Transcript Point of Contact Point of Entry

Point of Contact
Point of Entry
(If you don’t want “em” there…..
Don’t put “em” there!)
Dr. Barry Perrou
Criminalization of Mental Illness
USC Spring Symposium
April 2013
April 2013
Key Solutions



Law Enforcement is the Social Gate Keyper
The “key” to keeping them in (Folger Adam)
The “key” to putting them in (Peerless)
Police Calls for Service Involving
Mental Illness
Reg
Pop
Calls
M/I Calls
LA
3.8M
850K
68K
186
8
8 Min
CO
9.8M
2.2 M
175K
480
20
3 Min
CA
35M
7.8 M
626K
1716
72
50 Sec
US
288M
64.4M
5.15 M
14,120
588
6 Sec
Lt Paul Geggie LAPD @ 2003
Per day
Per hour
Min’s B/T
Impact on Law Enforcement
Option I (Hospitalization)

Typical M.H. Call for L.E.


Min. 4 hours (10-97 to 10-98) (Copo-Babble)…….Without Complications
Add on Times






L.E. does not have the ability to hospitalize at a “Private Hospital”
 L.E. does not deal with Medical Insurance or 3rd party payer systems
Medical Clearance often required before Psych. Dept. of same hospital will accept
patient
Over crowded Psych. ER’s
Use of Force
 Possible medical treatment for Deputy / Patient
 Field Supervisor summoned to scene or hospital (mandatory With or W/O injuries)
 Interview and photos of injuries
 Coordination?? B/T free standing Psych. Hospitals and Medical Facilities can be time
consuming
Who is handling the “Crime in Progress Calls” in our
neighborhoods?
This is an “Unfunded Mandate” for Police Budgets
Impact on Law Enforcement
Option II (Arrest)

Arrest Process (Approx. 2-hrs) vs (4+hrs Hosp)




Over-crowded Jails
Over-crowded Jail Mental Health / Forensic Units
Over-crowded Court system
Almost anyone can be arrested

Stress and Aggravation can cause arrestable behavior

L.E. can be part of the solution or part of the problem for the patient
The choice of options sometimes can be based on supply and
demand and the systems of care in place to provide service
to our communities. Subsequently, the decision gets
pushed back to the streets and the discretionary powers of
the officer
“Point of Contact, Point of Entry”
Recommendations to Prevent Patients
from Becoming Inmates

Law Enforcement Training

Increase training for persons with disabilities from 8 hrs to 20 hrs. (to
include stigma)


Develop multi-disciplinary field response teams (Cops and
Clinicians) to include 40 hrs, 4-Pts, 8 hrs Locked Facilities






MET
SMART
HOPE
This concept has proven very effective in role-modeling, helping, non-threatening behavior for
uniform field patrol officers at the point of contact.
These existing programs are fully capable for assisting the Assisted Outpatient Treatment
(AOT) laws
Develop uniform agency procedures for the collaborative
handling of patients




Emphasis on the “Critical 2 minutes” (Point of Contact)
L. E. System
M. H. System
Hospital System
Jail Diversion Program (Treatment options before
Sentencing)
Final Thoughts

First Sworn L. E. Woman to lose her life in the line of duty
in the U.S

EOW March 20, 1919

Deputy Emma Benson (Los Angele County Sheriff Department)

Traffic Accident while transporting a psychiatric patient to Metro.

Mental Health Unit (Psych Detail)
 Late 40’s / 50’s
 Enola Gray

Pavlovian Principle of pairing task and reward –
Handcuffing
Our role as seniored officers – challenge our instutitional
culture; lead by example

Final Thoughts









Nice to Know / Need to Know (Training)
ABA Criminal Justice
Mental Health Standards; 1984
Common Sense
DMH-PD (830 P.C. – 5150 WIC)
Fire Dept. Greater Responsibility
MET Outcomes: 45% Private Hospital, 50% County Hospital,
5% other (Arrested, Referrals)
MET Teams (Ambulette- EMT Deputies, M.H.
Clinician/Nurses)
Pre-3 Strikes Program preventing arrest for minor crimes
L.E. - Psych - “Them”