Law enforcer or social worker? Exploration of the role of police in responding to persons with mental illness

Police are increasingly responding to incidents involving persons with mental illness (PMIs). This is an important area of research considering the well-documented challenges these types of interventions represent for police officers and police agencies more broadly. Yet, to date, there remains limited empirical knowledge about the extent of police involvement with PMIs, particularly in the Australian context. Similarly, little is known about police officers’ perception of the role they perform with PMIs and the influences that shape their role performance, despite evidence of the challenges modern-day police are facing in the attempt to consolidate the ‘law enforcer’ and ‘service’ elements of the police role. The overarching objective of this research program is to gain a better understanding of the role of police in responding to PMIs. Within this objective, three more specific aims are derived, each targeting a distinct, yet complementary, component of police roles with PMIs: 1) To examine the frequency, distribution and outcomes of police involvement with persons with mental illness in Queensland, Australia; 2) To examine police officers’ attitudes towards their role in responding to persons with mental illness; and 3) To use the role episode model to examine the perceptions and experiences of police officers in responding to persons with mental illness. The role episode model was chosen as a theoretical framework that guided this research program. This model allows for a comprehensive exploration of police officers’ perceptions of this element of police role through an identification of the members of their role set, analysis of the expectations held by each role sender, and finally by studying the presence and outcomes of role-related stress. Two research studies were conducted, addressing a total of 15 research questions. In Study 1, Queensland Police Service (QPS) administrative data from two selected police regions in Queensland were analysed for the frequency, distribution and the outcomes of police-PMI encounters. In Study 2, an online survey with 242 sworn QPS officers was undertaken to examine their perceptions of the role of police in responding to mental health related calls for service. In Study 1, 12,415 mental health related calls for service were identified, accounting for 2.6% of all calls for service. Significant temporal and spatial variation of these calls was noted. Socio-demographic characteristics identified as increasing the rate of police-PMI contacts included: younger median age, smaller population size, low percent of Indigenous population, high percent of population with severed disability, and a greater degree of socioeconomic disadvantage. An analysis of the outcomes of mental health calls showed frequent utilisation of health-related pathways, predominantly by initiating transfers to a mental health facility, and a very low incidence of arrests. The likelihood of a health-related outcomes was increased when the call was initiated by an ambulance officer or other professional agencies, when the incident occurred in a public location (rather than in a private residence), when there was a risk to PMIs’ life, or any indications of violence or aggression. In Study 2, police officers reported that on average, a quarter of their time is taken up by engagements with PMIs, and most of them felt that this is too much. Overall, officers accepted their involvement with PMIs as part of their role, though a considerable number continued to feel that the extent of their work with PMIs is excessive and reflective of the failings of the mental health system. Participating police officers identified on average four persons or groups as having an important influence on how they perform their work with PMIs: these were most commonly themselves, colleagues, their immediate supervisor and PMIs. Officers described their personal expectations regarding their work with PMIs as requiring an equal application of the ‘law enforcement’ and ‘service’ aspects of their role. Their expectations were aligned with those perceived to be held by other members of the police service, however, for the majority of officers, they were incongruent with the more service-oriented expectations attributed to the broader community and the mental health sector. The study results revelated moderate levels of role conflict and low levels of role ambiguity resulting from police work with PMIs. Various organisational and personal factors were found to predict the likelihood of experiencing high levels of these role-related stresses. Of particular interest is a positive association between the officers’ identification with the ‘crime control’ aspects of their role and high levels of role-related stress. Finally, results showed that role ambiguity, but not role conflict, increases the likelihood of officers reporting poor job satisfaction. The theoretical contribution of this research is through an innovative application of the role episode model to research on mental health policing. It offers a confirmation to the previously debated, but never empirically investigated, argument that engagements with PMI place police within a complex network of stakeholders and exposes them to role expectations from disciplines that are characterised by different expectations about provision of care to vulnerable members of society. There are also several practical implications of the findings of this research program. Most notably, information about spatial and temporal distribution of mental health calls for service can be used to guide the data-driven, targeted allocation of police resources using the principles of hot-spot policing. The information about the extent of police involvement with PMIs can also help improved police officers’ awareness of the realities of mental health policing. Finally, several recommendations for future research are highlighted, particularly around the need to examine the role of occupational socialisation on the development of police officers’ perception of their role as first responders to mental health related incidents. It is hoped that continued research into these topics can continue to support police in providing safe and effective responses to people experiencing mental health crises.