DE-ESCALATION, NOT FORCE, THE KEY
California has a prison population of about 115,000 inmates, and the mentally ill population accounts for about 36,800 of those individuals. That’s roughly the total number of people who can fit in Petco Park. According to a 2017 Stanford University report on mental illness in American prisons, the percentage of state prisoners with mental illness had increased by a whopping 77 percent in the past decade while the general prison population had declined 25 percent.
As stated in a 2015 report from the Treatment Advocacy Center, adults with severe mental illness account for one in four people killed in police encounters, putting them at 16 times greater risk than other civilians of being killed in a law enforcement confrontation. Once in the prison system, the environment and penalty policies exacerbate symptoms among incarcerated individuals with mental illness, often provoking noncompliant behavior and further mental decline.
When working among populations with fragile mental status, de-escalation training is crucial. Current police officers receive little training on de-escalation tactics and mental illness. To combat these negative encounters between police and civilians, the Los Angeles City Council voted in October to create an unarmed crisis response team that could respond to nonviolent 911 calls instead of the Los Angeles Police Department.
The proposed crisis response teams will be made up of mental health specialists and professionals trained in deescalation. They will be dispatched for calls regarding mental health crises, behavioral distress, substance abuse and suicide threats in place of police officers. These professionals will then assess an individual’s state of mental health. Following assessments, these trained professionals would then ideally be able to de-escalate the situation and if determining they are safe, avoid placing individuals in the criminal justice system. Instead they will help connect the person with proper mental health resources and facilities.
While a crisis response team is a great start in diverting the mentally ill from incarceration, its success will ultimately be limited if we do not have accessible and timely services to redirect people for crisis care as well as ongoing care. With the growing number of individuals and families in San Diego affected by mental illness, it is especially important to focus policy on addressing the source of the problem, our failed mental health care system. We propose that San Diego implement a similar task force as in Los Angeles — and increase both the amount of accessible mental health services that can be delivered in a timely fashion and the type of pragmatic resources that can make ongoing care available beyond an immediate crisis.
Although San Diego enacted a crisis response team in 2017, called PERT (Psychiatric Emergency Response Team), these teams are not the first responders on a nonviolent 911 call. Instead, they are called in later by police officers. We insist that in instances of nonviolent crimes, nonuniformed mental health providers should be first on scene. These changes help community members and are cost-effective. They limit the high cost of police responses to crisis calls and divert individuals from jail, savings taxpayers’ money that way as well. Stanford’s study on mental illness in prisoners details how community mental health treatment can be much more effective as well as less expensive than incarceration. For example, the Stanford study found that the average annual cost of incarcerating a state prisoner in California is over $70,000. The cost of treating a person with mental illness in the community is much lower, at about $22,000. The cost savings from keeping fewer people in the prison system should then be reallocated toward funding more psychiatric beds, beyond the 6,000 provided statewide, and increasing community-based programs, as well as supportive services to promote long-term treatment adherence.
We have allowed the current system to continue for too long despite its cost deficiency, maltreatment and ineffective methods. Considering that nearly 1 in 6 Californians experience some mental illness, you likely know or indirectly know someone affected by it.
It’s time we change the way we look at mental health care in the United States and establish justice for our fellow community members.
A 2015 study found that adults with severe mental illness account for one in four people killed in encounters with police.
Flanzer