U.S. Department of Justice 

Office of Community Oriented Policing Services 

www.cops.usdoj.gov 

Pe o p l e w i t h 

M en t a l I l l n e s s 

by 

Gary Cordner 

Problem-Oriented Guides for Police 

Problem-Specific Guides Series 

No. 40 
www.PopCenter.org 

Center for Problem-Oriented Policing 

Got a Problem? We’ve got answers! 

Log onto the Center for Problem-Oriented Policing website 

at www.popcenter.org for a wealth of information to help 

you deal more effectively with crime and disorder in your 

community, including: 

• Web-enhanced versions of all currently available Guides 

• Interactive training exercises 

• Online access to research and police practices 

• Online problem analysis module. 

Designed for police and those who work with them to 

address community problems, www.popcenter.org is a great 

resource in problem-oriented policing. 

Supported by the Office of Community Oriented Policing 

Services, U.S. Department of Justice. 
Problem-Oriented Guides for Police 

Problem-Specific Guides Series 

Guide No. 40 

People with 

Mental Illness 

Gary Cordner 

This project was supported by cooperative agreement 

#2004CKWXK002 by the Office of Community Oriented Policing 

Services, U.S. Department of Justice. The opinions contained herein 

are those of the author(s) and do not necessarily represent the official 

position of the U.S. Department of Justice. References to specific 

companies, products, or services do not constitute endorsements 

from the author(s) or the Justice Department. Rather, such references 

are used to supplement discussion of the issues. 

www.cops.usdoj.gov 

ISBN: 1-932582-63-0 

May 2006 

About the Problem-Specfc Gudes Seres  

About the Problem-Specific Guides Series 

The Problem-Specific Guides summarize knowledge about 

how police can reduce the harm caused by specific crime 

and disorder problems. They are guides to prevention 

and to improving the overall response to incidents, not 

to investigating offenses or handling specific incidents. 

The guides are written for police—of whatever rank or 

assignment—who must address the specific problem the 

guides cover. The guides will be most useful to officers 

who: 

•	 Understand basic problem-oriented policing principles 

and methods. The guides are not primers in problemoriented policing. They deal only briefly with the initial 

decision to focus on a particular problem, methods to 

analyze the problem, and means to assess the results of a 

problem-oriented policing project. They are designed to help 

police decide how best to analyze and address a problem 

they have already identified. (A companion series of ProblemSolving Tools guides has been produced to aid in various 

aspects of problem analysis and assessment.) 

•	 Can look at a problem in depth. Depending on the 

complexity of the problem, you should be prepared to spend 

perhaps weeks, or even months, analyzing and responding 

to it. Carefully studying a problem before responding helps 

you design the right strategy, one that is most likely to 

work in your community. You should not blindly adopt the 

responses others have used; you must decide whether they 

are appropriate to your local situation. What is true in one 

place may not be true elsewhere; what works in one place 

may not work everywhere. 
 People wth Mental Illness 

•	 Are willing to consider new ways of doing police 

business. The guides describe responses that other police 

departments have used or that researchers have tested. 

While not all of these responses will be appropriate to 

your particular problem, they should help give a broader 

view of the kinds of things you could do. You may think 

you cannot implement some of these responses in your 

jurisdiction, but perhaps you can. In many places, when 

police have discovered a more effective response, they have 

succeeded in having laws and policies changed, improving 

the response to the problem. 

•	 Understand the value and the limits of research 

knowledge. For some types of problems, a lot of useful 

research is available to the police; for other problems, 

little is available. Accordingly, some guides in this series 

summarize existing research whereas other guides illustrate 

the need for more research on that particular problem. 

Regardless, research has not provided definitive answers to 

all the questions you might have about the problem. The 

research may help get you started in designing your own 

responses, but it cannot tell you exactly what to do. This 

will depend greatly on the particular nature of your local 

problem. In the interest of keeping the guides readable, 

not every piece of relevant research has been cited, nor has 

every point been attributed to its sources. To have done so 

would have overwhelmed and distracted the reader. The 

references listed at the end of each guide are those drawn 

on most heavily; they are not a complete bibliography of 

research on the subject. 

•	 Are willing to work with others to find effective 

solutions to the problem. The police alone cannot 

implement many of the responses discussed in the guides. 

They must frequently implement them in partnership with 
About the Problem-Specfc Gudes Seres  

other responsible private and public entities including other 
 

government agencies, non-governmental organizations, 
 

private businesses, public utilities, community groups, 
 

and individual citizens. An effective problem-solver must 
 

know how to forge genuine partnerships with others 
 

and be prepared to invest considerable effort in making 
 

these partnerships work. Each guide identifies particular 
 

entities in the community with whom police might work to 
 

improve the overall response to that problem. Thorough 
 

analysis of problems often reveals that entities other than 
 

the police are in a stronger position to address problems 
 

and that police ought to shift some greater responsibility to 
 

them to do so.
 

The COPS Office defines community policing as 

“a policing philosophy that promotes and supports 

organizational strategies to address the causes and reduce 

the fear of crime and social disorder through problemsolving tactics and police-community partnerships.” 

These guides emphasize problem-solving and police-community 

partnerships in the context of addressing specific public 

safety problems. For the most part, the organizational 

strategies that can facilitate problem-solving and policecommunity partnerships vary considerably and discussion 

of them is beyond the scope of these guides. 

These guides have drawn on research findings and police 

practices in the United States, the United Kingdom, 

Canada, Australia, New Zealand, the Netherlands, and 

Scandinavia. Even though laws, customs and police 

practices vary from country to country, it is apparent that 

the police everywhere experience common problems. In 

a world that is becoming increasingly interconnected, it is 

important that police be aware of research and successful 

practices beyond the borders of their own countries. 
v People wth Mental Illness 

The COPS Office and the authors encourage you to provide 

feedback on this guide and to report on your own agency’s 

experiences dealing with a similar problem. Your agency 

may have effectively addressed a problem using responses 

not considered in these guides and your experiences and 

knowledge could benefit others. This information will be 

used to update the guides. If you wish to provide feedback 

and share your experiences it should be sent via e-mail to 

cops_pubs@usdoj.gov. 

For more information about problem-oriented policing, visit 

the Center for Problem-Oriented Policing online at www. 

popcenter.org. This website offers free online access to: 

•	 the Problem-Specific Guides series 

•	 the companion Response Guides and Problem-Solving Tools 

series 

•	 instructional information about problem-oriented policing 

and related topics 

• an interactive training exercise
 

• online access to important police research and practices. 
 
Acknowledgments v 

Acknowledgments 

The Problem-Oriented Guides for Police are very much a 

collaborative effort. While each guide has a primary 

author, other project team members, COPS Office staff 

and anonymous peer reviewers contributed to each guide 

by proposing text, recommending research and offering 

suggestions on matters of format and style. 

The principal project team developing the guide series 

comprised Herman Goldstein, professor emeritus, 

University of Wisconsin Law School; Ronald V. Clarke, 

professor of criminal justice, Rutgers University; John 

E. Eck, professor of criminal justice, University of 

Cincinnati; Michael S. Scott, clinical assistant professor, 

University of Wisconsin Law School; Rana Sampson, 

police consultant, San Diego; and Deborah Lamm 

Weisel, director of police research, North Carolina State 

University. 

Cynthia Pappas oversaw the project for the COPS Office. 

Suzanne Fregly edited the guide. Research for the guides 

was conducted at the Criminal Justice Library at Rutgers 

University under the direction of Phyllis Schultze. 

The project team also wishes to acknowledge the members 

of the San Diego, National City and Savannah police 

departments who provided feedback on the guides' format 

and style in the early stages of the project, as well as the 

line police officers, police executives and researchers who 

peer reviewed each guide. 

Contents v 

Contents 

About the Problem-Specfc Gudes Seres . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  

Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v 

The Problem of People wth Mental Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 

Common Stuatons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 

Dangerousness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 

Harms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 

Related Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 

Factors Contrbutng to the Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 

Densttutonalzaton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 

Crmnalzaton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 

Medcalzaton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 

Prvatzaton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 

Understandng Your Local Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 

Askng the Rght Questons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 

Incdents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 

Stakeholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 

Vctms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 

Offenders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 

Locatons/Tme . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 

Measurng Your Effectveness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 

Responses to the Problem of People wth Mental Illness . . . . . . . . . . . . . . . . . . . . . 19 

General Consderatons for an Effectve Response Strategy . . . . . . . . . . . . . . . . 19 

Specfc Responses to People wth Mental Illness . . . . . . . . . . . . . . . . . . . . . . . . 22 

Improvng the Polce Response to Incdents . . . . . . . . . . . . . . . . . . . . . . . . . 22 

Workng Wth Stakeholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 

Protectng Vctms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 

Targetng Offenders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 

Targetng Locatons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 

Responses Wth Lmted Effectveness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 
v People wth Mental Illness 

Appendx: Summary of Responses to People wth Mental Illness . . . . . . . . . . . . . . . 41 

Endnotes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 

About the Author . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 

Recommended Readngs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 

Other Problem-Orented Gudes for Polce . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 
The Problem of People wth Mental Illness 1 

The Problem of People with 

Mental Illness 

Problems associated with people with mental illness pose 

a significant challenge for modern policing.

1 This guide 

begins by describing the problem and reviewing factors 

that increase the challenges that police face in relation 

to the mentally ill. It then identifies a series of questions 

that might help you analyze your local policing problems 

associated with people with mental illness. Finally, it reviews 

responses to the problems and what we know about these 

from evaluative research and police practice. 

Police officers frequently encounter people with mental 

illness—approximately 5 percent of U.S. residents have 

a serious mental illness,

§ and 10 to 15 percent of jailed 

people have severe mental illness.

2 An estimated 7 percent 

of police contacts in jurisdictions with 100,000 or more 

people involve the mentally ill.

3 A three-city study found 

that 92 percent of patrol officers had at least one encounter 

with a mentally ill person in crisis in the previous month,

4 

and officers averaged six such encounters per month. The 

Lincoln (Nebraska) Police Department found that it handled 

over 1,500 mental health investigation cases in 2002, and 

that it spent more time on these cases than on injury traffic 

accidents, burglaries, or felony assaults.

5 The New York City 

Police Department responds to about 150,000 “emotionally 

disturbed persons” calls per year.

6 

It is important to recognize at the outset that mental illness 

is not, in and of itself, a police problem. Obviously, it is a 

medical and social services problem. However, a number 

of the problems caused by or associated with people with 

mental illness often do become police problems. These 

include crimes, suicides, disorder, and a variety of calls 

for service. Moreover, the traditional police response to 

people with mental illness has often been ineffective, and 

sometimes tragic. 

§ Unfortunately there is not one 

standard definition of mental illness. 

Medical doctors, research scientists, 

psychiatrists, psychologists, and 

social workers define it differently 

depending on whether their focus 

is more on organic conditions, 

personality, or behavior. One 

working consensus definition 

designed for policy makers is 

“Mental illness is a biopsychosocial 

brain disorder characterized by 

dysfunctional thoughts, feelings, 

and/or behaviors that meet DSMIV diagnostic criteria” (Kelly, 2002). 

