The Mental Health “System” and the Police

Like you I’ve been watching and listening to the news coverage of the Tucson shooting.  It was truly a tragic event.  We are all wondering what could have prevented this from happening–and how can we prevent it from happening again?  I’ve seen some articles that suggest that the “mental health system” in Arizona failed.  Clearly Loughner had serious mental issues.  So why didn’t the “system” do something? 

I can tell you why.  Because there really is no “system.”  Largely it is a fragment of service here and there.  But largely the mentally ill are dealt with by the police.  To be sure, I don’ t think our old system from the pre-1970’s was that good either. People were locked up who didn’t need to be and who didn’t present any danger.  The problem now is that we’ve gone to the other extreme and we now must prove that a person is a “danger to themselves or others” before they can be detained.  Not always a very clear standard.  Simply being irrational or delusional isn’t enough to detail a person unless we can prove that present a danger. Right now we are fortunate to have some help from Oakland Community Mental Health.  They have a jail diversion program that provides us with an alternative to jail.  This program requires people in the program to participate in their care in order to stay out of jail (like take their meds). 

Frequently the police are the only social resource that deals with  the mentally ill. We are called to a scene where there is a person acting irrationally.  They may be causing a disturbance at a restaurant, for example, scaring other patrons and refusing to leave.    Traditionally the police have few alternatives and so the person ends up arrested and in jail.  The jail is not equipped to handle the mentally ill. Because of their illness they sometimes are not able to assist in their treatment and may refuse medication. Families struggle when they have a mentally ill member whose behavior gets out of control and their only resource that will come to their home is the police.It is a complicated problem and one that often proves dangerous to the community at large and to the police. 

PBS ran a televised series of panels a few years ago about community problems, dealing with the mentally ill was one of them.  Since Tucson they have re run this particular session and through the magic of the Internet I am able to give you a link to it.  It is short at a bit over 7 minutes but this panel highlights the challenges we face.   

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