Chapter VI: Training Practitioners and Policymakers and Educating the Community

The successful implementation of many (if not all) of the policy statements in this report depends on criminal justice staff who understand mental illness and the mental health system.  Similarly, failure by mental health professionals to learn how the criminal justice system works in their jurisdiction will undermine any efforts to build partnerships between the criminal justice and mental health communities.  While training is not a panacea - and even with the best education and guidance, criminal justice or mental health personnel may not always know what the best course of action is - it can significantly improve services to people with mental illness, their families, and the community and reduce the stigma associated with mental illness.  For these reasons, training (and cross-system training) must be a part of any comprehensive effort to improve the response to people with mental illness who come into contact with the criminal justice system.

In addition, because the involvement of individuals with mental illness in the criminal justice system is a problem that concerns the community and requires solutions at the local level, it is incumbent upon criminal justice and mental health stakeholders to educate the community about the issue.

Every organization, at a minimum, should expect the following of any of their employees who come into contact with a person with mental illness:

• minimize the risk of injury or harm to the responder, the community, and the person with mental illness;
• respect the individual and the rights of that person;
• be conscientious of responses most likely to aggravate or improve the condition of the person;
• understand that a person with mental illness is no more likely to be violent than a person without mental illness (except in cases where a mental illness is accompanied by a co-occurring disorder); and
• know, at least generally, the mental health resources that are available to them.

Familiarizing practitioners with the above issues, while a huge accomplishment in and of itself, is usually not sufficient to ensure the successful implementation of a program that targets people with mental illness.  Whereas every good training program ensures that all staff have a basic familiarity with mental illness, agencies differ considerably in their efforts to provide staff with the additional expertise needed to implement many of the policy statements included in this report.  Indeed, many of the policy statements in this report contemplate extensive training that goes far beyond the fundamentals described above.  For example, a defense attorney needs specific skills to represent effectively a client who has a severe mental illness and who is offered an opportunity to participate in community-based supervision in lieu of incarceration.

In some jurisdictions, policymakers insist that all personnel have some elements of a sophisticated understanding of mental illness and appropriate responses. In other agencies, officials identify only a special cadre of staff to receive highly specialized training.  In smaller jurisdictions, including most of those in rural areas, the size of the police agency and jail and court staff is so small that it is more likely that training and experience will be gained in less structured or specialized formats.  The policy statements in this section of the report recognize that approaches to ensuring that staff have a sufficient set of skills, background, and general degree of competence must vary accordingly.

At the same time, the recommendations for implementation of the policy statements vary according to the criminal justice audience (i.e., law enforcement, courts, and corrections). For example, sworn staff in large police departments or state prison systems typically are required to participate in extensive annual in-service training programs.  On the other hand, training for judges, prosecutors, or defense attorneys is less routine; there are fewer opportunities available to incorporate mental health issues into existing training programs.

That said, there remain several common elements of an initiative to improve practitioners' skills in responding to people with mental illness.  The policy statements are organized according to these elements:

• Training goals and objectives
• Training curriculum
• Trainers
• Evaluation of training

One theme that is apparent in nearly every training initiative that addresses mental health issues as they relate to the criminal justice system is the need for practitioners to be educated about the missions, procedures, and policies of the systems with which they collaborate.  The mental health treatment system and the various parts of the criminal justice system have different - sometimes even contradictory - goals and methods.  For example, treatment providers and parole officers may view very differently a consumer's incomplete adherence to a treatment plan, such as missing counseling sessions.  Whereas many treatment providers view such setbacks as part of the recovery process, a parole officer may view a temporary lapse in treatment as grounds for violation and reincarceration.  Cross-training efforts, in which members of different criminal justice and mental health agencies educate one another about the basic premises and objectives of their various systems, is crucial to helping bridge these gaps that may stifle successful collaboration.

When designing and implementing training, agencies should be cognizant of local, state, and federal standards.  A curriculum that has been successful in one state may not be effective in another due to different laws, standards, and requirements.  In Oklahoma, for example, police academy training is state-run and individual agencies do not have control over the training mandated for new recruits.  Additionally, commitment laws may vary drastically from one state to another.  In Florida, under the Baker Act, only certain facilities are designated for people with mental illness whom officers believe are a danger to themselves or to others.[1]

 

Training, in and of itself, can be an expensive undertaking.  Many agencies or departments already have extensive training programs in place.  Expanding training topics to include mental health issues (or to improve the thoroughness with which mental health issues are addressed) increases further the time staff are not at their posts or in court.  This, in turn, can increase an organization's overtime costs or relief factor.  There are other expenses beyond the staff costs:  trainers, training facilities, and written materials, to name a few.  Despite these costs, many city, county, or state agencies simply cannot afford to refrain further from training their staff on these issues.  Effective training can have a dramatic impact on the number of injuries, and deaths, that staff untrained to respond to a person with mental illness sustain. Such incidents generate high costs - both directly (overtime, compensatory time, lawsuits) and indirectly (community trust).  Nowhere in the country have such impacts of training been touted as impressively as in Memphis, Tennessee where the police department's pioneering work training officers to serve on crisis intervention teams reduced dramatically staff injuries and use of lethal force incidents. [2]

Recognizing the value of training while acknowledging the expense of providing this service, this section of the report suggests in numerous places how jurisdictions can minimize the expense of training by tapping existing resources in the community or government.  Stakeholders should also recognize the value of informal training, often known as experience exchange.  For example, a ride-along program that exposes mental health service providers to the daily experiences of a police officer is not costly, except in terms of staff time, but is instrumental to improving collaboration and trust across systems.  The same is true for training programs that allow criminal justice personnel to visit mental health crisis centers or community mental health facilities.

Although the discussion in this section of training curricula for various criminal justice and mental health constituencies recommends numerous topics that should be included in effective training, it is by no means an exhaustive description.  It is important for every community to evaluate its own needs and resources when determining what information should be included to improve the response to people with mental illness who come into contact with the criminal justice system.