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Committee on Untreated Mental Illness

Police Chiefs: Persons with Serious Mental Illness Increasingly Involved with Police

Criminal Justice System Not the Solution

Decades ago persons with serious mental illness were institutionalized, often in deplorable facilities with little or no care. In some cases, persons with mild forms of mental illness were undiagnosed and lived out their lives in these facilities. In recent times these facilities were eliminated, and a model which advocates for deinstitutionalization took its place. While this model works well for persons with mild forms of mental illness and even for those with more severe forms of mentalillness with appropriate treatment and medications, there are those who require more in depth care. But when those persons do not get that care, by choice or otherwise, it is not uncommon that they exhibit behaviors which arouse suspicion, curiosity, and in some cases, also violate the law. When persons act out, exhibit strange behavior or appear disturbed, the police are often on the front lines of those calls from the public. While police are trained for a variety of situations, they are not therapists. Police do not provide treatment – they do not prescribe medications. But they are sometimes faced with a dilemma. How to protect someone who is a danger to themselves or others? Adding to the frustration is finding appropriate medical or mental health resources at a time when services are being cut. One officer noted, “What can we do when we have someone who wants to fight people on the street, or is disruptive in a convenience store and needs mental health treatment at 3:00 in the morning and there are no beds available? No shelters? No detox facilities? By taking someone to lockup and getting them off the street to a place where they are warm and fed is sometimes the only option. In good conscience, we can’t leave them to hurt someone or themselves.” But cops are the first ones to say that the criminal justice system is not the place to address the issues of those with mental illness. It is an option of last resort that has more commonly become the first option because of lack of services, funding, and empathy.

The New York State Association of Chiefs of Police (NYSACOP) has been an advocate for appropriate services for persons with serious mental illness, including Assisted Outpatient Treatment, where appropriate.

Issues Faced by Police Chiefs

  • The condition of the individuals officers are being called to respond to seems to be poorer than in the past. They are more severely ill.
  • There have been many preventable tragedies in NYS
  • There are fewer hospitals willing to admit those who need medical intervention. New York State is short 4,000 psychiatric beds assuming perfect community services existed.
  • New Yorkers are more likely to be incarcerated for mental illness than hospitalized
  • People with untreated serious mental illness sometimes present a threat to themselves or others.
  • District attorneys, public defenders and court calendars are being overwhelmed.

Consequences

  • There are frequent “round-trippers”: individuals who are stabilized, released, abandon their treatment, and deteriorate again to the point where police intervention occurs
  • Officers have to drive far away to find an appropriate hospital
  • Officers have to sit hours before the hospital examines or admits the person
  • Hospitals refuse to admit and discharge before fully stabilized
  • Involuntary treatment is largely only available after individuals become ‘danger to self or others’ rather than to prevent dangerousness
  • Police are often forced to take those who need treatment to jails instead.

Solutions

NYSACOP believes the following will help prevent individuals with untreated serious mental illness from becoming a criminal justice responsibility and will keep public, police and patients safer, while saving money to tax payers.

  • NYSACOP and the International Association of Chiefs of Police (IACP) endorsed greater use of Assisted Outpatient Treatment (AOT) (known as Kendra’s Law in New York State). AOT allows courts to order a small group of the most seriously ill who have already had multiple incidents of homelessness, arrest, violence, and/or hospitalization to stay in mandated and monitored treatment as a condition of living in the community. It has successfully cut arrest violence and hospitalization 70% each. NYSACOP supports wider use of AOT.
    • Evaluate mentally ill prisoners for potential inclusion in AOT prior to their release.
    • Evaluate involuntarily committed hospital patients for inclusion in AOT prior to their release.
    • Provide a mechanism to allow families of people with serious mental illness to inform authorities of people who could benefit from AOT and require the authorities to determine if AOT or alternative services could help.
  • Mental Health Courts. Mental Health courts do after a crime has been committed, what AOT does before: it allows courts to order certain persons with serious mental illness to stay in treatment.
  • Police Training. Because police have become first responders for the seriously ill, government should provide funds for specialized training for all officers within the police academies. All officers will come into frequent contact with persons with untreated serious mental illness so all should be trained. Until that time, Crisis Intervention Training (CIT) should be funded for select officers within departments.
  • Greater availability of hospitals. As NYSACOP noted in an op-ed, as hospital availability decreases, incarceration graphincreases. NYSACOP believes there should be easier access to hospitals for individuals with serious mental illness so police do not have to drive hours to find a hospital or wait hours for someone to be admitted. Once admitted, patients should be fully stabilized and connected to whatever services are needed to maintain that stability back in the community. As state hospitals close, local emergency rooms become overcrowded. NYSACOP supports a moratorium on closing state psychiatric beds and the building of more facilities.
  • Greater role for law enforcement. Because treatment of the untreated seriously mentally ill has become a law enforcement responsibility, state legislators committees, and task-forces considering mental health policy should consult with NYSACOP and other professional police organizations and include them in their deliberations.
  • Expand community services that are specifically and narrowly targeted to the most seriously ill and are evidence based to improve meaningful outcomes like reducing homelessness, suicide, arrest, and incarceration.

Chief/Ret. Michael Biasotti said, “It is this association’s goal to decrease the frequency of negative interactions between the police and those with mental illness.”  

Individuals interested in helping those efforts should contact the NYSACOP Committee on Untreated Mental Illness at This email address is being protected from spambots. You need JavaScript enabled to view it.

More information:

Congressional Testimony of Former NYSACOP President Michael Biasotti (Video)
Police Chief op-ed in Albany Times Union on psychiatric hospital closures
Police Chief op-ed in Albany Times Union on SAFE Gun control legislation
Police Chief op-ed in New York Daily News on gun control for mentally ill
Police Chief op-ed in New York Post on Kendra’s Law
Survey of 2400 senior law enforcement officers on mental illness

Other Organizations

Mental Illness Policy Org  (NYS Page here)
New York State Office of Mental Health
Treatment Advocacy Center
NAMI NYS

New York State Association of Chiefs of Police (NYSACOP) Committee on Untreated Mental Illness:

  • Chief/Ret. Michael Biasotti, Chairperson (New Windsor, NY Police Department); 2012-2013 President/NYSACOP
  • Chief David Zack (Cheektowaga, NY Police Department), 2016-2017 President/NYSACOP
  • Chief/Ret. Mark Spawn (Fulton, NY Police Department)

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