SAN FRANCISCO – When police officers are trained to recognize and handle psychiatric emergencies, they are less likely to arrest the mentally ill and more likely to refer them to treatment centers.
And people with mental illness who arrive from police custody are likely to be less agitated, less in need of seclusion and restraints, and more cooperative with initial psychiatric evaluations, "because the officers interact with patients in a very different way compared to most police encounters," said Dr. Michael T. Compton, the lead investigator of a study that evaluated the impact of one such training course, the Memphis Crisis Intervention Team (CIT) program.
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Officers in the Memphis Crisis Intervention Team (CIT) volunteer for a 40-hour program to hear lectures about how to recognize mental illness, learn de-escalation techniques, and visit local psychiatric facilities to meet staff.
Officers who volunteer for the 40-hour program hear lectures about how to recognize mental illness, learn de-escalation techniques, and visit local psychiatric facilities to meet staff and hear first-hand from patients what it’s like for them to deal with the police.
In the study, Dr. Compton asked 183 officers in six Georgia police departments – most around Atlanta and one in Savannah – to record how they resolved encounters with people they suspected were mentally ill, developmentally disabled, or suffering from drug or alcohol problems. In 1,098 encounters over 6 weeks, the 93 officers who went through the training were twice as likely as the 90 who did not to refer those people to treatment, instead of arresting them. The results were statistically significant.
CIT-trained officers logged 517 encounters; 40% ended in referral, and 13% ended in arrests. Among the 183 officers as a whole, 34% of the 1,098 encounters ended in referrals, and 19% ended in arrests. CIT officers also used less force.
The Memphis CIT program is not new; it was launched in 1988 in response to a fatal police shooting in that city. Since then, about 2,400 police departments nationwide have implemented the Memphis model, but sometimes need help training new officers, said Dr. Compton, a professor of psychiatry and behavioral sciences at George Washington University, Washington.
It would help "if mental health providers can volunteer for some of the lectures or to do a site visit because, in a way, police officers are doing part of what ought to be our work; they’re out in the streets performing psychiatric triage," he said.
Officers who were at least 40 years old, and those who had been on the force for at least 10 years were also more likely to refer people to services.
Role playing is central to the de-escalation training; officers learn to actively listen, reflect back what they’re told, and give people plenty of time to answer questions.
They also are taught not to argue against the delusions of acutely psychotic people, but not go along with them, either. Instead, officers learn to pick up on the emotions. They might say something like, " ‘Am I understanding you correctly? It feels like there’s someone following you? That sounds really scary, and you’re really upset. Tell me more about what’s going on and how I may be able to help you,’ " Dr. Compton explained.
The idea is to slow the encounter down so mistakes aren’t made on either side.
Dr. Compton said he has no disclosures.