Use of Nonfatal Force on and by Persons With Apparent Mental Disorder in Encounters With Police

Abstract

Although a number of factors have been examined in relation to their effect on the prevalence and characteristics of police use of force, studies examining whether the person appeared to be mentally ill during the incident are lacking. Police recorded that 306 (7.2%) of the 4,267 people on whom they used force in Victoria, Australia, between 1995 and 2008 appeared to have a mental disorder. This group was more likely to threaten or use weapons on police and to have weapons used or threatened against them by police, as compared to those not deemed by police to be mentally disordered. Increased emphasis on communication and verbal deescalation tactics during police training and practice as well as proactive broader system-level changes should be implemented between police and mental health services to enable more effective management of these incidents to reduce the need to resort to increased use of force to resolve them.

Police management of mental health crisis situations in the community: status quo, current gaps and future directions

“…For example, detailed examination of a Victorian police use of force database (Kesic et al 2013a(Kesic et al , 2013b showed a significant over-representation of mood and anxiety disorders, psychosis, schizophrenia, substance use disorder and personality disorders with a high degree of comorbidity as compared to the estimated prevalence of these disorders in the general community (Short et al 2010).…”

“…Indeed, studies have suggested that the presence of substance use is common in mental health crisis incidents and even considered to be the trigger of the incident by police in over one in five cases (Short et al 2013). When all of these elements are present together, the police are more likely to report to having to resort to using force to resolve the situation (Garner and Maxwell 2002, Police Complaints Authority 2003, Kesic et al 2013a, 2013b. Despite an increasing understanding of some of the common 'ingredients' of these potentially volatile situations, what remains unclear at this time is a detailed understanding of the decision-making behind the officer's decision to use force and how individual perceptions of dangerousness inevitably impact on this process.…”

“…Given the very complex nature of police encounters with people in mental health crisis (Clifford 2010), and statistically significant increased likelihood that police use more severe force on people who they perceive to be mentally ill (Johnson 2011, Kesic et al 2013b, police use of force guidelines clearly need more nuanced consideration (Bronitt and Gani 2012). To propose a more tailored approach to the de-escalation of mental health crisis encounters, we now consider the approach to de-escalation and limitsetting widely accepted as core business in inpatient mental health settings to discern if and how these core principles could be applied to, and help inform, the policing context.…”

“…In such circumstances, research reports a tendency to escalate fast towards higher levels of force in the management of acute or severe psychiatric distress. There is evidence to suggest that physical responses have become part of routine in inpatient psychiatric care (Irwin 2006), while research exploring the nature of police encounters concludes that there is a tendency for police to resort to using more force when confronted with people in psychiatric crisis (Fyfe 2000, Strong 2009, Kesic et al 2013b. Similarly in nursing, despite the focus on the use of communication and de-escalation strategies, psychiatric staff still reportedly commonly resort to the use of control and restraint methods and have similar difficulties with their approach style, commonly aggravating the encounter and leading to an escalation of behaviours and risk and therefore requiring more coercive force responses (Bowers et al 2011).…”

“…The evidence base in this area has traditionally focused on lethal use of force, especially officer-provoked suicide involving mentally ill people. Literature from Canada Cotton 2010, Parent 2011), the United States of America (Deane et al 1999), Australia (Godfredson et al 2010, Kesic et al 2013a, 2013b and the United Kingdom (Moore 2010) confirms the over-representation of mentally ill or/and intoxicated people involved in such encounters with the police. Hence, a natural conclusion, perhaps, made by a number of prominent authors is that the police are not sufficiently prepared or trained to successfully manage situations involving people who are experiencing mental illness who present in distress and/or behave violently (Brouwer 2005, Cotton and.…”