The same report identifies the main 

examples of serious mental illness 

as: 

• All cases of schizophrenia 

(a psychotic disorder) 

• Severe cases of major depression 

and bipolar disorder (mood 

disorders) 

• Severe cases of panic disorder, 

obsessive-compulsive disorder, 

and post-traumatic stress disorder 

(anxiety disorders) 

• Severe cases of attention deficit/ 

hyperactivity disorder (typically, a 

childhood disorder) 

• Severe cases of anorexia nervosa 

(an eating disorder). 

Timothy A. Kelly (2002) “A 

Policymaker’s Guide to Mental 

Illness.” Washington, DC: The 

Heritage Foundation. http://www. 

heritage.org/Research/HealthCare/ 

BG1522.cfm. 
2 People wth Mental Illness 

Over the last decade, many police agencies have sought 

to improve their response to incidents involving people 

with mental illness, especially emergency mental health 

situations. These new developments, however, have been 

targeted almost exclusively at improved handling of 

individual incidents. Little attention has been devoted 

to developing or implementing a comprehensive and 

preventive approach to the issue. 

Common Situations 

Police officers encounter people with mental illness in 

many different types of situations, in roles that include 

criminal offenders, disorderly persons, missing persons, 

complainants, victims, and persons in need of care (see 

table). According to one Texas study,

7 the five most 

frequent scenarios are as follows: 

• A family member, friend, or other concerned person calls 

the police for help during a psychiatric emergency. 

• A person with mental illness feels suicidal and calls the 

police as a cry for help. 

• Police officers encounter a person with mental illness 

behaving inappropriately in public. 

• Citizens call the police because they feel threatened by the 

unusual behavior or the mere presence of a person with 

mental illness. 

• A person with mental illness calls the police for help 

because of imagined threats. 

Of these typical situations, ones involving the threat of 

suicide were rated as the most difficult to handle. Each 

of the others listed above was rated as somewhat difficult 

to handle. The two behaviors that were rated as most 

problematic overall were threatening suicide and nuisance 

behaviors. 
The Problem of People wth Mental Illness 3 

Roles of People with Mental Illness and Examples 

Role Examples 

Offender • A person with mental illness commits a personal or property 

crime. 

• A person with mental illness commits a drug crime. 

• A person with mental illness threatens to commit suicide. 

• A person with mental illness threatens to injure someone else 

in the delusional belief that that person poses a threat to him 

or her. 

• A person with mental illness threatens to injure police as a 

means of forcing police to kill him (commonly called “suicide 

by cop”). 

Disorderly person • A family or community member reports annoying or disruptive 

behavior by a person with mental illness. 

• A hospital, group home, or mental health facility calls for 

police assistance in controlling a person with mental illness. 

• A police officer on patrol encounters a person with mental 

illness behaving in a disorderly manner. 

Missing person • A family member reports that a person with mental illness is 

missing. 

• A group home or mental health institution reports that a 

person with mental illness walked away and/or is missing. 

Complainant • A person with mental illness calls the police to report real or 

imagined conditions or phenomena. 

• A person with mental illness calls the police to complain about 

care received from family members or caretakers. 

Victim • A person with mental illness is the victim of a personal or 

property crime. 

• A family member, caretaker, or service provider neglects or 

abuses a person with mental illness. 

Person in need of 

care 

• Police are asked to transport a person with mental illness to or 

from a hospital or mental health facility. 

• Police encounter a person with mental illness who is neglecting 

his or her own basic needs (food, clothing, shelter, medication, 

etc.). 
4 People wth Mental Illness 

These are the most common situations in which police 

encounter people with mental illness. It is important to 

realize, though, that when police officers handle some 

of these situations they do not always realize that mental 

illness is involved (such as a shoplifting or a disorderly 

person). Officers may try to handle the situation as 

usual (by giving directions, issuing commands, or making 

an arrest, for example) but not get the cooperation or 

compliance expected, sometimes leading to escalating 

tension. This highlights the importance of training in 

mental illness recognition as well as crisis management 

techniques. 

Dangerousness 

A fairly common perception is that people with mental 

illness are disproportionately involved in violent crime. 

This is true in one respect but not in another. A small 

subset of people with mental illness, those who are 

actively experiencing serious psychotic symptoms, are 

more violent than the general population. Research 

suggests several factors associated with this group’s 

violent behavior, including drug and alcohol abuse, 

noncompliance with medication requirements, and 

biological or biochemical disorders.

8 In general, however, 

“violent and criminal acts directly attributable to mental 

illness account for a very small proportion of all such 

acts in the United States. Most persons with mental illness 

are not criminals, and of those who are, most are not 

violent.”9 

Police interactions with people with mental illness can be 

dangerous, but usually are not. In the United States, 982 

of 58,066 police officers assaulted in 2002, and 15 of 636 

police officers feloniously killed from 1993 to 2002, had 

“mentally deranged” assailants.

10 These represent one out 

of every 59 assaults on officers and one out of every 42 
The Problem of People wth Mental Illness 5 

officers feloniously killed—relatively small portions of all 

officers assaulted and killed. 

Encounters with police are more likely to be dangerous 

for people with mental illness than for the police. An 

early study found that an average of nine New York City 

police shootings per year between 1971 and 1975 involved 

emotionally disturbed people.

11 Between 1994 and 1999, 

Los Angeles officers shot 37 people during encounters 

with people with mental illness, killing 25.

12 A review 

of shootings by the police from 1998 to 2001 in the 

United Kingdom indicated that almost half (11 out of 24) 

involved someone with a known history of mental health 

problems.

13 It is estimated that people with severe mental 

illness are four times more likely to be killed by police.

14 

Serious injury and death of people with mental illness at 

the hands of the police are especially tragic, for obvious 

reasons. Reduction of such injuries and deaths should be a 

high-priority objective for every police agency. 

Harms 

The harms associated with the police handling of people 

with mental illness are implicit in the situations and 

examples the table provides, but deserve some discussion. 

A person with mental illness may harm other citizens by 

committing personal or property crimes or engaging in 

disorderly and disruptive behavior. Alternatively, a person 

with mental illness may be harmed as a crime victim, as an 

abused family member or patient, as a person who suffers 

through self-neglect, or as a person whose mental health 

problem has left him or her erroneously subjected to 

criminal charges and jail confinement. Society in general 

may be harmed if excessive police, criminal justice, and/or 

medical resources are consumed by problems associated 

with people with mental illness. 
6 People wth Mental Illness 

It is important to keep the concept of harm in mind 

when addressing this particular problem, because there 

is a tendency to simply define people with mental illness 

as the problem, and getting them out of sight as the 

solution. In contrast to most police problems, however, 

this is not one that involves wholly voluntary behavior— 

rather, it involves behavior that medical conditions cause 

or compound. Consequently, police have to be careful not 

to blame people with mental illness, but instead focus on 

behavior that causes harm to self or others. 

Related Problems 

The police problem of people with mental illness is 

closely connected to three other problems noted below. 

This guide does not specifically address these problems, 

but addressing people with mental illness in your 

jurisdiction may require that you take on these problems, 

as well: 

• homelessness 

• drug abuse 

• alcohol abuse 

The people the police encounter who have mental health 

problems or emergencies are also frequently homeless. 

For example, a Honolulu study found that 74 percent of 

law violators who the police believed to have a mental 

disorder were also homeless.

15 In London, about 30 

percent of minor offenders referred for admission to 

a station-house diversion program for the “mentally 

disordered” were living on the streets.

16 
The Problem of People wth Mental Illness 7 

Similarly, the people with mental illness the police 

encounter are likely to have substance abuse problems. 

About three-quarters of jail and prison inmates with 

mental illness also have a substance abuse problem.

17 

Current substance abuse was identified for about half of 

psychiatric emergency room referrals in New York State,

18 

and nearly two-thirds of psychiatric emergency patients 

evaluated by a police-mental health outreach team in Los 

Angeles were known to be serious substance abusers.

19 

Factors Contributing to the Problem 

Understanding the factors that contribute to your problem 

will help you frame your own local analysis questions, 

determine good effectiveness measures, recognize key 

intervention points, and select appropriate responses. Four 

important factors that strongly affect the current mental 

health situation in America are deinstitutionalization, 

criminalization, medicalization, and privatization. 

Deinstitutionalization 

Perhaps the single biggest factor affecting the policing of 

people with mental illness has been deinstitutionalization.

20 

During the 20th century, and especially after 1960, 

public attitudes, laws, and professional mental health 

practices changed, leading to the closing of many state 

hospitals, psychiatric hospitals, and what used to be called 

insane asylums. Society’s preference shifted away from 

institutionalizing people with mental illness. Unfortunately, 

adequate community-based services to pick up the slack 

were never provided. This vacuum persists to this day, to 

the extent of complete failure of the mental health system 

in many jurisdictions. 
8 People wth Mental Illness 

Criminalization 

After deinstitutionalization, many people with serious 

mental illnesses were returned to the community, but 

adequate community-based services were not established. 

Predictably, calls to the police about crimes and disorder 

involving people with mental illness increased.

21 Police 

tried to handle many of these calls informally, but if 

the behavior persisted, options were limited. Frequently, 

efforts at civil commitment were unsuccessful (the person 

had to pose a danger to him- or herself or others), and 

other inpatient or outpatient mental health services were 

unavailable, cumbersome, or uncooperative. Inevitably, 

police often turned to arrest and a trip to jail as the 

only available solution to the immediate problem. This 

had the general effect of criminalizing mental illness 

and reinstitutionalizing people with mental illness—but 

in jail or prison instead of a psychiatric facility. One 

analysis concluded that “in 1955, [0].3 percent of the 

U.S. population was mentally ill and residing in a mental 

institution; whereas in 1999, [0].3 percent of the national 

population is mentally ill and is in the criminal justice 

system.”22 

Medicalization 

The dominant treatment for mental illness has evolved 

from electric shock and psychotherapy more toward 

medication. To be sure, other treatments remain viable, 

and combined treatments are generally preferred, but 

today, medication plays a central role. Consequently, an 

important aspect of community-based mental health 

care is getting noninstitutionalized people with mental 

illness to take their medication as prescribed.

23 Factors 

that interfere with regular use of prescribed medications 
The Problem of People wth Mental Illness 9 

include the negative side effects associated with some 

drugs, the high cost of medication, the tendency to 

self-medicate, the abuse of illegal drugs and alcohol, 

and the lack of monitoring/follow-up by the overtaxed 

community-based mental health system. 

Privatization 

Many of today’s community-based mental health facilities, 

especially group homes, are operated by private individuals 

or companies. To be sure, government-run mental health 

facilities can be inefficient, callous, and neglectful. 

However, private profit-making facilities introduce another 

issue—greed. Privately run facilities have an inherent 

incentive to cut expenses; this often translates into 

minimum staffing levels and low-paid staff, which in turn 

results in a facility that relies on the police to help manage 

patients/clients. As a result, police resources are wasted 

and people with mental illness do not get the quality of 

care that they deserve. 

