How Police Can Better Handle the Mentally Ill

Barely concealing his anger, Chaplain Thomas Nangle told an overflow funeral mass for Chicago policeman Richard Francis that the 60-year-old officer did not give his life in the line of duty—rather, it was "taken" from him.

Days before, on July 2, Francis, a 27-year veteran of the force, responded to a call steps from the police station where he was assigned. An emotionally disturbed person—EDP in police parlance—had fought with another passenger on a city bus. Before Francis could calm the woman, she grabbed his gun and shot him in the head. All too predictably, family members of the woman, Robin Johnson, told reporters that they had tried to get the woman help as her life slipped downhill.

From coast to coast, mentally ill people, without reliable access to the costly on-demand care they need, are left to fend for themselves. In the aftermath of the movement in the 1970s to close large mental asylums, many of today's mentally ill are left to their own devices; they are often homeless and without full-time advocates. With government unable or unwilling to properly serve this population, the criminal-justice system is left to pick up the slack.

Contrary to what many assume, the mentally ill are most often the victimized, not the victimizers. A 2005 study by researchers at the Feinberg School of Medicine at Northwestern University suggested that persons with serious mental illnesses are 11 times more likely than the general population to be victims of violent crime, with perhaps as many as 1 million crimes committed against those with serious mental-health issues each year.

But relying on the police to address the problem has too often resulted in tragedy, not only on the mean streets of big cities but in quieter places as well. In Silverton, Ore. (population, 7,500), a 20-year-old Irish immigrant, Andrew Hanlon, described by friends and family as suffering from paranoia and delusions, was shot and killed by a police officer investigating a report that Hanlon was trying to break into a residence on June 30. The officer who shot Hanlon told a grand jury—which voted not to indict him—that he thought Hanlon had wielded a broken bottle. At a candlelight vigil attended by 100 people, friends of the deceased man questioned the use of deadly force, saying that the police should have known the man was more of a local character than an actual threat and that he was banging on doors, not trying to break into anyone's home. The killing drew international attention. The same cannot be said about the shooting death, nine days later, of a homeless, emotionally disturbed 40-year-old Newark, N.J., man, Francisco Martes, who was shot by police after allegedly waving a knife at an officer. This more "typical" EDP incident garnered little press coverage beyond the usual police-blotter report.

Experts on treatment say the police for the most part do a good job handling the millions of interactions they have each year with the mentally ill. But is it irresponsible to ask them to undertake duties that perplex even trained, savvy professionals? "The police are not meant to be street-corner psychologists," says Dr. Linda A. Teplin of Northwestern University, one of the authors of the 2005 report about mentally ill crime victims. She notes the chronic shortage of beds for the mentally ill in treatment facilities, something that results in fewer stays, shorter stays and the reality that "you have to be extremely mentally ill" to get one of them. There is also a pressing need for more housing for this population. For law enforcement, experts say more training and more nonlethal weapons such as the controversial Taser could be beneficial.

Following the deaths of two people in Rhode Island this year in separate encounters with police, Rep. Patrick Kennedy secured a grant of $200,000 to enhance police training for responding to the mentally disturbed. After a third person, a man in police custody, died, Kennedy called for the creation of a statewide crisis-intervention team that would be available to handle cases of emotionally disturbed individuals.

Pressured by media coverage about mentally ill people committing serious crimes, New York city and state officials recently acknowledged major failings in mental-health care and oversight and in the exchange of information between mental-health providers and law enforcement. A task force recommended training New York Police Department dispatchers, who handle roughly 90,000 calls annually regarding the emotionally disturbed, to ask better questions so that the officers responding have more information.

The task force also called for the creation of a location database with call histories involving the mentally ill so that specially trained emergency-service officers can be dispatched more expeditiously. Another proposal: to establish Mental Health Care Monitoring Teams in New York City, which would help coordinate and track the care of high-need clients. According to the New York Daily News, $13 million will be spent to create a sophisticated tracking system that will improve the continuity of mental-health care, identify when individuals requiring care cease treatment and speed up interventions for high-risk people when, for example, they stop taking anti-psychotic medications.

And New York plans to expand its use of mental-health courts and to share information from the tracking system with criminal-justice agencies to improve treatment of mentally ill individuals who are arrested. Civil-liberties groups are watching warily to make sure that the information collected by the database does not end up being used against mentally ill defendants.

The New York report cited the "struggle" that facilities are faced with in treating tens of thousands of mentally ill persons under correctional supervision. Thomas Faust, the former executive director of the National Sheriffs' Association, has said that the large growth in many correctional facilities is due to a lack of mental-health resources. The three largest de facto mental-health facilities in the country, he wrote in 2003, are actually jails: "Riker's Island (in New York City), Los Angeles County and Cook County [in Chicago]." An estimated one in five prisoners in these facilities receive or require daily mental-health attention—treatment they would likely be denied in the outside world.

According to a 2000 report by the federal government's National Institute of Justice, once a mentally ill person is arrested for disorderliness, that person is labeled a "criminal" and will likely continue to be arrested when acting out in the future, rather than receive treatment.

In a presidential-election year featuring a Republican candidate who prides himself on straight talk and a Democrat who suggests the nation adopt a new can-do ethos, perhaps there is a glimmer of promise that the dialogue on criminal justice this fall can extend past the archetypical embrace of blame and "toughness" and examine the 50-state crisis in mental-health care. On the streets, there is hard work to be done.