Skip to main content

Advertisement

SpringerLink
Log in

Assessing the capability of a co-responding police-mental health program to connect emotionally disturbed people with community resources and decrease police use-of-force

  • Published:
Journal of Experimental Criminology Aims and scope Submit manuscript

Abstract

Objectives

The objective of the study is to assess the capability of a mobile crisis intervention team (MCIT) to connect emotionally disturbed people (EDP) with community resources and decrease police use-of-force.

Method

In order to have equivalent groups, interventions managed by the MCIT were matched to incidents handled by traditional police officers with similar propensity scores.

Results

Average treatment effects (ATEs) were computed to assess the impact of the MCIT. The MCIT was associated with decreases in police use-of-force (ATE = − 0.08; p ≤ 0.01), EDP transported to the hospital against their will (ATE = − 0.06; p ≤ 0.10), and EDP transported to the hospital in general (ATE = − 0.42; p ≤ 0.01). EDP were more likely to be referred to community resources (ATE = 0.19; p ≤ 0.01) or managed by their social network (ATE = 0.22; p ≤ 0.01) when the MCIT was involved in the intervention.

Conclusion

The MCIT was effective in connecting EDP with community resources, avoiding unnecessary transports to the hospital, and reducing police use-of-force.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. This expression, emotionally disturbed person (EDP), is used throughout the article. Most of the time, the diagnosis of mental illness or disorder is made by the police officer, based on his/her perception and not on a formal diagnosis. The person can be impaired by alcohol, medication, mental illness or a combination of factors. The police officer may maintain that the person is emotionally disturbed but not necessarily suffering from a mental health problem.

  2. In order to estimate the propensity score, one needs to select variables that may be relevant to the treatment and outcomes in question (Apel and Sweeten 2010). Despite their relevance, some variables found in police reports were not used to compute the propensity score. The presence of firearms and the race were almost constant. Only 1.5% of interventions involved the presence of a firearm on the scene, including cases where the firearm was stored and not accessible to the EDP. Almost all EDPs (97.5%) were Caucasians. Some other variables had many missing values. Information on the employment status, the first language (e.g., French, English, or Spanish) and on the prescribed medication was, respectively, missing in 49.1%, 46.6%, and 90.7% of the cases.

  3. While MCITs seek to reduce pressure on the criminal justice system, arrests were not analyzed in this study. Only 3.0% (n = 12) of all interventions were followed by an arrest or incarceration. Only one of them occurred when the intervention was conducted by the MCIT.

  4. Among the 37 interventions involving the use-of-force, the force was mainly used to contain the EDP, either with straps or handcuffs (64.9%), or with physical control techniques such as joint locks or takedowns (18.9%). Escorting the EDP (10.8%), giving orders (2.7%), and using intermediate weapons (2.7%) were the other techniques.

  5. The force was used in 66.7% of interventions where transportation to the hospital against the will of EDP occurred in comparison with 3.6% for other interventions not involving the application of P-38.

  6. EDPs transported to the hospital against their will were also included in this variable.

  7. Nearest neighbor matching was also used but results were inconsistent. Some estimates were not computed when the bootstrap was used. It was also impossible to compute ATEs for several outcomes when subsamples were used, especially when small calipers, and 3 to 5 neighbors were used.

References

  • Alpert, G. P., & Dunham, R. G. (2004). Understanding police use of force: officers, suspects, and reciprocity. New York: Cambridge University Press.

    Google Scholar 

  • Apel, R. J., & Sweeten, G. (2010). Propensity score matching in criminology and criminal justice. In A. R. Piquero & D. Weisburd (Eds.), Handbook of quantitative criminology (pp. 543–562). New York: Springer.

    Google Scholar 

  • Baess, E. P. (2005). Integrated mobile crisis response team : review of pairing police with mental health outreach services. Retrieved May 1st, 2019 from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.583.1431&rep=rep1&type=pdf.

  • Becker, S. O., & Ichino, A. (2002). Estimation of average treatment effects based on propensity scores. The Stata Journal, 2, 358–377.

  • Bittner, E. (1967). Police discretion in emergency apprehension of mentally ill persons. Social Problems, 14, 278–292.

    Google Scholar 

  • Blais, E., & Bacher, J-L. (2007). Situational deterrence and claim padding: results from a randomized field experiment. Journal of Experimental Criminology, 3, 337–352.