Understandng Your Local Problem 11 

UnderstandingYour Local Problem 

The information provided above is only a generalized 

description of police problems associated with people 

with mental illness. You must combine the basic facts 

with a more specific understanding of your local problem. 

Analyzing the local problem carefully will help you design 

a more effective response strategy. 

Asking the Right Questions 

The following are some critical questions you should 

ask in analyzing your particular problem of people with 

mental illness, even if the answers are not always readily 

available. Your answers to these and other questions will 

help you choose the most appropriate set of responses 

later. 

Incidents 

It is important to gather information about the quantity 

and types of incidents involving people with mental 

illness. A jurisdiction may find that one or two particular 

types of incidents constitute a large part of its problem, 

providing a focus for analysis and response. This 

information may be difficult to obtain, however, because 

many police agencies’ call classification systems do not 

include a code for “person with mental illness,” “mental 

health emergency,” or “emotionally disturbed person.” 

If the police department’s communications system does 

not provide reliable data, it may be necessary to do a 

special study in which officers and dispatchers record 

this type of information for some months to facilitate 

problem analysis. Another option is to backtrack from 
12 People wth Mental Illness 

known indicators of incidents involving people with 

mental illness. For example, if one call at an address is 

found to involve a victim with mental illness or a false 

complaint reported by someone with mental illness, all 

previous calls at that address could be analyzed to check 

for a hidden hot spot. Similarly, all previous calls involving 

the particular person (victim or complainant) could be 

extracted from the department’s computer system to 

determine if the individual might be an unrecognized 

repeat victim or repeat false complainant. 

You should not overlook other data sources. Hospitals 

(general and/or psychiatric), ambulance services, and 

community-based mental health agencies might have 

useful data on commitments, referrals, and transports. 

In addition, academic institutions and mental health 

advocates might have conducted studies of the mental 

health situation in your jurisdiction, or they might be 

willing to partner with the police agency in conducting 

such studies. 

• How many total incidents involving people with mental 

illness does your agency handle in a year, and how 

much police time is consumed? 

• How many of each type of incident involving people 

with mental illness does the agency handle in a year, 

and how much police time does each consume? 

• How do police handle incidents (informal handling, 

formal referral, involuntary commitment, arrest, etc.) 

for each type of incident involving people with mental 

illness? 

• How often do officers use force when handling 

incidents involving people with mental illness? 

• How often are officers injured when handling incidents 

involving people with mental illness? 

• What proportion of people with mental illness whom 

officers encounter are homeless and/or serious 

substance abusers? 
Understandng Your Local Problem 13 

Stakeholders 

It is important to identify institutions, organizations, and 

individuals in the community who play significant official 

or unofficial roles in the mental health system. Since most 

police officers are not intimately familiar with all the 

players in the mental health system, these stakeholders and 

potential guardians may not be well known or obvious. 

Because these entities can contribute expertise, authority, 

and resources, though, it is very beneficial to identify 

them and, if possible, engage them as participants in 

collaborative problem-solving. 

• What public and private inpatient and outpatient 

psychiatric/mental health facilities (psychiatric hospitals 

and wards) are located in or serve the jurisdiction? 

• What other residential facilities serving people with 

mental illness (group homes, assisted living facilities, 

nursing homes, etc.) are located in or serve the 

jurisdiction? 

• What other services for persons with mental illness are 

provided in the jurisdiction through the public health 

department, general hospitals, counselors, therapists, 

etc.? 

• What laws and regulations govern the mental health 

system’s operation in your jurisdiction? 

• What advocacy organizations representing people with 

mental illness, such as the National Alliance for the 

Mentally Ill or the Mental Health Association, are in the 

jurisdiction? 

• What types of mental health services does the local jail 

provide? 

• What institutions and organizations provide services in 

the jurisdiction for people who are homeless or who 

have serious substance abuse problems? 

• In regard to each of the items above, how does the 

system differ for minors (juveniles)? 
14 People wth Mental Illness 

Victims 

Identifying victims is important because certain categories 

of people, or even some specific individuals, may be 

more heavily victimized than others, suggesting avenues 

for problem-solving activity. Victims in situations 

involving people with mental illness might include 

specific community members, mental health workers, 

family members, or the mentally ill themselves. When 

any of these people become crime victims, the police 

may be notified, although of course many crimes also 

go unreported. Unfortunately, even when reported, such 

crimes may not be flagged or marked as involving a 

person with mental illness. This can make it difficult to 

identify both one-time and repeat victims. 

• When people with mental illness commit a crime, who 

are the victims (strangers, businesses, caregivers, etc.)? 

Who are repeat victims? 

• When people with mental illness cause nuisances and 

disorder, who are the victims? Who are repeat victims? 

• When crimes are committed against people with 

mental illness, who are the victims and what are their 

circumstances (family members, institutional residents, 

etc.)? Who are repeat victims? 

• When people with mental illness are neglected and/or 

abused, who are they and what are their circumstances? 

Who are repeat victims of neglect and abuse? 

Offenders 

It is important to look for people who cause a 

disproportionate share of the problem. People with 

mental illness may be offenders, or others may commit 

offenses against them. As mentioned above, however, it 
Understandng Your Local Problem 15 

can be difficult to identify cases involving people with 

mental illness from police data, thus making it challenging 

to identify offenders and repeat offenders associated with 

such cases. 

• Which people with mental illness commit personal and 

property crimes? Who are the repeat offenders? 

• Which people with mental illness cause nuisances and 

disorder? Who are the repeat offenders? 

• What crimes do people commit against people with 

mental illness? Who are the offenders? Who are the 

repeat offenders? 

• Who neglects and/or abuses people with mental illness? 

Who are the repeat offenders? 

Locations/Times 

The locations and times of incidents and crimes involving 

people with mental illness may be important to identify. 

Typical locations include public places (such as parks, 

business districts), businesses, and residences. Particularly 

important to look at, though, are hospitals, clinics, 

homeless shelters, drop-in shelters, and group homes. 

These places may have concentrations of people with 

mental illness, or they may be common destinations for 

people who experience serious chronic mental illness or 

episodic mental health crises. There may also be certain 

times of the day, days of the week, or weeks of the 

year that the incidence of calls involving people with 

mental illness is particularly high. The routine schedules 

of agencies that assist people with mental illness might 

influence these peak times. 

• Where do incidents and crimes involving the people 

with mental illness occur? 

• Where are the jurisdiction’s “hot spots” of incidents 

and crimes involving people with mental illness? 
16 People wth Mental Illness 

• Do different types of incidents and crimes involving 

people with mental illness cluster in different locations? 

If so, where are those locations? 

• Are there particular times of the day, days of the week, 

or weeks of the year in which the incidence of calls 

involving people with mental illness is especially high or 

low? 

Measuring Your Effectiveness 

Measurement allows you to determine to what degree 

your efforts have succeeded, and suggests how you 

might modify your responses if they are not producing 

the intended results. You should take measures of your 

problem before you implement responses, to determine how 

serious the problem is, and after you implement them, to 

determine whether they have been effective. All measures 

should be taken in both target areas and surrounding 

areas, if applicable. (For more detailed guidance on 

measuring effectiveness, see the companion guide to this 

series, Assessing Responses to Problems: An Introductory Guide 

for Police Problem-Solvers.) 

The following are potentially useful measures of the 

effectiveness of police responses to problems associated 

with people with mental illness: 

• reduced victimization of people with mental illness 

• reduced repeat victimization of people with mental 

illness 

• reduced total calls for service involving people with 

mental illness 

• reduced calls for service at hot spots (although you 

should take care to ensure that, for example, reduced 

calls from a group home are not caused by a facility 

operator’s preventing residents from reporting abuse or 

neglect) 
Understandng Your Local Problem 17 

• reduced amount of police time consumed by calls 

involving people with mental illness 

• reduced total calls for each type of situation involving 

people with mental illness (especially if police target 

their efforts toward specific types of situations) 

• reduced arrests of people with mental illness (assuming 

that more effective alternatives to arrest are available) 

• reduced civil commitments of people with mental 

illness (although it might be desirable to increase the 

volume of civil commitments for some period if civil 

commitment is a preferred alternative to criminal arrest) 

• increased referrals of people with mental illness to 

community-based services 

• reduced injuries to people with mental illness caused by 

police officers 

• reduced injuries to police officers caused by people with 

mental illness 

• increased “customer” satisfaction—post-incident 

satisfaction of complainants, victims, and offenders 

• increased “expert” satisfaction—high ratings of police 

effectiveness by mental health and legal professionals. 

Responses to the Problem of People wth Mental Illness 19 

Responses to the Problem of People 

with Mental Illness 

Your analysis of your local problem should give you 

a better understanding of the factors contributing to 

it. Once you have analyzed your local problem and 

established a baseline for measuring effectiveness, 

you should consider possible responses to address the 

problem. 

General Considerations for an Effective 

Response Strategy 

The following response strategies provide a foundation 

of ideas for addressing your particular problem. These 

strategies are drawn from a variety of research studies 

and police reports. Several of these strategies may apply 

to your community’s problem. It is critical that you tailor 

responses to local circumstances, and that you can justify 

each response based on reliable analysis. In most cases, 

an effective strategy will involve implementing several 

different responses. Law enforcement responses alone are 

seldom effective in reducing or solving the problem. Do 

not limit yourself to considering what police can do: give 

careful consideration to whom else in your community 

shares responsibility for the problem and can help police 

better respond to it. 

You will note that one set of responses fits under the 

label “improving the police response to incidents.” 

Normally, problem-oriented policing is not very concerned 

with improving incident response—rather, it is focused 

on the underlying problems and conditions that give rise 

to incidents. In the case of people with mental illness, 

however, it is widely recognized that traditional police 
20 People wth Mental Illness 

response to incidents has been unsatisfactory, and a 

tremendous amount of attention has been focused on 

improving incident response over the past decade. It 

has been much less common, so far, for police to take 

a problem-oriented approach to situations involving 

people with mental illness. The responses described below 

address both the incident-oriented and problem-oriented 

approaches. 

1. Working with the mental health community. Mental 

health professionals and others who work with or as 

advocates for people with mental illness can be viable 

partners with the police. They can provide training and 

direct assistance during emergencies, as described below.

24 

They provide inpatient and outpatient services for people 

with mental illness and operate emergency facilities. There 

seems to be a general recognition that “neither the mental 

health system nor the law enforcement system can manage 

mental health crises in the community effectively without 

help from the other.”25 

Working together can be a challenge, however. The 

police responsibility to reduce disorder and hold 

offenders to account does not always square with the 

clinical and treatment goals of mental health providers. 

For these reasons as well as privacy and confidentiality 

considerations, the law enforcement and mental health 

systems sometimes fail to share information fully or 

quickly. Also, each system has a tendency to want to 

unload problematic individuals onto the other system.

26 

Police often complain about the difficulty of getting 

hospitals to accept responsibility for people in crisis, while 

mental health professionals often complain that the police 

are too quick to seek civil commitment and too prone to 

place criminal charges. 
Responses to the Problem of People wth Mental Illness 21 

The police problems associated with people with mental 

illness provide an opportunity for collaboration and 

partnerships.

