Over many years, I have been consulted by law enforcement agencies concerning individuals suffering from severe mental illness, who repeatedly enact misdemeanor crimes, either in the community or their home resulting in them being jailed, usually for short periods of time. On other occasions, police may arrest them, only to see them released the next day. Law enforcement sometimes finds those in the mental health system less than helpful concerning such individuals, with those on the mental health/medical side saying there is nothing they can do or that there are HIPAA confidentiality requirements that make them unable to speak with the law enforcement professionals who are trying to get this person help.
These suffering individuals are repeatedly are enmeshed in the criminal justice system whereas law enforcement officers clearly see them as needing extensive mental health care. They are being placed in the wrong place without proper care. To state the obvious, jails are not treatment facilities. Beyond that, there’s always the risk that their behavior may result in them getting hurt or hurting someone else. Given our ‘system’ as it is (not as it should be) – in particular, viewing the criminal justice and mental health systems as one, poorly coordinated whole, what options to law enforcement officers have to possibly make things better for such people.
National Alliance on Mental Illness (NAMI) – For those whose conflicts usually involves their family, if the latter are not currently involved with NAMI, they should be. They provide education and support for families who care for individuals with mental illness. NAMI can provide advocacy for a person speaking as a powerful organization, in cases where a single family cannot. In addition, NAMI can and does provide funding for police, jail personnel and EMTs concerning dealing with individuals suffering from mental illness.
Mental Health Power of Attorney - Some people—in particular, those who have insight into their illness when they are on their medications—will benefit from a Mental Health Power of Attorney. Here, the mentally ill person, when in sound mind, agrees that another person will have legal authority over them when they decompensate (lose control of their behavior and mental function).
Legal Guardianship – in this case, the person is generally not able to make decisions for themselves. Such a person—and their family, neighborhood and larger society—will benefit if someone else has legal authority concerning many of their actions. This is particularly true with individuals who have neurological impairments or severe mental illness.
Legal Advice – In all such cases, those who are involved with such an individual usually need legal advice. Lots of people can’t afford a lawyer. There are organizations such as Legal Shield where people pay a small monthly retainer. In return, they get unlimited calls for legal advice on the phone. If a case must go to court, that’s different; one pays legal fees, to that lawyer or another, but one can get all kinds of legal advice.
From the Police Side – Your police agency needs a point person who can communicate with all the people and agencies involved with an individual who, due to their mental illness, is causing chaos throughout the community. If you have an extant CIT program, the coordinator/team leader is ideal. They are important to:
Talk with the jail: Ideally, the jail also has a point person there with whom you can a) note the individuals of concern b) note the problems when trying to get mental health or other help. This way you can document what the jail is not the proper place for such an individual, and you can clearly delineate why.
Get a point person within the probation/parole office. Often, the individuals of concern are in deferred prosecution, probation, etc., and the probation/parole officer is the one most central in their lives. Again, you want a point person from that office.
You need a point person from the prosecutor’s office. They are familiar with legal issues, and hopefully, they are surely concerned about community resources being misdirected.
You need a representative from the hospital, particularly from the ER, where such individuals are conveyed, when they are in mental health crises, or when they need to be medically cleared before they are taken to jail.
A representative from the mental health system. This should include someone from the mental health agency or agencies) who serve such individuals. Also, in states where designated mental health professionals are responsible for mental health holds and psychiatric commitments, a member of their team needs to be present as well.
In sum, you have a committee. The goal is that you have regular meetings problem solving/brain storming for the individuals having the most difficult time negotiating the system, getting in trouble legally when it’s a mental health issue.
And may I note one more resource of my own - I wrote a book for families who live with or care for individuals suffering from mental illness and/or substance abuse. Of this book, IN THE EYE OF THE HURRICANE, a reviewer on Amazon wrote: “This book has solutions for almost any situation when you're dealing with a mentally ill family member. I am going to use this as my bible for dealing with a mentally ill sibling. Bravo Ellis Amdur for writing this book.” I have written a lot of books on this subject for a variety of professional specialties. However, professionals see people (usually) at their worst, and for only brief periods of time. One of the worst situations for any human being to be in is a situation where one doesn’t know what to do; that sense of helplessness is awful. I wanted to provide people with information that, although I cannot guarantee absolute success in every situation, at least provides people with knowledge of ‘what to do.’ If a family acquires the tools to make their interactions with their loved one more benign, more nourishing, not only will things be better in the home, there will be less likelihood that the individual of concern will have negative encounters with people outside the home.
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