Although encounters with people who have mental illness constitute a relatively small portion of a police department's service calls, such encounters are complex and time-consuming. In about 30% of cases the individual is taken into custody and transported to an emergency room, a mental health facility, or jail. The remaining calls are resolved informally, and officers are able to provide only short-term solutions. Thus the same individuals are encountered repeatedly, which strains limited resources and fosters frustration.

In response, many jurisdictions are exploring ways to improve the outcomes of these encounters, with a response that prioritizes treatment over incarceration when appropriate. To assist these efforts, the Council of State Governments Justice Center, in partnership with the Police Executive Research Forum, led a consensus process that identified ten essential elements of successful law enforcement-based response programs. The components, which are described in a recently issued report, are derived from recommendations made by law enforcement personnel, mental health professionals, advocates, and mental health consumers. An early draft was posted on a Web-based discussion forum, and hundreds of stakeholders provided feedback for incorporation into the report. Until this effort was undertaken, there was limited debate or agreement at the national level about which elements are essential, the report notes.

The ten essential elements are collaborative planning and implementation; program design; specialized training; call-taker and dispatcher protocols; stabilization, observation, and disposition; transportation and custodial transfer; information exchange and confidentiality; treatment, supports, and services; organizational support; and program evaluation and sustainability. The report is designed for use by a community planning committee seeking to create and implement an effective program. Each element is briefly described, and several details are presented for the committee's consideration. For example, in the description of custodial transfer, program planners are reminded that because many people with mental illness have a history of trauma, custodial restraints may escalate agitation, and policies regarding use of restraints should be carefully reviewed. In addition, planners should ensure that facilities capable of assuming custodial responsibility are available at all times, have personnel qualified to conduct a psychiatric evaluation in a timely fashion so that officers can return quickly to their duties, and have a policy never to turn away individuals brought by law enforcement.

The report, Improving Responses to People With Mental Illnesses: The Essential Elements of a Specialized Law Enforcement-Based Program, follows and builds on a report published earlier this year—The Essential Elements of a Mental Health Court. The reports are available at www.consensusproject.org/mhcp. A similar consensus document describing elements of programs that bring together corrections systems and mental health systems is in development. The reports are supported by the Bureau of Justice Assistance of the U.S. Justice Department.