FAMILY INTERACTION WITH LAW
call 9-1-1 is an extremely stressful decision. It is by definition an
emergency. Not only do you have concern for the person about whom you
are making the call, but you also want to make sure that law enforcement has
enough information so that they will be able to respond effectively and
control the volume of your voice. When you shout over the phone, it is
difficult for the 9-1-1 operator to understand what you are saying.
Certainly this is a very emotionally charged time, but if the operator can
only hear shouting, the information is not efficiently received. As
calmly and clearly as possible, tell the operator the following if the
information is available:
The patientís name.
Your relationship to the patient.
That the patient is mentally ill.
Name of the diagnosis (schizophrenia,
Any medication being used.
Has medication use stopped? If so, for
Describe what the patient is doing now.
Do you feel threatened?
Is there a history of violent acting out?
Does the patient hear voices?
Does the patient fear someone?
Are there any weapons in the house? If
so, try to safely remove them before calling 9-1-1
Where the patient is within the house.
Request a CIT Trained deputy / officer.
LAW ENFORCEMENT ARRIVED
all the lights in the house turned on,
so that all occupants can be clearly visible to the arriving officers.
estimated that the officers responding to the emergency call establish a
comfort zone, by knowing that you are not a threat, who the patient
is and who is possibly also agitated.
calmly as possible, identify yourself and tell the officer:
Who you are.
Who you have called about.
What you relationship is to the patient.
That the patient has a mental illness.
What kind of mental illness it is.
What medication is being taken.
Has medication use stopped and for how
If the patient is violent or delusional
Any history of suicide attempt.
An attending psychiatristís and / or case
managerís telephone number.
Officers responding to a 9-1-1 emergency call are very focused
when they arrive on the scene. First, they will make the scene safe for
you, the patient, and themselves. The more informed and at ease the
officers are, the less likelihood that someone will get injured or that the
situation will worsen.
the time that is necessary answering all of the officerís questions. Answer directly and concisely. Do not ramble, but offer
any advice you deem helpful. After this is done, they will usually be able
to deal with the situation and to answer any questions. Although it is
difficult in times of crisis, being patient is essential.
INTERVENTION TEAMS (CIT):
PROGRAM FOR LAW ENFORCEMENT OFFICERS
individual with mental illness is in danger of physical injury, if his or
her behavior is out of control, or if other persons are in danger, it is
important to know what steps to take. Plan ahead by locating available
sources for help, the number for the local police or sheriffís department,
name and phone number of a mental health professional, community mental
health center crisis emergency number, friends or neighbors who may be of
help, and the nearest National Alliance of Mental Illness affiliate. Keep
these numbers posted by the telephone along with 2-1-1 services if available
in your area. Talk with the patientís social worker or psychiatrist and
with the community mental health center so you will know how to obtain
services when needed.
sense deterioration in you relative or friendís mental condition, try to
find out what is going on. Everyone occasionally has a bad day. However,
these are usually early warning signs that signal problems; changes in sleep
or social activities, increased hostility or suspiciousness. Try to get him
or her to see a psychiatrist or social worker. The object is to avert a
should have to call for help in a crisis, if possible have information
available about the family member or friendís diagnosis, medications,
previous hospitalization (s), and a description of the specific behavior
that precipitated the crisis. It may be useful to have several copies of
such information to give to the police and to mental health professionals.
if the individual needs crisis intervention, you might need to contact a CIT
officer, if available in your area. The Crisis Intervention Team
(CIT) Program is composed of specially trained uniform patrol
officers who respond to all calls related to a person having a mental
illness crisis. Officers can face challenges from or about persons
attempting suicide, threatening harm to others or displaying other dangerous
symptoms or behavior. This requires new and special talents and knowledge.
In Florida, over 3,000 law enforcement officers have been trained in the
nationally acclaimed 40-hour CIT course. The faculty, who are all
professionals, family members or consumers from the local mental health
community, volunteer their time and talents to provide the most up-to-date
information to law enforcement officers, regarding mental illnesses,
medications, de-escalation techniques, Baker Act authority, and unusual
behaviors such as suicide, homicide, and aggressiveness. The course
includes several hours spent in discussion with persons with mental illness
who share their past interactions with the law.
originated by the Memphis Police Department. It is staffed by officers who
are capable and willing to routinely and repetitively handle this type of
non-criminal call for service in addition to their normal patrol duties.
Repeated opportunities to develop techniques and gain knowledge of the
mental health system, is of paramount importance for successful and safe
interventions. Dispatching only CIT trained officers on calls involving
persons having a public crisis due to a mental disorder demonstrates CITís
value to the community through the saving of lives, time and money.
AND JAIL DIVERSION
to the Surgeon General, the criminalization of mental illness is the silent
epidemic of our times. One attorney stated our jail and prison system is
perhaps the greatest danger facing persons with mental illness today. The
number of inmates in Floridaís prisons with a mental illness and the number
of those incarcerated in county jails with a mental illness has grown at an
alarming rate since the mid 80ís. Placing individuals who have had a public
crisis with a mental illness in jail, or sending them to a prison creates a
vicious cycle as they are generally not able to receive all of the care and
support they need to manage their mental illness. When released, they tend
to recycle back to jail and / or prison. Early treatment, early diagnosis
and early intervention when symptoms escalate, may well succeed in avoiding
incarceration. When this is not possible, NAMI members have worked with
state and local law enforcement agencies and community health centers, to
make it possible to treat rather than punish persons who are mentally ill,
by diverting them from jails and courts into residential treatment
programs. This is true for both adults and children who find themselves in
the juvenile justice system.
Individuals living with a mental illness who are facing legal problems
should seek legal assistance. If they cannot afford a private attorney,
Florida Legal Aid Service or the local State of Florida Public Defenders
Office, mental health advocates, and others should be able to help. The
attorney representing the individual should look into release of the person
on bond as quickly as possible to allow them to get into treatment before
their situation worsens. In cases where this may not be possible, the
attorney should make an appropriate motion to ensure that proper psychiatric
treatment and support is available while release or trial is pending.
It is also
helpful to find an attorney who has some understanding of brain disorders,
the legal defenses available, and their impact of on the consumer who is
charged. If the offense is of a minor nature, a skilled attorney may be
able to arrange for a transfer to a psychiatric facility for treatment in
exchange for delaying the criminal case with ultimate dismissal of the
charges. Compliance with the recommended treatment may be ordered by the
court as a condition of probation or even an alternative to trial or a
substitute for serving time in jail.
It is not
unusual that contact with the criminal justice system may provide the first
opportunity to identify mental illness and connect the individual with
community mental health centers. While it may not always be possible to
avoid the original incident and incarceration, it should be the goal of the
family, the person with mental illness, and the mental health system to
eliminate future incidents.