Simultaneously Solving Crime and Poor Mental Health - Looking for a solution…

J. Shymko

            In failing to provide sufficient mental health training, law enforcement turns a blind eye to the importance of de-stigmatization, equity, historic injustices, and safety, further perpetuating harm to vulnerable communities. Thus, “for the sake of everyone involved, police should be well prepared and have adequate support to answer the call when people are in mental health distress. They should also be equipped to play a role in preventing crises as part of a consistent, integrated, efficient system involving criminal justice, corrections, community services, mental health, and broader health care directives.”[i] It is better for all that this be remedied, as “when people with mental illness are treated fairly and feel respected in their contact with police and other criminal justice and correctional services- when they have a sense of ‘procedural justice’- they are more likely to be cooperative.”[ii] Following, people are then more likely to seek treatment prior to the crisis, ideally turning law enforcement away from further perpetuating incorrect stereotypes of those in need of mental health aid. To achieve this, Honourable Judge Raymond Wyant believes that “what is needed is an understanding, training, and collaborative effort among agencies that are both internal and external to government, educating everyone involved in how to recognize, access, and work with people experiencing mental health issues.”[iii]

Critical incidents …

            As a consequence of their duties, officers have the potential to face daily trauma. Such experiences have been termed “critical incidents”. Critical incidents can be defined as “‘often and unexpected’, can ‘disrupt ideas of control and how the world works’, can feel emotionally and psychologically overwhelming, ‘can strip psychological defences’, and ‘frequently involve perceptions of death, [a] threat to life, or []  bodily injury’.”[iv] These occurrences contribute significantly to the decline of an officer’s mental health, ultimately increasing reactive behaviour and further deterring the public from seeking help when needed.

            One method of confronting the side effects of critical incidents has been the use of “Critical Incident Stress Debriefing (CISD)” by many police departments.[v] This method allows officers to discuss the scene and what they experienced within 1-10 days after the crisis. While this strategy may appear sound in theory, some researchers believe that CISD may be more detrimental than beneficial. One study found that after questioning those who had experienced a critical incident, the group in which the CISD method was applied  “exhibited significantly more post-traumatic stress disorder signs than non-briefed subjects” one-week post-trauma.[vi] Unsurprisingly, this is believed to be the result of workplace stereotypes and pressures, as one theory explaining the results is that officers felt critiqued during their critical incident debriefs which would exacerbate the impact of the trauma they were already facing.[vii]

            Alternatively, a strategy that is claimed to be supported by greater evidence than that of CISD, is the application of ‘psychological first aid”. The concept of psychological first aid is to apply practical help rather than psychological help to police officers after experiencing a critical incident.[viii] Psychological first aid is to only be applied once signs of distress are exhibited after a crisis, where the individual’s needs and concerns are assessed, emotional and social support are provided, and the individual is protected from future harm by offering practical assistance.[ix] It is emphasized that psychological first aid is not therapy, mental health treatment, or debriefing. Instead, the focus of the aid is to calm the individual, ensure safety and comfort, identify immediate needs, and connect the individual with resources and other collaborative services to support their coping strategies.[x] 

            Others advocate for the use of a Crisis Intervention Team (CIT) model within law enforcement.[xi] CIT involves mental health training that “establishes a single point of entry to psychiatric services, partnerships with community providers and people with lived experience, and changes in police and health provider policies and procedures.” CIT has nearly three thousand active programs worldwide.[xii]  Key to the success of the CIT has been role-playing scenarios which demonstrate how when one can relive a traumatic incident without judgment or critique it can serve as a healthy technique for recovery. [xiii] The thinking behind CIT is that the “ability to recognize and identify certain mental health conditions enables police officers to adjust their communication strategies and behaviour with a focus on procedural justice, empathy, and patience, to prevent the risk of escalating violence and traumatic experiences”,[xiv] reiterating the importance of developing mental health literacy.

Risk assessment training…

            It is also important to shine a spotlight on issues with law enforcement’s ability to assess risk. It was reported that “ten percent of police calls respond to incidents involving people with serious mental illness. These calls are perceived to involve higher risk, lead to more arrests and sometimes fatal use of force.”[xv] This is in part due to officer’s inability to appropriately perceive and interpret mental illness when one is in crisis, resulting in the use of unnecessarily reactive legal force. Risk assessment should strengthen the following skills: (1) the ability to recognize specific disorders or psychological distress, (2) knowledge and beliefs about risk factors and causes, (3) knowledge and beliefs about self-help interventions, (4) knowledge and beliefs about available professional help, (5) attitudes which facilitate recognition and help-seeking, and (6) knowledge of how to seek further mental health information.[xvi] Not only is risk assessment training beneficial for the individuals involved in the encounter but for the costs of criminal justice as well. Considering what a small portion of chronic offenders represent in the total offender population, they consume disproportionate amounts of time and resources.[xvii] Saskatchewan has recognized the extent of the benefits of risk assessment training and has made efforts to work with high-risk and chronic offenders to review each client’s pattern of offence and recidivism, nature of the offence, and relevant unique circumstances to increase police capacity, better mental health and improve social services.[xviii]