  • Blais, E., Roy, L., Boivin, R., Leclerc, B., & Choiniere-Tran, K. (2019). Police interventions with mentally disturbed individuals (in French). Criminologie, 52, 321–348.

  • Boivin, R. (2017). Correlates of subject (ive) resistance in police use-of-force situations. Policing: An International Journal of Police Strategies & Management, 40, 719–732.

    Google Scholar 

  • Borum, R. (2000). Improving high risk encounters between people with mental illness and the police. The Journal of the American Academy of Psychiatry and the Law, 28, 332–337.

    Google Scholar 

  • Broner, N., Lattimore, P. K., Cowell, A. J., & Schlenger, W. E. (2004). Effects of diversion on adults with co-occuring mental illness and substance use: outcomes from a national multi-site study. Behavioral Sciences & the Law, 22, 519–541.

    Google Scholar 

  • Canada, K. E., Angell, B., & Watson, A. C. (2012). Intervening at the entry point: differences in how CIT trained and non-CIT trained officers describe responding to mental health-related calls. Community Mental Health Journal, 48, 746–755.

    Google Scholar 

  • Clarke, R. V., & Weisburd, D. (1994). Diffusion of crime control benefits: observations on the reverse of displacement. Crime Prevention Studies, 2, 165–184.

    Google Scholar 

  • Compton, M. T., Bahora, M., Watson, A. C., & Oliva, J. R. (2008). A comprehensive review of extant research on crisis intervention team (CIT) programs. The Journal of the American Academy of Psychiatry and the Law, 36, 47–55.

    Google Scholar 

  • Cornish, D. B. (1994). The procedural analysis of offending and its relevance for situational prevention. Crime Prevention Studies, 3, 151–196.

    Google Scholar 

  • Cotton, D., & Coleman, T. (2006). Contemporary policing guidelines for working with the mental health system. Ottawa: Canadian Association of Chiefs of Police.

    Google Scholar 

  • Cotton, D., & Coleman, T. G. (2010). Canadian police agencies and their interactions with persons with a mental illness: a systems approach. Police Practice and Research: An International Journal, 11, 301–314.

    Google Scholar 

  • Cross, A. B., Mulvey, E. P., Schubert, C. A., Griffin, P. A., Filone, S., Winckworth-Prejsnar, & Heilbrun, K. (2014). An agenda for advancing research on crisis intervention teams for mental health emergencies. Psychiatric Services, 65, 530–536.

    Google Scholar 

  • Deane, M. W., Steadman, H. J., Borum, R., Veysey, B. M., & Morrissey, J. P. (1999). Emerging partnerships between mental health and law enforcement. Psychiatric Services, 50, 99–101.

    Google Scholar 

  • Ellis, H. A. (2014). Effects of a crisis intervention team (CIT) training program upon police officers before and after crisis intervention team training. Archives of Psychiatric Nursing, 28, 10–16.

    Google Scholar 

  • Engel, R. S., & Silver, E. (2001). Policing mentally disordered suspects: a reexamination of the criminalization hypothesis. Criminology, 39, 225–252.

  • Engel, R. S., Sobol, J. J., & Worden, R. E. (2000). Further exploration of the demeanor hypothesis: The interaction effects of suspects’ characteristics and demeanor of police behavior. Justice Quarterly, 17, 235–258.

  • Engel, R. S., McManus, H. D., & Herold, T. D. (2020). Does de-escalation training work? A systematic review and call for evidence in police use-of-force reform. Criminology & Public Policy (in Press).

  • Farrington, D. P. (2003). Methodological quality standards for evaluation research. The Annals of the American Academy of Political and Social Science, 587, 49–68.

    Google Scholar 

  • Farrington, D. P., & Welsh, D. (2005). Randomized experiments in criminology: what have we learned in the last two decades. Journal of Experimental Criminology, 1, 9–38.

    Google Scholar 

  • Farrington, D. P., Lösel, F., Braga, A. A., Mazerolle, L., Raine, A., Sherman, L. W., & Weisburd, D. (2019). Experimental criminology: looking back and forward on the 20th anniversary of the Academy of Experimental Criminology. Journal of Experimental Criminology. https://doi.org/10.1007/s11292-019-09384-z.

  • Fazel, S., Hayes, A. J., Bartellas, K., Clerici, M., & Trestman, R. (2016). Mental health of prisoners: prevalence, adverse outcomes and interventions. The Lancet Psychiatry, 3, 871–881.

