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Colliding worlds: Law enforcement and the mentally ill

June 29, 2015 | Patricia Harriman

Dr. Jody Rawles

When the mentally ill are in crisis, law enforcement officers are often the first responders, and sometimes the last, as well. Such was the case in the 2011 death of Kelly Thomas, a homeless man diagnosed with schizophrenia, who died after a confrontation with Fullerton police.

The Thomas tragedy brought increased public attention to severe mental illness, homelessness and county mental health programs, as well as greater scrutiny to police activity, particularly in connection with the mentally ill. In response, local law enforcement agencies began collaborating with mental health advocates and providers to develop training programs that help officers recognize when they are dealing with mental illness and how to appropriately handle those encounters.

Dr. Jody M. Rawles, a leading advocate for improved access to psychiatric care and more effective mental health laws, is one such expert working with the chiefs of police in cities throughout Orange County, as well as the California Highway Patrol, to fill in the gaps of their traditional training.

“Mental illness is not in and of itself a law enforcement problem, but when an officer is called for an incident, such as shoplifting or disorderly conduct, it often becomes a law enforcement problem,” said Rawles, a clinical psychiatrist and interim chairman of the UCI Health Department of Psychiatry & Human Behavior.

“Although illegal, criminal thought processes are rational. The thought processes of the mentally ill are not.”

De-escalation techniques

When peace officers attempt to handle an incident, such as shoplifting or disorderly conduct in a traditional way, they issue commands or give directions. If the expected cooperation or compliance does not occur, tensions can escalate and the consequences can be deadly. The irrational responses of a mentally ill person are often exacerbated by drug or alcohol abuse, making the situation even more dangerous, said Rawles.

“A criminal will at some point recognize that the officer has a badge and a gun, and understands what that means,” Rawles said. “A mentally ill person may think that you are a spy or a terrorist, and that it is his duty to protect America.”

Officers must be able to differentiate between a situation that requires force and one that can be de-escalated verbally. Instead of being arrested and charged with a crime, the mentally ill person can be diverted into treatment. Rawles’ presentation includes a video with vignettes of five scenarios that depict different types of mental illness.

“We can’t train law enforcement personnel to be diagnosticians, but we can help them try to get an understanding of what these mental illnesses look like,” Rawles said.

Greater safety for all parties involved 

Rawles’ ultimate goal, in conjunction with other psychiatrists from the Orange County Psychiatric Society and National Alliance on Mental Illness Orange County, is to develop a sustainable, comprehensive county-wide model that offers greater safety for all parties involved, as well as increased access to mental health treatment and services for those in need.

The desired result is a decrease in the frequency of encounters between the mentally ill and law enforcement, and a reduction in the associated costs of psychiatric clinic visits and incarcerations.

“The purpose of detaining a mentally ill person is to help him or her, not to punish them,” Rawles said. “It is important to the parties involved, as well as to the public at large, that encounters between the law and the mentally ill be focused on providing psychiatric care.”

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