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De-escalate encounters with persons in mental health crisis using noninvasive alternatives to force

Training, tactics and tools give officers options for resolving potential conflict without contact

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BolaWrap is a noninvasive restraining device that can bring a person in crisis into compliance without force.

Wrap Technologies

Sponsored by Wrap Technologies

By Laura Neitzel, Police1 BrandFocus Staff

Use of force by law enforcement has always been under scrutiny, but that scrutiny has grown more intense in recent years as public demands for reform in policing have grown louder. Officers are already undergoing a crisis of public confidence as well as internal struggles as agencies grapple with recruiting and retention problems and short staffing.

Meanwhile, other problems – like opioid addiction and untreated mental illness – are growing and putting further pressure on police officers, who are often the first to respond to a person in crisis (PIC). The American Psychological Association estimates that at least 20% of police calls for service involve a mental health or substance use crisis.i

While police departments are under pressure to reduce use of force, they are also responding to more calls with people who are not necessarily unwilling – but often unable – to comply with police commands. Having to use escalating levels of force to bring an individual into compliance not only increases the risk of injury or death to the person in crisis, it also increases the risk of death or injury to the officer.

Using force against a noncompliant PIC can lead to other negative consequences for the agency or officer, including litigation, increased insurance costs, loss of career and emotional and psychological trauma.

What is needed to reduce use-of-force encounters with PICs are alternative tactics and tools – like BolaWrap – that reduce conflict with no or minimal physical contact.

Risks inherent in encounters with persons in crisis

Treatment Advocacy Center estimates that at least “one in four fatal police encounters ends the life of an individual with severe mental illness.”ii

“People with severe mental illness are being routinely abandoned by the mental health system. It forces law enforcement officers (LEOs) to step into a dangerous situation if the untreated become a `danger to self or others,’” according to Mental Illness Policy Org. “This too frequently results in people with untreated severe mental illness being injured, incarcerated and sometimes killed by police. It also, too frequently, results in police being injured or killed by people with untreated severe mental illness.” iii

Often these encounters end in injury or death for the person in crisis, and the department and responding officers can face allegations of using excessive force. Whether or not an individual officer is found liable, an incident like this can impact not only the department, but the officer’s career and mental health.

According to a 2006 review of officer-involved shootings, “The sources of stress attached to an officer-involved shooting are multiple and include the officer’s own psychological reaction to taking a life, the responses of law enforcement peers and the officer’s family, rigorous examination by departmental investigators and administrators, possible disciplinary action or change of assignment, possible criminal and civil court action, and unwanted attention – sometimes outright harassment – by the media.”iv

While encounters are unpredictable and officers often have no choice but to apply more aggressive tactics or lethal force, no officer wants to risk their life or career or take an innocent life.

There is increasing recognition that police officers are often thrust into positions where they have to make difficult judgments about the mental state and intent of an individual perceived to be in crisis. Special skills, techniques, abilities and tools are required to effectively and appropriately resolve the situation while minimizing violence.

Here are some of the actions law enforcement agencies are taking to reduce the risk of having to use force in encounters with persons in crisis.

Crisis intervention team training

The International Association of Chiefs of Police recommends that law enforcement agencies provide officers with training to determine whether a person’s behavior is indicative of a mental health crisis and equip their personnel with guidance, techniques, response options and resources so situations may be resolved in as constructive, safe and humane a manner as possible.

Crisis intervention team (CIT) training teaches law enforcement officers to safely de-escalate mental and behavioral health crisis situations. Law enforcement agencies that have CIT programs in place have reported as much as an 80% decrease in officer injuries during mental health crisis situations.v

Research has indicated that police CIT training is effective and has good outcomes for police officers who receive the training. A survey of police officers indicated that CIT-trained officers perceived themselves as less likely to escalate to the use of force in a hypothetical mental health crisis encounter.

There is also good evidence for benefit in officer-level outcomes, such as officer satisfaction and self-perception of a reduction in the use of force.vi

Coresponder teams

In addition to CIT training, some law enforcement agencies are moving to a model for crisis response that pairs trained police officers with mental health professionals to respond to incidents involving individuals experiencing behavioral health crises.

While the coresponder model is fairly new, preliminary evidence indicates it shows promise in enhancing crisis de-escalation, increasing individuals’ connection to services and reducing pressure on the criminal justice system by reducing arrests, police detentions and time spent by officers in responding to calls for service.vii

911 dispatch diversion

Police officers are often asked to respond to calls that may be better suited for behavioral health professionals. Implementing 911 dispatch diversion can help communities conserve public safety resources and reduce reliance on police by first determining whether law enforcement is necessary for the response. If connection to an embedded clinician or other mental health professional is more appropriate, dispatchers are able to facilitate a response that helps link the person to services or treatment. Embedded clinicians can also help glean information from callers such as psychiatric history, treatment compliance, current medications and symptoms.viii

Add noninvasive methods to the use-of-force continuum

The use-of-force continuum is a widely accepted model presented to law enforcement officers as a guide to address threat, resistance, evasion and potential harm. The use-of-force continuum has been a five-stage model: officer presence, verbal commands, empty hand control using bodily force, less-lethal force – like pepper spray, baton and conducted energy devices – and, finally, lethal force.

