While speaking in Milwaukee last year, I met a woman named Maria. Her 31-year-old son, Dontre, had recently been killed in an interaction with law enforcement in a city park—a place he went to get away from the frightening voices he heard in his head. On the day he died, the police had been called to check on Dontre’s well-being after he was seen sleeping in the park. What could have been an opportunity for crisis intervention resulted in a loss of life.
Dontre’s death is a tragedy. What makes it even more tragic is the fact that, far too often, these types of interactions end similarly. On many occasions, responders who encounter a person experiencing a mental health crisis aren’t equipped with the training and skills to respond to appropriately.
When an individual is experiencing hallucinations, acting strangely, or showing other symptoms of a mental health crisis, first responders may incorrectly perceive this person’s behavior as violent. Preventing escalation and procedural flexibility can save lives. First responders need to be able to recognize the signs of psychiatric crisis and have the skills to respond effectively.
I’m honored to be speaking about these issues at the National Dialogues on Behavioral Health conference, where the focus is on preventing the criminalization of persons with mental illnesses. Having a mental illness is not a crime. Individuals should not be unfairly arrested or incarcerated due to a health condition such as a mental illness. It’s also important to recognize that mental health crises are not the inevitable result of having a mental illness. Many people with the most serious mental illnesses experience factors that can lead to crises such as poverty, unemployment, social isolation, and multiple physical and behavioral health conditions. Many more end up in jails and prisons inappropriately.
Positive outcomes begin with prevention and early diversion programs. There are a number of SAMHSA programs designed to foster collaboration between the mental health and justice systems, improve outcomes for individuals, and promote public safety. SAMHSA’s Early Diversion grant programs create successful partnerships between law enforcement and behavioral health professionals to address the behavioral health needs of people involved in, or at risk of being involved in, criminal and juvenile justice systems.
One well-known, police-based, early diversion program is the Crisis Intervention Team (CIT) model developed in Memphis, Tennessee in 1988. The CIT model, which reduces arrests, diverts individuals from the justice system, and increases public safety, has been replicated in cities, rural areas, and multiple jurisdictions nationwide. The program equips police and public safety personnel to recognize the signs of a psychiatric crisis, and de-escalate these situations with respect for the individual’s rights and dignity and concern for public safety.
Courts also are an important venue for diverting nonviolent offenders into treatment. Municipal courts, in particular offer a unique opportunity to identify, engage, and divert individuals with behavioral health disorders shortly after their arrest. SAMHSA’s new report, Municipal Courts: An Effective Tool for Diverting People with Mental and Substance Use Disorders from the Criminal Justice System, examines the opportunities and challenges associated with municipal court diversion and outlines the essential elements for effective practice.
Jails and prisons were never intended to be de-facto mental health facilities. As President Obama recently said, “We’re a lot better off if we’re investing in economic development and housing and jobs…on the front end.” Through continuing our work with the criminal and juvenile justice systems, individuals with behavioral health conditions, and their families, we can create justice and opportunity for all.