The role of stigma and uncertainty in moderating the effect of procedural justice on cooperation and resistance in police encounters with persons with mental illnesses

Characterizing Arrests and Charges Among Individuals With Serious Mental Illnesses in Public-Sector Treatment Settings

OBJECTIVE

Individuals with serious mental illnesses are overrepresented in all facets of the legal system. State-level criminal histories of patients with serious mental illnesses were analyzed to determine the proportion who had been arrested and number of lifetime arrests and charges, associations of six variables with number of arrests, and the most common charges from individuals’ first two arrests and most recent two arrests.

METHODS

A total of 240 patients were recruited at three inpatient psychiatric facilities and gave consent to access their criminal history. Information was extracted from Record of Arrest and Prosecution (RAP) sheets for lifetime arrests in Georgia.

RESULTS

A total of 171 (71%) had been arrested. Their mean±SD lifetime arrests were 8.6±10.1, and mean lifetime charges were 12.6±14.6. In a Poisson regression, number of arrests was associated with lower educational attainment, Black or African American race, the presence of a substance use disorder, the presence of a mood disorder, and female sex. Common early charges included marijuana possession, driving under the influence of alcohol, and burglary and shoplifting. Common recent charges included probation violations, failure to appear in court, officer obstruction–related charges, and disorderly conduct.

CONCLUSIONS

Findings point to a need for policy and program development in the legal system (e.g., pertaining to charges such as willful obstruction of an officer), the mental health community (e.g., to ensure that professionals know about clients’ legal involvement and can partner in strategies to reduce arrests), and social services sectors (to address charges, such as shoplifting, often related to material disadvantage).

The Impact of Crisis Intervention Team Response, Dispatch Coding, and Location on the Outcomes of Police Encounters with Individuals with Mental Illnesses in Chicago

The Crisis Intervention Team (CIT) model has been implemented in over 3,000 communities across the USA. Research to date has shown beneficial results in terms of officers' knowledge, attitudes, self-efficacy, stigma, and force preferences. This study aimed to broaden the lens on the implementation context of CIT to examine whether factors in the environment and response process affect how calls are resolved. This study focused on several factors-CIT response, call location, and upstream decisions to pre-identify calls as mental health-related-that may impact call outcomes. Our findings suggest that CIT response, dispatch coding, and the places where calls originate play a role in shaping outcomes. More research is needed to unpack the effects of this wider CIT implementation environment.

Police Responses to Persons with Mental Illness: The Policy and Procedures Manual of One Australian Police Agency and ‘Procedural Justice Policy’

Persons with mental illness (PWMI) often report negative perceptions of police treatment following receiving criminalising and heavy-handed police responses. To appropriately control officer discretion and to harness ethical, legal, and efficient police practice when encountering vulnerable and diverse individuals, police agencies across the world issue policy documents to their officers. These documents serve as a reflection regarding how police agencies aspire to manage PWMI in the community. Using a procedural justice framework, this research measures how a large police agency in Australia aspires to manage PWMI and whether the police policy document provides sufficient detail in advocating the appropriate and just police treatment of PWMI. A content analysis of the policy document revealed a lack of sufficient procedural guidelines in effectively controlling police officer discretion when encountering PWMI in the community. This article argues that without further consolidation to embed appropriate procedural guidelines into the policy document, the procedural policy gaps may have a negative effect on the experiences of PWMI when encountering the police.

Caught in the currents: evaluating the evidence for common downstream police response interventions in calls involving persons with mental illness

The origins of this report, and of the Mental Health and Policing Working Group, can be traced to the unique situation Canadians have faced as a result of the COVID-19 pandemic. The unique circumstances of this global outbreak, which have for many Canadians resulted in serious illness and death, intensified economic uncertainties, altered family and lifestyle dynamics, and generated or exacerbated feelings of loneliness and social dislocation, rightly led the Royal Society of Canada’s COVID-19 Taskforce to consider the strains and other negative impacts on individual, group, and community mental health. With the central role that police too often play in the lives of individuals in mental and (or) emotional crisis, we were tasked with exploring what can be reasonably said about the state of our current knowledge of police responses to persons with mental illness.

The Stigma of Addiction and Effects on Community Perceptions of Procedural Justice in Drug Treatment Courts

We present a series of four between-subject, multifactorial experiments that examine how labeling offenders with addiction, as well as if that psychiatric label is described to be biologically influenced, may affect community perceptions regarding the importance of procedural justice in drug treatment courts. Stigmatization toward addiction is hypothesized to moderate community views on procedural justice. Labeling with addiction garnered nonsignificant effects on community perceptions of the importance of procedural justice in drug treatment courts. Yet, patterns of moderation analyses indicated that participants with higher degrees of stigmatization toward an offender with addiction, and particularly if that psychiatric label was also described to be biologically influenced, rated the importance of offenders experiencing aspects of procedural justice as significantly higher. Higher degrees of public stigmatization associated with the “brain disease model” of addiction appear to coexist with increased community support for offenders with such labels experiencing increased procedural justice and fairness.

A pilot study exploring mental health consumers' experiences with the police

Police encounters with people experiencing mental illness are both common and problematic. While there is an international body of literature on police officers' perceptions of mental-health-related incidents, few studies have sought to understand these encounters from the perspectives of people experiencing mental illness. This pilot study recruited 26 people through a state-wide Consumer Advisory Group who completed an online survey regarding their encounters with police. Results indicated that when people perceived procedurally just treatment from police they were more likely to co-operate with them and to evaluate the encounter positively. The nature of police involvement and levels of internalised stigma moderated the association between perceived procedural justice and their evaluation. Prior contacts were also important in shaping participants' overall attitudes towards police. Findings highlight the importance of officers treating people experiencing mental illness fairly and respectfully to facilitate peaceful encounters and help foster more positive perceptions of the police.

