Under-resourced and understaffed: How small LE agencies address mental health outreach
Research indicates that rural locations have higher rates of mental illness, opiate addiction and suicide than urban areas
The twin crises of mental health and crime in small towns, historically under-researched and underreported, are finally gleaning a steady trickle of attention.
A March 2021 report by the nonprofit National Police Foundation (available in full below) explores the topic of small law enforcement agencies and their response to subjects in mental health crisis. Researchers focused on the use of the Crisis Intervention Team (CIT) model, which combines training with access to mental health resources, in agencies with 10 to 75 officers.
The COPS Office defines a “small law enforcement agency” as less than 50 officers. The research team chose their range of 10-75 officers based on their belief that agencies with fewer than 10 officers would be unlikely to “encounter behavioral health incidents with any frequency,” or to “have felt the need to develop innovative ways to respond” to them.
This was probably a necessary choice even though it left out all of the very smallest departments, comprising nearly half of the law enforcement agencies in the nation. After all, data that can’t be gathered can’t be analyzed and very small departments rarely have dedicated PIOs to field surveys, answer multi-part questions and return calls. Nevertheless, a significant proportion (nearly 40%) of the returned surveys were from departments with between 10-20 officers, according to research assistant Michael Lebron. It is encouraging that the information was not gathered solely from departments on the larger end of the spectrum.
Crisis intervention goals
The goal for CIT is improved safety for both law enforcement and their citizen contacts since, as the report explains, about a quarter of subjects killed by police are “thought to be in mental health crisis.”
The report does not address the risks mentally ill subjects pose to police; data on that topic is hard to find and what exists appears to be inconclusive. A long list of officers killed in the line of duty by suspects with mental health diagnoses provides an urgent incentive to improve access to resources and training, but without context it may also be unnecessarily alarming.
The overall results of the survey were hopeful: of the more than 300 departments participating, all but 12 reported that they provide some sort of “specialized response” to mental health calls. More than 60% provide some sort of crisis response training to all officers, and another 30% to at least some officers. About a third had at least one officer fully CIT certified, with about half of responding agencies instead participating in a regional CIT partnership.
Some departments used a co-responder model, with a mental health specialist riding along with officers, or available to respond when summoned. Others depended on specialists or specially trained officers from neighboring localities. ICAT (Integrating Communications, Assessment and Tactics) was the most common training model, intended for use with subjects who are unarmed, or armed with weapons other than firearms.
Small and rural departments in many cases adapted models developed for urban agencies to accommodate fewer resources, larger geographical areas and longer response times. For example, in Appalachia a telehealth app allows officers to consult remotely with a mental health expert for insight into conditions surrounding a call, potential behavioral triggers and suggestions for de-escalation techniques.
Addressing training gaps
There was a wide variance in the length of training provided to officers and the availability of mental health responders. Training times ranged from just less than a day to as much as 700 hours, with the average around 40 hours. The smallest agencies were most likely to have no CIT training at all, and about one in five had no access to any mental health expert for assistance. Ideal situations also included training for dispatchers in order to clarify the needs of those calling for aid.
Agencies that cannot afford the training and personnel for their own CIT response may band together with other agencies and mental healthcare providers to fill in the gaps. The regional crisis response approach lowers overhead but leaves unaddressed the long response times and limited availability. As one respondent wrote in the survey, ”The rural portion of the county is only partially covered.”
Another unforeseen hitch in the regional model is the drain on officer time. There’s a lot of waiting. Officers wait for mental health specialists to return calls, to respond to scenes or queries for counsel, for follow-up after incidents and for feedback on case disposition. They wait physically at scenes to provide security for medical and mental health providers, and they wait for transport, or to be the transport. For departments that may have only one or two officers on shift – or at all – that’s a hardship.
Without question, the two biggest challenges for small agencies dealing with mental health crises are cost and the vacuum where mental health services should be. Even money can’t solve every problem. One survey response included the note, “...we...need more professional mental health responders in western Kansas. Extremely hard to pay someone to move out west and more importantly, find someone who is willing to live in western Kansas.”
While urban crises top daily headlines, small town and rural stresses have simmered in the background, ignored unless they boil over into tragedy. It’s been easy to overlook the places that don’t make the news daily, even though research indicates that rural places have higher rates of mental illness, opiate addiction and suicide than urban areas.
Chief Social Scientist Robert Davis acknowledged that the current report does leave gaps in its focus on “larger” small agencies, but feels that it is a start and the topic is worth following up to fill those gaps. I agree with him. Something is always better than nothing, and it is a relief to see the spotlight turn to shine on places left behind, until now.