Schizophrenia research

Published: 2019-04-18 04:25:56
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Over the last two decades or so, efforts have been made to improve services to individuals suffering from schizophrenia and other serious mental illnesses who come into contact with law enforcement officers. The efforts include diversion programs in correction facilities, training of police officers, formation of mental health courts, as well as re-entry programs for convicts released from prison. A study shows that about 7% of all criminal complaints and subsequent police investigations involve a person suffering from a mental health condition (King & Murphy, 123). However, according to the same study, more than half of the cities in which it was conducted did not have a laid-down protocol for dealing with people with psychiatric conditions. More and more effort has been made to expand these programs in a way that they benefit patients, the law enforcement officers involved, and the society at large. According to King & Murphy (124), notable one of these programs is the CIT (Crisis Intervention Team) training for law enforcement officers. A majority of modern CIT programs base their designs on a 1988 project heralded by the University of Memphis, the Memphis Police Department, the National Alliance for the Mentally Ill, and the university of Tennessee. The project was meant to equip police officers with information to do with mental conditions while training them on better ways of dealing with individuals suffering from psychiatric disorders such as schizophrenia. In the program, participants received 40 hours of training with the successful ones getting certified as specialized crisis calls first responders. Training is made up of information on mental conditions and ways of mitigating potentially violent situations. A part of this program involves enhancement of partnerships between psychiatric emergency departments and the police. This way, the chances of individuals undergoing psychiatric emergencies being taken to mental facilities rather than prisons are increased. 

It may seem as if there is not much to the CIT programs. However, a number of studies conducted over the last several years imply that these programs minimize the deployment of law enforcement officers in various communities, reduce instances of unnecessary arrests while also raising the numbers of referrals to mental health facilities. According to Freudenberg & Heller (98), their effectiveness go a long way in reduce more expensive alternatives such lengthy incarceration periods. Another positive attribute of CIT programs is that they facilitate a better understanding of the aggressive manner in which schizophrenic people behave. Such insight can help minimize stigmatization of the disease among law enforcement officers. The number of people who are taken into police custody while suffering from schizophrenia and with no prior treatment is staggering. It is unfortunate that such patients often fail to get access to treatment until they come into contact with the criminal justice system. CIT’s Memphis model was definitely a step in the right direction. On the other hand, lawmakers have been contributing to the issue as well. For instance, in recent years, a number of laws have been passed aimed at increasing funding towards improvement of relations between law enforcement and mental health systems. A notable law is the Mentally Ill Offender Treatment and Crime Reduction Act that was enacted in 2004 (Freudenberg & Heller, 101).  

A non-profit organization called the Vera Institute of Justice that deals with justice and public safety issues conducted a research in 2013. Its findings were that it costs up to three times more for an individual suffering from a serious mental health condition to be dealt with by the criminal justice system when compared to getting treated within the community. The study also found out that certain mental health programs resulted in fewer arrests and shorter prison sentences among mentally challenged populations. Keeping any of the above mentioned issues within the jurisdiction of the criminal justice system is not a good idea. Advocates such as the Treatment Advocacy Center would prefer a stronger government-run mental health system be in place- one that deters mental conditions from deteriorating to the extent that they require intervention from the criminal justice system. All in all, before something like that happens, perhaps the best option would be overhaul this system in such a way that it can deal with mentally handicapped people more sensibly (Prins, 863). 

No one appears to like the above mentioned setup. All in all, the reality of it coming into existence has spurred some law enforcement officials to reconsider their ways at the behest of advocates. To a certain extent, this can be seen as harm reduction. It’s not the police that should be responding to crises related to mental health. However, considering the reality of the situation, they should receive some training on how to properly handle such situations. For instance, law enforcement officers may not understand that individuals experiencing psychotic episodes genuinely cannot control their actions at the instance. However, if these officers are aware that someone cannot control what he or she is doing, it minimizes the likelihood of a confrontation getting out of hand. After all, why would an officer use excessive force on someone, or punish them for something they cannot help (Steadman et al. 841). 

Through de-escalation, officers attempt to put themselves in the shoes of people suffering from a mental health condition. By doing this, they should keep their distance; calmly talk to the individual they are approaching, and try to make him or her relax. The point is to get that person to win the officer’s trust and eventually convince him or her to submit with little or no violence. From there, the officer then subdues the individual by gently talking them down and finally admitting them to healthcare. This strategy can even involve acknowledging, although not accepting, the individual’s delusions. For example, if a person in a psychotic state thinks that he or she is the president, an officer should not argue on whether it is true but just play along with it. The point is that provided the individual is talking and not doing something threatening, de-escalation is taking place. Such a strategy can be much safer not just for the person suffering from a mental health condition, but for the officer too given that it makes the individual in the midst of the crisis less prone to lashing out. 

