The Intersection of Health and Justice: An Evaluation of Mental Health First Aid Training for Justice-involved Professionals

• Published date: 01 March 2024
• DOI: http://doi.org/10.1177/10986111231169275
• Author: Christine L. Arazan,Leah Weich
• Date: 01 March 2024
• Subject Matter: Articles

Article

Police Quarterly

2024, Vol. 27(1) 31–52

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DOI: 10.1177/10986111231169275

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The Intersection of Health and

Justice: An Evaluation of

Mental Health First Aid

Training for Justice-involved

Professionals

Christine L. Arazan

1

and Leah Weich

1

Abstract

Where historically justice and behavioral health professionals have functioned inde-

pendently in systems that often collide, the ability to provide community b ehavioral

health training to justice involved professionals may lead to enhanced public safety and

decreases in incarcerations. This study evaluated the impact of the Mental Health First

Aid program completed by 85 justice professionals. Study participants completed a

questionnaire before and after the training to assess the impact on knowledge, atti-

tudes, and beliefs. Findings suggest the training reduced stigmatizing attitudes and

improved participants’recognition of mental health disorders, self-conf‌idence in

providing help, and intent to help. The results of this study provide preliminary evi-

dence supportive of justice communities investing in the Mental Health First Aid

training consistent with the International Chiefs of Police Association’s commitment to

the “One Mind Campaign”to ensure that justice professionals have the skills to safely

and responsibly meet the needs of people with mental illness

Keywords

mental health f‌irst aid, justice professionals, law enforcement, jail, behavioral

health

1

Northern Arizona University, Flagstaff, AZ, USA

Corresponding Author:

Christine L. Arazan, Criminology and Criminal Justice, Northern Arizona University, P.O. Box 15005 5 E.

McConnell Drive, Flagstaff, AZ 86011-5005, USA.

Email: Christine.arazan@nau.edu

Collisions frequently occur at the intersection of mental health and criminal justice,

with tragic and sometimes fatal consequences. Nearly half (44%) of individuals in-

carcerated in U.S. jails have a history of a mental health conditions (Bronson and

Berzofsky, 2017), and those with serious mental illness have a 60% f‌ive-year re-arrest

rate when released from correctional facilities (Torrey et al., 2017). However, despite

frequent encounters, law enforcement and corrections off‌icers are often inadequately

trained to respond to persons with mental illness (PwMI) (Morgan and Miles-Johnson,

2022).

Whether responding to a suicide attempt or a report of a disorderly person, police

off‌icers are often the f‌irst to arrive to crises involving PwMI (Vermeer et al., 2020).

Called “streetcorner psychiatrists”by some (Watson and Angell, 2013), police off‌icers

often prescribe the fates of PwMI, inf‌luencing whether they receive proper treatment,

are left to continue to manage their current situation on their own, or are cycled through

the criminal justice system (Watson et al., 2008). Approximately one in 10 calls that

off‌icers respond to involve PwMI (Lord & Bjerregard, 2014), and police spend more

time responding to these calls than they do on assaults, burglaries, and traff‌ic incidents

combined (Cordner, 2006).

Caused by misconceptions that often stem from a lack of mental health education,

many people hold stereotypes and prejudices regarding mental illnesses. Link et al.

(1999) found the public tends to desire social distance from individuals depicted with

symptoms of mental illness in vignettes, as well as perceive them as disproportionately

dangerous compared with any real threat posed. Unfortunately, justice-involved

professionals are not immune to these stigmatized beliefs. In fact, recent evidence

suggests that police hold more stigmatizing views towards PwMI than other com-

munity members (Tartaro et al., 2023). As an off‌icer’s actions regarding use of force are

inf‌luenced by a suspect’s demeanor (Farrell, 2022), this consideration of stigma is

especially relevant to police work, and it is even more of a concern today. Americans

were found to be twice as likely to perceive people with schizophrenia as violent in

2018 than they did in the 1996 (Pescosolido et al., 2021). However, police interactions

are actually more likely to be dangerous for the PwMI than for the off‌icers (Cordner,

2006). While mental illness was only attributed to one out every 42 fatal assaults on

police off‌icers in the United States between 1993 and 2002 (Cordner, 2006), PwMI die

in approximately one of every four fatal police interactions (Saleh et al., 2018) and are

16 times more likely to be killed in a police encounter than the general population

(Fuller et al., 2015). When police off‌icers perceive PwMI as a threat and have limited or

no training on how to peacefully defuse these types of crises, they may resort to undue

force, or in other cases, “mercy bookings”in order to maintain the safety of themselves

and/or others (Smith et al., 2022). This greatly contributes to the critical issue that

PwMI represent a disproportionately large fraction of the jail and prison populations

(Bronson and Berzofsky, 2017). In America, there are three times more severely

mentally ill people in jails and prisons than in hospitals. In Arizona, one of the worst

states for access to mental health care, the ratio balloons to almost 10 times more

(Torrey et al., 2010).

32 Police Quarterly 27(1)