However, the increased focus on de-escalation and development of new noninvasive tools that can help officers gain compliance when faced with potential force encounters suggests it’s time to add a new step to the model: noninvasive methods, including CIT and non-lethal methods like BolaWrap.

Noninvasive methods provide alternative approaches for officers to consider when communication efforts break down but they are not ready to escalate to pain compliance. Noninvasive methods minimize the need for physical contact and may prevent the need for forced takedown, which can cause severe trauma to the person in crisis and the officer as well.

According to an unpublished white paper advocating for the addition of noninvasive methods to the use of force continuum,ix noninvasive methods include:

1. Engaging mental health practitioners as coresponders, as in the CIT and coresponder models or 911 dispatch diversion approaches mentioned above.
2. Directing or redirecting backup officers to increase or decrease visibility and avoid overresponse.
3. Using noninvasive, pain-free devices like BolaWrap.
4. Engaging family, neighbors, friends or peers to provide support to the PIC.
5. Using backup officers to distance family members, observers and others who agitate the situation.
6. Controlling noise to minimize the PIC’s stress and confusion caused by excessive noise.
7. Controlling lighting to the officer’s advantage, such as using light as a means of control, diversion and cover.
8. Requesting K-9 officers to use police-service dogs to circle-and-bark to contain the PIC.

Use noninvasive, no-pain devices

BolaWrap is a noninvasive restraint device that can help officers achieve compliance from a PIC without the need for close physical proximity – which is where injuries are most likely to occur. Because it restrains from a range of 10–25 feet without inflicting pain, it is a useful addition to the officer’s toolbelt in situations where a subject is noncompliant but use of force is not desired, as with a person in crisis or with a physical or mental disability. BolaWrap immobilizes the subject long enough for officers to approach and restrain the individual in handcuffs without incident.

Many agencies that are actively expanding their ability to resolve increased encounters with PICs, like Detroit Police Department, are adding BolaWrap to their noninvasive toolkit, along with coresponse teams and CITs.

As long as police departments continue to respond to calls involving people in crisis, they need tools and tactics that will help them respond effectively and humanely. Adopting noninvasive methods before escalating to pain compliance is more likely to lead to better outcomes for individuals, officers and communities alike.

For more information on BolaWrap, visit Wrap Technologies.

Read next: Why agencies should add this non-lethal restraint device to every officer’s belt

[i] “Building mental health into emergency responses,” Abramson, Ashley. Monitor on Psychology. May 2021. https://www.apa.org/monitor/2021/07/emergency-responses

[ii] “Overlooked in the Undercounted: The role of mental illness in fatal law enforcement encounters.” Fuller, Doris A., Lamb, Richard H., M.D., Biasotti, Michael, Snook, John. Treatment Advocacy Center. December 2015. https://www.treatmentadvocacycenter.org/overlooked-in-the-undercounted

[iii] “115 Law Enforcement Officers Killed by Mentally Ill.” Mental Illness Policy Org. https://mentalillnesspolicy.org/crimjust/120LEOSkilledbyMentallyIll.html

[iv] “Officer-Involved Shooting: Reaction Patterns, Response Protocols, and Psychological Intervention Strategies.” Miller, Laurence. International Journal of Emergency Mental Health. 2006. https://ovc.ojp.gov/sites/g/files/xyckuh226/files/media/document/imp_officer_involved_shooting-508.pdf

[v] “Police Response to Mental Health Emergencies: Barriers to Change.” Dupont, Randolph, Cochran, Sam. U.S. Journal of the American Academy of Psychiatry and the Law. 2000. https://www.ojp.gov/ncjrs/virtual-library/abstracts/police-response-mental-health-emergencies-barriers-change

[vi] “Effectiveness of Police Crisis Intervention Training Programs.” Rogers, Michael S., McNiel, Dale E., Binder, Renee. Journal of the American Academy of Psychiatry and the Law. September 2019. https://jaapl.org/content/early/2019/09/24/JAAPL.003863-19

[vii] “Assessing the Impact of Co-Responder Team Programs: A Review of Research.” IACP/The University of Cincinnati Center for Police Research and Policy. October 2021. https://www.theiacp.org/sites/default/files/IDD/Review%20of%20Co-Responder%20Team%20Evaluations.pdf

[viii] “Tips for Successfully Implementing a 911 Dispatch Diversion Program.” Council of State Governments Justice Center. October 2021. https://www.ojp.gov/ncjrs/virtual-library/abstracts/tips-successfully-implementing-911-dispatch-diversion-program

[ix] “Expanding the Use of Force Continuum to Include Non-Invasive Methods.” Greenberg, Sheldon, DeVita, Charles. January 2023.

Laura Neitzel is Director of Branded Content for Lexipol, where she produces written and multimedia branded content of relevance to a public safety audience, including law enforcement, fire, EMS and corrections. She holds degrees in English from the University of Texas and the University of North Texas, and has over 20 years’ experience writing and producing branded and educational content for nationally-recognized companies, government agencies, non-profits and advocacy organizations.
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