Forensic psychology has spawned a variety of subspecialties in recent years, including the specialization of police psychology. Law enforcement personnel frequently encounter individuals suffering from acute psychological crisis, acute mental illness, and/or chronic mental illnesses. Methods for handling these situations came forth from hostage-taking situations and have developed into models for crisis intervention and de-escalation. These models have been used to develop crisis intervention teams and crisis negotiation teams in a number of law enforcement agencies. Forensic psychologists working within the police subspecialty have an opportunity to work within the development, implementation, and day-to-day operations of crisis intervention teams.
While one of the most contemporary specializations of psychology, forensic psychology has already seen the development of a number of subspecialties with the realm of psychological professionals who work most directly with law enforcement agencies and the courts. The police psychologist represents one of the subspecialties within forensic psychology. One of the common tasks of the police psychologist is to train and work with police officers on proper procedures and techniques for encounters with mentally ill persons (Bartol & Bartol, 2008). Adequate training provided by police psychologists to police personnel on the identification of individuals who may be mentally ill, who may be in psychogenic crisis, and who may need psychopharmacological treatment as opposed to or in supplement to arrest can provide for more effective positive outcomes for all parties involved. While police psychologists are more likely to assist in the development and implementation of a crisis intervention team, they may also in some cases function as a part of the team alongside police personnel and other mental health professionals (Bartol & Bartol, 2008). This literature review will examine salient research into the frequency of police encounters with mentally ill persons, the development of crisis intervention teams, the efficacy of the crisis intervention model, and the roles that a forensic (police) psychologist can participate in the crisis intervention model.
Frequency of Encounters
It is well established and understood that law enforcement agencies – particularly those in urban environments – are tasked with responding to a variety of non-routine and critical incidents including barricaded subject incidents, attempted suicides, confrontations with irate or violent individuals, confrontations with emotionally disturbed persons, and confrontations with persons suffering from mental illnesses. Contemporary research tells us that these situations occur more often than most in the public would necessarily realize. It has been estimated that 26.4% of Americans in the general population have a diagnosed or diagnosable mental illness that occurs during any given year and further that 46.4% of Americans in the general population will have a diagnosed or diagnosable mental illness occur during their lifetime ((Demyttenaere, Bruffaerts, & Posada-Villa, 2004). Nationwide research indicates that approximately 7% of police contacts involve people who are psychologically disordered (Borum, Deane, Steadman, & Morrissey, 1998). Approximately 24% of the state prison inmates and approximately 21% of the county and city jail population in 2006 reported a recent history of or current mental illness (James & Glaze, 2006). Approximately 16% of probationers in 2006 were reported to have a mental illness (Ditton, 2006). Approximately 66% of boys and 74% of girls in the juvenile justice systems throughout the United States meet the diagnostic criteria for at least one major mental illness (Telpin, Abram, McClelland, Dulcan, & Mericle, 2002). Ackley (2010) reported that an estimated one in five adolescents suffers from emotional disorders and further that 19.2% of substance-dependent adolescents in one study met the diagnostic criteria for Posttraumatic Stress Disorder. Further, many of the offenses committed by criminal offenders will have human victims of whom 25% will experience Posttraumatic Stress Disorder in their lifetime compared to the lifetime PTSD prevalence of 9.4% for persons who are not victims of crime (Kilpatrick & Acierno, 2003). Based on these research findings, the frequency of police encounters with the mentally ill should not be underestimated nor should the importance of appropriate responses in such situations be discounted as trivial.
Crisis Intervention Teams
New tactics and strategies are all too often born from disaster. Law enforcement began seeking alternative, less-lethal strategies than the typical tactical enforcement approaches after the Attica Prison disturbance in 1971 and the Munich Olympics hostage incident in 1972. In 1971, the mistreatment of inmates and racial tensions sparked a prison riot that resulted in a five-day standoff where three inmates and one correctional officer were killed by rioting prisoners. A tactical assault of the prison ensued that resulted in the deaths of 29 prisoners and 10 hostages. In 1972, a Palestinian organization took 9 Israeli hostages in the Olympic village in Munich, demanding that over 200 Palestinian prisoners be released and that they be granted safe passage to leave West Germany. The tactical response resulted in the deaths of 11 hostages and 1 police officer. These two tragedies and the input of psychologists gave birth to hostage negotiation techniques in law enforcement. The success of these techniques gained support within law enforcement over several years, with techniques being refined for use in areas other than hostage situations (Augustin & Fagan, 2011).
