Road Runners: Role of Law Enforcement in Mental Illness Transports

Law Enforcement Public Health Annual Conference, Toronto, Ontario.

Transcript

1. Law Enforcement & Public Health 2018 Toronto, CA October 23, 2018 ROAD RUNNERS Role of Law Enforcement in Mental Illness Transports
2. Treatment Advocacy Center The Treatment Advocacy Center is the only national nonprofit dedicated exclusively to eliminating legal and other barriers to the timely and effective treatment of severe mental illness We do not accept funding from hospitals, companies or entities involved in the sale, marketing or distribution of pharmaceutical products. ESTABLISHED 1998 by E. Fuller Torrey, M.D.
3. } Passing and supporting implementation of laws, policies and practices to improve access to treatment for the most severe psychiatric diseases } Decriminalizing mental illness by promoting treatment options instead of incarceration } Promoting less restrictive civil commitment laws, including outpatient commitment laws to support recovery in the community (e.g., Kendra’s Law) } Educating the public and policymakers about the psychiatric bed crisis and its consequences } Researching and publishing evidence and data on the impact of severe mental illness on individuals, families and communities. Working to Improve Treatment Access by -
4. Keeping the Issues in the Spotlight
5. ROAD RUNNERS Mental Illness Transport LAW ENFORCEMENT
6. Severe Mental Illness in the US
7. Severe Mental Illness in the United States An estimated 8.3 millionadults in America have severe mental illness That is a 3.3% prevalence rate of schizophrenia and severe bipolar disorder in the general population Approximately 50% receive no treatment in a given year
8. The “New Asylums” An estimated 1.8 million of individuals with serious mental illness are booked into US jails every year Nearly 400,000 are incarcerated on any given day; 40% of individuals with severe mental illness spend time behind bars during their lifetimes
9. Why “New Asylums”? In 1955, we had almost 560,000 beds in state hospitals By early 2016, we had 37,679
10. Law Enforcement Encounters People with SMI are at higher risk than the general public to become law enforcement incident calls, typically because of untreated symptoms. } At least 1 of 10 incident calls to law enforcement are associated with a mental health crisis In Rhode Island, it has been reported that 40% of police calls involve people who were mentally ill
11. Divert to What? And How? } Individuals with SMI use 87% more law enforcement resources than individuals without mental illness } In North Carolina, Law Enforcement completed more than 32,000 trips in one year to transport psychiatric patients
13. Law Enforcement Survey
15. Full report will be released in 2019
16. Survey Findings
17. Snapshot of Survey Respondents There were individual responses to the survey The findings represent more than total law enforcement service calls and encounters with individuals with mental illness in 2017
18. Snapshot of Survey Respondents
19. States with the most number of responses: } Georgia } Wisconsin } New York Snapshot of Survey Respondents States with no responses: } Connecticut } Alaska
21. Violence 1 out of every 4mental illness transports are for frequent flyers 1out of every 3individuals with mental illness transported by law enforcement are perceived to be a potential risk of harm to others Super-utilizers
22. Support Services for Mental Illness Transports Only 17% of law enforcement encounters with individuals with mental illness resulted in a mobile crisis team assisting. When they were requested, the vast majority of time they were available. Less than 1 in 3 police departments or sheriff offices utilize medical vehicles for their transports. When they were requested, the vast majority of time they were unavailable. “Our real issue is waiting on AMR to respond to complete the transport. Sometimes they have a long ETA so we just transport the 60 miles round trip to save time.”
23. Types of Transport Non-Emergency Emergency
24. Types of Transport Non-Emergency Emergency } 38% of mental illness transports due to a mental health call } 16% of transports due to unplanned encounter while on patrol } 31% of mental illness transports for involuntary commitment or evaluation } 15% of transports due to planned transfer to jail, court or a hospital
26. Time “The bigger problem is the amount of time invested by our officers in waiting at the hospital or mental health facility with the patient while the staff is trying to find placement. Sometimes we are there in excess of 12 hours waiting.”
27. Distance
28. Money
29. What happens when mental illness isn’t treated? Care falls to the systems that cannot say no
30. “Big problem and hard to deal with. We don’t have enough mental health bed spaces available, so many end up spending weeks in our jail.” “We are a small department & staff is very streamlined. When mental health issues arrive, it puts a strain in all areas of Sheriff Dep’t because we must serve all in every capacity & promote safety for all citizens.”
31. “In no other medical emergency would providers recommend law enforcement as the best place to call for help.”
32. The Way Forward Ø Paradigm shift – embrace & enforce the zero intercept Ø Promote policies that requires medical system to transport Ø Accountability & shifting incentives Ø Transfer responsibility to mental health system Ø Address capacity issues & continuum of care Ø Increase psychiatric bed supply; end all or nothing care! Ø Informed decision making & break down silos Ø Promote data collection and evaluation on role of mental illness in public service systems
34. Acknowledgements } This project was funded with generous support from } Special thanks to Chief Mike Biasotti (ret.) for his advisory and project support.
35. Questions? Comments? Elizabeth Sinclair Director of Research Office of Research and Public Affairs sinclaire@treatmentadvocacycenter.org @TreatmentAdvCtr #TACResearch