Thursday, February 19, 2015

Mental Health Care and the Problem of Violent Policing

Surely by now many people understand that if they call 911 when a loved one is having a mental health crisis, their loved one is liable to be killed. This is doctrine all across the land. In any case where police are dispatched and they sense a threat of any kind, to themselves or others, they are supposed to neutralize the threat with whatever level of force they deem necessary under the circumstances.

Indeed, even when someone is suicidal and only threatening their own lives, the police doctrine is to "neutralize" the suicidal individual -- with deadly force if needed -- so as to... protect?

Police are dispatched any time a caller to 911 says they fear for their lives, or a loved one is armed and making threats, or there are guns or other weapons in the house, or it looks to them like a scary person is armed, blah blah blah, in other words, most any time there might-could be a threat of some kind to someone or some inanimate object.

If a diagnosed mental illness such as schizophrenia is mentioned, the likelihood of police killing the subject goes way up. Way-way up.

It is what the police are trained and expected to do.

Consequently, I have long said, "Don't call 911 in such cases unless you want your loved one dead."

Often enough in such cases, SWAT teams and snipers are sent on the call, the primary purpose being to kill. Period.

These are rules of engagement the public seems to be oblivious to is unaware of, because practically every day another call to 911 for help in dealing with a mentally ill loved one leads to another death, and families are shocked. "I called for help," they say, "but they killed my loved one instead." Yep. That's right. That's the kind of "help" first responding police are trained and expected to render. Why is this still a surprise? It's been SOP since most of the mental hospitals were closed decades ago.

Because so many loved ones in mental health crisis are killed by police year in and year out -- by my reckoning close to 400 a year, about a third of the total killed by police each year -- there is a nascent movement to revive the mental health care system something like it was before the Reaganite push to dismantle the system in the name of "civil liberties." Yes, that worked out well, didn't it?

Liberty for whom, to do what?

There is no doubt that there was a problem in the mental health care system as it was prior to the Reaganite dismantlement. It was enormous, for one thing. At any given time more than 4 million people were incarcerated in public and private mental hospitals and asylums across the land. This is about double the outrageous current prison population. Too often, patients had no way out, and many were held for life against their will, and sometimes against the will of their loved ones.

Too often, too, the care patients received in state run institutions was abominable. Private institutions were not much better.

The Reaganite solution was just to shut the institutions down and suggest that relatives and communities take care of their mentally ill -- or let the police do it in their stead.

This policy led to an enormous increase in the homeless population to start with, an increase that has never abated. Prison populations skyrocketed as well. It's often pointed out that a third or more of those in prison are mentally ill and most of them receive no treatment -- apart from periodic beatings, solitary confinement, pepper-sprayings and such like.

There are inadequate community mental health care facilities in the best of circumstances, and in many areas, there are none at all. Families are rarely prepared to cope adequately with a mentally ill loved one, and even their best efforts may lead to tragedy. Especially when they call for Emergency Services to "help."

Service providers and consultants milk the system for money while providing as little care as possible. This is how the system, such as it is, is set up. Mental health care budgets are often the first cut when times are tough -- as they have been for years during this Permanent Recession. Too bad for the victims.

Reviving and restoring the previous system of state run asylums and mental hospitals is probably not the best idea under the current regime of public parsimony and brutality. I can see it easily leading to something like the eugenics programs that operated in this country and abroad, most horribly in Nazi Germany.

A better system is one that operates locally not centrally, and is tied in with the communities served. This was supposedly what the devolution of mental health care from the closure of state hospitals to communities was leading to, but it never did. Instead, the police and prison system expanded to take on the difficult cases, and the rest were pretty much left to fend for themselves as best they and their families could manage. That was the "civil liberties" solution.

It's not working.

Or perhaps it is working but not the way anyone of compassion envisioned.

No, it's cruel and deadly. It's violent and catastrophic. It's corrupt and dangerous.

When a third of the police killings in the country are of mentally ill and/or suicidal individuals, it should be plain as day that there is a structural and institutional problem that might be correctable. Unfortunately, pro-police propaganda has worked well to convince many people that the proper course of action toward those who do not obey police is to kill them, regardless of mental health or suicidal tendencies.

If it's only 400 a year, what's the big deal, right? More than that die in a week in traffic accidents. More than that are killed in a week by non-police firearms. This is a violent country. Always has been.

A compassionate mental health care system would not dispatch police, snipers and SWAT teams on every 5150 call. It just wouldn't happen. Instead, there would be crisis teams available to perform interventions, and care facilities would be available that would provide more than a 72 hour observation window and a few prescriptions for psychotropic drugs -- which can cause more problems if not monitored carefully.

There would be mental health care facilities in the community provided as a public service like any other, staffed by professionals and available on an as-needed basis.

Care would not be restricted to certain hours or days of the week, and appointments would not be so limited that weeks or months pass before someone could check in for care and treatment.

A proper mental health care system would include homeless and addiction services, without discrimination toward patients based on the nature of their homelessness and/or addictions.

All this can be done, probably for less money than the current violent policing and imprisonment "treatments" for mental illness, homelessness and addiction cost, but money isn't the real issue. More public money is going to prison systems these days than to higher education in many jurisdictions, and there is little notice, let alone complaints about it. Mental health care spending is a relatively minor component to many public budgets, and what little is being spent is constantly on the chopping block when public budgets need tightening.

In some places like California, taxes were raised specifically to fund more adequate mental health care provisions, and the additional tax revenue was immediately -- and perhaps permanently -- diverted to fund other state budgetary needs.

We need to be clear with one another and with our elected representatives that the current system of incarceration and killing the mentally ill is not acceptable.

But that's only the first step.

Creating and sustaining an acceptable system will take a massive effort, but it can be done.

The question is, when will that first step be taken?

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