One of the more contemporary strategies born from hostage negotiation techniques is the development of crisis intervention teams (CITs) and crisis negotiation teams (CNTs) to aide law enforcement in the successful resolution of critical and crisis incidents. These teams use specialized training techniques to diffuse what could easily become volatile situations usually without lethal force and oftentimes without any use of force (Augustin & Fagan, 2011). The first crisis intervention team was formed years later in 1988 following an incident in Memphis (Tennessee) where a mentally ill person brandishing a knife was shot and killed by police officers. The team was developed by the Memphis Police Department in conjunction with the National Alliance on Mental Illness (NAMI) and was composed of police officers specially trained to respond quickly to the needs of persons with mental illness. The primary goal of the first crisis intervention team was to defuse crisis incidents while ensuring the safety of everyone involved (Oliva & Compton, 2008).
Utilization and Effectiveness
Contemporary research has begun to show significant increases in both utilization of crisis intervention teams and effectiveness in jurisdictions where crisis intervention teams are utilized. Ten years ago, 21% of law enforcement organizations surveyed in urban environments had specialized police units dedicated to handling crisis and mental health calls (Hails & Borum, 2003). More recent surveys indicate that the prevalence and use of crisis intervention teams continues to grow and develop. By 2007 over 400 crisis intervention teams were operating in the United States (Bureau of Justice Assistance, 2007). The effectiveness of crisis intervention teams has been investigated with positive results. Dupont and Cochran (2000) reported that the rates of injuries sustained by police officers were lower in cases where CITs were utilized. Hanafi, Bahora, Demir, and Compton (2008) found that officers trained and assigned to CITs had more empathy for mentally ill persons, greater patience when handling crisis situations, and a reduction in the use of high-intensity police strategies. Young and Brumley (2009) found high rates of satisfaction among both consumers of CIT services and officers involved in CITs. Other research has suggested that the use of CIT can have positive long-term consumer outcomes (Compton et al, 2008). The Bureau of Justice Assistance (2008) has found that specialized law-enforcement based response programs such as CITs enhance traditional law enforcement roles by providing a new set of response options tailored to the needs of people with mental illnesses, establish appropriate links for those individuals to appropriate services, and enhance collaboration with mental health partners, other criminal justice agencies, and community members.
Law Enforcement’s Response to Crisis
Police officers in Texas responding to mental health related incidents have three general categories of available responses including resolving the incident in the field, affecting an arrest for a criminal violation, or affecting an emergency detention under the Texas Mental Health Code. According to Section 573.001 of the Texas Health and Safety Code (APOWW), a peace officer, without a warrant, may take a person into custody if the officer has reason to believe and does believe that (A) the person is mentally ill; (B) because of that mental illness there is a substantial risk of serious harm to the person or to others unless the person is immediately restrained; and (C) believes that there is not sufficient time to obtain a warrant before taking the person into custody (Texas Health and Safety Code, 2001). While the parens patriae powers and Chapter 573 of the Texas Health and Safety Code legitimize the power of police to intervene in mental health concerns, it does not – and should not – result in emergency detention being the primary response option in every situation. Research conducted by psychologist Linda Teplin for the National Institute of Justice found that police typically resolve mental health related incidents in the field 72% of the time, affect an arrest for a criminal violation 16% of the time, and affect an emergency hospitalization 12% of the time (Teplin, 1986, 2000).
Roles for Police Psychologists
Forensic psychologists working within the police psychology subspecialty can take on more integrated roles in crisis intervention teams than simply in the program development and implementation phases. Some provide support to law enforcement team members as consultants or advisors. In these cases, the forensic psychologists work behind the law enforcement negotiators in order to develop profiles, identify salient personality factors, conduct risk assessments, identify positive and negative triggers to use or avoid during negotiations, and assess the mental status of involved parties in order to provide information to the law enforcement officers involved to enable them to be more effective. Other forensic psychologists provide support to crisis intervention teams as a post-incident debriefer or counselor after a critical incident has occurred. In these cases, the psychologist leads the Critical Incident Stress Debriefing (CISD) or the Critical Incident Stress Management (CISM) program. Finally, some forensic psychologists work as integral members of a crisis intervention team, potentially as a primary negotiator. From research, to program design and implementation, to program support, to team member selection and training, to full participation – the roles of a forensic psychologist working within the police psychology subspecialty are broad when it comes to assisting the police function in handling encounters with mentally ill or emotionally compromised individuals.
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