Five months ago, an elderly family in Suffolk County dialed 911 for assistance in subduing their 35-year-old son who was diagnosed with a mental illness. According to published reports in Newsday, the very same scenario of this family or their neighbors calling the local police department to assist in subduing this particular individual, whose behavior was illustrative of someone in acute psychiatric crisis had occurred some 40 times over the course of five years. Sadly, the call five months ago was the last for the patient, who died after being subdued and restrained by local police.
Those of us in the mental health field are often not surprised at such sad news. This particular case and thousands more across our country illustrate a difficult task for law enforcement personnel, heartbreaking decisions that must be made by caring families, and a professional dilemma for our mental health system. How do we as an industry work with law enforcement, families, patients and advocates in order to respond to a rapidly increasing number of emergency calls involving the mentally ill?
Law enforcement officials in Nassau County have reported an 8 percent increase since 2000 in the number of calls involving the mentally ill in need of assistance. In 2003 Nassau County reports that the police received 2,558 such calls. According to mental health advocates, professionals and industry leaders, part of the cause has been the state's continued shutdown of psychiatric centers and long-term hospital beds. This issue has also been compounded by under-funding of our community-based mental health system, lack of insurance parity for mental illness treatment within the managed care and private health insurance fields and a growing number of younger patients ages (18-29) who present new challenges including suffering from co-occurring disabilities of mental illness and substance abuse.
The above-referenced case, which is currently under investigation, is not the norm. Most calls for assistance to law enforcement are handled both professionally and successfully, with the patient being transported to an appropriate hospital, admitted for treatment and discharged with an appropriate aftercare plan. However, when the rare case presents itself in which someone is hurt or in this instance dies, it calls attention to a significant problem within our community mental health system. It is unfair to accept the police as the default frontline in emergency mental health care, especially, without proper training and on-going assistance from mental health professionals.
What is needed to more effectively address this problem is more training, more funding, and more partnering between law enforcement and mental health. The Law and Psychiatry Institute at North Shore Long Island Jewish Health System along with state forensic professionals recently conducted a series of focus groups throughout the state including one on Long Island in order to gather information for use in a training program for police officers. Many cities and villages throughout the country are revamping their training curriculum to broaden skills related to mental illness and dealing with the mentally ill who might be in crisis in our communities. Both New York State and Nassau and Suffolk Counties have numerous programs in place to address the needs of this population. But, with limited state funding and a greater reliance on federal Medicaid dollars to fund the system, our emergency services, residential programs, case management and family support systems cannot reach everyone.
Yes, the police need more training and so do the professionals, paraprofessionals and support staff that is working on the front lines. New York State and Long Island have the ability to effectively and successfully serve the mentally ill in the community. We must continue to build meaningful partnerships with law enforcement, the legislature, the judicial system and the community-based mental health service providers to ensure that our policies and approach is the best it can be. It is time to strengthen our local mental health system in New York State and not continue to aggressively shift the burden to Washington.
We must reconsider current policies relative to fast tracking the closing of state hospital beds, while community residential resources are shrinking. While it is correct to focus on a more at-risk and potentially vulnerable population in need of community-based services, every person diagnosed with a mental illness is vulnerable and in need of community-based care. We must professionally police our own industry before we default our responsibilities to the police.