Living with Serious Mental Illness, Police Encounters, and Relationships of Power: A Critical Phenomenological Study

Background and Purpose: The criminalization of mental illness has drawn and kept a disproportionate number of people living with mental illness in jails and prisons across the United States. The criminal legal system is ill-equipped or unequipped to provide meaningful mental health care. Police often serve as gatekeepers to the criminal legal system in the midst of encounters involving people living with serious mental illness. The literature that examines police decision-making amid these highly discretionary encounters has been primarily situated in post-positivist, quantitative methodologies focused on police perspectives. There is a dearth of research with the direct involvement of people living with serious mental illness that employs more advanced qualitative methodologies.

The purpose of this study was to understand the lived experience of police encounters from the perspective of people living with serious mental illness through multi-level analysis of the interpersonal and structural contexts which underpin these encounters.

Methods: Sixteen adults were recruited using purposive and snowball sampling thru a community organization and pre-existing relationships. Participants’ ages ranged from 29 to 63 years old. There were about two times more men (n=11) than women (n=5) in this study. Looking at race and gender, there were three Black men, one Black woman, eight white men, one white transwoman, and three white women. There were a broad range of serious mental illness diagnoses represented amongst participants with ten of the participants identifying multiple diagnoses (e.g. a participant reported schizoaffective disorder and bipolar diagnosis while another participant reported rapid cycling bipolar, PTSD, generalized anxiety, and psychosis, etc.).

The participants completed semi-structured interviews guided by open-ended questions in line with the study’s critical phenomenological lens, were exploratory, and focused on participants’ understandings of their lived experiences. The interviews were transcribed verbatim and interpretative phenomenological analysis was completed.

Findings: The findings included the interpretive analysis organized around six themes that emerged regarding the lived experience of police encounters: (a) significant context, to include serious mental illness, was made invisible, (b) the carceral response to serious mental illness and interpersonal issues, (c) law enforcement’s power to force submission, (d) facets of escalation, (e) law enforcement encounters lacked essential care, and (f) law enforcement encounters served as a microcosm of the criminal legal system. The findings also reported two descriptive areas for participants—aspects of serious mental illness and contemplations of power.

Conclusions and Implications: Findings include implications regarding complexity of calls, officers’ perceptions of dangerousness and a readiness to escalate, and a more comprehensive understanding of impacts on the lives of people living with serious mental illness after even a single arrest. Also, criminalizing mental illness generates an expectation of personal ‘order’ in the midst of structural disorder. These findings’ implications, in the context of the current wave of national police response models and reform, move towards a growing edge of critical phenomenology that incorporates intersectionality and disciplinary power and the central role of an abolition feminist praxis at the nexus of mental health, crisis response, and collective care.