Perceptions and experiences of people with mental illness regarding their interactions with police

Abstract

This study examined the perceptions and lived experiences of people with mental illness in relation to their interactions with the police. A community-based participatory research approach was used and a procedural justice theoretical perspective guided the study. In-depth, semi-structured interviews were conducted by peer researchers with 60 people with mental illness who had interacted with the police and were living in Metro Vancouver, Canada. Among the study participants, contact with the police was frequent and occurred under a diverse range of circumstances. The majority of participants perceived being treated in a procedurally just manner by the police officer(s) who were involved in their most recent interaction. Almost three-quarters (n = 43, 72%) of participants were generally satisfied with how the police officer(s) had handled their most recent interaction. The slight majority of participants (n = 30, 51%) rated their previous contacts with the police as a positive experience overall, with 32% (n = 19) indicating that their previous interactions with the police were negative life experiences. The findings paint a more balanced picture than that which is often portrayed by the media. Emphasizing a procedural justice framework for police handling of situations involving people with mental illness is a vital step toward improving how these interactions are experienced and perceived.

Introduction

In contrast with popular media depictions (Sieff, 2003, Stout et al., 2004), most people with mental illness do not commit criminal or violent acts; however, research suggests that contact with the police is common among this population (Bloom et al., 1986, Gelberg et al., 1988, Holcomb and Ahr, 1988, Theriot and Segal, 2005). Explanations for the occurrence of these interactions are complex, but generally focus on clinical risk factors, such as co-occurring substance use problems and treatment non-adherence, as well as social and systemic factors, including deinstitutionalization policies, homelessness, poverty, community disorganization, poorly funded and fragmented community-based services, hospital emergency room bed pressures, overly restrictive civil commitment criteria, intolerance of social disorder, and criminal law reforms (Borum et al., 1997, Cotton and Coleman, 2010, Lamb et al., 2004, Silver, 2006, Van Dorn et al., 2014). Furthermore, the police play a pivotal role in the application of both civil commitment legislation and criminal procedure on account of their mandated role in society, contributing to the frequency of encounters with people who have mental illness (Cotton & Coleman, 2010).

Increasingly, police officers have assumed expanded functions of maintaining social order, which include responding to mental health crises (Lamb et al., 2004, Patch and Arrigo, 1999). As a result, they can significantly influence the lives of people with mental illness. Police are often the principal first responders to situations involving people with mental illness, which has earned them the monikers “de facto mental health service providers” (Patch & Arrigo, 1999) and “psychiatrists in blue” (Menzies, 1987). In many situations, police officers have considerable discretion to use a range of informal or formal interventions, thereby assuming a gatekeeper function to the mental health and criminal justice systems (Lamb et al., 2002, Patch and Arrigo, 1999, Watson et al., 2004).

Many factors affect the subjective experience of interacting with the police. In addition to the purpose or outcome of the interaction, procedural justice theory suggests that the perceived fairness with which people are treated during police interactions influences their subjective experience of the encounter (Cascardi et al., 2000, Wales et al., 2010, Watson and Angell, 2007). Accordingly, the degree to which police officers treat people with dignity and respect, provide them with opportunities to present their own side of the story, and appear concerned for their welfare is likely to affect the nature and perception of these encounters (Watson & Angell, 2007). This is consistent with research showing that people with mental illness who feel powerless and coerced tend to experience higher levels of internalized stigma (Link, Castille, & Stuber, 2008).

Internationally, police services are investing considerable resources in initiatives, such as specialized police response programs and training, designed to improve the manner in which officers respond to and interact with people who have mental illness (Cotton and Coleman, 2010, Parent, 2007, Price, 2005, Steadman et al., 2000, Tucker et al., 2008). Many of these efforts have been triggered by inquiries into fatal encounters involving the police and people with mental illness. A significant limitation of these important initiatives is that they have not been systematically informed by the perspectives and experiences of people who live with mental illness, likely due in part to the dearth of research in this area. We are aware of only two systematic studies that have examined in-depth the perceptions and experiences of people with mental illness regarding their encounters with the police: the first involved interviews with 26 community mental health service users (Watson, Angell, Morabito, & Robinson, 2008) and the second was comprised of interviews with 16 individuals with psychotic illnesses who had been detained by the police (Jones & Mason, 2002). Together, findings of these studies indicate that perceptions vary and are heavily influenced by the attitudes and behaviors of police officers; however, the generalizability of results derived from such small samples is questionable and further research is required.

Using a community-based research approach and guided by procedural justice theory, the present study contributes to this body of knowledge by examining the perceptions and experiences of people with mental illness in relation to their interactions with the police.