In a current emergency, see Someone I Know Is in Crisis.
Open this link on your smartphone for mobile psychiatric crisis information.
In the absence of a well-functioning mental health system, law enforcement officers are often the first responders called to mental health emergencies. Jails, not hospitals, are where individuals in crisis find themselves as a result.
Nearly half of all individuals with schizophrenia or bipolar disorder will be jailed at some point in their lives. Individuals with serious mental illness also are significantly more likely to be injured or killed during an encounter with law enforcement.
The following steps before and after the criminal justice involvement of a loved one with serious mental illness are provided to help you prepare and respond for this possibility.
BEFORE CRIMINAL JUSTICE INVOLVEMENT
- If your friend or family member is untreated and has a pattern of unpredictable behavior, make an effort to get to know members of your local police department by visiting your local zone or precinct station during business hours.
o Ask to speak to the community resource or other officer who works with citizens and explain the circumstances.
o Ask if the department has a crisis intervention or mobile crisis team of officers with specialized training in responding to psychiatric crisis; ask to meet with one or more of the members to describe the situation.
o Familiarize officers with the techniques you know for reassuring and calming your loved one during crisis. - If you must call 911 in an emergency, immediately tell the dispatcher, “I am calling about a psychiatric emergency.” Ask that officers trained in mental illness crisis response be dispatched to the scene. See Calling 911 for sample scripts.
- If your loved one is jailed, learn the relevant state or local policies and practices regulating treatment of mental illness behind bars.
o Ask whether pretrial evaluation to determine competency is available in the community to avoid delays in treatment or adjudication that could result if there is a shortage of psychiatric beds for this service.
o See The Treatment of Persons with Mental Illness in Prisons and Jails for information about your state’s requirements and practices.
AFTER CRIMINAL JUSTICE INVOLVEMENT
- Once your loved one is behind bars, insist upon seeing the psychiatric or medical staff serving inmates to ensure that medication schedules are maintained or treatment is restarted.
- Take all the relevant psychiatric history of your loved one – diagnosis, hospitalization history, incarceration history, medication information – to the correctional facility and insist on delivering it to the psychiatric or medical official in charge.
CRITICAL: Be sure corrections personnel are familiar with your loved one’s triggers, symptoms and typical behaviors when in crisis or symptomatic. - Jails and correctional facilities are exempt from some HIPAA provisions and can obtain medical information about an inmate for many purposes, including the provision of health care. If you do not have needed information about a loved one’s diagnosis, prescriptions and other treatment needs, the jail may be able to obtain it. Insist that they do.
- Call the county clerk’s office, county prosecutor or your own city councilman or county supervisor/commissioner to ask if your jurisdiction operates mental health courts. Mental health courts are a jail diversion practice in which qualifying offenders may be ordered into mental illness treatment – and the mental health system ordered to serve them – in lieu of incarceration.
- Determine whether the charges against your loved one are those considered by your local mental health court. Typically, mental health courts hear cases that involve non-violent misdemeanors.
- Advocate with your loved one’s public defender or attorney to seek his or her assignment to the mental health court, which links qualifying offenders to community-based treatment in lieu of incarceration.