There's a diary out today. Yet another instance where the police come to the home of someone in a mental health crisis and the crisis ends in death. I wish this was a rare occurrence, but today's diary is one in a long string of police shootings. This 3 year old Salon article claims about half of police shootings are of mentally ill people. The anecdotal data alone suggests that the police are ill trained to deal with calls for help with mentally ill people.
I was leading a work related discussion group last week with some mental health professionals and the Miami case of Lavall Hall's shooting came up. Every Licensed Social Worker in the room wondered why the family called 911 instead of (in no particular order):
1. Following the crisis plan that Lavall Hall should have had
2. Why they didn't call Hall's mental health counselor/provider for direction
3. Why the family thought calling 9-1-1 could/would help
I do paperwork. I can code, bill, train, do compliance, HIM security, risk management, write IEPs and write grants, but I don't do clinical stuff other than first aid and CPR. I agreed with these mental health professionals, but not because of mental health protocol. I was looking at it from my family background that includes British/Irish/white/Puritan ancestor/Evangelical/Catholic/Rail Road history that combines into what's best described as a Country Western LP for a family background. Calling the police would be unthinkable to me. It would be the sure path to disaster.
Let me explain.
I've written about my first husband before, so I need to clarify that I'm not writing about domestic violence episodes, but when a family member or friend is having a mental health crisis. There's a big difference between these situations, but yes, someone who is in crisis can yell loudly, scare their friends and family, break furniture and yes, these crises can be life threatening; but that doesn't mean they need the police to shoot them dead. There are other solutions.
Like many people, I have a big circle of friends family and acquaintences. I have connections to people, family and friends dealing with dementia and Alzheimer's, or veteran family members and friends dealing with PTSD and yet more colleagues, family and friends dealing with depression, bi-polar, Aspberger's, or intellectual disabilities. I've been around people with mental issues and intellectual disabilities since I was a baby. These are caring, sharing people who sometimes need a little extra care and consideration. While growing up I got plenty of experience of seeing how the adults dealt with tense moments (really tense hours) with what I now know is called a mental health crisis.
Am I an expert in dealing with a mental health crisis? Hell, no, but I wouldn't find it helpful having an armed and dangerous man/woman in blue barking orders to contain a situation they probably are clueless to contain. The situation would have to be dire, like, the house is on fire or they are waving a loaded gun around dire; before I'd call 9-1-1. Why? Because our police are trained to use tactics and strategies that go against every effective strategy I've witnessed a professional mental health provider use when dealing with a client in crisis.
A mental health professional uses soothing tones, reassurance and acceptance. They are looking for information, mutual understanding and collaboration to mediate the situation. The police only want immediate compliance and control. Barking orders like "Calm Down!", "Drop it", "Sit Down", "Put Your Hands on Your Head!" in a loud authoritative voice tends to aggravate people in crisis and ratchet up the discord. Getting angry because a confused person in crisis doesn't hear, let alone process the idea they need to obey the police officer prematurely leads to threats to use force with tasers and guns. That doesn't help. Sure, psychiatric nurses can use aggressive methods to stop patients from hurting themselves and others. They use restraints, too; but they are not the first option and lethal force is out of the question. There's rules about aggressive tactics and restraint use that law enforcement ignores. The police are not up to the task of negotiating with a mentally ill person in crisis. Either they don't have the skill set or they seem to never remember it's a skill they possess.
What we need is a psychiatric ambulance service staffed by psychiatric professional nurses that takes over immediately after entry. I don't understand why police unions aren't clamoring for something like this. You'd think they would want to see fewer articles claiming police using excessive force. You'd think they'd have someone go over to Bergen, Norway and Amsterdam to see how their psychiatric ambulance services work. You'd think the police unions would want to better serve and protect their population.
But, no, today the officer told the man's mother, among other things,“That’s what we do.”
So, no, the last thing I would do and I'd have to be sorely desperate to do it, is call 9-1-1 if I had a loved one in the middle of a mental health crisis. I'd figure out a way to get them to the hospital myself.
6:38 AM PT: Thank you all for listening to my rant. My compliance meeting is still fresh on my mind and it became apparent to me that many mental health professionals themselves wouldn't call for official "help" during a mental health crisis. I think we need to demand a psychiatric emergency service aside from law enforcement. There's a precedent for it.
12:50 PM PT: Thanks again Rescue Rangers for putting this in the community spotlight and for it's appearance on the rec lost (for a while). I only glanced at this before I ran out this morning. I'm back and can respond.