Depressive symptoms and sickle cell pain: The moderating role of internalized stigma

Recent studies describe the clinical implications of sickle cell disease (SCD) stigma. However, little is known about its link to depressive symptoms or its relative influence on the association between depressive symptoms and SCD pain. We examined whether internalized stigma about SCD moderated the relation between depressive symptoms and pain among 69 adults attending a SCD clinic who reported pain episodes and healthcare use over the past three months. Unadjusted bivariate analyses showed a marginal association between depressive symptoms and SCD pain frequency (r = .21, p < .10). Further analyses adjusting for health care use indicated a moderating effect of internalized stigma (b = -.10, p < .05): a significant association between depressive symptoms and pain was observed among participants low in internalized stigma, but this relationship was attenuated at moderate and high stigma levels. These results denote counterintuitive consequences of internalized attitudes about SCD and suggest a need for further study of the psychosocial and clinical implications of SCD stigma.

A Vicious Cycle: A Social-Psychological Account of Extreme Racial Disparities in School Discipline

Can social-psychological theory provide insight into the extreme racial disparities in school disciplinary action in the United States? Disciplinary problems carry enormous consequences for the quality of students' experience in school, opportunities to learn, and ultimate life outcomes. This burden falls disproportionately on students of color. Integrating research on stereotyping and on stigma, we theorized that bias and apprehension about bias can build on one another in school settings in a vicious cycle that undermines teacher-student relationships over time and exacerbates inequality. This approach is more comprehensive than accounts in which the predicaments of either teachers or students are considered alone rather than in tandem, it complements nonpsychological approaches, and it gives rise to novel implications for policy and intervention. It also extends prior research on bias and stigmatization to provide a model for understanding the social-psychological bases of inequality more generally.

Improving police interventions during mental health-related encounters: Past, present and future

There are calls across America for police to re-imagine themselves as "guardians" rather than "warriors" in the performance of their innumerable duties. The contentious history of police attitudes and practices surrounding encounters with people affected by mental illnesses can be understood through the lens of this wider push toward guardianship. At least as far back as the de-institutionalization of mental health care and the profound lack of community-based resources to fill service deficits, the role of police as mental health interventionists has been controversial and complex. This paper reviews the first wave of reform efforts designed to re-shape police sensibilities and practices in the handling of mental health-related encounters. We argue that such efforts, centred on specialized training and cooperative agreements with the health care sector, have advanced a guardian mindset through improved knowledge and attitudes about mental health vulnerabilities and needs. Building on the progress made, we suggest there are critical opportunities for a new wave of efforts that can further advance the guardianship agenda. We highlight three such opportunities: (1) Enhancing experiences of procedural justice during mental health-related encounters; (2) Building the evidence base through integrated data sets; and (3) Balancing a "case-based" focus with a "place-based" focus.

The Impact of Psychological Science on Policing in the United States

The May 2015 release of the report of the President’s Task Force on 21st Century Policing highlighted a fundamental change in the issues dominating discussions about policing in America. That change has moved discussions away from a focus on what is legal or effective in crime control and toward a concern for how the actions of the police influence public trust and confidence in the police. This shift in discourse has been motivated by two factors—first, the recognition by public officials that increases in the professionalism of the police and dramatic declines in the rate of crime have not led to increases in police legitimacy, and second, greater awareness of the limits of the dominant coercive model of policing and of the benefits of an alternative and more consensual model based on public trust and confidence in the police and legal system. Psychological research has played an important role in legitimating this change in the way policymakers think about policing by demonstrating that perceived legitimacy shapes a set of law-related behaviors as well as or better than concerns about the risk of punishment. Those behaviors include compliance with the law and cooperation with legal authorities. These findings demonstrate that legal authorities gain by a focus on legitimacy. Psychological research has further contributed by articulating and demonstrating empirical support for a central role of procedural justice in shaping legitimacy, providing legal authorities with a clear road map of strategies for creating and maintaining public trust. Given evidence of the benefits of legitimacy and a set of guidelines concerning its antecedents, policymakers have increasingly focused on the question of public trust when considering issues in policing. The acceptance of a legitimacy-based consensual model of police authority building on theories and research studies originating within psychology illustrates how psychology can contribute to the development of evidence-based policies in the field of criminal law.

The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care

Treatments have been developed and tested to successfully reduce the symptoms and disabilities of many mental illnesses. Unfortunately, people distressed by these illnesses often do not seek out services or choose to fully engage in them. One factor that impedes care seeking and undermines the service system is mental illness stigma. In this article, we review the complex elements of stigma in order to understand its impact on participating in care. We then summarize public policy considerations in seeking to tackle stigma in order to improve treatment engagement. Stigma is a complex construct that includes public, self, and structural components. It directly affects people with mental illness, as well as their support system, provider network, and community resources. The effects of stigma are moderated by knowledge of mental illness and cultural relevance. Understanding stigma is central to reducing its negative impact on care seeking and treatment engagement. Separate strategies have evolved for counteracting the effects of public, self, and structural stigma. Programs for mental health providers may be especially fruitful for promoting care engagement. Mental health literacy, cultural competence, and family engagement campaigns also mitigate stigma's adverse impact on care seeking. Policy change is essential to overcome the structural stigma that undermines government agendas meant to promote mental health care. Implications for expanding the research program on the connection between stigma and care seeking are discussed.