27 A number of agencies and individuals, 

besides the police, have a professional interest in, and 

responsibility for, preventing incidents and tragedies as 

well as improving immediate and follow-up services. 

Others, including people with mental illness and their 

families, have a more personal but no less compelling 

interest in the same ends. Police departments should 

take the lead, if necessary, in building collaboration and 

partnerships among these groups to enhance incident 

response, coordination, and prevention. 

2. Working with emergency hospitals. Those emergency 

hospitals (whether general hospitals or specialized 

psychiatric hospitals) to which police may take people 

in crisis are important elements of the mental health 

system. Police agencies should meet with staff of these 

hospitals periodically to clarify expectations, develop 

workable protocols, and address problems and issues. For 

example, it should be clear when an officer must remain 

at the hospital and when hospital security can take over. It 

should be clear whether either the police or an ambulance 

is responsible for transporting a patient to another facility. 

It should be the responsibility of police commanders and 

specialists to work these matters out in advance, so that 

patrol officers with people in crisis at 2 a.m. do not have 

to argue and debate with hospital staff. 

3. Appointing police liaison officers. Issues related to 

people with mental illness need champions within the 

police department, or else they run the risk of falling 

through the cracks. Some police departments appoint an 

officer or commander to serve as liaison to the entire 
22 People wth Mental Illness 

mental health community, including sitting on appropriate 

boards and committees. In addition, some departments 

appoint liaison officers for each mental health facility 

(hospital, shelter, group home, etc.) in the jurisdiction. 

These facility liaison officers can be particularly effective 

for problem-solving location-specific issues to reduce and 

prevent crimes, disorder, and calls for service at current 

and potential hot spots (see responses below under 

“Targeting Locations”). 

Specific Responses to People with Mental Illness 

Improving the Police Response to Incidents 

4. Training generalist police officers. Training should 

be regarded as a promising method for improving the 

police response to incidents involving people with 

mental illness, but it is no panacea and should not be 

regarded as the complete solution to the problem.

28 

Some police academies use role-playing—sometimes with 

trained actors—to teach police officers how to handle 

incidents involving people with mental illness.

29 Proper 

training typically integrates lecture, discussion, tours of 

mental health facilities, and role-playing.

30 Many states 

now require that police officers receive preservice and 

in-service training in dealing with people with mental 

illness.

31 

Although some training on handling mental health crises 

is provided in most police academies,

32 it may not be 

adequate. A British survey found that 61 percent of police 

officers felt inadequately trained to deal with problems 

associated with people with mental illness.

33 A study of 

Pennsylvania police departments found that 47 percent of 

respondents disagreed that they were “qualified to manage 

persons with mental illness.”34 
Responses to the Problem of People wth Mental Illness 23 

The aim of training is typically “to enhance officers’ 

understanding of mental disabilities and their symptoms, 

to increase the knowledge of available community 

resources and dispositional alternatives, and to develop 

some basic crisis communication skills.”35 It is also 

important to train police to “make decisions free 

of prejudice, preformed attitudes, and stereotypical 

approaches.”36 Evaluations indicate that such training can 

succeed in improving understanding and knowledge, but 

that it is more difficult to change police officers’ attitudes 

and behaviors. Training that exaggerates the danger 

involved in police encounters with people with mental 

illness can lead to premature and excessive use of force, 

but realistic training with role-playing might significantly 

reduce police use of deadly force when dealing with 

emotionally disturbed people.

37 A review of the evidence 

on the effectiveness of training for generalist patrol 

officers concluded that “educational programs and crisis 

intervention training are probably not harmful and may 

be helpful, but there is good reason to believe that they 

are not sufficient to change fundamentally the nature of 

police encounters with mentally ill persons in crisis.”38 

5. Providing more information to patrol officers. 

Ordinary patrol officers called up on to handle incidents 

involving people with mental illness can benefit from 

at least two types of specific information. One is 

information about clinics, shelters, and mental health 

services that are available in the community. Armed 

with this type of information, officers may be able to 

effectively refer people with mental illness to agencies 

better suited to provide treatment and other services, 

and/or to provide such information to family members 

or other potential guardians. Departments might provide 

this information to officers via brochures, printed referral 

agency directories, or the agency’s online intranet or web 

site. 
24 People wth Mental Illness 

A second type of information that might be valuable 

for patrol officers pertains to community members 

with a history of mental illness. People who repeatedly 

report fictional events, for example, or who have had 

mental health crises that led to violent encounters with 

officers, might be logged in a database or flagged in 

the department’s dispatching system. The purpose of 

this information would be to forewarn an officer who 

subsequently is dispatched to a chronic caller’s address, or 

who encounters a potentially violent person. Otherwise, 

especially in a large department, officers find themselves 

at a disadvantage dealing with people whom they know 

nothing about, despite the fact that the people have a 

history with other agency officers.

39 

Of course, the compilation and dissemination of this 

type of information raises some legal and privacy issues 

that have to be carefully addressed (one would hope that 

everyone with a police scanner would not hear that “a 

known mental case resides at that address” or some similar 

announcement). Another concern is labeling—advance 

information about a person’s mental illness history might 

prejudice an officer’s decision-making. One study found 

that advance information about a suspect did not affect 

officer arrest decisions in a minor crime situation, but 

officers were “less willing to investigate and take action on 

behalf of a victim with mental illness.”40 

6. Using less-lethal weapons. Police officers can resolve 

most tense and threatening situations involving people 

with mental illness by maintaining a calm demeanor, using 

good oral and nonverbal communication, and using proper 

tactics, but when those techniques fail, it is crucial to have 

additional alternatives short of deadly force. Too often in 

the past in encounters with people experiencing mental 

health crises, officers have used poor tactics and then 
Responses to the Problem of People wth Mental Illness 25 

turned immediately to the use of deadly force.

41 Today, 

the practicality and effectiveness of less-lethal police 

weapons, including pepper spray and stun guns, have 

improved and police agencies should explore obtaining 

those that are reliable and affordable. In particular, lesslethal weapons offer police officers important alternatives 

in those situations when a person with mental illness is 

wielding a knife or a blunt object in a threatening manner, 

or when the person’s strength threatens to overwhelm 

the officer. Needless to say, police agencies need to have 

clear policies and procedures in place that guide officers’ 

use-of-force decisions and ensure that police use the leastnecessary amount of force. 

7. Deploying specialized police officers. In recent 

years, the most popular approach to improving police 

response to incidents involving people with mental illness, 

and especially crisis incidents, has been specialization. 

Departments have seen the value of preparing specialist 

officers or even special units to handle these situations, 

relieving regular patrol officers of that responsibility. 

Specialists can be carefully selected and given extra 

training, and then over time they acquire substantial 

experience, all of which should contribute to better 

performance. 

The Memphis, Tennessee CIT (Crisis Intervention Team) 

model is the most pervasive.

42 A cadre of selected patrol 

officers (10 to 20 percent of those assigned to patrol) 

receive extra training (40 hours initially) and then serve 

as generalists/specialists—they perform the full-range 

of regular patrol duties, but respond immediately (from 

anywhere in the city) whenever crisis situations occur 

involving people with mental illness. In those situations, 

these officers assume on-scene command as soon as they 

arrive. They are trained to handle the crisis situations 
26 People wth Mental Illness 

as well as to facilitate the delivery of treatment and 

other services. In particular, they become knowledgeable 

about voluntary and involuntary commitment, plus they 

become well known to professionals in the mental health 

community, facilitating the delivery of treatment and other 

services to the people in crisis. 

Evidence indicates that the CIT model has worked 

effectively in Memphis.

43 Response times are generally 

under 10 minutes, the CIT officers handle 95 percent of 

all mental disturbance calls, regular patrol officers support 

the program, police time spent waiting for mental health 

admissions is dramatically down, arrest rates of people 

with mental illness are low, referrals to treatment are high, 

police-caused injuries suffered by people with mental 

illness are down, officer injury rates are down, and callouts of the Special Weapons and Tactics team are down. A 

recent CIT evaluation in Louisville, Kentucky also found 

that “in addition to reducing use of force, officer injury, 

and criminalization of mental illness, CIT programs may 

save money and reduce psychiatric morbidity by referring 

severely ill subjects to appropriate treatment earlier than 

might occur otherwise.”44 

Several limitations of the Memphis CIT model for smaller 

agencies should be noted.

45 First, in small agencies, at 

least half of, if not all, officers would need the specialized 

training so that a CIT officer would always be on duty; 

in such a situation, picking these officers could not be as 

selective as in Memphis, since every officer or every other 

officer would be selected. Also, the likelihood that those 

officers in a small agency would gain substantial additional 

experience in handling people in mental health crisis 

would be reduced, simply because the volume of such 

situations would be limited. In addition, a key factor in the 

success of the CIT model is networking and collaboration 
Responses to the Problem of People wth Mental Illness 27 

between police and mental health service providers. In a 

small jurisdiction, however, such providers may be totally 

absent, and certainly not available around the clock. 

Consequently, the CIT model may not be as effective 

in smaller jurisdictions as it is in larger ones. That said, 

it may still be more effective than other alternatives, 

especially the alternative of providing officers with no 

special training in dealing with people with mental illness. 

8. Deploying specialized nonpolice responders. An 

alternative to specialized police response to calls and 

crises involving people with mental illness is specialized 

nonpolice response. This usually involves response by 

social workers/mental health clinicians or some kind of 

combined sworn police and nonsworn civilian response.

46 

The nonpolice approach is generally based on the belief 

that educated and trained mental health professionals 

have skills and knowledge that most police officers do 

not. The combined model adds the recognition that 

situations involving people in mental health crisis can 

be dangerous and may require the use of physical force 

and/or enforcement of the criminal law, capacities that are 

provided by police officers, not social workers or mental 

health clinicians. 

Implementation of these nonpolice and combined models 

can be even more complicated and challenging than the 

Memphis CIT model, because social workers and mental 

health professionals are not routinely available 24 hours 

a day or typically dispatched to emergencies in the field. 

Nevertheless, models of this type have been used in 

Birmingham (Alabama), Knoxville (Tennessee), Burlington 

(Vermont), Los Angeles, San Diego, and a number of 

other cities.

47 Comparative analysis suggests that these 

nonpolice alternatives do not succeed in handling as high 
28 People wth Mental Illness 

a proportion of applicable calls and do not achieve as 

quick a response as the CIT model, but they may resolve 

a greater proportion of incidents at the scene or through 

referral, whereas the CIT approach tends to rely on 

transporting the person in crisis to a treatment location.

48 

The choice between police and nonpolice specialized 

responses largely depends on available resources. If 

a jurisdiction can afford both, it should employ both. 

Where available, the services of a trained clinician at 

the scene of a mental health crisis seems to help divert 

people away from the criminal justice and emergency 

medical systems in favor of informal handling and referral 

to nonemergency treatment providers. In most cases, 

however, sufficient social work/mental health resources 

are rarely available to provide prompt mobile response 

to a majority of incidents. In these situations, specialized 

police response seems to help prevent tragedies and 

unnecessary criminalization and to provide a number of 

other positive outcomes, as noted above. 

