Law enforcement interaction with the dangerously mentally ill

Highly recommended piece by Greg Sancier, Ph.D. a contributor on interacting with the dangerously mentally ill with a list of pre-incident indicators cops should look for. 

For years now the controversial debate has raged on regarding people who suffer from mental illness and if they pose a significant threat to the general public, law enforcement and to public safety.  The answer is, ‘No, they don’t.’  Statistically if you look at the most recent data presented it does show that people who suffer from mental illness are no more prone to be violent then people in the general population.  However, the major distinction is when people who do suffer from mental illness demonstrate particular behaviors then the answer is a definitive Yes, they are more violent.

Here is Dr. Torrey’s potential-for-violence checklist:

1.) Past history of violence — the individual’s past history of violence is the most important predicator of future violence among all people-whether mentally ill or not
2.)  Substance abuse — Typically alcohol, amphetamines, cocaine, and PCP can exacerbate violent tendencies
3.) Anosognosia with medication non-compliance — those individuals who are not aware of their illness and refuse to take medication.
4.) Antisocial Personality Disorder — The combination of severe psychiatric disorder in an individual with these personality characteristic leads, as would be expected to more frequent incarceration and violent behavior.
5.) Paranoid Symptoms — SMI individuals who have fixed false beliefs due to paranoid symptoms can become extremely violent
6.) Neurological Impairment — Those who suffer from neurological impairment have been found to be more violent.
7.) Gender — Typically men account for 85-90 percent of violent behavior throughout the world; women for only 10-15 percent. Women with severe psychiatric disorders are the exception to this rule. Many studies have shown that women with psychosis are equally assaultive as men.

For years, not only as a police trainer in Crisis Intervention Techniques (CIT), but as a hostage negotiator, patrol officer, and later as a Psychologist who specialized in crisis intervention, I responded to virtually thousands of incidents in which my interactions with the severely mentally ill were not dangerous.  Conversely there were also many more that did involve people who were mentally ill that were extremely dangerous.  They were dangerous due to a number of conditions all of which I would say were not only controlled by some form of mental illness, but also with accompanying factor of substance abuse — this condition is known by clinicians as a Co-Occurring Disorder.

In fact, never during my 30 years of abovementioned experience in law enforcement, did I ever encounter any subject in a mental health crisis who was not under the influence of some chemical.  Never.

For the complete article click here: