On January 25, 2012, officers of the Portland Police Bureau (PPB) responded to a call of a suicidal subject armed with a handgun (later determined to be a replica) which culminated in the death of Brad Lee Morgan. In response to this incident, city officials asked for a review of suicide calls and related data, which led to a larger investigation of what factors may be influencing police interactions with persons in mental health crisis. Upon review of the data, it was found that annual suicide calls to 911 in Portland grew from 630 to 12,003 per year from 2001 to 2011. The volume of calls may fluctuate in frequency due to broader societal factors, such as growing homeless populations, changes in care for those with mental illness, and increasing demand due to structural factors (such as a financial crisis).
Understanding what influences the occurrence of these incidents, whether these incidents are increasing or decreasing over time, and what the outcomes of these incidents are is critical for future planning. It is also important to analyze the outcomes of police interactions with those experiencing crisis, especially incidents that include use of force.
PRIMARY RESEARCH QUESTION(S)
What factors contributed to the increase in mental health crisis calls and how did the PPB respond to these demands?
This report contains an analysis of Bureau of Emergency Communications (BOEC) (911) call data between 2001 and 2011 related to suicide and other call types, an analysis of reports on the mental health system, and statistical data related to suicide. Interviews were conducted with BOEC staff, PPB staff, community experts on suicide and mental health issues, as well as individuals involved in community mental health. Data concerning involuntary commitment, Multnomah County’s Investigative Commitment Program (ICP), and police holds was gathered from the PPB Statistical Support Unit and queries of the Bureau’s SQL server.
Researchers found that the following factors contributed to the rise in interactions between police and people experiencing mental health crisis:
Since 2004, Multnomah County expanded mental health services to adults by 90 percent (this does not necessarily indicate increased need but demonstrates improved service delivery and may indicate increased demand).
Since 2001, total suicides have increased by more than 33 percent (although rates have risen less and decreased considerably since the mid-1990s).
Suicide calls responded to by the Portland Police Bureau have risen 90 percent since 2001.
Attempted suicides have risen by nearly 13 percent since 2001.
Welfare check calls (a broad range of calls, only some of which are related to mental health) have risen 39 percent since 2001.
Investigations by Multnomah County’s ICP have risen nearly 70 percent since 1998 (this is exceptionally important as the ICP investigates holds for mental health issues prior to civil commitment and is an excellent indicator of increased demand related to issues surrounding mental health).
Despite the increase in these contacts, use of force by Portland Police Officers has decreased substantially over the last four years.
Contact between police and persons in a mental health crisis in Portland has grown in the last 15 years. In response, PPB has provided every single officer with Crisis Intervention Training, instituted a mobile crisis unit consisting of an officer and a mental health professional, developed excellent relationships with mental health partners, and instituted a more robust review of force. PPB may benefit from additional research, including:
The creation of a police-friendly (no refusal) facility to a quick-release, priority access facility, that will accept persons with co-occurring mental health crisis and substance abuse.
The institution of a system-wide review of outcomes related to all mental health holds, with an emphasis on holds which do not qualify for a notice of mental illness resulting in an involuntary hospitalization or admission to the CATC. This should be re-occurring (possibly quarterly) and outcomes should be shared with police officers to help improve their responses to these issues.
Renewed promotion of the dedicated police line in the Multnomah County 24 hour Mental Health Call Center available to officers wanting immediate access to mental health information, if available, during the course of an encounter.
Stewart, G., Gerritsen, L., Covelli, E., & Henning, K. (2012). Report on Police Interactions With Persons in Mental Health Crisis. Portland, Oregon: Portland Police Bureau.