NEARLY 20 years ago, I
was a social worker in a county jail where I first began to understand just how
frequently the police deal with people with mental illnesses. Run-ins with the
police were a regular occurrence for many of my clients, with officers often
knowing them by name. They were overwhelmingly poor, and poor people with
mental illnesses are also likely to experience homelessness and substance abuse
— issues that place them at increased risk of police contact and incarceration.
All too often, those
interactions can end in violence and death, as was the case with 19-year-old
Quintonio LeGrier, who was shot and killed by a Chicago police officer last
month. Responding to a 911 call made by Mr. LeGrier’s father, officers found
Mr. LeGrier wielding a baseball bat, and one officer quickly opened fire.
This was not Mr.
LeGrier’s first encounter with law enforcement. He’d had several confrontations
with the police at the university he’d attended in recent months — at least one
of these incidents involved officers’ guns being drawn. His experience bears a
striking resemblance to that of one of my former clients who was a college
student in the late 1990s and who had several tense exchanges with the police
as his symptoms worsened.
What’s remarkable is
that, even about 20 years later, the police remain the primary responders to
mental health crises like these. According to data compiled by The Washington
Post, of nearly 1,000 people shot and killed by police officers in the United
States in 2015, 25 percent displayed signs of mental illness. And about 14
percent of individuals in American jails and prisons have a serious mental
illness, which means that, for most officers, interacting with individuals with
mental illness is an almost daily occurrence.
There are two
simultaneous national crises — one of police violence and the other of
inadequate mental health treatment — and we are making a mistake if we focus
blame only on the police. They have become, by default, the way in which our
society chooses to deal with people with mental illness in crisis, particularly
in poor and minority communities. We need also to address the declining state
of mental health services across the country.
Right now, we are
moving in the opposite direction. Between 2009 and 2011, Mr. LeGrier’s home
state, Illinois, eliminated more than $113 million in community mental health
treatment services. In Chicago, the number of public mental health clinics was
cut in half — to 6 from 12 — in 2012 as a cost-saving measure. Illinois’s path
follows the national trend of funding cuts for mental health services. And of
course these cutbacks primarily affect people living in poverty, who are
already at heightened risk of suffering from mental illnesses.
So that leaves the
police as our de facto front line. To date, the dominant police model has been
the Crisis Intervention Team (C.I.T.), which provides training on responding to
mental health emergencies. Current research is as yet inconclusive on whether
this training actually reduces the use of force, and police departments
struggle with training and dispatching trained officers to the right calls.
About 15 percent of Chicago police officers are C.I.T. trained, while experts
recommend training for at least 25 percent.
But training alone will
not solve the problem of police violence against people with mental illnesses.
A few cities, like San Antonio, have made strides in building a better system
by integrating mental health services with law enforcement. We need to invest
more broadly in a mental health crisis system to work in conjunction with the
police.
For example, in
domestic disturbance cases like Mr. Le Grier’s, a triage mental health worker
could quickly gather pertinent information, assess risk of harm and engage
family members as part of a coordinated effort. A crisis team could respond to
the call, with police assistance if needed, to determine the safest and most
clinically appropriate disposition. A responsive system would have suitable
support available, such as a triage center or respite beds to provide urgent
services, which would offer a clinically driven alternative to the more typical
choices of jail, the emergency room or the morgue.
This is tricky terrain
— even promising new approaches won’t completely eliminate fraught interactions
between the police and people with mental illnesses, or the chance of violence
on either side. But they provide a wider and more fitting array of responses
that could go a long way to averting future violence or incarceration. They certainly
would have helped many of the clients I worked with in jail.
We also need to wrestle
with our own complicated attitude toward people with mental illness. Mr.
LeGrier’s death is a rare case of national attention being paid to a person
with mental illness being gunned down by the police, perhaps because a
bystander, Bettie Jones, was also killed. Just 10 days after the shooting of
Michael Brown in Ferguson, Mo., and only a few miles away, a young man with
mental illness named Kajieme Powell was fatally shot by the police in St.
Louis. Mr. Brown’s death incited widespread protests, but despite the fact that
Mr. Powell’s shooting was actually captured on video, his senseless death went
largely unnoticed.
If we are to prevent
future tragedies, then we should be ready to invest in a more responsive
mental-health system and relieve the police of the burden of being the primary,
and often sole, responders. For the sake of individuals like Quintonio LeGrier,
Kajieme Powell and many of the clients I’ve served, I hope we are.
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