Behaviour training…

            Within this blog it has been discussed how negative connotations surrounding mental health penetrate society through social, personal, and workplace stigmas. These attitudes are unfortunately very difficult to change, which brought researchers to experiment with altering officers’ behaviours instead. In this study, the primary objective was to maintain a focus on officer engagement throughout a one-day mental health training program that targeted officer behaviour when responding to a mental health crisis.[xix] This was accomplished by focusing on de-escalation techniques, officer empathy, and symptom recognition when placed in emotionally arousing scenarios and provided with feedback.[xx] 

            The results of this study were astonishing. Following the training of over 650 officers, significant behavioural improvements were present six months after the day-long training. The amount of mental health calls increased by an average of 40% which is believed to be due to officers’ enhanced abilities to recognize when a crisis is due to poor mental health, evidenced by the 40% decrease in the use of force following training.[xxi] Police officers too benefited from this training, as 20% less time was spent on each mental health call due to improved communication, empathy, proper de-escalation techniques, and knowledge of appropriate solutions, which resulted in officers reporting a 23% increase in their confidence when interacting with individuals who were in psychiatric distress.[xxii]

            Most notably, these positive results came with a change in police attitudes. The results of these studies lead researchers to conclude that a fault of current programs is that they likely fail to establish an apparent cost-benefit relationship between training and results in action.[xxiii] It is stated that “if the end goal is to improve an officer’s behaviour toward individuals with mental illness, a more efficient way is to focus on changing behaviour, assuming attitudes may change accordingly”,[xxiv] addressing the psychological phenomenon of cognitive dissonance within police officers. Cognitive dissonance occurs when one’s attitudes and behaviours are inconsistent with each other creating a tension that is relieved when attitudes are shifted to match behaviours. Thus, in the case of law enforcement, attitudes may only change if officers are unable to justify externally, why they behaved in a certain way.[xxv]

            Following, the theory of planned behaviour supports the idea that attitudinal changes occur most often due to cognitive dissonance. The theory of planned behaviour connects attitudes and behaviours with the determinant of expressed behaviour being internal behavioural intentions.[xxvi] Behavioural intentions are said to be composed of three main predictors. First, the strength of attitudes toward the behaviour. Second, subjective norms surrounding the behaviour, such as a coworker’s impression or judgment of one seeking help for PTSD. Finally, perceived behavioural control pertains to how much control the individual believes they have over their own behaviour and how confident they feel about their ability to perform.[xxvii] This indicates that “even if officers have better or worse attitudes towards those with mental illness, there is no guarantee that they will behave more positively”,[xxviii] supporting the hypothesis that behaviour modification is more directly effective than attempts to alter attitudes.             

Encouraging integrated information…

            It is integral that information be shared openly through social services without compromising the integrity of confidentiality as “when police, who are educated and trained in mental health intervention are paired with mental health service providers, the strain on emergency room is reduced, successful diversion increases with fewer arrests and charges, and individuals are taken to emergency rooms more appropriately.”[xxix] This perspective is supported by various scholars and governments due to the effectiveness in creating a well-rounded education and it proved to be cost-efficient. [xxx] As stated, “central to any next step will be the continued inclusion of people with lived experience of mental illness as vital stakeholders in the discussion between the mental health and police officers”.[xxxi] This is emphasizing the importance of inclusion rather than exclusion of those with mental illness in conversations about policy and procedure that will ultimately have great impacts on their lives.

            The sharing of information and experiences should not be restricted to professionals. For example, peer support groups were found to be another useful tool in collectively working towards recovering from trauma and de-stigmatizing mental health concerns. Findings revealed that peer support groups served a greater purpose than simply being a conversation, rather, they effectively aided in recovery and contributed to mental health literacy.[xxxii] 

Firsthand experience from Michael Koppang.

            I was privileged to have the opportunity to speak with Michael Koppang. From his work with the Royal Canadian Mounted Police (RCMP), the Canadian military, and presently Manitoba Justice, Michael has an appreciation for the ever-evolving discussion surrounding the mental health of officers that has occurred during the time of his ongoing career. I gained insight into his unique experiences in law enforcement and his perspective on how mental health is addressed in this field.

