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Take a population health approach to violence

October 24, 2016

It seems that every day we are reminded that homicides and police shootings have become a national crisis. What is not given as much attention in the news is that many of these fatal interactions affect people with mental illnesses or substance use disorders in disproportionate numbers. Individuals with severe mental illnesses are 10 times more likely to be victims of violent crime than the general population, and people with mental health disorders are 16 times more likely to be killed in a police interaction than other civilians, according to the Treatment Advocacy Center.

Crime and police violence (both toward police and at their hands) are among the most acute and intensive issues facing communities. This is both a public safety and a population health emergency.

Police officers are often the first to respond to behavioral health crises, but the use of typical police tactics can be disastrous, as seen in the case of Deborah Danner, the 66-year-old Bronx, N.Y., woman who was killed by police earlier this month and many other altercations between police officers and individuals with mental illnesses. 

Communities need a population health strategy to address mental illness and crime, before they escalate to violence, incarceration or worse. One great population health management strategy is to work closely with law enforcement in your community to implement a crisis intervention team (CIT). Like mental health first aid, the goal of CIT is to bring together members of a community (in this case law enforcement and behavioral health providers) to avert potential crises.

Training law enforcement in behavioral health

The training for CITs is rooted in community-oriented policing, a philosophy that encourages police officers to work with members of their community. Police department-based CITs work closely with service providers, local hospitals and other community leaders to improve interactions with those experiencing behavioral health issues.

CIT programs have been conceptually proven to connect people to counseling, services, treatment and medication, as well as being more cost-effective than prison. CIT programs can reduce the number of re-arrests for people who are mentally ill through jail-diversion techniques by 58%. Consider this: housing an individual in jail costs approximately $31,000 a year, compared to $10,000 per year for community-based treatment. 

How to work with your local police

What can service providers do to foster collaboration? First, it is helpful to reach out directly to the police departments in your area. Let them know which resources are currently available, where they can bring people for services, and how to best speak to a person who is in crisis. Sometimes, counselors will even accompany police officers on calls for service to assist them and the people they encounter.

It may also be useful to create a steering committee made up of police, service providers and other community members to discuss best practices and ways to help avoid stigma for those experiencing behavioral health crises. Your organization may opt to create a memorandum of understanding (MOU) with local authorities to avoid misunderstandings and establish trust across agencies.

As police officers continue to respond to people experiencing mental health crises, it is imperative that service providers work with law enforcement officials in a population health approach to crime.  Partnering in a collaborative manner not only improves outcomes, but it also increases positive community involvement and consequently improves the health and well-being of the entire community. Recognizing that service providers and police departments, which may have been previously siloed, have similar goals ultimately helps communities in cost-savings, treatment expansion, and cooperation, making communities safer and healthier for all.

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