The voices of Urban Institute's researchers and staff
July 29, 2016

Mental health on both sides of the blue line

This post is part of a series from Urban scholars reflecting on recent events involving police use of force and shootings of police. The posts represent the individual thoughts and perspectives of their authors.

Ongoing examples of police shootings of citizens, along with recent shootings of police in the line of duty have the world asking, how can we stop the bloodshed?

While no simple solution exists, it is astounding that mental health awareness and treatment—coupled with racial disparity in both policing and mental health—have not loomed larger in this national conversation. It doesn’t take a deep dive into history to show how policing and mental health can collide. Quintonio LeGrier, Kevin Matthews, Ruben Jose Herrera, and Michael Noel are just a few of the people shot by police over the past year while in mental health crisis.

Flipping the psychological lens to the officer, panic and perceived loss of control may well have contributed to the death of Philando Castile, whose partner said he was shot while reaching for his license and registration after openly stating that he was armed and had a permit to carry.

Such acutely tragic, high-profile incidents only scratch the surface of the more complex relationship between policing and the mental health needs of both citizens and officers.

Why mental health and crisis training is essential for law enforcement

Police routinely encounter people in mental health crisis. These situations are at high risk of being misread and mishandled, particularly when officers do not recognize that the person is in crisis.

Research shows that officers who have not been trained to detect mental health issues are less likely to correctly identify mental illness in citizen interactions. Other research finds that people suffering mental health challenges are more likely to be combative, disrespectful, or hostile toward police.

Add these sides of the equation together, and it becomes somewhat clearer why police are between 1.4 and 4.5 times more likely to use force in encounters with citizens with mental illness.  

These numbers are particularly concerning in light of socioeconomic and racial disparities. In many of the same communities of color that experience the most violence and are the most heavily policed, mental health diagnoses are more prevalent and residents are less likely to receive adequate treatment

As first responders to violence—and in many cases mental health and substance abuse–related crises—police can be essential partners in supporting community health. Beyond the clearly defined mental health “crisis” situations that officers encounter, mental health and de-escalation techniques may also be critical in communities affected by trauma resulting from both violence and the criminal justice system’s response to it. 

Many police departments are adopting Crisis Intervention Team training, an intensive training course designed to help officers detect mental illness, engage in de-escalation techniques and crisis mediation, and become familiar with mental health services and operations. The program yields promising results: one study found that Crisis Intervention Team–certified officers were less likely to use force or draw their weapons when subduing a person with mental illness, instead employing de-escalation techniques like slowing the situation down and communicating in ways that demonstrate empathy.

What about officers’ mental health needs?

But these trainings fall short in one critical area. Research suggests that officers who would under most circumstances treat citizens equitably and respectfully are less likely to do so when under significant stress or in poor mental health. This is no small concern, given the high prevalence of mental and emotional health issues officers experience related to long-term job stress and shift work, including depression, anxiety, post-traumatic stress disorder, sleep disorders, and elevated risk of suicide.

Add to this the recent sniper- and ambush-style killings of officers, making stress and anxiety levels among law enforcement even higher.

Some officers may also enter the police force with preexisting mental health issues that, if not screened out or addressed, risk affecting their work. One notable example of this is combat veterans who join or rejoin police work after military service and are at heightened risk for post-traumatic stress disorder

At the same time, police are frequently placed in fast-paced, high-pressure situations where stable decisionmaking is paramount and the potential consequences of mistakes are high—from poorly founded arrests to precipitous, panic-driven, or otherwise unjustified uses of force. Despite this, mental health support in police departments remains weak and heavily stigmatized, and research on how officer mental health affects interactions with community members is virtually nonexistent.

Supporting officers’ mental health is key to strengthening community relations

As shootings by and against police officers leave the country reeling, supporting officers’ mental health is key to strengthening police-community relations and reinforcing police’s growing role as mental health first responders.

This does not negate the need for improved access to treatment in neighborhoods most acutely affected by policing, which remains an urgent public health priority. Rather, understanding how officer mental health shapes interactions with the community—and identifying and implementing strategies to improve it—should be a critical component of public safety strategies.

The vast majority of police are wholly dedicated to public service, to upholding the law, and to keeping our communities safe. They put their lives on the line every day, and in increasingly risky settings. They deserve more resources, support, and treatment to reduce stress levels and address mental health issues—leading to better health and lives for both officers and the people they are entrusted to protect. 

In this Wednesday, Sept. 2, 2015 photo, instructors Melinda Wolbransky, center, Lt. Mark Turner, center background, and Detective James Shanahan, right, go over Sgt. Cecilia Luckie, foreground right, and Officer John Gonis's performance during a Crisis Intervention Training class at the New York Police Department Police Academy, in New York. A new training for New York City police is combining actors, the mentally ill and psychology experts to better prepare officers responding to people in the throes of a mental crisis. Photo by Mary Altaffer/AP

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