Policing a neurodiverse world

February 20, 2024

When responding to calls related to mental health crises, police should work to change the environments where people with psychiatric disabilities live and work, rather than simply connecting them with medical intervention.

Professor David Thacher, a nationally renowned expert in criminal justice policy, makes this argument in a new paper published in Policing: A Journal of Policy and Practice.

Over the past three decades, police departments across the country have adopted models designed to manage “mental health” incidents. The most wide-spread model, Crisis Intervention Team (CIT), aims to improve safety during these incidents by training officers to recognize signs of mental illness, de-escalating encounters with people in crisis, and offering access to treatment rather than punishment.

But programs like CIT miss the opportunity to address more widespread problems in the community’s capacity to support people with psychiatric and cognitive disabilities, Thacher said.

“Apart from the work they do in improving access to mental health treatment, police also have work to do to improve society’s capacity to accommodate neurodivergent people,” he said. “Police should think not just what can we do with this individual, but what can we do in this environment to prevent this from happening again?”

Thacher suggests that the social model of psychiatric disability—which calls on society to better accommodate people with mental and cognitive disabilities—can help police departments think more broadly about this important part of their work.

“If you think about why psychiatric disability leads to the kinds of conflicts or crises that lead someone to call the police, it’s often something about the social institution or community environment,” he explained.

Thacher cites an example of a police department in Durham County, England, which received 10 calls a month from a facility called the Croft Unit, which housed two dozen people with psychiatric and cognitive disabilities. Most of the calls came from staff at the facility reporting assaults, property damage, and disruptive behavior instigated by residents.

Overwhelmed by the calls, the police set up a meeting with Croft Unit staff. They learned that minor conflict often spiraled out of control because staff lacked the training to de-escalate these situations. Turnover among staff was high, and new staff members did not receive complete information about individuals at the facility. In addition, the facility was often understaffed overnight.

Police reported their concerns to the facility’s management team and the local county council. Staff members received additional training on how to handle conflict and calls from the Croft Unit fell slightly, but officers still felt they were responding to calls that staff should have handled on their own. Eventually, the police department contacted the Care Quality Commission, the agency charged with oversight of health care facilities in England. The agency conducted two surprise inspections and found that Croft was not following established standards of care.

As a result, the company that owned the facility fired the manager and hired someone with extensive mental health experience. The new manager relocated a few high-needs residents to other facilities that could more adequately meet their needs and improved conflict-management training for staff. Police calls from the facility fell by more than 80% after these changes.

The Croft example illustrates several important points, Thacher said. Most importantly, police have the capability to improve institutions in their communities to better serve people with psychiatric and cognitive disabilities.

By highlighting institutional failures, police departments can instigate change that makes a lasting difference, Thacher said. “Sometimes it’s not the individual, but the people or environment around them that are escalating the crisis.

“By virtue of the work they do, police end up being in touch with how institutional practices are working, and how they are not working,” he said. “Police often know before anyone else in a community about those problems.”

Thacher’s goal is to raise awareness about the social sources of police calls that involve people with psychiatric and cognitive disabilities, and encourage police departments to think more broadly about trends in their own communities.

“I want to point to existing examples of different strategies to address these problems, and encourage police departments to approach this part of their work from a different viewpoint,” he said.


Written by Sheri Hall.