Policy Text
TRAINING BULLETIN
“Department Training Bulletins shall be used to advise members of current police techniques
and procedures and shall constitute official policy.” Index Number: III-N
Alpha Index: Mentally Ill Persons Effectiv Date:
29 Sep
e
06
POLICE CONTACT WITH MENTALLY ILL PERSONS
Definition and Prevalence
A mental disorder is defined as “a behavioral or psychological syndrome or pattern associated with distress, or disability, or associated with increased risk of su ffering death, pain, disability, or loss of freedom. The
behavior or syndrome must be considered a manifestation of a psychological or biological dysfunction in the individual”.
1 The number of persons affected with mental illness or disorders is large. As many as one family
in five is estimated to be affected by mental illness.
Law Enforcement Contact
Mentally ill persons have special needs; they may require assistance or become victims of crimes. They frequently come to the attention of the police. A California Little Hoover Commission report
2 suggests that
law enforcement frequently handles mentally ill persons like it handles other special needs that lack adequate community resources.
There are special challenges associ ated with mentally ill persons. They may not understand or follow
instruction, and they may appear to misbehave. Some mental illnesses are associated with antisocial or criminal behaviors. For each of th ese reasons police have frequent c ontact with mentally ill persons.
It is helpful to recognize when a person is suffering from a mental illness. Although it can be difficult for
mental health professionals to agree on diagnoses, officers can learn to recognize the common or more
disruptive signs of mental illness. Many mentally il l persons suffer breaks from reality in which they
experience auditory, visual, or other hallucinations . They may hear “command voices” that give them
commands or directions to do dangerous or destructive things. Other behaviors the officers may look for are:
• Confused thinking and speech where the subject has trouble in communicating in coherent
sentences.
• Emotional flatness or lack of expression, wh ere their speech is brief and lacks content.
• The subject displays a sense of heightened energy, euphoria, racing thoughts, inflated feelings of power, and /or reckless behavior.
• Profound sadness and irritability, feelings of guilt, hopelessness, changes in their sleep patterns, and a decrease in appetite.
1American Psychiatric Association, 2000 Diagnostic and statistical manual disorders(4th edition, text revised),
Washington, DC
2 Being There: Making a Commitment to Mental Health (Report #157, November 2000)
2
Police Contact with Mentally I ll Persons, Index Number III-N
Prevalence of Violence
It is a common belief that mentally ill persons are viol ent and threatening. A national study supported by the
McArthur Foundation3 found that, in general, even seriously mentally ill persons who take their prescribed
medications are not more likely to be involved in viol ence than the general pub lic. There are exceptions to
this finding. Mental illness together with alcohol or su bstance abuse is known to lead to confrontations and
violence. Particular diagnoses or illness (e.g., paranoid schizophrenia) may produce delusions that make a
person fearful. Their beliefs that someone or something intends to injure them may lead to suicidal or violent behavior.
Safety Concerns
Approach persons known or suspected of suffering from mental illness with the same safety concerns as any
other call for service: safety of the subject, safety of the uninvolved persons, and officer safety remain
important. Mentally ill persons may suffer from delusion s or breaks from reality, they may be frightened by
responding officers or may not comply with the officers’ directions. Emergency psychiatric detentions are
inherently dangerous. They require officers to evaluate persons believed to be dangerous to themselves or
others, and take them into custody. The only Oakland Police Department call for service to result in the deaths of more than one responding officer involved a mentally ill person. Calls regarding persons suspected
of suffering of mental illness shall not be taken without a cover officer. When information from OPD
Communications indicates that a person suffering from mental illness is violent (radio code 5150B), a
supervisor shall also respond to the incident.
Recently, there have been a number of cases resulting in the use of lethal force against the person who was
being evaluated or detained. Case studies of detentions in California and nationwide reveal a number of calls
in which officers attempted detentions or put themselves in positions that aggravated the mentally ill subjects
and escalated the confrontation.
4 The officers in the case studies often l acked adequate tactical plans or the
manpower to accomplish the detention. Due to poor planni ng, the officers had to resort to lethal force when
the subject became combativ e to protect themselves.
Civilian Mobile Crisis Team
Civilian Mobile Crisis Teams (CMCT, Radio Call Sign 37C51) have resources that are not available to law
enforcement. Communicatio ns Division shall dispatch a CMCT, if available, to calls involving persons with
mental illness. If mobile crisis personnel are available to respond, they may have knowledge of the subject’s
history, medication and usual complaints from mental h ealth records, or from thei r personal experience with
the subject. The CMCT can arrange appropriate referrals, aftercare, or follow up fo r the mentally ill subjects
and their families. A history of mental health treatment or even the fact that a person had been treated for a
mental illness is protected information under the fede ral Health Insurance Portability and Accountability Act
(HIPAA). Mental health personnel may be prohibited from sharing these facts with responding officers. Officers shall defer to the mental health expertise of the CMCT and allow