Working with Stakeholders 

9. Initiating assisted outpatient treatment. A result of 

deinstitutionalization is that many people with serious 

mental illness live in the community. For a variety of 

reasons, these people often fail to adhere to prescribed 

treatment, including medication. In most states, if 

a person is under court jurisdiction, a condition of 

remaining in the community can be compliance with 

prescribed treatment. Studies in New York, North 

Carolina, and elsewhere have demonstrated that when 

mechanisms are in place to encourage adherence to 

prescribed treatment, problems are reduced.

49 Assisted 

outpatient treatment (AOT), also called outpatient 

commitment, uses enforcement of treatment plans by 

mental health workers or others (sometimes including 
Responses to the Problem of People wth Mental Illness 29 

police) to increase compliance. Results indicate that “AOT 

is effective in reducing the incidents and duration of 

hospitalization, homelessness, arrests and incarcerations, 

victimization, and violent episodes. AOT also increases 

treatment compliance and promotes long-term voluntary 

compliance.”50 

10. Establishing crisis response sites. Several 

jurisdictions, including Memphis, Montgomery County 

(Pennsylvania), and Multnomah County (Oregon) have 

established specific facilities where police can transport 

people in mental health crisis, as an alternative to the 

general hospital emergency room or jail.

51 These sites 

are usually located within hospitals. What sets them apart 

from the norm is their identification as a central drop-off 

point, the availability of both mental health and substance 

abuse services, a no-refusal policy for police (although this 

does not mean that inpatient stays are guaranteed), and 

their streamlined intake procedures (usually 30 minutes or 

less for officers). These features have resulted in reduced 

police officer frustration and reduced reliance on arrest 

and jail to deal with people with mental illness. 

11. Establishing jail-based diversion. It is inevitable 

that some people with mental illness will be arrested 

for minor crimes and disorder. When these people 

get to jail and are identified as suffering from serious 

illness, they can be diverted immediately after booking 

(with special conditions), as soon as the case is reviewed 

for prosecution (through deferred prosecution with 

conditions), or as soon as the case comes to court (by 

summary probation with conditions).

52 Techniques like 

these benefit the jail by removing detainees with mental 

illnesses who require services that the jail probably cannot 

provide, and they benefit the detainee by diverting them 

from jail to treatment. For these diversion options to be 

successful, though, resources must be in place to supervise 
30 People wth Mental Illness 

§ See the Problem-Oriented Guide 

titled Analyzing Repeat Victimization. 

release conditions and provide treatment. Otherwise, 

diversion will just contribute to the deinstitutionalization/ 

criminalization revolving door. 

12. Establishing mental health courts. When people 

with mental illness do go to court for committing 

minor offenses and disorder, the experience is often 

unsatisfactory, because most prosecutors and judges 

lack the experience and expertise to handle such cases 

effectively, including knowledge about mental illness and 

awareness of treatment options. Also, general criminal 

court can be chaotic, causing lots of cases to receive only 

superficial attention. In this context, people with mental 

illness sometimes get much longer incarceration sentences 

than makes any sense, burdening the jail or prison 

and failing to address the defendant’s real problems. 

Conversely, in other cases, people with mental illness get 

unsupervised probation without treatment conditions, 

compounding deinstitutionalization effects. One remedy 

for this dilemma is a specialized mental health court, in 

which one or a few judges hear all such cases and have 

ready access to mental health professionals.

53 These courts 

are in a much better position than a general criminal court 

to make adjudication and sentencing decisions that are 

tailored to the specific needs of each defendant, while at 

the same time protecting the community. 

Protecting Victims 

13. Protecting repeat crime victims. An effort should 

be made to identify repeat crime victims associated with 

people with mental illness, because previous victimization 

is generally the best predictor of future victimization.

§ 

When repeat crime victims are identified, the behaviors 

or conditions connected to their victimization should be 

identified to explore possible responses. For example, if 
Responses to the Problem of People wth Mental Illness 31 

a person with mental illness is a repeat victim, an abusive 

caregiver might be uncovered. Alternatively, it might 

be discovered that the person frequents risky places or 

engages in risky behaviors. It is also possible, of course, 

that the crimes reported by the person with mental illness 

are imaginary and never happened. Identifying any of 

these “causes” could lead to solutions that reduce or even 

eliminate future victimizations. Alternatively, people with 

mental illness might habitually victimize others—caregivers, 

family members, employers. 

14. Providing services to victims. From the standpoints 

of equity and prevention, it is important to provide 

information and services to people with mental illness who 

are crime victims, as well as to people who are victimized 

by people with mental illness.

54 In either instance, standard 

victim services should be provided as well as information 

specifically associated with mental illness. It should be 

noted that a person with mental illness who is a crime 

victim may experience more trauma than another person, 

including the possibility that memories of past abuses 

can be triggered. Similarly, family members of a person 

with mental illness who are victimized by that person may 

experience extra fear, anger, remorse, or even guilt because 

of the intimate relationships involved.

§ 

In one case in Baltimore County, Maryland, police 

responded frequently to a residence based on complaints 

from neighbors about trash and property in disrepair.

55 

They made referrals to social services agencies, but both 

the police and social services responses were fragmented, 

resulting in no improvement and continued calls. When the 

situation was finally targeted, it was determined that the 

real victim was a mother who lived in the house with her 

grown daughter. The daughter, who suffered from mental 

illness, abused and intimidated her mother. This led to a 

case management focus with services for the mother and 

§ Police agencies and individuals can 

obtain more information for and 

about victims from the National 

Organization for Victim Assistance, 

the National Center for Victims of 

Crime, the U.S. Justice Department 

Office for Victims of Crime, and the 

National Alliance for the Mentally 

Ill, among others. 
32 People wth Mental Illness 

involuntary commitment of the daughter, as well as the 

establishment of a Vulnerable Adults Assistance Network 

in the county designed to address future situations more 

promptly. 

Targeting Offenders 

15. Targeting repeat criminals. It is widely recognized 

that a relatively small proportion of offenders commit 

a relatively large proportion of offenses. If people with 

mental illness are identified who are repeat criminal 

offenders, attention should be focused on them. This 

may involve criminal charges, involuntary commitment, 

better guardianship, court-ordered medication, restraining 

orders, or any number of other techniques, depending 

on the circumstances. The key is to focus attention on 

anyone who is responsible for a disproportionate share of 

a problem. 

Similarly, there may be community members who commit 

repeat crimes against people with mental illness. These 

might include assault, theft, harassment, or fraud. The 

perpetrators might be caregivers, family members, 

neighbors, or relative strangers. Because people with 

mental illness who report crimes are sometimes treated 

with skepticism and suspicion, those who repeatedly 

victimize them may be more difficult to identify than 

should be the case. Police efforts to identify and target 

these people should be given high priority, though, 

because they are repeat criminals and because of their 

victims’ particularly vulnerable nature. 
Responses to the Problem of People wth Mental Illness 33 

16. Targeting those responsible for repeat or chronic 

disturbances. Chronic disturbances involving people with 

mental illness are among the most frustrating situations 

for police, because there are few options available to 

officers. If a person with mental illness is merely being 

loud, being annoying, or acting strangely, involuntary civil 

commitment is not usually an option, because the person 

is not putting himself or others in danger. In response to 

any particular incident, officers might attempt informal 

“soothing or smoothing,”56 look for a guardian, command 

the individual to cease or leave, or make an arrest for 

disorderly conduct. When the same person engages in the 

same behavior repeatedly, however, officers may run out 

of options quickly, especially if the jail tightens its criteria 

on accepting people with mental illness. The situation 

is exacerbated if there are complainants who expect the 

officer to do something. 

Although easy solutions may not be available, it is 

nevertheless productive to target those people responsible 

for repeat or chronic disturbances. In San Diego, for 

example, police received an average of four calls per 

month about a man who was disruptive and threatening 

in his neighborhood.

57 Previous responses were found to 

have been ad hoc and ineffective. When police targeted 

him, they were able to meet with him, gather his history, 

and then use criminal charges and probation conditions to 

exercise greater control over him. At the same time, the 

police organized and empowered the community to apply 

more supervision over the man and gather better evidence 

in case additional charges or probation revocation became 

necessary. The end result was a 75 percent decrease in 

calls and a community that was more satisfied that the 

police department had helped them address a chronic 

problem. 
34 People wth Mental Illness 

In Charlotte, North Carolina, police were called to a 

single residential address over 100 times in regard to 

trash, property in disrepair, and threats to neighbors.

58 

An unmarried couple lived at the residence. When police 

targeted the situation, they learned that the woman 

suffered from mental illness and that she had completely 

intimidated her common-law husband, in addition to 

terrorizing the neighborhood. Police identified relatives 

of the man, and gained their assistance once a long-term 

involuntary commitment for the woman was obtained. 

The house and property were then completely cleaned 

up. The man chose to remain at the residence. Once the 

woman was released from inpatient care, she moved to 

a different residence and started working. During the 

follow-up period, both people were reported as doing 

well, and the police department received no further calls. 

17. Targeting those responsible for repeat calls for 

service. In addition to chronic disturbances, some 

individuals are responsible for a disproportionate volume 

of calls for police service. In the case of people with 

mental illness, this might involve a large number of false, 

imaginary, or trivial calls. If police can identify and target 

these repeat complainants, they may be able to reduce the 

volume of calls substantially. For example, in Georgetown, 

Texas, police discovered that they had received 70 calls 

over eight years from a particular address.

59 Upon 

investigation, they found an elderly woman suffering 

from mental illness who was living in a very deteriorated 

home, but who refused to move or make repairs. With 

persistence and patience, officers were able to get her 

some greatly needed medical attention. With medical 

professionals involved, they were then able to make a 

case for involuntary commitment, after which the woman 

moved into a group home and exhibited much better 

physical and mental health. The police received no more 

calls from the address or from the woman. 
Responses to the Problem of People wth Mental Illness 35 

In Ithaca, New York, calls from emotionally disturbed 

people were the police department’s most common 

noncrime calls.

60 Police officers were familiar with a 

number of chronic callers, but the department had not 

adopted a systematic approach other than responding 

to each incident as it was reported. A new system was 

adopted in which calls from or about people with mental 

illness were handled as they were received, but also 

referred to community-based officers and mental health 

providers for next-day follow-up. People were recontacted 

and an effort was made to coordinate a variety of service 

providers. Chronic calls were all but eliminated. 

Targeting Locations 

18. Targeting hot spots. Crime, disorder, and calls for 

service tend to be concentrated in a subset of all locations 

in any jurisdiction. This general pattern seems to hold 

with regard to problems associated with persons with 

mental illness. In Lexington, Kentucky, for example, of 

507 calls for service in one year that could be identified 

in dispatch data as involving a person with mental illness 

and that had exact addresses, 20 percent occurred in just 

17 locations, each of which had three or more calls during 

the year.

