Electronic System Links Police Queries to Mental Health System

One way of reducing the number of persons with mental illness in U.S. jails and prisons is to avoid locking them up in the first place, noted Beth Broussard, M.P.H., of the Department of Psychiatry at Lenox Hill Hospital in New York.

Aaron Levin

“The best place to intervene to reduce unnecessary incarceration and criminalization is at the beginning,” said Broussard at IPS: The Mental Health Services Conference, held last month in New York.

One well-tried intervention is Crisis Intervention Training (CIT), in which police officers learn to recognize the signs of mental illness and then direct individuals to appropriate settings for evaluation or care.

CIT is widely recommended but is far from universally taught to officers, many of whom are skeptical of its value, said Broussard. “CIT requires a lot of resources, time, training, and changes to department policies.”

So Broussard and colleagues are testing another model of intervention in Georgia, one that can be used by officers without CIT training but can offer another path to early diversion. Their work is one segment of the Opening Doors to Recovery (ODR), a multicomponent case-management service model developed in conjunction with the Georgia chapter of the National Alliance on Mental Illness that seeks to reduce inpatient psychiatric rehospitalization, arrests, and incarcerations.

The research was supported by the Bristol-Myers Squibb Foundation.

When patients enroll in ODR, they are offered participation (with additional informed consent) in a plan under which they disclose that connection to the state’s criminal justice information system. In general, when officers respond to a call, they conduct a routine background check by computer. If the individual is registered in the ODR program, the officers get a message to call a toll-free number linking them to the local mental health system. The community navigation specialist on call then works with the officer, either on the phone or in person, to help resolve the situation.

Early results from the ongoing trial indicate good acceptance by police officers, especially those who have not taken CIT training.

“The non-CIT-trained officers liked it because they did not have to struggle over whether mental illness was present,” said Broussard. “They don’t have to step outside their usual role, and just running their usual routine check can give them useful information.”

The system offers the police another tool in their tool box, said Broussard. They prefer receiving advice from mental health professionals rather than being on their own. Not all arrests were averted, but getting people to a follow-up appointment was better than simply letting them go or arresting them, they felt. In addition, the intervention of the community navigation specialist sometimes resulted in the officer placing lesser charges against the subject, she said. Patients liked the system as well, she said.

Curiously, many of the hits to the system have been coming from sources other than the police, she said. Some have come from jail personnel doing discharge planning prior to release or from parole officers, suggesting other potential future uses. ■