When Police Intervene

Was that how it happened in the recent Britney Spears case?
We respond to about 100 calls a day that we know involve mental illness. Of those 100 calls, we place 20 to 25 persons a day on involuntary holds. They happen exactly as this case has been reported to have happened. Family members contact authorities, the police respond, an assessment is conducted, and the patient is transported to the hospital. And that happens 20 to 25 times a day in the city of Los Angeles.

Now, that being said, there's been some heat over the large police presence, what with all the motorcycles and all the units that responded. The only thing I can say about that is that we do this 20 to 25 times a day, but we don't usually have to deal with 100 paparazzi trying to jump on the hood of the police car to prevent that person from getting to the hospital. That particular situation required a different kind of police response only because there was a crowd-control issue. That case was handled exactly as any other case we come across. We respond, we do the best we can, we make contact with the hospital, we transport the patient to the hospital.

And having a high-profile person involved wouldn't change the number of people deployed with the SMART team?
No, as a rule. We would probably dispatch a supervisor, which we wouldn't dispatch necessarily to a regular call, only because of the high-profile issues that come into play. Depending on the level of the high-profile individual, I would also probably respond. I can think of, off the top of my head, five celebrities in 2007 that were placed on 5150 holds by the Los Angeles Police Department, and I was at four of them. And I guarantee, you've never heard of any of [those cases]. If we do our job right, no one ever knows about it, because we work very hard to protect the patient's right to confidentiality. If we do our job right, we get in there, we meet with a family member, we get the person, we transport them, and no one is the wiser.

Then what broke down with this specific case?
The only reason anyone knew the police were at that particular residence was because there were 100 paparazzi out front. They're staked out there all the time. Most celebrities we encounter don't have that. Truly, this case was only different from a case we would handle with any other citizen because of the crowd issue. Everybody saw it, just go back to Jan. 4. People were literally climbing on the ambulance. Standing in front of the police cars and the ambulance, so it couldn't move. That's a huge issue for anyone, celebrity or not. If a person is suffering from any medical condition and you can't get the ambulance through, you have to bring in crowd control, and unfortunately that's going to result in additional police resources being drained.
    
Was Britney suicidal?
I can't comment on the specifics of the case, but if you look at some of the things about the diagnosis that have been published, or just look up mania and some of the associated behaviors, one of the issues with people who are manic is that they are not cognizant of the consequences of their actions. They don't realize that their actions are placing other people in danger or placing them at high risk. Whether it's the fact that they're not eating, or engaged in dangerous behaviors as a result of their manic state. Just because a person is a danger to themselves as a result of a manic episode doesn't mean the person is suicidal, or in any way harboring a suicidal thought.

[State regulation] 5150.05 allows us to use information from a credible third party to establish what's going on. Say, if a person is manic and hasn't slept for three days; my officer will not have seen that. If the person says, 'No, I'm fine, I just had a nap a little while ago,' how do we establish that this is indeed the case? We have credible witnesses who can say these are the activities the person has engaged in.

The bottom line is, if we're dealing with a patient who suffers from a mental illness and we're putting them on involuntary hold, then we are absolutely firm in our belief that that person is a danger to themselves, a danger to others or gravely disabled.

© 2008