POLICING AND BEHAVIORAL HEALTH CONDITIONS

When police officers address public safety, they increasingly encounter individuals with behavioral health care needs. We do not ordinarily think of police as frontline mental health care workers; they are not trained as treatment providers. And yet, many of the people that police routinely detain, question, search, and arrest are acutely in need of such behavioral health interventions. In the decades following the deinstitutionalization of large numbers of psychiatric patients in the 1960s and 1970s throughout the United States, “the police have become frontline professionals who manage these persons when they are in crisis.”1 Law enforcement is the portal by which many adults with behavioral health conditions enter both the criminal legal system and the civil commitment system. Police officers are described as “street corner psychiatrists” and “de facto mental health providers.”2 The unprecedented growth in mass incarceration3 in the United States, in tandem with deinstitutionalization and the lack of community-based services and low-income housing, have contributed to what is arguably a public health crisis. Large and disproportionate numbers of adults with serious mental illnesses that impair thought and dysregulate mood, often with co-occurring substance use disorders, are detained in our nation’s largest city jails, under conditions that make recovery difficult.4