61 Those locations included a psychiatric hospital, 

a general hospital, two shelters, three group homes, and 

10 apartment buildings. Moreover, when all calls for 

service at each of those locations were then examined, it 

was apparent that the calls initially identified as involving 

people with mental illness were just a small portion of the 

total volume of calls at these locations. The two shelters 

totaled 641 calls for the year, the psychiatric hospital 133, 

and the three group homes 134. At five of the apartment 

buildings, further investigation revealed a total of 122 

calls from five persons known to be suffering from mental 

illness (i.e., one person per building), plus another 76 calls 

with no complainant name. 
36 People wth Mental Illness 

Of course, identifying hot spots is just the first step. 

Once a chronic repeat call location is identified, it is 

important to analyze the situation to determine the nature 

of the calls and why they are occurring, as a prelude to 

implementing tailored responses. The situation might 

involve a single chronic false complainant, a poorly 

managed group home, or a hospital with inadequate 

security staff. 

Effective responses at hot spots clearly depend on 

problem analysis. In Overland Park, Kansas, police 

identified a man in an apartment complex who made 

chronic unfounded calls to 911.

62 The man had ignored 

previous suggestions and encouragement to take 

advantage of available mental health services. Finally, 

officers contacted mental health providers directly and 

asked them to reach out to the man. He did accept 

the services that were recommended, and the police 

department received no further calls. 

19. Regulating facilities more effectively. One effective 

approach to a mental health facility hot spot might be to 

apply or enhance external regulation. In San Diego, calls 

to the police from an apartment building had increased 

from three to 13 per month.

63 Analysis revealed that the 

apartment building had been turned into an independent 

living facility for people with mental disabilities, with 

four residents living in each of eight units. Further 

investigation determined that independent-living facilities 

were intended for people capable of living on their 

own, which was not the case for the residents of this 

building. The independent-living designation was being 

used fraudulently because such facilities were largely 

unregulated by the state, in contrast to group homes. The 

facility’s operators were simply ignoring state regulations 
Responses to the Problem of People wth Mental Illness 37 

so that they could make more money, one result of which 

was a high volume of calls to the police. Another result 

was that residents were underserved and endangered. The 

police threatened the operators with a civil injunction and 

called in state regulators. Within a short time, the facility 

was closed and the residents were dispersed to more 

appropriate accommodations. 

In Lancashire, England, police found that some mental 

health facilities had high rates of walk-aways and missing 

persons.

64 Their analysis indicated that key factors 

included the physical features and security of the facilities 

as well as management practices. The constabulary 

appointed liaison officers to work with each mental health 

facility to improve its security and practices, and then took 

the extra step of negotiating very specific performance 

targets for each facility. In the future, if a facility exceeds 

its annual performance limit for missing persons, it will 

come under government review and run the risk of losing 

its license and social services funding. 

Responses with Limited Effectiveness 

20. Arresting people with mental illness. Except when 

people with mental illness commit serious crimes, arrest 

is generally not an effective response. When police 

arrest people with mental illness for minor crimes and 

disturbances, it is frequently because they cannot identify 

any other options and are desperate for a short-term 

solution. Even so, jails often refuse to accept the arrestees, 

resulting in their almost-immediate release. Longterm solutions are not usually reached either, because 

prosecutors often refuse to file charges. Making arrests 

in these situations typically frustrates both police officers 

and the people who get arrested, while accomplishing little 

or nothing. 
38 People wth Mental Illness 

In those instances when arresting someone with mental 

illness does result in jail and prosecution, police may feel 

satisfied that a short-term solution has been achieved, 

but evidence indicates that the costs are considerable, as 

explained below. 

21. Incarcerating people with mental illness. People 

with mental illness may end up in jail awaiting trial, in jail 

serving a sentence, or in prison serving a sentence. They 

end up in jail and prison in large numbers—about one in 

six inmates has a mental illness, and the jails serving New 

York, Los Angeles, and Chicago each hold more people 

with mental illness per day than any hospital in the United 

States.

65 Sheriffs, jail administrators, and prison wardens 

regularly express their frustrations over the stresses and 

strains caused in their institutions by the inappropriate 

criminal justice incarceration of persons with mental 

illness. 

Neither jail nor prison is a good setting for mental health 

treatment, if such treatment is even available. People 

with mental illness often get worse while incarcerated, 

and tragedies involving victimization and suicide are too 

common.

66 In the long run, criminal justice incarceration 

of the mentally ill harms the lives of those people, 

interferes with the proper operation of jails and prisons, 

and accomplishes little or no long-term solution to the 

original crime-and-disorder problems that led to arrest and 

incarceration in the first place. Referral, treatment, and 

civil commitment for people with mental illness should be 

preferred over arrest and criminal justice incarceration as 

responses to minor crime-and-disorder problems. 
Responses to the Problem of People wth Mental Illness 39 

22. Ignoring the needs of people with mental illness. 

Police officers sometimes get frustrated by people with 

mental illness, and respond by doing nothing. They may 

ignore disruptive behavior, hoping that no citizen will 

complain, or refuse to respond when chronic complainants 

call to report a crime, or try to trick or distract a person 

whose behavior seems driven by mental illness. The real 

purpose of these responses is to extricate the officer from 

the immediate situation, leaving the problem unresolved. 

Doing nothing, while understandable when officers have 

little training about mental illness or few viable response 

options, nonetheless demonstrates poor policing. 

Appendx 41 

Appendix: Summary of Responses to 

People with Mental Illness 

The table below summarizes the responses to people 

with mental illness, the mechanism by which they are 

intended to work, the conditions under which they ought 

to work best, and some factors you should consider before 

implementing a particular response. It is critical that you 

tailor responses to local circumstances, and that you can 

justify each response based on reliable analysis. In most 

cases, an effective strategy will involve implementing 

several different responses. Law enforcement responses 

alone are seldom effective in reducing or solving the 

problem. 

Response 

No. 

Page 

No. 

Response How It Works Works Best If... Considerations 

General Considerations for an Effective Response Strategy 

1. 20 Working 

with the 

mental health 

community 

Police develop 

partnerships 

and collaborate 

with mental 

health agencies 

and advocacy 

groups 

...the collaboration is 

focused on identifying 

and solving specific 

problems 

Mental health agencies are 

typically underfunded and 

overwhelmed; police may 

want to help support and 

empower advocacy groups 

to increase their influence 

on legislation and funding 

2. 21 Working with 

emergency 

hospitals 

Police meet 

regularly with 

the staffs of 

emergency 

hospitals to 

address issues 

and problems 

...a sense of 

teamwork and shared 

responsibility can be 

developed 

Protocols must be 

developed in advance and 

effectively implemented so 

that patrol officers are not 

faced with debating doctors 

and nurses in the middle of 

the night 
42 People wth Mental Illness 

Response 

No. 

Page 

No. 

Response How It Works Works Best If... Considerations 

3. 21 Appointing 

police liaison 

officers 

Helps police 

and other 

organizations 

maintain focus 

on and develop 

expertise in 

mental health 

issues 

...liaison officers 

have credibility within 

the police agency so 

that they quickly hear 

about complaints and 

problems 

Liaison officers to the 

entire mental health system 

should have sufficient rank 

to represent the whole 

police agency and establish 

standing with doctors, 

psychiatrists, etc.; liaison 

officers to specific facilities 

can be area specialists (beat 

officers) or mental health 

specialists 

Specific Responses to People with Mental llness 

Improving the Police Response to Incidents 

4. 22 Training 

generalist 

police officers 

Improves 

police officers’ 

awareness and 

understanding 

of mental 

illness and 

thereby 

improves their 

responses to 

incidents 

...the training is 

hands-on, realistic, 

and focused on 

making good 

decisions that protect 

the safety of the 

individual, the general 

public, and officers 

It is important to demystify 

mental illness and help 

officers overcome 

stereotypes and prejudices 

5. 23 Providing more 

information to 

patrol officers 

Increases the 

likelihood that 

people with 

mental illnesses 

will be properly 

referred to 

treatment 

services 

...adequate mental 

health services are 

available and the 

police data and 

communications 

system forewarns 

officers about 

previous incidents and 

encounters involving 

specific complainants, 

suspects, victims, 

subjects, and 

addresses 

Storing and communicating 

information about 

individual histories of 

mental illness and mental 

health crises raises 

significant privacy issues; 

legal restrictions may vary 

from state to state 
Appendx 43 

Response 

No. 

Page 

No. 

Response How It Works Works Best If... Considerations 

6. 24 Using lesslethal weapons Reduces the 

likelihood of 

serious injury 

or death to 

people with 

mental illnesses 

...less-lethal weapons 

are effective, 

noncontroversial, and 

immediately available 

to officers in the field 

Less-lethal weapons may 

affect a person in mental a 

health crisis differently from 

other persons; agencies 

must assure that officers 

do not resort to less-lethal 

weapons before exhausting 

nonviolent alternatives 

7. 25 Deploying 

specialized 

police officers 

Improves the 

police response 

to situations 

involving 

mental illness 

through the 

delivery of 

specialized 

knowledge, 

skills, and 

...mental health 

practitioners are 

included in the 

training so that 

familiarity, trust, 

and teamwork are 

developed 

Deploying around-the-clock 

specialists and developing a 

team approach with mental 

health practitioners may 

be difficult for small/rural 

police agencies and in 

jurisdictions that lack their 

own mental health facilities 

experience 

8. 27 Deploying Improves ...sworn and non- It is important to have 

specialized 

nonpolice 

the response 

to situations 

sworn personnel work 

together as a team 

clear guidelines about the 

differing roles of sworn 

responders involving and non-sworn responders 

mental illness and clarity about decisionthrough the making authority 

delivery of 

specialized 

knowledge, 

skills, and 

experience 
44 People wth Mental Illness 

Response 

No. 

Page 

No. 

Response How It Works Works Best If... Considerations 

Working With Stakeholders 

9. 28 Initiating 

assisted 

outpatient 

treatment 

Increases the 

likelihood 

that people 

with mental 

illness will 

receive proper 

treatment and 

medication, 

thereby 

decreasing 

the likelihood 

of the need 

for police 

intervention 

...mental health 

workers enforce 

court-ordered 

treatment compliance 

Compliance enforcement 

has been shown to 

reduce incidents, arrests, 

victimization, violent 

episodes, and homelessness 

10. 29 Establishing 

crisis response 

sites 

Improves 

the response 

to people in 

mental crisis 

through readily 

available 

specialized 

services 

...intake procedures 

are streamlined, a 

no-refusal policy is 

in place, and both 

mental health and 

substance abuse 

services are available 

Police should understand 

that a no-refusal policy does 

not guarantee extended 

or inpatient stays, just a 

guarantee that the facility 

will accept the person for 

evaluation 

11. 29 Establishing 

jail-based 

diversion 

Improves the 

mental health 

treatment of 

offenders and 

reduces the use 

of scarce jail 

resources 

... when screening 

occurs immediately 

after booking 

Immediate diversion will 

generally be available only 

for minor offenders; more 

serious offenders may be 

considered for diversion 

at the prosecution or 

adjudication stages 

12. 30 Establishing 

mental health 

courts 

Enhances the 

special expertise 

of judges in 

adjudicating 

mentally ill 

offenders 

... when specialized 

judges and courts 

work closely with 

mental health agencies 

and advocacy groups 

Small jurisdictions may 

not have the resources or 

volume of mental health 

cases to support specialized 

judges or courts 
Appendx 45 

Response 

No. 

