
KT2000 May 2014 #3
LeftyMom May 2014 #4
mike_c May 2014 #6
Ilsa May 2014 #7
upaloopa May 2014 #11
Ilsa May 2014 #14
postulater May 2014 #9
upaloopa May 2014 #10
Vinca May 2014 #15
hedgehog May 2014 #19
jwirr May 2014 #12
Igel May 2014 #16

Response to hedgehog (Original post)

Sun May 25, 2014, 01:49 PM

1. Ronnie Raygun shut down the mental health hospitals

I am starting to wonder if he had not done that, if we would not have as many mentally ill people out there unidentified.

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Response to treestar (Reply #1)

Sun May 25, 2014, 02:03 PM

5. The problem wasn't shutting down the hospitals

 

that was a good thing, as society was basically warehousing people and robbing them of dignity and quality of life. The problem was they didn't follow up wiht community treatment/ACT teams, etc. Our country has a miserable history of treating anyone different as criminals/sub human.

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Response to phil89 (Reply #5)

Sun May 25, 2014, 02:22 PM

8. I heard an interview on NPR of a woman who helped shut down the hospitals.

The theory at the time was exactly as you said. They thought they were warehousing people and robbing them of dignity and quality of life. The flaw in their thinking was that these mentally ill people would act in their own "self-interest" and continue with outpatient counseling and drug treatments. As it turned out, most of them didn't think they had a problem and didn't show up for aftercare. Many chose to self-medicate with alcohol and street drugs. They wanted to be left alone so they disappeared into the alleys and bushes where they would not be bothered. When society ever does pay them any mind, it is most likely to be in the form of a police officer.

The woman's interview had a whole "road to hell paved with good intentions" tone of resignation to it.

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Response to Throd (Reply #8)

Sun May 25, 2014, 03:25 PM

13. Assertive Community Treatment teams

 

seems to work pretty well as a middle ground between the two. Many people with mental illness do need some form of supervision, but I see no reason to have been basically putting them in a prison for something that wasn't their fault. In grad school we toured one of the old state hospitals in Indiana. People were often brought there as children, left by their families and lived their entire lives there. Even had a graveyard on the grounds for them. Society was very fearful and dismissive of anything different. Seems it was met with fear and a desire to throw them away and act as if they didn't exist. Just another chapter in our awesome country's treatment of non-white, non-hetero, non-"normal" people.

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Response to phil89 (Reply #13)

Sun May 25, 2014, 04:47 PM

17. We've repalced virtual prisons (mental asylums) with actual prisons!

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Response to hedgehog (Original post)

Sun May 25, 2014, 01:57 PM

2. Experienced cops might be able to sense if someone is homicidal

But your overall point is sound.

And the thing is that we can't involuntarily commit someone to a mental ward just because they are weird and eccentric. They have to present a real danger to themselves or others. Only professionals in mental health can really sense that.

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Response to bluestateguy (Reply #2)

Sun May 25, 2014, 04:50 PM

18. How often does the average officer encounter someone who is homicidal?

Despite the plethora of crime shows on television, murder is relatively rare and I think typically is an outcome of domestic violence allowed to proceed unchecked, a poorly planned robbery or a result of gang activity. It seems often to be a crime of impulse as well.

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Response to hedgehog (Original post)

Sun May 25, 2014, 01:57 PM

3. that is the system

the mentally ill person is on their own until laws are broken, then it is off to prison. The families may have devoted their lives to watching over and caring for the mentally ill person - most often with no help.

There is a financial system that needs tweeking too. Maybe the family qualifies for some kind of healthcare and education assistance but when the person turns 18 they will have to qualify for disability if the problems are that bad. That usually means that the person is now on their own to find a place to live, fit in and survive. What a shock that must be when some do not have a real understanding of what it takes to live in society.

These are people we throw overboard - to the streets and jails. A society that serves the 1% could care less.

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Response to hedgehog (Original post)

Sun May 25, 2014, 02:03 PM

4. It's more expensive than actual treatment, and of course it makes things worse.

The suicide rate at the local jail is an ongoing problem in my community, and after years (I want to guess about ten?) of attention to it there doesn't seem to be any change in the situation.

But people are always willing to vote more money for cops and jails, and they're not willing to fund mental health treatment, whether in our outpatient.

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Response to hedgehog (Original post)

Sun May 25, 2014, 02:09 PM

6. this troubles me, too....

Frankly, police are among the LAST persons I'd like to see making psych evals of any sort.

The solution is not to police mental illness more closely, but to make the means of doing harm, especially guns, more difficult to acquire. That will lengthen the time available for intervention by more qualified professionals BEFORE someone who's mentally unstable becomes a mass shooter.

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Response to hedgehog (Original post)

Sun May 25, 2014, 02:19 PM

7. It is a great question with substantial weight to it.

I think this needs to be asked of all local politicians running for office and/or sheriff. Why should any local politician expect to be rewarded with promotion to higher political office when they can't address the local problems that affect constituents on a daily basis?

Maybe every community should be required to have several experienced psychiatrists on retainer for emergency calls.

K&R.

