Urban Police

Police have long been recognized as a community mental health resource, a role that has expanded in recent years as a result of deinstitutionalization. Policies of deinstitutionalization implemented in the United States have reduced the state and county hospital psychiatric patient populations from a total of 560,000 in 1955 to 125,000 in 1981, a decline of 75 percent (Wacholz and Mullaly). As a result, individuals with mental disorders currently reside in communities where psychiatric care is provided by community-based mental health facilities or the criminal justice system. Within this context, police serve as gatekeepers responsible for choosing which type of facility, mental health or criminal justice, that citizens with mental disorders will enter.

As a result of deinstitutionalization, police calls to incidents involving citizens with mental disorders have increased significantly, leading to increases in criminal justice processing of these citizens (Bonovitz and Bonovitz). The notion that the criminal justice system is increasingly relied upon to handle persons with mental disorders—particularly those engaging in minor offenses—is often referred to as the criminalization of the mentally disordered. The criminalization hypothesis rests on the belief that mentally disordered citizens are more likely to be arrested than non-mentally disordered citizens, and that the population of mentally disordered people in prison has risen dramatically (Lamb and Weinberger). Only two studies have examined the relative probabilities of arrest for mentally disordered versus non-mentally disordered suspects. Teplin's 1984 study of police discretion toward mentally disordered citizens in Chicago in 1981 found the probability of being arrested was approximately 20 percent higher for mentally disordered suspects compared to non-mentally disordered suspects. However, another study of police discretion in multiple sites in 1977 and 1996–1997 has found that police are significantly less likely to arrest mentally disordered suspects (Engel and Silver). Therefore, the debate over the criminalization hypothesis continues.

Police have a large amount of discretion available to them when deciding what course to take regarding mentally disordered suspects. Observations of the police suggest that they are more likely to use informal means to handle situations involving mentally disordered citizens. For example, officers often use "psychiatric first aid" as an alternative to hospitalization or arrest (Teplin and Pruett). This may be due to the strong standards generally attached to hospitalization. For example, in the state of Florida, the Baker Act requires that citizens who pose a danger to themselves or others be involuntary hospitalized. Other states have similar legislation. Officers are also reluctant to hospitalize mentally disordered citizens because hospitals often refuse to admit them because they do not have enough beds, cannot handle dangerous or violent persons, or impose higher admissions criteria than required by the law.

In an effort to better handle situations involving mentally disordered citizens, 45 percent of large departments surveyed in 1998 indicated that they use some type of specialized response (Deane et al.). This research group reported that three models of specialized police response were the most common: (1) police-based specialized police response (sworn officers trained to provide mental health crisis intervention, also act as liaisons to mental health system); (2) police-based specialized mental health response (mental health consultants hired by police department provide telephone consultations to officers in the field); and (3) mental health—based specialized mental health response (use of mobile mental health crisis teams). Nonetheless, more than half of the large departments surveyed did not have any type of specialized response developed for handling mentally disordered citizens, and officers often consider handling "mentals" as social work that should not be the responsibility of the police (Bittner, 1967).