Page 

No. 

Response How It Works Works Best If... Considerations 

Protecting Victims 

13. 30 Protecting 

repeat crime 

victims 

Increases the 

likelihood that 

people with 

mental illness 

who are repeat 

crime victims, 

as well as repeat 

victims of 

offenders with 

mental illness, 

receive special 

attention 

... repeat victims 

are identified 

sooner rather than 

later in the course 

of their repeated 

victimizations 

It is important to try to 

identify guardians (official 

or unofficial) who can both 

protect vulnerable victims 

and influence them to 

change any risky behavior 

14. 31 Providing 

services to 

victims 

Increases the 

likelihood 

that crime 

victims who 

have mental 

illness, as well 

as victims of 

offenders with 

mental illness, 

will recover 

from their 

victimization 

and successfully 

navigate the 

legal system 

... victim services 

agencies, mental 

health agencies, 

and mental health 

advocacy groups 

collaborate 

Police must be careful not 

to dismiss victimization 

claims by people with 

mental illness; while false 

reports are common, so 

is victimization of people 

with mental illness by family 

members, unprofessional 

service providers, and 

others 
46 People wth Mental Illness 

Response 

No. 

Page 

No. 

Response How It Works Works Best If... Considerations 

Targeting Offenders 

15. 32 Targeting 

repeat 

criminals 

Increases the 

likelihood that 

people with 

mental illness 

who commit 

repeated 

crimes, as well 

as offenders 

who commit 

repeated crimes 

against people 

with mental 

illness, are 

targeted for 

special attention 

... repeat offenders 

are identified sooner 

rather than later for 

special enforcement, 

prosecution, and/or 

treatment 

Repeat offenders often 

go unrecognized and fall 

through the cracks of the 

criminal justice system; 

concerted effort is required 

to keep this from happening 

16. 33 Targeting those 

responsible 

for repeat 

or chronic 

disturbances 

Increases the 

likelihood that 

people with 

mental illness 

who repeatedly 

create 

disturbances 

are targeted for 

special attention 

... guardians and 

handlers (including 

family members and 

service providers) 

can be persuaded 

to exercise more 

supervision and 

influence over 

disorderly behavior 

Restoring order and 

resolving disturbances are 

among the most challenging 

police responsibilities; 

particularly when these 

involve a person with 

mental illness, informal 

alternatives are preferred, 

and jail should be avoided 

17. 34 Targeting those 

responsible for 

repeat calls for 

service 

Increases the 

likelihood that 

people with 

mental illness 

who repeatedly 

call the police 

about trivial 

or imaginary 

problems are 

targeted for 

special attention 

... repeat 

complainants receive 

follow-up visits to 

identify underlying 

issues and implement 

systematic responses 

Because chronic 

complainants may initiate 

calls from various locations, 

it is necessary to analyze 

calls for service to identify 

repeat complainants as well 

as repeat addresses 
Appendx 47 

Response 

No. 

Page 

No. 

Response How It Works Works Best If... Considerations 

18. 35 Targeting hot 

spots 

Concentrates 

attention on 

locations 

with multiple 

incidents 

and/or calls 

for service 

involving 

people with 

mental illness, 

thereby 

correcting 

conditions that 

create incidents 

... guardians and 

managers can be 

persuaded to exercise 

more supervision and 

authority over hotspot locations 

Hot-spot analysis related to 

calls and crimes involving 

people with mental illness is 

challenging because police 

data systems often do not 

include categories or flags 

indicating mental illness 

19. 36 Regulating 

facilities more 

effectively 

Compels 

mental health 

service facilities 

to improve 

their practices, 

thereby 

reducing the 

likelihood that 

police will need 

to intervene 

... liaison officers 

work with each facility 

to analyze problems, 

recommend solutions, 

and monitor 

compliance 

Because mental health 

facilities are often profitmaking businesses that 

are poorly regulated by 

governing authorities, 

they frequently arise as 

hot spots; these facilities 

typically account for a 

disproportionate share of 

calls and crimes involving 

people with mental illness 

and should be a principal 

target of problem-oriented 

policing 

Responses With Limited Effectiveness 

20. 37 Arresting 

people with 

mental illness 

Intended to 

deter offenders 

through 

punishment and 

incapacitation 

... arrested people 

are promptly diverted 

into the mental health, 

medical, or social 

service systems 

People with mental illness 

who commit serious crimes 

should be arrested, leaving 

decisions about criminal 

liability to the courts; minor 

offenders, however, are 

not likely to be prosecuted, 

adjudicated, or incarcerated, 

making arrest an ineffective 

response from every 

perspective 
48 People wth Mental Illness 

Response 

No. 

Page 

No. 

Response How It Works Works Best If... Considerations 

21. 38 Incarcerating 

people with 

mental illnes 

Intended to 

deter offenders 

through 

punishment and 

incapacitation 

... mental health 

services are available 

in the jail 

Incarceration of people 

with mental illness is never 

beneficial for the individual 

or the jail; it harms the 

individual, creates risks for 

other detainees, and greatly 

complicates the operation 

of the jail 

22. 39 Ignoring the 

needs of 

people with 

mental illness 

Done in 

hopes that the 

problem will go 

away 

... problems are 

minor and other 

stakeholders shoulder 

the responsibility 

Ignoring people in need 

is an abdication of a basic 

police responsibility 
E

ndnotes 49 

Endnotes 

1 Re

uland and Margolis (2003): 35. 2 Lamb, Weinberger, and Gross (20

04): 108. 3 Deane et al. (1999). 4 Borum et al. (1998): 401. 5 Lincoln Police Department (2004). 6 Waldman (2004). 7 Peck (2003): 6. 8 Landsberg et al. (2002): 5–8. 9 Marzuk (1996): 485. 10 Federal Bureau of Investigation (2004). 11 Fyfe (2000): 345. 12 Meyer and Berry (1999). 13 Dowd (2004). 14 Treatment Advocacy Center (2005a). 15 Green (1997): 476. 16 James (2000): 538. 17 Reuland and Margolis (2003): 35. 18 Way, Evans, and Banks (1993): 393. 19 Lamb et al. (1995): 1269. 20 Murphy (1986). 21 Patch and Arrigo (1999). 22 Borum (2000): 333. 23 Meehan (1995). 24 Gentz and Goree (2003). 25 Lamb, Weinberger, and DeCuir (2002). 26 Wolff (1998). 27 Cordner (2000). 28 Dupont and Cochran (2000). 29 Pang (2004). 30 Norris and Cooke (2000). 31 “Indiana Boosts Cop Training to Deal With 

Mentally 

Ill” (2004). 

32 

Deane et al. (1999). 

33 

Dunn and Fahy (1987). 
50 People wth Mental Illness 

34 Ruiz and Miller (2004): 369. 35 Borum (2000): 333. 36 Daniel (2004): 388. 37 Fyfe (2000); Waldman (2004). 38 Borum (2000): 333. 39 Cordner and Perkins (1996); Perkins (1996). 40 Watson, Corrigan, and Ottati (2004): 383. 41 Fyfe (2000). 42 Dupont and Cochran (2000). 43 Borum (2000); Dupont and Cochran (2000); Steadman 

et al. (2000); Reuland and Margolis (2003). 44 Strauss et al. (2005). 45 Cordner (2000). 46 Lamb, Weinberger, and DeCuir (2002). 47 Lamb et al. (1995); Lodestar (2002); Reuland and 

Margolis (2003). 48 Steadman et al. (2000). 49 Treatment Advocacy Center (2005b). 50 Treatment Advocacy Center (2005c). 51 Steadman et al. (2001). 52 Franczak and Shafer (2002). 53 Lerner-Wren (2002). 54 Reuland and Margolis (2003). 55 Baltimore County Police Department (1998). 56 Walter and Wagner (1996). 57 San Diego Police Department (1998). 58 Charlotte-Mecklenburg Police Department (2001). 59 Georgetown Police Department (1998). 60 Ithaca Police Department (1998). 61 Biebel and Cordner (2003). 62 Overland Park Police Department (1998). 63 San Diego Police Department (2000). 64 Lancashire Constabulary (2004). 65 Reuland and Margolis (2003). 66 Pfeiffer (2004). 
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About the Author 59 

About the Author 

Gary Cordner 

Gary Cordner is Foundation Professor of Police Studies at Eastern 

Kentucky University (EKU), where he also directs the Regional 

Community Policing Institute and the International Justice & Safety 

Institute. Past positions include dean of the College of Justice and 

Safety at EKU, president of the Academy of Criminal Justice Sciences, 

editor of Police Quarterly and the American Journal of Police, and 

police chief in St. Michaels, Maryland. Research interests include 

community policing, problem-oriented policing, police administration, 

and homeland security. Professor Cordner, who earned his Ph.D. 

from Michigan State University, has served as a judge for the annual 

Herman Goldstein Award for Excellence in Problem-Oriented 

Policing since 1996. 

Recommended Readngs 61 

Recommended Readings 

• A Police Guide to Surveying Citizens and Their 

Environments, Bureau of Justice Assistance, 1993. This 

guide offers a practical introduction for police practitioners 

to two types of surveys that police find useful: surveying 

public opinion and surveying the physical environment. It 

provides guidance on whether and how to conduct costeffective surveys. 

• Assessing Responses to Problems: An 

Introductory Guide for Police Problem-Solvers, 

by John E. Eck (U.S. Department of Justice, Office of 

Community Oriented Policing Services, 2001). This guide 

is a companion to the Problem-Oriented Guides for Police series. 

It provides basic guidance to measuring and assessing 

problem-oriented policing efforts. 

• Conducting Community Surveys, by Deborah Weisel 

(Bureau of Justice Statistics and Office of Community 

Oriented Policing Services, 1999). This guide, along with 

accompanying computer software, provides practical, basic 

pointers for police in conducting community surveys. The 

document is also available at www.ojp.usdoj.gov/bjs. 

• Crime Prevention Studies, edited by Ronald V. Clarke 

(Criminal Justice Press, 1993, et seq.). This is a series of 

volumes of applied and theoretical research on reducing 

opportunities for crime. Many chapters are evaluations of 

initiatives to reduce specific crime and disorder problems. 
62 People wth Mental Illness 

• Excellence in Problem-Oriented Policing:The 

1999 Herman Goldstein Award Winners. This 

document produced by the National Institute of Justice 

in collaboration with the Office of Community Oriented 

Policing Services and the Police Executive Research Forum 

provides detailed reports of the best submissions to the 

annual award program that recognizes exemplary problemoriented responses to various community problems. A 

similar publication is available for the award winners from 

subsequent years. The documents are also available at 

www.ojp.usdoj.gov/nij. 