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Response to Ilsa (Reply #7)

Sun May 25, 2014, 02:35 PM

11. They do.

We have mobile crisis units. Crisis residential units and crisis stabilization units. All are within touch if a doctor 24/7.
This is the County of Santa Barbara.
We just got a State Grant for $8 mil to expand this.
You cannot predict when someone is going to act out and you can't force people to seek professional help. Few of us understand the world of mental illness thus the bull shit in this board like pools are candy or we should keep people in hospitals.

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Response to upaloopa (Reply #11)

Sun May 25, 2014, 03:39 PM

14. I'm glad your community has them. Not all of them do.

I haven't heard of anything remotely like this in the smaller cities where I have lived. Usually, the police pick them up and deliver them to Emergency Departments for assessment.

Not everyone is familiar with the successes of outpatient treatment centers if they haven't had one nearby to provide the community with that experience. You have to remember that many other states are decades behind CA when it comes to things like best practices for the mentally ill and disabled. This type of decentralized, local home rule keeps communities in the dark and unaware of successes in other states.

Please don't piss on the folks who want to see changes but might not know of the best, most advanced practices. It's not helpful to call their comments "bullshit".

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Response to hedgehog (Original post)

Sun May 25, 2014, 02:28 PM

9. A cop in Milwaukee just killed a mentally ill man a couple weeks ago.

The man was hanging out downtown by Starbucks. The cop was questioning him when the man acted out. The cop pulled ou his stick, the man grabbed it and started attacking the cop. The cop shot him ten times.

Sad situation all around. The local discussion is about training the cops to recognize and deal with situations like this.

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Response to hedgehog (Original post)

Sun May 25, 2014, 02:34 PM

10. This us bull shit. Police are trained they can

have people taken to a hospital for observation if they are a danger to themselves or others.
I work for the alcohol, drug and mental health dept of Santa Barbara County. My place of work is a few miles from Isla Vista.

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Response to upaloopa (Reply #10)

Sun May 25, 2014, 03:46 PM

15. It's not that cut and dried.

Many moons ago I was a cop and many people who are either nuts, drunk or stoned can - on occasion - pull it together and appear totally normal. I remember one case in particular involving a guy who was a known mega-imbiber. A detective who had been on the force for about 20 years had been interviewing him on the street about something and was all set to let him drive away when I suggested we check him on the breathalyzer. As I recall he was 3 times the legal limit . . . yet he acted completely normal. On the other hand, we picked up a naked guy in a snowstorm who thought he was a polar bear and took him straight to the hospital.

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Response to upaloopa (Reply #10)

Sun May 25, 2014, 05:01 PM

19. Unfortunately, many hospitals are not prepared to handle someone in a mental health crisis.

The mentally ill person ends up waiting in a hospital emergency room with all the chaos that implies while someone calls around looking for an open psych bed. It's torture for some patients, and other patients are a hazard to themselves and the hospital staff.

I actually witnessed one incident of this type. We were sitting in an ER cubicle waiting for my young son to get treatment for his asthma. It was very irritating to be kept waiting while we could hear on the other side of the curtain, an ambulance crew chit-chatting with the nurses. Suddenly there was a great deal of shouting and running around. A gentleman who had been brought in for psych observation had gotten tired of waiting, strolled down the hall, gotten into the ambulance and drove off. As it happened, he was well known to the police in this small town, so they were waiting for him at home when he drove up.

(Please don't read this as a blanket condemnation of emergency room personnel and/or ambulance teams. This was a slow night at a small town hospital.)

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Response to hedgehog (Original post)

Sun May 25, 2014, 02:49 PM

12. Teachers are expected to recognize special children so that they can be referred for help. It is

because they have frequent contact with persons in need of help. That also pretty much describes the kind of contact the police have with many of the persons who are in need of health care. Is there any reason that the police should not take a course in the same thing that those teachers do?

No that will not allow them to diagnose all the persons they come into contact with but it would certainly help in some. And if we ever get back to placing the mentally ill in hospitals instead of jails this would be invaluable.

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Response to hedgehog (Original post)

Sun May 25, 2014, 03:57 PM

16. Because we so disliked all the other alternatives that we disposed of them.

You'd think that means we like the alternative that's left, since we chose it in everything but name, but few bothered to think that far into the future.

It's what happens when you legislate by trials. Nobody seriously goes to court to improve things for everybody; it's a convenient fiction to cover the fact that those who litigate go to court to improve things primarily for themselves.

So family members could have somebody committed. All well and good, there were supposed safeguards in place to prevent abuse but bribes and such could bypass the safeguards. So we disposed of them.

Doctors could do the same. But they often were bribed or acted out of self-interest. They often made bad decisions that were later all but irreversible. So we disposed of that "intake system."

We like the idea of a mentally ill person committing themselves. "Hi, doc, I think I'm mentally ill. Please lock me up, declare me incompetent and strip me of many of my civil rights, and drug me against my will if I change my mind. Evaluate me from time to time and discharge me, taking a reduction in your income, should I be of sound mind again." Only a crazy person would do that. Fortunately, most have too much sanity.

That leaves police.

Community groups might work, but just like with an HOA, they're probably better in theory than in practice.

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