When Police Intervene

Capping months of increasingly bizarre and troubling behavior, pop superstar Britney Spears had to be rushed to the hospital early Thursday morning for an involuntary mental health evaluation. Paramedics assisted by a line of Los Angeles Police Department motorcycle cops broke through the crowd of 100 paparazzi surrounding her hillside home to transport her to UCLA Medical Center. It was the second time in a month that authorities forced Spears to be involuntarily hospitalized; she spent two days at a medical facility in early January after she refused to hand over her two children to ex-husband Kevin Federline and barricaded herself in her bathroom with her 1-year old son. Since then, she has lost custody of her children and seemingly accelerated her downward spiral, occasionally speaking in a faux British accent.

The latest episode began when Spears' psychiatrist and family members alerted the LAPD about their concerns for her mental health and gathered at the star's home late Wednesday evening, according to a report in the Los Angeles Times. By 11 p.m., her neighborhood was teeming with photographers and camera crews, prompting an extensive police presence to manage the crowd and finally escort her to the hospital at 1 a.m. The scope and purpose of the police effort—as well as its reported (cops dispute it) $25,000 price tag—have sparked a debate: How should public resources be managed when dealing with celebrities? And, when it comes to Britney Spears, when is enough, enough?

Spears's case is especially notorious, but it's only one of about 100 cases a day when Los Angeles authorities dispatch a two-person SMART (Systemwide Mental Assessment Response Team) to the scene of a police call involving mental health. Typically, a cop and mental health worker evaluate the person's mental status, then decide whether to send the person to the hospital for an involuntary three-day evaluation, called a 5150, says LAPD Lt. Rick Wall, who heads the crisis response team that handles mental illness issues. Privacy laws prevented him from commenting on Spears's health, but Wall discussed his team's work and the added problems with the paparazzi with NEWSWEEK's Katie Paul. Excerpts:

NEWSWEEK: How was your unit involved in the handling of the Britney Spears case?
Rick Wall:I can't confirm that we were there for that particular case, but I oversee what's called the Crisis Response Support Section, which consists of a few different units. [One of those] is the SMART team, where we have an officer paired up with a person—a doctor, nurse or licensed clinical social worker—from the Los Angeles Department of Mental Health, who ride out to investigate when LAPD receive a call about a mental health problem. I have between 18 and 20 teams.
    
If a unit calls and says, hey we've got this patient, a 5150 [the California Mental Health code number for placing a person on an involuntary 72-hour hold], then we'll arrange, when we can, to have a SMART team respond, and what they do is relieve the patrol officers of that responsibility. Then we'll arrange for the hospitalization, to refer them to the appropriate follow-up entity with various mental health agencies. In LA right now, we average about 100 calls a day that are identified on the front-end as mental health calls.

What is the response sequence when you get a call involving a mental health case?
First, a patrol unit would be dispatched, hopefully one that's been trained [to handle mental illness]. If they identify that there is a mental health issue, they would then call the Mental Evaluation Unit and request a SMART team. We would then dispatch a SMART team that would provide an assessment to see if the person indeed meets the criteria for 5150. If they do, then we would arrange transportation, either by police car or ambulance to the appropriate psychiatric emergency hospital.

When the SMART team gets out there and the officers contact the triage desk and tell them what's going on, we keep track of all these calls, maintain profiles and databases. If during their investigation, they identify that this is just one in a series of episodes, or, if when they contact the Mental Evaluation Unit, they identify that this is a person that has generated a number of calls in recent weeks or months, then those cases automatically get flagged, and we make contact with the family to develop a strategy about how we're going to ensure this patient gets the treatment he or she needs.