Interactions between Mental Health and Law Enforcement Systems: Problems and Prospects for Cooperation

Abstract

This article examines the challenges posed by system specialization, as illustrated by the difficulties of coordinating the roles of the mental health and law enforcement agencies working with people with severe mental illness. Dealing with the needs of clients in one system when they are most appropriately served by the other may make both law enforcement and mental health systems appear ineffective and inefficient. This could increase the incidence of disorderly or violent behavior, which forments the myth that the seriously mentally ill are inherently dangerous. Despite the evident need to manage these issues, conventional methods of coordinating services have failed. This article concludes by developing a contracting model that creates more appropriate incentives for the two systems and bridges the gap between them.

Follow-up of Mental Care Users by Nurses in the Primary Care Setting in South Africa

“…Factors leading to the non co-ordination between the services include inadequate liaisons and communication between the two services; representatives being unskilled in the diagnosis of mental illness and decision being based less on psychiatric symptoms but more on the psychosocial and health care institutional factors (Jonsson & Moos, 2008;Wolff, 1998). The lack of intersectoral collaboration affects individuals, practitioners and service delivery as a whole (Thom, 2004).…”

The Police and Mental Health

“…Psychiatric emergencies have been dealt with effectively in communities in which close formal liaisons between law enforcement and the mental health system have been established (3,40). These arrangements facilitate the resolution of crises of persons with mental illness in the field without the need to resort to hospitalization or incarceration.…”

“…Neither the mental health system nor the law enforcement system can manage mental health crises in the community effectively without help from the other (40). If the collaboration between the two systems is to be successful, police and mental health professionals need to remember who they are.…”

Predictors of mismatched community mental health care among persons with co-occurring substance use and mental disorders

“…One possible explanation of this is a lack of resources (e.g., poor housing, financial problems) that prevents individuals from adequately coping with the social impairment of a mental disorder (Aneshensel & Phelan, 1999) which may also impede their capacity to advocate for support (Saxena, Thornicroft, Knapp, & Whiteford, 2007). The fact that legal problems also emerged as an important independent predictor of under-service may reflect long-standing and welldocumented challenges in the coordination of service across the mental health and criminal justice sectors (Wolff, 1998). With respect to the fairly strong association between under-service and personality disorders, part of the explanation may lie in the challenges that people with personality disorders might face in adhering to program guidelines despite higher levels of motivation and acute levels of symptom distress that have brought them into the treatment system (VanBeek & Verheul, 2008).…”