Proposal for Intervention in Mental Health Crises
A paper presented at Community Justice Coalition and International Commission of Jurists (Aust) event ‘BEDLAM: A hypothetical journey through the Justice and Mental Health Systems’ held on 29 September 2012.
This leaflet download highlights problem areas of the current Criminal Justice and Mental Health systems and raises possible solutions.
In a situation when a person feels disturbed or others feel disturbed by a person’s behaviour, it is most often handled by social processes in the person’s immediate community. At times, help is requested from outside organizations. The starkest failures have occurred after referral to police.
History of police failures
- Adam Salter, a mentally ill man armed with a knife that he was using to self-harm, was shot dead by police outside his home (Lakemba, 2009).
- Elijah Holcombe, a young mentally ill man, was shot and killed by police after a tragic series of events in which he believed he was being followed by police (Armidale, 2009).
- Roni Levi was shot dead after a mental breakdown in which he was armed with a knife (Bondi Beach, 1997).
- Tyler Cassidy, a fifteen-year-old thought to be mentally ill, was killed by police because of his ‘erratic’ behaviour (Victoria, 2008).
- Daniel Rolph was shot dead after stabbing a police officer during a manic episode, despite having a long history with police who were aware of his mental illness (Perth, 2007).
- Amanda Jones was the lucky survivor of a police shooting that occurred after she threatened a police officer with a knife (Perth, 2011).
- Jason Chapman, highly agitated and mentally ill, had three shots fired at him by two police officers when he came at them with a knife. No police at the scene contacted the Critical Incident Response Team. It is suggested, “police members at that time may not have been aware of the unit's existence” (Yarraville, 2004).
These people were loved and needed help, care and patient understanding. Instead, they were killed by armed police, trying to urgently control a situation without any useful training. Unfortunately, the list continues without any cultural change. Why?
Where did compassion go? When did mentally ill persons become 'others'?
The answers lie in the powerlessness of consumers within the health process, and particularly the alienation of those with mental health problems. The lived experience of mental illness is not awarded adequate respect and is not treated as a community skill for assisting others.
The allegations of corruption and the proposals for independent consumer representation contained in the “OUR PICK” Report have been ignored. However, the “Changing the Driver” Report, which analysed the principle of consumer-controlled funding, has been adopted by the Productivity Commission in its National Disability Insurance Scheme. Choice and a market are essential for a fair delivery of health services. It is essential that the views of mentally ill persons be valued by determining their own treatment.
Is there any police response so far?
There has been police recognition of a need to restructure methods and train police to deal with mentally ill persons. This was shown in Victoria where all operational officers and new recruits were to undergo training in how to manage mentally ill persons including ‘being instructed to identify signs of depression and paranoia and being taught to develop a rapport with people suffering mental issues’. In New South Wales, only a four-day mental-health training program was implemented. It is only targeted to reach 10% of frontline officers by 2015. Justice Action questions the effectiveness of this training and argues that it should be given priority and treated with higher importance.
Our Proposal: To establish a safe and effective response
Professor Patrick McGorry recognises that if people in the community and in particular, those in close contact with a person suffering from mental illness were better educated about mental illness, intervention would in most cases occur before police action is needed. For this purpose, we suggest the employment of a consumer worker.
What does a consumer worker provide?
Consumer workers are people with ‘lived experiences’ and can identity with the ‘person in question’, that is, the mentally ill person. This means that they themselves have or had a mental illness, which allows them to empathise with the ‘person in question’. A consumer worker can assist and comfort the person in question, allowing them to feel safe and thus, producing a more effective intervention. In this way, consumer workers can bridge the gap between the ‘person in question’ and the police.
Situations for intervention
It is often the case that when a person looks to help a mentally ill person, they find themselves contacting the police. For this reason, it is imperative that police have the option of sending a consumer worker. After the consumer worker considers the patient’s position and assesses the situation, police will be enabled to take a ‘defensive’ approach.
- Critical situations, e.g. with a weapon
Where the ‘person in question’ has a weapon in their possession, it is necessary for the people dealing with them to be safe. Safety requires a defensive situation, which is one where neither the ‘person in question’ nor the consumer worker nor the police get hurt. An effective method to execute this is to use a physical shield. This ensures that the police and the consumer worker are in a position of safety while being defensively prepared, as opposed to being simply ‘armed’ with lethal force. The Roni Levi case is a classic example of a possible defensive situation, as shown by the Justice Action team re-enactment using a riot shield.
- Non-critical situations
Where the ‘person in question’ is harmless to the extent that they carry no weapon, a consumer worker can be easily established. As mentioned above, a consumer worker can provide empathic support for the ‘person in question’ as they have the personal experience, time and skills from having experienced a mental illness.