Today’s reality of police officers serving as quasi-mental health workers comes as no surprise to those familiar with the public mental health system. State psychiatric hospitals have been closing en masse for two decades. This “deinstitutionalization” movement has the potential to give people with severe mental illness the chance to live in homes rather than hospitals. The results of deinstitutionalization policies, however, are a mixed bag. One problem is inadequate community crisis response. There is widespread agreement that crisis systems, which are under-resourced, have too many gaps. Enter law enforcement officers, first responders, and security guards.
The human consequences of these gaps were prominent in Metro Detroit news the last few months. Several Grosse Pointe Park police officers were accused of misconduct towards a homeless man with schizophrenia. A twenty-four year old Ferndale man, reportedly with a mental illness, died of asphyxiation during a confrontation with security guards at Northland Mall. The latter was a catalyst for a series of bills introduced in the Michigan legislature.
Each heartbreaking incident shines a bright light on the worst fears of family members. Will this happen to our loved ones who are mentally ill? Understanding that this is not an individual issue, but a gap in the system, raises big questions. Collectively, can we move out of reaction mode, stop responding to each tragedy after it happens, and build a better system?
We can, according to Dr. Mark Muntz of Northeast Ohio Medical Association. I heard Dr. Muntz discuss his Sequential Intercept model at a conference last week. The model, pictured above, suggests a comprehensive approach to crisis response. The goal is to get more people in to the mental health care that they need, away from jail and the streets.
It could work, because people with mental illness tend to move through the criminal justice system in predictable ways. Dr. Muntz describes SIM as a set of filters- each offering an opportunity where timely action could “intercept” an individual and lead to:
- Prompt access to treatment.
- Opportunities for diversion.
- Timely movement through criminal justice system.
- Linkage to community resources.
Focus on filter one, stresses Dr. Muntz. The better our response at the level of law enforcement and emergency services, the fewer people slip further in to the system.
We don’t know if having a model like this in place would have made a difference for either of these men. But collaborative work between police officers and mental health workers, as part of a comprehensive model like SIM, is key to building the kind of comprehensive crisis response we need to realize the potential of a community-based public mental health system.