    Google Scholar 

  • Fisher, W. H., Silver, E., & Wolff, N. (2006). Beyond criminalization: toward a criminologically informed framework for mental health policy and services research. Administration and Policy in Mental Health and Mental Health Services Research, 33, 544–557.

    Google Scholar 

  • Forchuk, C., Jensen, E., Martin, M.-L., Csiernik, R., & Atyeo, H. (2010). Psychiatric crisis services in three communities. Canadian Journal of Community Mental Health, 29, 73–86.

    Google Scholar 

  • Fuller, D. A., Lamb, H. R., Biasotti, M., & Snook, J. (2015). Overlooked in the undercounted: the role of mental illness in fatal law enforcement encounters. (Treatment Advocacy Center: A report from the Office of Research and Public Affairs).

  • Goffman, E. (1959). The presentation of self in everyday life. New York: Doubleday.

    Google Scholar 

  • Green, T. C. (1997). Police as frontline mental health workers: the decision to arrest or refer to mental health agencies. International Journal of Law and Psychiatry, 20, 469–486.

    Google Scholar 

  • Guerette, R. T., & Bowers, K. J. (2009). Assessing the extent of crime displacement and diffusion of benefits: a review of situational crime prevention evaluations. Criminology, 47, 1331–1368.

    Google Scholar 

  • Helfgott, J. B., Hickman, M. J., & Labossiere, A. P. (2016). A descriptive evaluation of the Seattle Police Department's crisis response team officer/mental health professional partnership pilot program. International Journal of Law and Psychiatry, 44, 109–122.

    Google Scholar 

  • Johnson, R. R., Stone, B. T., Miranda, C. M., Vila, B., James, L., James, S. M., Rubio, R. F., & Berka, C. (2014). Identifying psychophysiological indices of expert vs. novice performance in deadly force judgment and decision making. Frontiers in Human Neuroscience, 8, 1–13.

    Google Scholar 

  • Kaminski, R. J., Digiovanni, C., & Downs, R. (2004). The use of force between the police and persons with impaired judgment. Police Quarterly, 7, 311–338.

    Google Scholar 

  • Kane, E., Evans, E., & Shokraneh, F. (2018). Effectiveness of current policing-related mental health interventions: a systematic review. Criminal Behaviour and Mental Health, 28, 108–119.

    Google Scholar 

  • Kirst, M., Francombe Pridham, K., Narrandes, R., Matheson, F., Young, L., Niedra, K., & Stergiopoulos, V. (2015). Examining implementation of mobile, police-mental health crisis intervention teams in a large urban center. Journal of Mental Health, 24, 369–374.

    Google Scholar 

  • Kisely, S., Campbell, L. A., Peddle, S., Hare, S., Pyche, M., Spicer, D., & Moore, B. (2010). A controlled before-and-after evaluation of a mobile crisis partnership between mental health and police services in Nova Scotia. The Canadian Journal of Psychiatry, 55, 662–668.

    Google Scholar 

  • Lamanna, D., Shapiro, G. K., Kirst, M., Matheson, F. I., Nakhost, A., & Stergiopoulos, V. (2018). Co-responding police–mental health programmes: service user experiences and outcomes in a large urban centre. International Journal of Mental Health Nursing, 27, 891–900.

    Google Scholar 

  • Lamb, H. R., Weinberger, L. E., & DeCuir Jr., W. J. (2002). The police and mental health. Psychiatric Services, 53, 1266–1271.

    Google Scholar 

  • Landeen, J., Pawlick, J., Rolfe, S., Cottee, I., & Holmes, M. (2004). Delineating the population served by a mobile crisis team: organizing diversity. The Canadian Journal of Psychiatry, 49, 45–50.

    Google Scholar 

  • Landry, M., Blais, E., Chapdelaine, A., Carrier, S., & Elazhary, N. (2018). An evaluation of the implementation and effects of a mobile crisis intervention team intervening among individuals in crisis in the city of Sherbrooke (in French). Sherbooke, Quebec: Primary Health Care and Social Services University Institute.

  • Leclerc, B. (2014). Script analysis for crime controllers: extending the reach of situational crime prevention. (In S., Caneppele, & F., Calderoni (Eds.), Organized Crime, Corruption and Crime Prevention (pp. 13-20) Switzerland: Springer).

