PORTLAND, Me. — As community mental health systems fray under the strain of state budget cuts and a weak economy, law enforcement officers across the nation are increasingly having to step in to provide the emergency services that clinics have typically offered the mentally ill.
Police and sheriff’s departments that are already grappling with budget and manpower cuts say the situation is further straining their resources and forcing them to divert officers from their regular duties. It has also stoked fears among law enforcement officers of dangerous encounters between the police and people with severe mental illness.
“I worry that there’s going to be a tragedy,” said James Craig, chief of the Police Department here, where calls involving the mentally ill increased to 1,645 in 2009 from 1,424 in 2007. “I’m worried that an officer might lose his life dealing with a dangerous person, a person who really needs treatment.”
Improving the department’s handling of the mentally ill became one of Chief Craig’s biggest priorities last year after an officer was forced to dangle off the Casco Bay Bridge as he pulled a woman to safety during a suicide attempt. She was released from a hospital hours later and tried to jump off the bridge again.
The Portland department hired a full-time mental health coordinator in October.
In many ways, officers are better equipped than ever to handle calls involving the mentally ill. Hundreds of departments across the country, including in Portland, now offer Crisis Intervention Team training, which teaches officers to look for signs of mental illness and to work with doctors, nurses and therapists.
Despite increased awareness, many officers, mental health workers and advocates for the mentally ill say that with fewer hospital beds and reduced outpatient services — especially at centers that treat the uninsured — many patients’ family members and friends, and even bystanders, are turning to the police as the first choice for help when a crisis occurs. Many states are feeling the brunt of cuts that started years ago but have gotten worse because of the economy.
“A lot of people view calling the police as the only way to get loved ones any kind of treatment, because when the police come they have to do something,” said Laura Usher, the national Crisis Intervention Team coordinator for the National Alliance on Mental Illness. “But unfortunately that doesn’t necessarily always lead to appropriate treatment.”
“States across the country are cutting their mental health budgets, and people who are serviced by state mental health programs are the poorest, and they’re unable to get services any other way,” she added. “The community mental health system is broken.”
In Illinois, where mental health services were cut by $35 million this year — a $90 million cut was proposed — the state’s police departments are “essentially a 24-hour free service,” said Chief Robert T. Finney of the Champaign Police Department.
“We’re the people who get taxed with dealing with these people,” said Chief Finney, who is also vice president of the Illinois Association of Chiefs of Police. “Even if you arrest them and they’re released from your jail within hours, they’re back on your street doing the same thing.”
In Oklahoma, calls to the police involving mental illness have increased by 50 percent in the past year, said Stacey Puckett, executive director of the Oklahoma Association of Chiefs of Police. The state has cut about $17 million in mental health financing this year.
Ms. Puckett said officers were “traveling from one end of the state to the other and are out of their departments for 6, 8, 10 hours at a time.”
“It’s the bed shortage,” she said. “We just do not have enough beds for the numbers.”
Danny Ray of Ardmore, Okla., had to call the police in August after his 30-year-old son, who had been unable to get treatment, threatened him with a loaded gun.
“The police, if I had a problem right now, they are my only source of help,” said Mr. Ray, 57, whose son’s psychiatrist comes to town only once a month. Mr. Ray says he also finds it difficult to secure a bed for his son at the local hospital.
Rural areas are especially affected when mental health services are cut because officers must drive so far to admit mentally ill patients to hospitals.
Amanda Bittle, chief of the Police Department in Forest Park, Okla., an Oklahoma City suburb, started her career in a rural part of the state, and says it is often easier and less expensive for far-flung departments to encourage a mentally ill person to leave town than to drive the person to a hospital.
“It was cheaper for your department to buy a $59 bus ticket and send them as far away as you could,” Chief Bittle said. “I know that’s disturbing, but that’s the reality of what’s happening.”
The alternative, she said, is for a department to go “15 hours of no officer on the street, or an officer that’s paid overtime.”
“It’s sad,” she added, “but it comes down to those budgetary things.”
Tuesday, December 7, 2010
The NY Times. In the picture, Jo Freedman, center, the mental health liaison for the city of Portland, Me., with a firefighter who saved a suicidal woman.
Posted by BA Haller at 9:29 AM