The perceptions that the police and people with mental illness have of one another can influence the nature and quality of their interactions. Though a considerable body of research exists concerning the perceptions of police officers towards people with mental illness, there is a dearth of research focusing specifically on the perceptions that people with mental illness hold toward the police. The research described within this report is focused on addressing this knowledge gap.

Section 1 Highlights – Research Overview

The study was carried out in British Columbia, Canada from August 2009 to March 2011.

• The goal of the study was to improve the understanding of how people with mental illness perceive and interact with the police.
• A Participatory Action Research approach was used in the study to promote community engagement, active participation, and collaboration of people who live with a mental illness.
• The study included literature review, interview, survey, and focus group methods.
• The study participants were comprised of people who live with schizophrenia, schizoaffective disorder, other psychosis, or bipolar disorder and have had direct contact with the police, including 60 people who participated in interviews, 244 people who completed surveys, and 28 people who took part in focus groups.

Section 2 Highlights – Literature Review

A review of the research literature revealed several interesting trends regarding how people with mental illness have perceived and interacted with the police in other jurisdictions. For example:

• 2 in 5 people with mental illness have been arrested in their lifetime.
• 3 in 10 people with mental illness have had the police involved in their care pathway.
• 1 in 7 referrals to emergency psychiatric inpatient services involve the police.
• 1 in 20 police dispatches or encounters involve people with mental health problems.
• Half of the interactions between the police and people with mental illness involve alleged criminal behaviour.
• 2 in 5 encounters between the police and people with mental illness involve situations that are unrelated to criminal conduct.
• The majority of interactions between the police and people with mental illness are initiated either by the police (~25%), the person with mental illness (~15%), or their family (~20%).
• People with mental illness are over-represented in police shooting, stun gun incidents, and fatalities.
• Police encounters with people who have mental illness that involve police use of force are rare.
• Half of police encounters that involve people with mental illness result in transport or referral to services.
• 2 in 5 encounters between the police and people with mental illness are resolved informally.
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• 1 in 7 contacts between the police and people with mental illness end in arrest.
• Overall, people with mental illness who are suspected of committing a criminal offence are more likely to be arrested compared with those without mental illness; however, this varies by offence type, gender of the suspect, among other factors.
• Perceptions of people with mental illness about the police are neither uniformly positive nor negative.

Section 3 Highlights – Participant Priorities

The participants identified six major and five minor topic areas as priorities for the research study, which were used to guide the development of the interview and survey materials. The major topic areas pertained to:

• How people describe being treated by the police and how they perceive the police.
• Access to, and use of, information by the police.
• Use of force by police officers, which primarily concerned the experience of being the recipient of a police officer’s force.
• Personal experiences with being helped or assisted by the police comprised the fourth major topic area.
• The process and outcome(s) of interacting with the police.
• The degree to which mental illness has influenced encounters with the police.

Section 4 Highlights – Attitudes about the Police

• The survey results suggest that people with mental illness in British Columbia (BC) tend to hold more negative attitudes, in comparison to the general public, toward the police.
• Survey participants were more likely to rate police performance across several domains as ‘poor’ and less likely to rate police performance as ‘good’ in comparison to the general population of BC.
• In contrast to the 76% of the general public in BC that endorsed confidence in the police, only the slight majority of participants in our survey indicated that they had confidence in the police.
• More than three-quarters of the survey participants endorsed a positive view of the police in relation to respect for and legitimacy of the police role.

Section 5 Highlights – Interactions with the Police

• Numerous and recent contacts with the police were common among the participants, with 21% of survey participants and 37% of interview participants reporting more than 25 interactions with the police during their lifetime.
• A diverse range of situations and circumstances have brought participants into contact with the police. For example:
  • A common type of interaction involved being transported (e.g., to hospital or to jail) by a police officer, which was experienced by 90% of interview participants and 65% of survey participants.
  • Interactions with the police that involved a mental health crisis were experienced by 66% of survey participants and 35% of interview participants.
  • Many of the survey (48%) and interview (64%) participants had an interaction with the police in relation to their alleged criminal behaviour.
  • A large proportion of the participants also report interacting with the police in the context of requesting assistance as a victim of a crime, being stopped on the street, or in a casual or informal situation.
• More than three-quarters of the interview participants have been handcuffed or physically restrained by the police.
• A quarter of interview participants have been involved in an interaction with police that resulted in minor injury to the participant (not requiring medical attention), whereas 12% reported suffering serious injury (requiring medical attention).
• Survey participants generally tended to indicate that they were satisfied, rather than dissatisfied, with the way in which the police handled previous situations, especially those that did not involve suspected criminal activity (e.g., mental health crises).
• The slight majority of the interview participants rated their previous contacts with the police as a positive experience overall. One-third perceived their previous interactions with the police as a negative life experience.

Section 6 Highlights – In-Depth Perceptions of Most Recent Contact

• Interview participants were asked detailed questions about their most recent interaction with a police officer.
• Interview participants’ most recent experiences with the police were diverse, but commonly included a mental health crisis (28%), being stopped on the street by the police (18%), or requesting assistance from the police as a victim of a crime (18%).
• The majority of interview participants, including those who were experiencing a mental health crisis, perceived that they were treated in a procedurally fair manner by the police officer(s) who were involved in their most recent interaction. For example:
  • 85% indicated that they were treated with respect by the police officer(s).
  • 76% were satisfied with the way in which the officer(s) handled the particular situation.
• Items that were less frequently endorsed by the participants concerned whether participants understood, or were told by the officer(s), what was happening to them during the interaction, or what would happen to them after the interaction.
• The majority of interview participants were satisfied with the way in which their most recent interaction with the police was handled by the officer(s), with 80% indicating that they felt that the officer did a good job dealing with the situation.
• Many participants indicated that improvements could be made to they way in which their most recent situation was handled by the police. For example:
  • Almost half of the participants indicated that the situation could have been handled better.
  • More than a third of participants felt that, in the future, a similar situation should be handled differently.

Section 7 Highlights – Participant Recommendations

• Most interview participants thought it would be helpful for a police officer to have access to background information about a person with mental illness prior to arriving on scene with them; especially, if the officer was trained how to use the information appropriately.
• 90% of interview participants felt that it was ‘very’ or ‘extremely’ important to train police officers to handle situations that involve people with mental illness.
• Participants recommended the following elements for a training program that teaches police how to handle situations involving people with mental illness: (a) effective communication skills, (b) understanding mental illness and its effects, (c) treating people with compassion and respect, and (d) non-violent conflict resolution skills.
• Additional strategies suggested for improving how people with mental illness perceive and interact with the police included: (a) building stronger linkages between the police and the mental health community, (b) recognizing and rewarding positive police practices, (c) selecting and supporting police officers, (d) creating positive role models among police officers, (e) increasing accountability and oversight of the police, and (f) ensuring that health professionals are involved in responding to mental health-related calls for police service.