  • Leclerc, B., & Reynald, D. (2017). When scripts and guardianship unite: a script model to facilitate intervention of capable guardians in public settings. Security Journal, 30, 793–806.

    Google Scholar 

  • Livingston, J. D. (2016). Contact between police and people with mental disorders: a review of rates. Psychiatric Services, 67, 850–857.

    Google Scholar 

  • Matheson, F. I., Creatore, M. I., Gozdyra, P., Moineddin, R., Rourke, S. B., & Glazier, R. H. (2005). Assessment of police calls for suicidal behavior in a concentrated urban setting. Psychiatric Services, 56, 1606–1609.

    Google Scholar 

  • Morabito, M. S., Kerr, A. N., Watson, A., Draine, J., Ottati, V., & Angell, B. (2012). Crisis intervention teams and people with mental illness exploring the factors that influence the use of force. Crime & Delinquency, 58, 57–77.

    Google Scholar 

  • Price, O., Baker, J., Bee, J., & Lovell, K. (2018). The support-control continuum: An investigation of the staff perspectives on factors influencing the success or failure of de-escalation techniques for the management of violence and aggression in mental health settings. International Journal of Nursing Studies, 77, 197–206.

  • Puntis, S., Perfect, D., Kirubarajan, A., Bolton, S., Davies, F., Hayes, A., Harris, A., & Molodynski, A. (2018). A systematic review of co-responder models of police mental health ‘street’triage. BMC Psychiatry, 18, 256. https://doi.org/10.1186/s12888-018-1836-2.

    Article  Google Scholar 

  • Robertson, J., Fitts, M. S., Petrucci, J., McKay, D., Hubble, G., & Clough, A. R. (2019). Cairns mental health co-responder project: essential elements and challenges to programme implementation. International Journal of Mental Health Nursing, 29, 450–459.

    Google Scholar 

  • Rogers, P. J. (2000). Program theory evaluation: Not wheter programs work but how they work. In D.L. Stufflebeam, G.F. Madaus, & T. Kellaghan (Eds.), Evaluation models: Viewpoints on educational and human services evaluation (pp. 209–232). Boston: Kluwer.

  • Rosenbaum, N. (2010). Street-level psychiatry—a psychiatrist's role with the Albuquerque police department's crisis outreach and support team. Journal of police crisis negotiations, 10, 175–181.

    Google Scholar 

  • Rosenbaum, P. R., & Rubin, D. B. (1983). The central role of the propensity score in observational studies for causal effects. Biometrika, 70, 41–55.

    Google Scholar 

  • Rosenbaum, P. R., & Rubin, D. B. (1985). Constructing a control group using multivariate matched sampling methods that incorporate the propensity score. The American Statistician, 39, 33–38.

    Google Scholar 

  • Rossler, M. T., & Terrill, W. (2017). Mental illness, police use of force, and citizen injury. Police Quarterly, 20, 189–212.

    Google Scholar 

  • Rounsaville, B. J., Carroll, K. M., & Onken, L. S. (2001). A stage model of behavioral therapies research: getting started and moving on from stage 1. Clinical Psychology: Science and Practice, 8, 133–142.

    Google Scholar 

  • Schucan Bird, K., & Shemilt, I. (2019). The crime, mental health, and economic impacts of prearrest diversion of people with mental health problems: a systematic review. Criminal Behaviour and Mental Health, 29, 142–156.

    Google Scholar 

  • Scott, R. L. (2000). Evaluation of a mobile crisis program: effectiveness, efficiency, and consumer satisfaction. Psychiatric Services, 51, 1153–1156.

    Google Scholar 

  • Shadish, W., Cook, T. D., & Campbell, D. T. (2002). Experimental and quasi-experimental designs for generalized causal inference. Boston: Houghton Mifflin.

    Google Scholar 

  • Shapiro, G., Cusi, A., Kirst, M., O’Campo, P., Nakhost, A., & Stergiopoulos, V. (2015). Co-responding police-mental health programs: a review. Administration and Policy in Mental Health and Mental Health Services Research, 42, 606–620.

    Google Scholar 

  • Steadman, H. J., Deane, M. W., Borum, R., & Morrissey, J. P. (2000). Comparing outcomes of major models of police responses to mental health emergencies. Psychiatric Services, 51, 645–649.