A problem occurs in that, more often than not, police officers are trained to do the exact opposite of what is recommended above. Their training is all about being authoritative whereby they step in and actually take charge of the situation. A mentally unstable person is psychotic, most likely paranoid, and probably hearing voices telling him or her that others are trying to hurt them. When such a person comes into contact with a police officer in such a state, it is a recipe for disaster. The way such a situation plays out depends on how the officers respond to it. All in all, it is not like they approach these situations with ill motives. It’s just that they are basically trained to handle them in a poor manner. Hence, by altering the training module, officers can approach situations with a better idea of how to go about it, and possible avert a violent encounter. 

In addition to the above-mentioned training, some state and local governments in the United States have come up with diversion programs whose role is to try and direct people with mental conditions to care rather than to medical conditions. Some areas have incorporated mental health courts that connect likely prison-bound people to community-based mental health facilities. A good example is Fairfax County located in Virginia where a jail diversion program is in place. In it, low-risk offenders suffering from mental health conditions are moved to community-based care; something that has the potential of preventing ugly run-ins with law enforcement. All in all, these programs do have their shortcomings. Although they are capable of saving funds in the long-term, they require a major upfront investment as well as a shift in culture. The cost of such programs remains the biggest hurdle for both the law enforcement officials and lawmakers. It is a huge commitment to a policy that they are not sure is actually necessary, nor are they convinced that it will work. Whatever the case, such policies are gathering momentum across the United States, and to a good effect. The US does not seem to have a state-sponsored mental health system. Looking after severely mentally sick people has for a long time been the responsibility of the various states.  

It is also worth noting that most exceedingly violent criminals, such as mass shooters, are not suffering from any mental health issues. Thus, a question arises as to why treatment should be recommended as the answer. When it comes to mass shootings, a majority of Americans think that mental illnesses are to blame. However, forensic psychiatrists and criminologists state that this perception is critically flawed since it does not reflect on reality. Although some of the worst mass shooters in the history of the United States were psychotic, the vast majority of them did not suffer from any classic type of mental illness like psychosis or schizophrenia. Rather, they were just ruthless sociopaths who, despite behaving in an unfathomable manner, cannot be typically classified as being mentally ill.

Such oversimplification is propagated by the firearm industry and a society that is of the opinion that those suffering from mental illness can commit mass shootings. By setting in motion an overhaul of the mental-health system as a way of curtailing gun violence and mass shootings, the United States is chasing a high-budget cure that is unlikely to work on a basis of misinformation and wrong diagnoses.  

The issue of mental health problems in law enforcement does not apply to criminals only, but also to police officers themselves. According to reports, more officers lose their lives through suicide than in the course of duty. This finding raises questions as to what is wrong with the force and what can actually be done about it. A possible solution involves the implementation of a culture in law enforcement that is free from stigma. Too often, law enforcement officers experiencing personal crisis or going through destructive emotional episodes feel completely helpless, perhaps due to police culture or the nature of their duties. They may feel that admitting they have a problem may be interpreted as a sign of weakness, or proof that they are not up to the task. 

In some cases, this fear is justified by what is contained in official policy. Certain law enforcement agencies have in place a policy stating that any officer who is seeking or undergoing mental health treatment, or under psychotropic medication, should let the department know. Such an individual is likely to face duty restrictions while receiving such care. Given such misunderstanding or stigma, it is easy for false information to thrive that traps law enforcement officers in a labyrinth of anxiety or depression. 

Sometimes, this stigma is the fault of the officers themselves. As a profession, law enforcement values both physical and emotional toughness. Having a strong body and mind is a necessary value and something that most officers take pride in. however, a profession in which such strength is a necessity also has the potential of eroding it away. Even in the absence of duty-related stressors like in-house depression or critical incidences, life and biology come together to affect the mental functioning of an individual irrespective of what they do for a living; sometimes without warning.

Works Cited

Freudenberg, Nicholas, and Daliah Heller. "A Review of Opportunities to Improve the Health of People Involved in the Criminal Justice System in the United States." Annual review of public health 37 (2016): 313-333.

King, Claire, and Glynis H. Murphy. "A systematic review of people with autism spectrum disorder and the criminal justice system." Journal of autism and developmental disorders 44.11 (2014): 2717-2733.

Prins, Seth J. "Prevalence of mental illnesses in US state prisons: a systematic review." Psychiatric Services 65.7 (2014): 862-872.

Steadman, Henry J., et al. "Gun violence and victimization of strangers by persons with a mental illness: data from the MacArthur Violence Risk Assessment Study." Psychiatric services 66.11 (2015): 1238-1241.

 

 

sheldon

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