Modern policing presents many challenges – including increased burdens on the police force and risks for the people they are policing. As discussed in Chapter 1, beginning in the 1950s and 60s, many people were properly released from psychiatric hospitals to be treated in the community, with the benefits of modern medical treatments and social safety nets. Many of these people thrived, but others – particularly those who experienced more severe mental illness – did not get the support they needed (housing, health care, case management) to succeed. States did not fund community mental health centers that had been planned to replace hospital care. Meanwhile, substance use disorders increased by staggering amounts in most places, through the 1980s into the present day, with inadequate treatment available across the board – and an increasingly punitive criminal justice system with high incarceration rates and terms for drug crimes.

In the face of these demands, police departments have had to develop increased training and staffing capacity for addressing mental health and substance use in their communities. Police officers need a heightened awareness and concern for people with mental disorders, including mental illness, substance use, and developmental disabilities, whom they may encounter in their work. This section covers several types of policing initiatives intended to help them meet these challenges more effectively and safely for all concerned.

5.2.1 Speciality Units Within Policing

Police bureaus across the United States have developed speciality units to address specific needs in their communities. These speciality units vary among police departments and needs identified by the community. One need identified has been the productive and safe engagement of people with mental disorders, and departments are increasingly looking to police-mental health collaborations to satisfy this need. The Department of Justice has encouraged development of such programs and offers funding opportunities and a toolkit that you are welcome to review.

In Oregon, the Portland Police Bureau (PPB) has developed the Behavioral Health Unit (BHU), which consists of four tiers of police response to assist people in the community struggling with a behavioral crisis involving a known or suspected mental disorder or substance use disorder. While all Portland Police receive mental health response training, certain BHU officers have “enhanced” training on mental disorders and deescalation tactics, beyond that provided to officers in general. These officers with enhanced training serve in a voluntary capacity on teams that can be dispatched to situations requiring these particular skills and techniques (Portland Police Bureau, n.d.). Consider visiting the Portland Police Bureau’s Behavioral Health Unit webpage to learn more.

A co-response approach is also used by PPB, partnering with Cascadia Behavioral Health Services, as part of the continuum of tactics in PPB’s BHU. In practice, PPB’s co-response approach involves a concerned community member calling the police. If the subject is known to have mental health needs or the concerned community member reports indicators of a mental disorder, police may have mental health professionals assist in the response. Specifically, police may remain at a safe distance from the subject while the mental health professionals respond to the concern. If they are able to resolve the situation, then no police intervention is needed. If the situation becomes dangerous or escalated, police are nearby to respond accordingly.

In Figure 5.3, the required five-minute video shows an example of the work PPB’s Behavioral Health Unit provides to those struggling with mental health needs in the Portland metro area. This film shows a ride-along with Officer Josh Silverman and takes a brief look at a typical day for BHU’s Mobile Crisis Unit. While you watch this video, consider the benefits of having specialized behavioral health providers and specialized police officers working together as a team to address mental health needs in our communities.

Figure 5.3. Ride Along with the Portland Police Bureau’s Behavioral Health Unit [YouTube Video]. Portland Police Bureau’s Behavioral Health Unit works to take a different approach to policing that can more effectively serve the community and those experiencing mental disorders.

5.2.2 Crisis Intervention Training (CIT)

In addition to development of specific response units, police departments have developed training programs to qualify their officers to respond appropriately and safely to community members with a variety of mental disorders. The most well-known of these training approaches, Crisis Intervention Training (CIT) is also known as the “Memphis Model.”  Consider reviewing this website to learn more about the CIT program: Crisis Intervention Training [Website]

CIT training was first developed in response to public outcry after a Memphis police killing of an apparently suicidal young Black man, Joseph DeWayne Robinson, in 1987. Details are predictably scarce as to Robinson’s story, but it seemed clear after his death that his only weapon was a knife, and likely his only intent was to hurt himself. He was shot by police when he did not drop the knife per their demands (Connolly, 2017).

According to a 2016 New York Times article, “twenty-five percent or more of people fatally shot by police, have had a mental disorder” (Goode, 2016). More recent studies have placed the number even higher, and horrific incidents have continued. In October of 2022, for example, the family of Daniel Prude, a Black man experiencing an apparent drug-involved mental health crisis, was killed by police in an encounter where he was reportedly held, naked, in the street and suffocated in a “spit hood” that was placed on him while he was held on the ground. Prude’s family settled a multi-million dollar lawsuit against the Rochester, New York police department involved in Prude’s death, but police did not admit liability and no officers were ever charged criminally (Clifford, 2022).

The goal of CIT, when it was developed and as it is used in law enforcement settings nationwide, was to prepare officers for encounters like those with Robinson and Prude (and many others) in hopes of better outcomes. One training technique, for instance, is to change the way officers approach people with mental disorders and teach officers how to defuse potentially violent encounters before use of force would become necessary (Goode, 2016). CIT training has also been cited as reducing officer injuries in mental health crisis calls by eighty percent (National Alliance on Mental Illness, n.d.).

The Portland Police Bureau, faced with the horrific 2006 (See Spotlight in this Chapter) and an ensuing Department of Justice investigation alleging a pattern of excessive use of force against people with mental disorders, embraced CIT training for all of its officers, later adding the enhanced training for additional officers discussed earlier. However, CIT training still gets mixed reviews in terms of results, especially as experts recognize it takes more than the current standardized 40-hour training to make change. Change comes with a culture shift that goes beyond what a 40-hour training provides. Change must come from police bureau leadership, from the remainder of the criminal justice system (e.g. prosecutors and judges), and from on-going collaboration with community behavioral health specialists.

5.2.3 Public Safety Strategy

In Oregon, the Department of Public Safety Standards & Training (DPSST) is the agency that trains and certifies police officers, firefighters, first responders, 911 dispatch, and correctional officers. Every Oregon law enforcement officer, from every state and local agency,  attends a 16-week academy through DPSST where they are trained on a variety of topics including: DUII response, search warrants, firearm training, and more. DPSST has also incorporated trainings on domestic violence, sexual assault, and human trafficking into the curriculum. Oregon takes great pride in its DPSST programs, which have been required by Oregon law since 1961 and incorporate a significant amount of scenario-based and hands-on training of the sort most observers want for law enforcement officers (Gabliks, n.d.).

While the DPSST training incorporates information about mental disorders, the number of training hours dedicated to this topic is small compared to the number of encounters law enforcement officers will inevitably have with people with mental disorders – as well as the potential high-stakes nature of these encounters.

DPSST training sections on mental disorders are reviewed by  mental health professionals; however, these sections, along with many others, are taught by retired law enforcement officers. Experienced trainers in law enforcement are critical, however there is a missed opportunity when new law enforcement officers are trained primarily by seasoned officers. Holistic approaches at police academies are critical to provide law enforcement with various perspectives on  what it means to serve and protect a community. Without facilitation and input from behavioral health professionals, community members, and people with mental disorders who have had police encounters,new officers entering the field of policing are not as well-served as they might be by standard DPSST training.

5.2.4 Police Policing Mental Disorders Licenses and Attributions

Chapter conclusion written by Kendra Harding.

Figure 5.3. https://www.youtube.com/watch?v=v7Eg8B2EMqk&t=2s