Cutting social services puts strain on local police

As the state Legislature wrestles with difficult budget decisions relating to the fate of many social service programs, research suggests that changes implemented by the legislative budget cuts last session have corresponded to a strain on local emergency services.

Data from a study done by the University of New England School of Social Work in the late fall of 2007 suggest that police departments statewide have seen a 26 percent increase in the number of mental health-related calls for service. A majority of these calls for service also include evaluations at the emergency room. Police data suggest that a majority of these calls for service require transport and psychiatric evaluation in an emergency room often lasting between two and five hours.

If the trend continues, it is estimated that the increase in mental health-related calls for service and its impact on emergency room visits by law enforcement officers with mentally ill patients will be more than $1.3 million by June 2008. Of particular note is the marked increase in the calls for service between May and September 2007, when the state budget cuts from the last legislative session were fully implemented. As such, the data suggest that police departments across Maine have become the de facto emergency mental health provider in many areas of the state.

Mental illness has a chronic component much like any other disease. This means that just like a person with a chronic illness such as diabetes must develop strategies and changes in behavior to cope with the disease, such is the typical course of treatment for a person suffering with mental illness. Left untreated, a person with mental illness cannot develop these coping strategies and may have a mental health crisis, much like a physical health care crisis for someone who has untreated heart decease or diabetes.

A mental health crisis can take many different forms and untreated mental illness creates a host of community-related problems. When a person is a danger to themselves or others, law enforcement may be the first call to access emergency services. When a law enforcement officer receives a report of a suspected mental health crisis, he or she has limited options. If there is a credible danger, the law enforcement officer might take the person to the local emergency room for a mental health assessment and evaluation. By law and standard operating procedure, the police officer must stay with the person who is in crisis until he or she has been seen by a qualified provider and cleared for treatment, hospitalization or return back to their community.

Our research suggests that the average amount of time law enforcement officers spend with people who are in a mental health crisis is two to five hours. Data from departments in Aroostook County suggest they must transport people to Bangor or Augusta for evaluation and hospitalization. This can add additional time to managing the call, which also means the officer is unavailable to answer other police calls for service.

We all know that law enforcement resources are limited by many different factors including financial constraints of town and city budgets. The costs associated with municipal and county police departments are not reimbursed by the state. That is, municipal and county law enforcement operations are paid for by local property taxes. Conversely, mental health services are paid for by state and federal government sources in what is typically a $2 federal match for every $1 the state spends on these services. Thus, when there is a shift away from federal and state funding for supportive services to local funding for police services, the communities feel a dramatic impact as increased law enforcement costs correspond to increases in police and other emergency service budgets.

Additionally, our research also suggested that as law enforcement officers spend more time handling mental health-related calls for service, they are less available for other police functions. In smaller communities, it is typical for only one or two officers to be patrolling the streets in the evening and early morning hours. If the officer is busy monitoring a person who is having a mental health crisis at the hospital, this means that they are not available to answer other police calls or emergencies which may occur. While departments do have extensive coverage agreements with other agencies, the data suggest that there are many occasions when a community does not have any police coverage if the officer is occupied with another police-related matter.

As such, changes at the state level relating to the coverage and treatment for people with mental illness have dramatic impacts on local emergency services including budgets. As state policymakers and the governor’s office wrestle with these challenges, it’s important to look at the larger, local implications of these cuts on our already struggling municipalities.

Thomas Chalmers McLaughlin is co-director of the Center for Research and Evaluation at the University of New England School of Social Work in Portland.