Police officers' views of their encounters with people with personality disorder

Destigmatizing Borderline Personality Disorder: A Call to Action for Psychological Science

Despite recognition that borderline personality disorder (BPD) is one of the most stigmatized psychological disorders, destigmatization efforts have thus far focused on the views and actions of clinicians and the general public, neglecting the critical role that psychological science plays in perpetuating or mitigating stigma. This article was catalyzed by recent concerns about how research and editorial processes propagate stigma and thereby fail people with BPD and the scientists who study BPD. We provide a brief overview of the BPD diagnosis and its history. We then review how BPD has been stigmatized in psychological science, the gendered nature of BPD stigma, and the consequences of this stigmatization. Finally, we offer specific recommendations for researchers, reviewers, and editors who wish to use science to advance our understanding of BPD without perpetuating pejorative views of the disorder. These recommendations constitute a call to action to use psychological science in the service of the public good.

Implementation and evaluation of a juvenile mental health training for law enforcement in a medium-sized jurisdiction

The need for specialized training programs that are focused on youth mental health needs, awareness of community-based services, and de-escalation skills is growing across law enforcement agencies due to calls for service that involve youth in mental health crisis. The current study evaluates a juvenile mental health training for law enforcement that was developed based on agency needs. The training was completed by 159 officers and a pre-/post-test design was used. Findings suggest that officers were satisfied with the training and improvements were seen across several training constructs (confidence, preparedness, stigma, resource awareness, and de-escalation skills). Satisfaction with the training predicted change in confidence and preparedness. Recommendations for future research and the implementation of juvenile mental health trainings are discussed.

Co-creation of five key research priorities across law enforcement and public health: A methodological example and outcomes

WHAT IS KNOWN ON THE SUBJECT?: Between policing and health, there are many shared issues. Mental health distress and crises and caring for people who may be vulnerable are priority areas. Working together in partnership is challenging, and fragmented systems and processes are the result. This leads to poor experiences for the police, health professions and the public. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper describes an event that brought together 26 stakeholders involved in law enforcement and public health. The aim of this work was to identify the biggest shared challenges that they experience in their day to day jobs. The five key priorities were as follows: vulnerability; mental health crisis; decision-making around assessment and triage across professional groups and professional roles; peer support and organizational well-being; and information and data sharing. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This paper demonstrates the strength of bringing partners together throughout law enforcement and public health, making proper time to actually discuss the "big issues" which affect them, how they each experience these issues, and how they might have overcome these within their own professions. Only through working together as partners and having everyone on the same page with the shared priorities can we really start to make a difference in the areas and with the people who matter. The focus on "vulnerability" and "mental health crisis" demonstrates the complexity of the issues between the professions, and that they need to find effective ways to work together to support people. No one professional group can solve inter-professional challenges alone. ABSTRACT: Introduction Law enforcement professions now assume more responsibility for tackling mental health issues alongside public health colleagues than ever before. The term "vulnerability" is frequently used within Law Enforcement and Public Health (LEPH) to identify those requiring emergency mental health care. However, there are ongoing challenges within LEPH to determine whose responsibility this is. Aim To co-create the most important priorities for LEPH research in Scotland. Method The paper describes a collaborative workshop which brought together an Expert Advisory Group (EAG) of 26 senior stakeholders, from academia, policing, mental health nursing, psychiatry, paramedics, emergency medicine, people with lived experience, policy makers and third sector. Results The five key priorities included: vulnerability; mental health crisis; decision-making around assessment and triage across professional groups and professional roles; peer support and organizational well-being; and information and data sharing. Discussion The paper discusses the EAG group event as a co-production process, focusing on how key LEPH research priorities were derived. Implications for practice This paper demonstrates the inextricable link between co-production and co-creation of value via EAG group consensus on LEPH research priorities. Shared vision and professional will are not enough to ensure progress: there must also be shared policy, knowledge and access.

Co-responding police-mental health programmes: Service user experiences and outcomes in a large urban centre

As police officers are often the first responders to mental health crises, a number of approaches have emerged to support skilled police crisis responses. One such approach is the police-mental health co-responding team model, whereby mental health nurses and police officers jointly respond to mental health crises in the community. In the present mixed-method study, we evaluated outcomes of co-responding team interactions at a large Canadian urban centre by analysing administrative data for 2743 such interactions, and where comparison data were available, compared them to 16 226 police-only team responses. To understand service user experiences, we recruited 15 service users for in-depth qualitative interviews, and completed inductive thematic analysis. Co-responding team interactions had low rates of injury and arrest, and compared to police-only teams, co-responding teams had higher overall rates of escorts to hospital, but lower rates of involuntary escorts. Co-responding teams also spent less time on hospital handovers than police-only teams. Service users valued responders with mental health knowledge and verbal de-escalation skills, as well as a compassionate, empowering, and non-criminalizing approach. Current findings suggest that co-responding teams could be a useful component of existing crisis-response systems.

Reconciling mental health, public policing and police accountability

The paper evaluates a range of policy documents, parliamentary debates, academic reports and statutes in an attempt to contextualise the condition of mental health policing in England and Wales. It establishes that mental health care plays an important role in public policing and argues that police organisations need to institute urgent reforms to correct a prevailing culture of complacency. An unethical cultural attitude towards mental health care has caused decision-making and the exercise of police discretion to be neither well informed nor protective in many cases, resulting in the substandard treatment of people with mental health problems. The paper argues that changes introduced by the Policing and Crime Act 2017 and the revised College of Policing mental health guidelines do not go far enough and that more extensive root-and-branch reforms are needed.

The Stigma of Personality Disorders

This article reviews the recent literature on the stigma of personality disorders, including an overview of general mental illness stigma and an examination of the personality-specific stigma. Overall, public knowledge of personality disorders is low, and people with personality disorders may be perceived as purposefully misbehaving rather than experiencing an illness. Health provider stigma seems particularly pernicious for those with borderline personality disorder. Most stigma research on personality disorders has been completed outside the USA, and few stigma-change interventions specific to personality disorder have been scientifically tested. Limited evidence suggests that health provider training can improve stigmatizing attitudes and that interventions combining positive messages of recovery potential with biological etiology will be most impactful to reduce stigma. Anti-stigma interventions designed specifically for health providers, family members, criminal justice personnel, and law enforcement seem particularly beneficial, given these sources of stigma.

Police use of TASER devices in mental health emergencies: a review

The proliferation of TASER devices among police forces internationally has been accompanied by concerns about injuries and health effects, and about the use of TASER devices on vulnerable populations such as people with mental illness. TASER devices have generated a flood of research studies, although there remain unanswered questions about some of the key issues. This paper outlines the introduction of TASER devices to policing and their subsequent widespread adoption. The paper considers the role of police in mental health emergencies with a particular focus on use of TASER devices. Some factors contribute to the special vulnerability of people with mental illness to the effects of TASER devices. The paper also reviews research into use of TASER devices and raises issues about conflict of interest in research into TASER devices. We conclude that TASER devices look set to play a significant role in policing in the future. We make suggestions for a future research programme, and suggest guidelines for publication of papers in which there may be a conflict of interest.