Examining Law Enforcement Call Reports for Mental Health Incidents: Officers' "Process As Usual" Response

Background & Purpose: During mental health calls of service, law enforcement (LE) have wide discretion (including use of emergency powers invoking civil commitment) when they encounter behaviors that can warrant statutory arrest (Mehlman, 1972). Although LE has guidance on how to handle these matters, resolutions vary depending on the norms of their agencies (ex. petitions to local hospitals, incarcerate, etc.) (MCOLES, 2017). LE with tenure or who know someone with a mental illness are more likely to use informal resolutions on scene or petition an individual to local psychiatric services (Watson et al., 2009). However, this can be problematic when LE overuses hospitalization. Previous literature has discussed differences in LE encounters pre/post mental health training, officer discretion, and disposition. The current study evaluates petition types based upon process as usual (PAU) responses from LE.

Methods: The current study examines LE call reports from one metropolitan LE agency regarding mental health crisis encounters between March 1, 2019 to January 29, 2020. The objective is to describe PAU mental health crisis resolutions by LE officers. Variables of interest included petition rates, petition type (completed by a judge, officer, family member, friend, caregiver) as well as the disposition outcome. Petition types examined were whether or not a person was petitioned as the result of a judicial order, officer discretion (pre-determined criteria for a mental health petition) or assisted another agency with transportation to the hospital, an individual was petitioned either by a friend/family member/ caregiver or their input, or the individual did not meet criteria for a mental health petition (resolved informally). Frequencies were calculated via univariate analysis.

Results: The sample was predominantly male (56.4%, n=194) and white (61%, n=210) with an average age of 39.6 years old (SD=16.29). Of the petition options, LE mainly used their discretion (regarding petitions) or assisted other agencies with transportation to the hospital (84.9%, n=292), informal resolution (de-escalated the situation or the individual did not meet the criteria for a petition) (7.6%, n=26), and lastly, petitioned an individual based upon family or friend input (5.2%, n=18). Officers did not have any judicial orders to petition within this sample.

Conclusions & Implications: Although LE had options (informal de-escalation, local mental crisis center, hospitalization, jail) when handling calls (aside from assisting care/correctional facilities or local responders with hospital transport) they frequently petitioned individuals to the local hospital. This can be overwhelming to the hospital due to limited availability of psychiatric beds (Barker, 2013). Furthermore, when individuals are not directed towards community treatment supports, individuals are more likely to come into future contact with LE and fall into the revolving door between hospitalizations and incarceration, which can lead to behavioral and mental health decline (Kara, 2014). Although this study examines LE discretion PAU, it is anticipated had officers been CIT trained, they would have emphasized community treatment, which would reduce the trauma to individuals experiencing distress, as well as provide community support to officers to reduce further interactions with LE and reduce the burden upon hospitals (Usher et al., 2019).