Westborough, MA August 30, 2018 In the process of writing the Police Chief’s Guide to Mental Illness: Mental Health Emergencies, Leo Polizoti, Ph.D. my co-author and I quickly discovered that it is often not easy to identify people experiencing mental health crisis or emergency. Many are not forthcoming with the specific underpinning of their particular disorder because of embarrassment and shame associated with mental disability. For many the stigma of being labelled “mentally ill” is more than they can bear. Nevertheless, “the Treatment Advocacy Center, a nonprofit that studies topics related to mental health, has calculated that the odds of being killed during a police encounter are 16 times as high for individuals with untreated serious mental illness as they are for people in the broader population” according to Nathaniel Morris, M.D. in an article espousing the benefits of having psychiatric physicians under contract to provide consultation for police encounters with the mentally ill.
A program in Albuquerque, NM does just this by having a full-time physician on the staff for both training and face-to-face consultation. This is a costly endeavor whereas the average psychiatrist earns nearly $ 200,000 annually. The thought is that as a medical doctor greater acumen in distinguishing organic syndromes like dementia from more common disorders such has depression or anxiety. I agree but other clinicians when properly trained may provide similar expertise at a more cost effective salary. Many co-responder programs have master’s level clinicians riding with law enforcement. Generally a physician is employed when you expect patients or such clientele to be prescribed medication and follow up. My sense of the New Mexico program does not include medication management in its charge. Yet even physicians have difficulty differentiating the sane from the psychologically unwell.
In a famous study, Rosenhan suggests that the label associated with being schizophrenic causes the hospital staff to make misguided assumptions about the patients’ behavior through no fault of their own. When someone is seen as mentally ill, everything they do may be interpreted as symptomatic of their disorder.