Public safety concerns often transform into extraordinary challenges when law enforcement personnel are confronted with situations involving mentally ill individuals.

Those challenges can be daunting, and police officers and experts in the field say training for such occurrences is ongoing.

Many national incidents that have occurred in recent years have highlighted the need for police to better interpret the reasons behind certain actions, and how to deal with those actions in the moment.

While police officers are trained to handle the situations, officials said they haven’t seen much of a pattern in the number of mentally ill people they encounter.

“I wouldn’t say that we’ve experienced any change,” Carlisle Borough Police Chief Stephen Margeson said. “We have always had ... incidents of dealing with mentally ill or emotionally disturbed persons. It’s not like it is a pervasive problem. It is not uncommon, but it is not a pervasive, overwhelming problem for us.”

Trooper Adam Reed, coordinator of the Pennsylvania State Police public information office, said officers are required to fill out an incident form, the Mental Health Act report, for such encounters. The number of incidents has wavered with 455 incidents reported in 2011, 394 incidents reported in 2012 and 431 incidents reported in 2013.


Officers’ interactions with people, whether suspects or others involved in a situation, can be compounded when one of those people is affected by mental issues. Reed said that while it is important to identify behaviors, and to help those suffering from these issues, a key training aspect is officer safety.

“It certainly is important that we are aware of all the different conditions that do exist out there to properly deal with these individuals on a daily basis,” he said. “For example, it’s important for a police officer to determine when someone may be acting out of the ordinary due to some sort of a mental health condition as opposed to something like, say, a narcotic.”

Being able to recognize these issues helps officers determine how they will interact with the person, he said.

“Each case is more or less going to be different each time,” he said. “Each case is going to have its own set of circumstances the officer is going to have to be aware of to stay on top of things.”

Lance LoRusso, former police officer, Georgia attorney and author of “When Cops Kill,” said there is a dichotomy at work when police are called to a scene. This is present in their initial mission of safety for all involved.

“How do we manage that public safety element and still try to keep the situation as calm as possible without escalating? That is the question,” he said. “The first obligation that they have is to make sure that the public safety is protected, them included. These situations can turn violent very quickly — we’ve seen that several times in the news — and also maintain that they are doing the best to contain whatever threat level is there to the immediate environment.”

Margeson said that many times, officers don’t know what they are stepping into until they arrive at the incident location.

“In some cases, as far as officers may be concerned, the information available to them, they may simply be dealing with a criminal suspect,” he said. “Somebody that they have no idea about perhaps the mental state or the capacity of the individual, officers may only know about the specific conduct or behavior that this person may be engaged in which would be a crime. So now they will start out perhaps investigating it as a crime or maybe trying to take somebody into custody and arrest somebody without any knowledge that we do have a medical or mental illness or emotionally disturbed person there.”

While officers may be aware of specifics regarding a person, they undergo training in recognizing behaviors that would lead them to suspect mental issues are at play in the situation, and how to respond accordingly.


Mental health officials said it is important for police to understand these situations, in order to keep them from spiraling out of control.

“In my mind, what I would see as some of the challenges are time parameters that the officers would be dealing with,” said Michael Grier, director of Mental Health Services at Keystone Human Services. “They already have a lot on their plate at any time during the day or evening, and sometimes it may take a little bit of time to work through an issue with a person with a mental illness.”

Grier said that police, attempting to get the bottom of the problem, could be considered impatient by the individual. He said police need to be aware of these situations to keep everything under control and within safety concerns.

Silvia Herman, administrator of Cumberland-Perry Mental Health/Intellectual & Developmental Disabilities, an alliance of three organizations sharing the mission of empowerment and community support, said that police often have a very difficult job determining behaviors and why they are occurring, as well as the most appropriate method of response.

“It is important to understand that when drugs or alcohol enter the mix around behavior, that is an increased danger risk, both for the police officer, the community as well as the individual,” she said. “I think that learning to differentiate between and among multiple various factors, while maintaining safety because that is what police do first, is challenging.”


On order to de-escalate situations, officers are trained in dealing with individuals experiencing extreme mental or emotional distress.

Training and education are important for officers to learn how to deal with those facing these issues. Margeson said officers are trained from the beginning on identifying mental issues and tactics for dealing with those issues.

“Officers are, certainly at the entry level as part of the academy training, there is some basic instruction provided for officers in terms of dealing with the mentally ill or citizens with special needs,” he said,

Ongoing training is offered through several services for officers, which update and continue practices in properly dealing with individuals with mental illness. However, such incidents usually evolve rapidly, and even with all the training in the world, officers’ prime objective is community safety.

“There is no one single answer, solution or method,” Margeson said. “It depends on the circumstances and the degree of mental illness or how emotionally upset or disturbed at any given time.”

He said officers have to use their judgment, patience and training, to remain calm and deal with the situation.

Reed said the Commission on Accreditation for Law Enforcement Agencies, a credentialing agency that helps ensure police agencies maintain a certain operational standard, provides in-service training to the agencies members at least once every three years dealing with people with mental illness.

This in-service training, as well as stand-alone courses on mental illness, is offered to all officers, to provide information and coping mechanisms in order to keep situations from spiraling out of control.

Reed said that when trainees enter the State Police Academy to become officers, they given several courses on the topic as basic instruction that officers need in the streets.

Several courses have been offered over the past years, including aggression in the assault cycle, specifically as it relates to mental illness; autism; mental illness and behavior health issues; recognizing special needs; traumatic brain injury and a course on post traumatic stress disorder.

“It’s very important that officers are aware of these issues, quite simply because you don’t know what you are getting into as an officer when you are responding to calls on a daily basis,” he said. “We deal with all different types of people with all different types of backgrounds, so it is important we understand those people and are able to properly interact with them.”

Margeson said that in many cases, officers interact with certain individuals on a regular basis, in the daily community, building a relationship with them in order to understand certain problems and how to interact. “We do know that we have mentally ill people in the community, sometimes our officers have actually gotten to know these folks, because we’ve had dealings with them in the past. Sometimes that’s beneficial, where an actual relationship or rapport can be developed,” he said.

Emergency medical services personnel are also called to the scene, due to the combination of medical and mental issues. Officers often will use family or friends as assistance with dealing with individuals, in order to help resolve the situation.

“But that’s not a guarantee. Sometimes that can actually in some cases inflame a situation, can escalate the hostility or situation. That’s not a given either,” Margeson said. “There is no single rule book, do this step one two three, a lot of it is going to have to rely on the judgment and decision making that officers have to engage in literally in the moment, during the incident.”

LoRusso said training has advanced in the past 20 years, giving officers, “more arrows in their quiver,” in dealing with these volatile type of situations. “Even back in 1988 when I went to the police academy, we had a block of instruction dealing with the mentally challenged or the mentally disabled or mentally ill,” he said.

Crisis intervention training, which is also available to police agencies in Pennsylvania, teaches coping mechanisms to de-escalate situations when someone is mentally ill and going through some sort of a crisis, he said.

“A great deal of advanced training has taken place, and analyzes in how to deal with situations involving the mentally ill when there is a public safety intervention, things like suicide attempts, people standing on bridges, buildings, barricaded subjects, so the training has increased a great deal in the last 20 years,” he said.

Police are trained to evaluate on reaching a scene whether they are dealing with someone with mental illness. This comes through analysis of behaviors, actions or what the individual is saying. They are then trained in coping mechanisms to help resolve the situation.

“They can be very troubling incidents all the way around,” Margeson said.