            It was during Michael’s time spent in the Canadian military that he discovered the military recognized and implemented mental health solutions that are far more advanced than those in policing. He noted in particular the “Road to Mental Readiness” program to be particularly valuable. The program’s strategy of taking individual responsibility, where one can individually assess themselves and their immediate loved ones to place themselves on a traffic light scale, determining whether participation in mental first aid would be beneficial. This system was integrated into policing and was used so commonly and casually within law enforcement that the terms “green”, “yellow”, “orange”, or “red zone” are still used today among officers.[xxxiii]

            When I asked Michael what he wished to see moving forward to better support the mental health of those in law enforcement, he answered that he wished mental health services would be more readily available. He noted that the services offered remotely are not the same as those in urban environments. We discussed how it is common for an officer to be relocated to a rural community early in their career with the RCMP. This brings about its own unique struggles of isolation, unfamiliar stressors, the weight of a new career, and distance from loved ones, which would be better mitigated with proper mental health services.[xxxiv]

            Michael made several comments on what he found noticeably helpful in destigmatizing seeking help during his time in law enforcement. He recalled a time when it was routine for the service to send a reminder email during one’s birth month for a standardized check-in with a psychologist. This routine check-up helped to normalize seeing a professional and avoided the appearance of seeking help out of necessity. This process also allowed for ongoing mental health support, if during one’s check-in, additional psychological treatment was considered to be beneficial to the officer. Michael also emphasized the importance of providing a dual approach to the access of psychologists. Here, the psychologist connected to the workplace provides recommendations for various services that are independent or out-of-organization. This helps to reduce the stigma surrounding receiving help, as well as mitigating the fear of job repercussions.[xxxv]

            Michael and I’s discussion was full of optimism, speaking from his previous involvement in law enforcement, and presently Manitoba Justice, it sounds as though he has great hopes for the future of mental health within law enforcement.

[i] Ibid at 8.

[ii] Mental Health Commission of Canada, ed. “Balancing individual safety, community safety, and quality of life: How to improve interactions between police/security and people with mental illness~”, (17 June 2019), online: Centre for Innovation in Campus Mental Health <https://campusmentalhealth.ca/resource/balancing-individual-safety-community-safety-and-quality-of-life/> at 10.

[iii] Ibid at 2.

[iv] “Policing through the pain: How trauma impacts police officers”, (October 2019), online: International Public Safety Association <https://www.joinipsa.org/resources/Publications/Policing%20through%20the%20Pain%20-%20How%20Trauma%20Impacts%20Police%20Officers%20-%20International%20Public%20Safety%20Association%20-%20October%202019.pdf> at 9.

[v] Ibid at 18.

[vi] Ibid.

[vii] Ibid.

[viii] Ibid.

[ix] “World Health Organization (WHO)”, online: Psychological first aid: Guide for field workers <https://apps.who.int/iris/bitstream/handle/10665/44615/9789241548205_eng.pdf;sequence=1>.

[x] Ibid.

[xi] Supra note 1 at 11.

[xii] Ibid.

[xiii] Ibid.

[xiv] Wittmann, Linus et al. “Police officers’ ability in recognizing relevant mental health conditions”, (17 September 2021), online: Frontiers in psychology <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8484651/> at 2.

[xv] Supra note 1 at 12.

[xvi] Supra note 14 at 2.

[xvii] Supra note 1 at 12.

[xviii] Ibid.

[xix] Krameddine, Yasmeen I & Peter H Silverstone. “How to improve interactions between police and the mentally ill”, (9 December 2014), online: Frontiers <https://www.frontiersin.org/articles/10.3389/fpsyt.2014.00186/full> at 2.

[xx] Ibid.

[xxi] Ibid.

[xxii] Ibid.

[xxiii] Ibid.

[xxiv] Ibid at 3.

[xxv] Ibid.

[xxvi] Ibid.

[xxvii] Ibid.

[xxviii] Ibid at 4.

[xxix] Supra note 1 at 15.

[xxx] Ibid at 10.

[xxxi] Ibid at 29.

[xxxii] Milliard, Beth. “Utilization and impact of peer-support programs on Police Officers’ Mental Health”, (14 July 2020), online: Frontiers in psychology <https://pubmed.ncbi.nlm.nih.gov/32765375/>.

[xxxiii] Interview of Michael Koppang (October 27, 2023) on mental health in law enforcement and Manitoba Justice.

[xxxiv] Ibid.

[xxxv] Ibid.