• Not Rocket Science? Problem-Solving and Crime 

Reduction, by Tim Read and Nick Tilley (Home Office 

Crime Reduction Research Series, 2000). Identifies and 

describes the factors that make problem-solving effective 

or ineffective as it is being practiced in police forces in 

England and Wales. 

• Opportunity Makes the Thief: Practical Theory 

for Crime Prevention, by Marcus Felson and Ronald V. 

Clarke (Home Office Police Research Series, Paper No. 98, 

1998). Explains how crime theories such as routine activity 

theory, rational choice theory and crime pattern theory 

have practical implications for the police in their efforts to 

prevent crime. 

• Problem Analysis in Policing, by Rachel Boba (Police 

Foundation, 2003). Introduces and defines problem 

analysis and provides guidance on how problem analysis 

can be integrated and institutionalized into modern 

policing practices. 
Recommended ARepapdenndgs 63

• Problem-Oriented Policing, by Herman Goldstein 

(McGraw-Hill, 1990, and Temple University Press, 1990). 

Explains the principles and methods of problem-oriented 

policing, provides examples of it in practice, and discusses 

how a police agency can implement the concept. 

• Problem-Oriented Policing and Crime Prevention, 

by Anthony A. Braga (Criminal Justice Press, 2003). 

Provides a thorough review of significant policing research 

about problem places, high-activity offenders, and repeat 

victims, with a focus on the applicability of those findings 

to problem-oriented policing. Explains how police 

departments can facilitate problem-oriented policing by 

improving crime analysis, measuring performance, and 

securing productive partnerships. 

• Problem-Oriented Policing: Reflections on the 

First 20 Years, by Michael S. Scott (U.S. Department of 

Justice, Office of Community Oriented Policing Services, 

2000). Describes how the most critical elements of 

Herman Goldstein's problem-oriented policing model have 

developed in practice over its 20-year history, and proposes 

future directions for problem-oriented policing. The report 

is also available at www.cops.usdoj.gov. 

• Problem-Solving: Problem-Oriented Policing in 

Newport News, by John E. Eck and William Spelman 

(Police Executive Research Forum, 1987). Explains the 

rationale behind problem-oriented policing and the 

problem-solving process, and provides examples of 

effective problem-solving in one agency. 
64 People wth Mental Illness 

• Problem-Solving Tips: A Guide to Reducing 

Crime and Disorder Through Problem-Solving 

Partnerships by Karin Schmerler, Matt Perkins, Scott 

Phillips, Tammy Rinehart and Meg Townsend. (U.S. 

Department of Justice, Office of Community Oriented 

Policing Services, 1998) (also available at www.cops.usdoj. 

gov). Provides a brief introduction to problem-solving, 

basic information on the SARA model and detailed 

suggestions about the problem-solving process. 

• Situational Crime Prevention: Successful Case 

Studies, Second Edition, edited by Ronald V. Clarke 

(Harrow and Heston, 1997). Explains the principles and 

methods of situational crime prevention, and presents over 

20 case studies of effective crime prevention initiatives. 

• Tackling Crime and Other Public-Safety Problems: 

Case Studies in Problem-Solving, by Rana Sampson 

and Michael S. Scott (U.S. Department of Justice, Office of 

Community Oriented Policing Services, 2000) (also available 

at www.cops.usdoj.gov). Presents case studies of effective 

police problem-solving on 18 types of crime and disorder 

problems. 

• Using Analysis for Problem-Solving: A Guidebook 

for Law Enforcement, by Timothy S. Bynum (U.S. 

Department of Justice, Office of Community Oriented 

Policing Services, 2001). Provides an introduction for 

police to analyzing problems within the context of 

problem-oriented policing. 

• Using Research: A Primer for Law Enforcement 

Managers, Second Edition, by John E. Eck and Nancy G. 

LaVigne (Police Executive Research Forum, 1994). Explains 

many of the basics of research as it applies to police 

management and problem-solving. 
Other Problem-Orented Gudes for Polce 65 

Other Problem-Oriented Guides for Police 

Problem-Specific Guides series: 

1. Assaults in and Around Bars. Michael S. Scott. 2001. 

ISBN: 1-932582-00-2 

2. Street Prostitution. Michael S. Scott. 2001. ISBN: 1-932582-01-0 

3. Speeding in Residential Areas. Michael S. Scott. 2001. 

ISBN: 1-932582-02-9 

4. Drug Dealing in Privately Owned Apartment Complexes. 

Rana Sampson. 2001. ISBN: 1-932582-03-7 

5. False Burglar Alarms. Rana Sampson. 2001. ISBN: 1-932582-04-5 

6. Disorderly Youth in Public Places. Michael S. Scott. 2001. 

ISBN: 1-932582-05-3 

7. Loud Car Stereos. Michael S. Scott. 2001. ISBN: 1-932582-06-1 

8. Robbery at Automated Teller Machines. Michael S. Scott. 2001. 

ISBN: 1-932582-07-X 

9. Graffiti. Deborah Lamm Weisel. 2002. ISBN: 1-932582-08-8 

10. Thefts of and From Cars in Parking Facilities. Ronald V. 

Clarke. 2002. ISBN: 1-932582-09-6 

11. Shoplifting. Ronald V. Clarke. 2002. ISBN: 1-932582-10-X 

12. Bullying in Schools. Rana Sampson. 2002. ISBN: 1-932582-11-8 

13. Panhandling. Michael S. Scott. 2002. ISBN: 1-932582-12-6 

14. Rave Parties. Michael S. Scott. 2002. ISBN: 1-932582-13-4 

15. Burglary of Retail Establishments. Ronald V. Clarke. 2002. 

ISBN: 1-932582-14-2 

16. Clandestine Drug Labs. Michael S. Scott. 2002. 

ISBN: 1-932582-15-0 

17. Acquaintance Rape of College Students. Rana Sampson. 2002. 

ISBN: 1-932582-16-9 

18. Burglary of Single-Family Houses. Deborah Lamm Weisel. 

2002. ISBN: 1-932582-17-7 

19. Misuse and Abuse of 911. Rana Sampson. 2002. 

ISBN: 1-932582-18-5 
66 People wth Mental Illness 

20. Financial Crimes Against the Elderly. 

Kelly Dedel Johnson. 2003. ISBN: 1-932582-22-3 

21. Check and Card Fraud. Graeme R. Newman. 2003. 

ISBN: 1-932582-27-4 

22. Stalking. The National Center for Victims of Crime. 2004. 

ISBN: 1-932582-30-4 

23. Gun Violence Among Serious Young Offenders. Anthony A. 

Braga. 2004. ISBN: 1-932582-31-2 

24. Prescription Fraud. Julie Wartell and Nancy G. La Vigne. 2004. 

ISBN: 1-932582-33-9 

25. Identity Theft. Graeme R. Newman. 2004 ISBN: 1-932582-35-3 

26. Crimes Against Tourists. Ronald W. Glesnor and Kenneth J. Peak. 

2004 ISBN: 1-932582-36-3 

27. Underage Drinking. Kelly Dedel Johnson. 2004 ISBN: 1-932582-39-8 

28. Street Racing. Kenneth J. Peak and Ronald W. Glensor. 2004. 

ISBN: 1-932582-42-8 

29. Cruising. Kenneth J. Peak and Ronald W. Glensor. 2004. 

ISBN: 1-932582-43-6 

30. Disorder at Budget Motels. Karin Schmerler. 2005. 

ISBN: 1-932582-41-X 

31. Drug Dealing in Open-Air Markets. Alex Harocopos and Mike 

Hough. 2005. ISBN: 1-932582-45-2 

32. Bomb Threats in Schools. Graeme R. Newman. 2005. 

ISBN: 1-932582-46-0 

33. Illicit Sexual Activity in Public Places. Kelly Dedel Johnson. 2005. 

ISBN: 1-932582-47-9 

34. Robbery of Taxi Drivers. Martha J. Smith. 2005. 

ISBN: 1-932582-50-9 

35. School Vandalism and Break-Ins. Kelly Dedel Johnson. 2005. 

ISBN: 1-9325802-51-7 

36. Drunk Driving. Michael S. Scott, Nina J. Emerson, Louis B. 

Antonacci, and Joel B. Plant. 2005. ISBN: 1-932582-57-6 

37. Juvenile Runaway. Kelly Dedel. 2006 ISBN: 1932582-39-8 

38. The Exploitation of Trafficked Women. Graeme R. Newman. 

2006. ISBN: 1-932582-59-2 
Other Problem-Orented Gudes for Polce 67 

39. Student Party Riots. Tamara D. Madensen and John 

E. Eck. 2006. ISBN: 1-932582-60-6 

40. People with Mental Illness. Gary Cordner. 2006. 

ISBN: 1-932582-63-0 

Response Guides series: 

• The Benefits and Consequences of Police 

Crackdowns. 

Michael S. Scott. 2003. ISBN: 1-932582-24-X 

• Closing Streets and Alleys to Reduce Crime: Should 

You Go Down This Road? Ronald V. Clarke. 2004. 

ISBN: 1-932582-41-X 

• Shifting and Sharing Responsibility for Public Safety 

Problems. Michael S. Scott and Herman Goldstein. 

2005. ISBN: 1-932582-55-X 

• Partnering with Businesses to Address Public Safety 

Problems. Sharon Chamard. 2006. ISBN: 1-932582-62-2 

• Video Surveillance of Public Places. Jerry Ratcliffe. 

2006. ISBN: 1-932582-58-4 

Problem-Solving Tools series: 

• Assessing Responses to Problems: An Introductory 

Guide for Police Problem-Solvers. John E. Eck. 2002. 

ISBN: 1-932582-19-3 

• Researching a Problem. Ronald V. Clarke and Phyllis A. 

Schultz. 2005. ISBN: 1-932582-48-7 

• Using Offender Interviews to Inform Police Problem 

Solving. Scott H. Decker. 2005. ISBN: 1932582-49-5 

• Analyzing Repeat Victimization. Deborah Lamm 

Weisel. 2005. ISBN: 1-932582-54-1 
68 People wth Mental Illness 

Upcoming Problem-Oriented Guides for Police 

Problem-Specific Guides 

Domestic Violence 

Bank Robbery 

Witness Intimidation 

Drive-by Shootings 

Disorder at Day Laborer Sites 

Child Pornography on the Internet 

Crowd Control at Stadiums and Other Entertainment Venues 

Traffic Congestion Around Schools 

Problem-Solving Tools 

Risky Facilities 

Response Guides 

Crime Prevention Publicity Campaigns 

Crime Prevention Through Environmental Design 

For more information about the Problem-Oriented Guides for 

Police series and other COPS Office publications, please call 

the COPS Office Response Center at 800.421.6770 or visit 

COPS Online at www.cops.usdoj.gov. 

For More InForMatIon: 

U.S. Department of Justice 

Office of Community Oriented Policing Services 

1100 Vermont Avenue, N.W. 

Washington, DC 20530 

To obtain details on COPS programs, call the 

COPS Office Response Center at 800.421.6770 

Visit COPS Online at the address listed below. 

e04062003 May 2006 

ISBN: 1-932582-63-0 

www.cops.usdoj.gov