    Google Scholar 

  • Steadman, H. J., Osher, F. C., Robbins, P. C., Case, B., & Samuels, S. (2009). Prevalence of serious mental illness among jail inmates. Psychiatric Services, 60, 761–765.

    Google Scholar 

  • Taheri, S. A. (2016). Do crisis intervention teams reduce arrests and improve officer safety? A systematic review and meta-analysis. Criminal Justice Policy Review, 27, 76–96.

    Google Scholar 

  • Terrill, W. (2005). Police use of force: a transactional approach. Justice Quarterly, 22, 107–138.

    Google Scholar 

  • The Allen Consulting Group, A. C. G (2012). Police, Ambulance and Clinical Early Response (PACER) Evaluation. Retrieved from the Internet March 2nd, 2020 from: https://www2.health.vic.gov.au/about/publications/researchandreports/Police-Ambulance-and-Clinical-Early-Response-PACER-Evaluation-Report.

  • Weisburd, D. (2000). Randomized experiments in criminal justice policy: prospects and problems. Crime & Delinquency, 46, 181–193.

    Google Scholar 

  • Weisburd, D. (2010). Justifying the use of non-experimental methods and disqualifying the use of randomized controlled trials: challenging floklore in evaluation research in crime and justice. Journal of Experimental Criminology, 6, 209–227.

    Google Scholar 

  • Weisburd, D., Lum, C. M., & Petrosino, A. (2001). Does research design affect study outcomes in criminal justice? The Annals of the American Academy of Political and Social Science, 578, 50–70.

  • Wood, J. D., & Watson, A. C. (2017). Improving police interventions during mental health-related encounters: past, present and future. Policing and Society, 27, 289–299.

    Google Scholar 

  • Wood, J., Swanson, J., Burris, S., & Gilbert, A. (2011). Police interventions with persons affected by mental illness. A critical review of global thinking and practice. Center for Behavioral Health Services & Criminal Justice Research. Rutgers University.

  • Wood, J. D., Watson, A. C., & Fulambarker, A. J. (2017). The “gray zone” of police work during mental health encounters: findings from an observational study in Chicago. Police Quarterly, 20, 81–105.

    Google Scholar 

Download references

Acknowledgments

This study was supported by a grant from the Vitae Foundation. The authors thank Bernadette Wilson for editing this manuscript. The authors are also grateful to three anonymous reviewers for their constructive and helpful comments.

Author information

Authors and Affiliations

  1. School of Criminology and International Centre for Comparative Criminology, Université de Montréal, 3150, rue Jean-Brillant, Room C4117, Montreal, Quebec, H3T 1N8, Canada

    Etienne Blais

  2. Department of Nursing, Université du Québec à Trois-Rivières, Drummondville Campus, 555, Boulevard de l’Université, Room 2002, Drummondville, Quebec, J2C 0R5, Canada

    Marjolaine Landry

  3. Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Sherbrooke, 3001, 12e ave Nord, Sherbrooke, Quebec, J1H 5H3, Canada

    Nicolas Elazhary

  4. School of Social Work, Université de Sherbrooke, 2500, Boul. de l’Université, Sherbrooke, Quebec, J1K 2R1, Canada

    Sebastian Carrier

  5. Faculty of Law, Université Laval, 1030, Avenue des Sciences Humaines, Room 1121, Québec, Québec, G1V 0A6, Canada

    Anne-Marie Savard

Authors
  1. Etienne Blais
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marjolaine Landry
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nicolas Elazhary
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sebastian Carrier
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anne-Marie Savard
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Etienne Blais.

Additional information

Law

P-38.001—act respecting the protection of persons whose mental state presents a danger to themselves or to others.

Appendix

Appendix

Table 4 Average treatment effect (ATE) of the MCIT on five outcomes: first 6 months
Full size table
Table 5 Average treatment effect (ATE) of the MCIT on five outcomes: last 6 months
Full size table
Table 6 Average treatment effect (ATE) of the MCIT on five outcomes: controls selected in the pre-treatment period only
Full size table
Table 7 Average treatment effect (ATE) of the MCIT on five outcomes: controls selected in the treatment period only
Full size table

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Blais, E., Landry, M., Elazhary, N. et al. Assessing the capability of a co-responding police-mental health program to connect emotionally disturbed people with community resources and decrease police use-of-force. J Exp Criminol 18, 41–65 (2022). https://doi.org/10.1007/s11292-020-09434-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11292-020-09434-x

Keywords

Search

Navigation