The “Gray Zone” of Police Work During Mental Health Encounters

Published date01 March 2017
Date01 March 2017
Subject MatterArticles
The Gray Zoneof
Police Work During
Mental Health
Encounters: Findings
From an Observational
Study in Chicago
Jennifer D. Wood
, Amy C. Watson
and Anjali J. Fulambarker
Although improving police responses to mental health crises has received significant
policy attention,most encounters between police and persons with mental illnesses do
not involve major crimes or violence nor do they rise to the level of emergency
apprehension. Here, we report on field observations of police officers handling
mental health-related encounters in Chicago. Findings confirm these encounters
often occur in the gray zone,where the problems at hand do not call for formal
or legalistic interventions. In examining how police resolved such situations, we
observed three core features of police work: (a) accepting temporary solutions to
chronic vulnerability, (b) using local knowledge to guide decision making, and (c)
negotiating peace with complainants and call subjects. Findings imply the need to
advance field-based studies using systematic social observations of gray zone decision
making within and across distinct geographic and place-based contexts. Policy implica-
tions for supporting police interventions are also discussed.
police, mental health encounters, crisis intervention, peacekeeping
Department of Criminal Justice, Center for Security and Crime Science, Temple University, PA, USA
Jane Addams College of Social Work, University of Illinois at Chicago, IL, USA
School of Social Work, Simmons College, MA, USA
Corresponding Author:
Amy C. Watson, Jane Addams College of Social Work, University of Illinois at Chicago, 1040W
Harrison St., Chicago, IL 60607, USA.
Police Quarterly
2017, Vol. 20(1) 81–105
!The Author(s) 2016
Reprints and permissions:
DOI: 10.1177/1098611116658875
Although police performance is traditionally assessed in terms of clearance rates
and crime reduction, patrol of‌f‌icers have long functioned as “incidental”
health interventionists (Matthews & Rowland, 1954). Over 90% of of‌f‌icers on
patrol have an average of six encounters with individuals in crisis each month
(Cordner, 2006), and 7% to 10% of all police encounters involve people af‌fected
by mental illness (Borum, Deane, Steadman, & Morrissey, 1998; Franz &
Borum, 2011; Hails & Borum, 2003; Watson et al., 2010). For vulnerable citizens
who may not otherwise seek or be able to access help, the police operate as a last
resort “intercept” (Munetz & Grif‌f‌in, 2006), making critical decisions about how
to resolve encounters and whether to initiate formal interventions by criminal
justice, behavioral health, or social services.
Police decisions of how best to intervene are complex because mental illness is
often accompanied by substance us e, physical health vulnerabilities , and home-
lessness (Draine, Salzer, Culhane, & Hadley, 2002). Co-occurring substance use
disorders are highly prevalent among criminal justice system involved persons
with mental illnesses (Slate, Buf‌f‌ington-Vollum, & Johnson, 2013), with f‌igures
as high as 75% for jail populations (Abram & Teplin, 1991; National GAINS
Center, 2002). Experiences of homelessness are also common for justice-involved
persons living with mental illnesses or comorbid disorders (DiPietro &
Klingenmaier, 2013; James & Glaze, 2006; Markowitz, 2006; National Health
Care for the Homeless Council, 2013; Slate et al., 2013). With deinstitutionaliza-
tion from state psychiatric hospitals all but complete (Slate et al.,2013), the health
intervention role of police is both salient and controversial, especially given a
series of high-prof‌ile tragedies involving fatal shootings by of‌f‌icers (Goodman,
2015; Reuters, 2015; Santos & Goode, 2014; The Associated Press, 2015).
In addition to concerns about the misuse of force in the handling of mental
health-related encounters, much of the literature has focused on the “criminal-
ization” of those whose needs would be better served by behavioral health and
social services (Slate et al., 2013; Teplin, 1983, 1984). In ef‌forts to reduce crim-
inalization—and the rates of arrest leading to this—both researchers and prac-
titioners have advocated for interventions using specially trained personnel with
knowledge on how to recognize mental illness, de-escalate potentially volatile
encounters, and make the best possible use of health referrals or transports to
resolve situations. The most popular intervention models are the Crisis
Intervention Team (CIT) model, which includes police of‌f‌icers with specialized
mental health training (Hartford, Carey, & Mendonca, 2006; Schaefer Morabito
& Socia, 2015; Steadman, Deane, Borum, & Morrissey, 2000; Watson,
Morabito, Draine, & Ottati, 2008; Watson et al., 2010) and coresponse arrange-
ments (Hails & Borum, 2003; Victoria Auditor-General, 2009; Wilson-Bates,
2008) where health professionals such as psychiatric nurses or social workers
assist police through telephone consultations or by responding at the scene (for a
review, see Wood, Swanson, Burris, & Gilbert, 2011). Overall, such ef‌forts to
82 Police Quarterly 20(1)

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