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HomeMy WebLinkAboutPolicy 225 - Responding To Mentally Ill Persons OSHKOSH POLICE DEPARTMENT POLICY AND PROCEDURE TITLE: RESPONDING TO MENTALLY POLICY SERIES: 225 ILL PERSONS Effective Date: 09-16-21 Date Issued: 09-02-21 Chief of Police: Dean Smith Date Signed: 09-02-21 (signature on file) CALEA Standard: 41.2.7 WILEAG Standard: 6.1.10 Statutes: §51.15; §51.42(3); §51.45(11); §55.06; §55.135 Review Date: 08-19-21 Review By: PSD Lieutenant & Command Staff Rescinds Policy Dated: Policy 225 dated 05-01-14 (Policy 210 Patient Procedures Mercy Medical Center dated 10-01-93) (Directive 264 Transference of Committal Custody) 225.01 Purpose 225.02 Policy 225.03 Definitions 225.04 General Procedures 225.05 Adult Intervention Options 225.06 Juvenile Intervention Options 225.07 Alcohol or Another Drug Incapacitation 225.08 Training Appendix A Statement of Emergency Detention by Law Enforcement Officer (ME-901) Appendix B Statement of Emergency Protective Placement (GN-4000) Appendix C Protective Custody Report 225.01 PURPOSE It is the purpose of this policy to provide guidance for officers of the Oshkosh Police Department when responding to suspected mentally ill persons in order to identify and provide the most effective and understanding response possible to law enforcement situations involving people experiencing a mental health crisis. 225.02 POLICY Responding to individuals during police contacts who are known or suspected to be mentally ill requires an officer to make difficult judgments about the mental state and intent of the individual. It may require an officer to use special police skills and abilities to effectively and legally deal with the person so as to avoid unnecessary violence. The possibility of unpredictable and sometimes violent behavior should be considered when responding to people who have mental illness. Officers should never compromise or jeopardize their safety or the safety of others in these situations. State law guides officers regarding the detention of persons that show symptoms of mental illness and are considered a danger to themselves and/or others. Officers shall use this and subsequently responding to the mentally ill person in a humane manner. Agency personnel shall afford people who have mental illnesses the same rights, dignity and access to police and community services as are provided to all citizens. No single policy or procedure can address all of the situations that officers may be required to provide assistance to persons who have mental illnesses. 225.03 DEFINITIONS A. Behavioral Health Officer (BHO): An Officer who is the primary contact for mental health systems/providers, governmental and private, wishing to address system or individual mental health-related concerns and will work directly with other Oshkosh Police staff to make our services as efficient and effective as possible for our work with mental health consumers and their systems of support. 1 B. Crisis Intervention Team (CIT) Officer: An Officer who has received advanced specialized training in recognizing and understanding the signs and symptoms and varying degrees of mental illness and how to de-escalate a crisis. C. Emergency Detention (Chapter 51.15): A procedure whereby an officer detains a person that is behaving in such a way that leads the officer to believe the person may meet the commitment standards. Those standards are mental illness, proper subject for treatment, and dangerousness. Dangerousness can include any recent acts or failures to act that could result in death or serious bodily harm to the subject or others, inability to meet basic needs because of mental condition or impaired judgement. D. Emergency Protective Placement (Chapter 55.06): A procedure whereby an officer detains a person that is behaving in such a way that leads the officer to believe the person is in need of protective services. Persons that are suffering from a long-term, non-treatable problem such as infirmities of aging, organic brain disorders, long-term mental illness or substantial developmental disability may be in need of protective services. E. Incapacitated by alcohol or another drug (Chapter 51.45(11)): Means that a person, as a result of the use of or withdrawal from alcohol or another drug, is unconscious or has his or her judgment otherwise so impaired that he or she is incapable of making a rational decision, as evidenced objectively by such indicators as extreme physical debilitation, physical harm or threats of harm to himself or herself or to any other person, or to property. F. Intoxicated person (Chapter 51.45(11)): Means a person whose mental or physical functioning is substantially impaired as a result of the use of alcohol, a controlled substance, a controlled substance analog, or another drug. G. Mental Illness: Any of various conditions characterized by impairment of an social, psychological, biochemical, genetic or other factors, such as infection or head trauma. A subject may suffer from mental illness if he/she displays an inability to think rationally, exercise adequate control over behavior or impulses (e.g. aggressive, suicidal, homicidal, sexual), and/or take reasonable care of his/her welfare with regard to basic provisions for clothing, food, shelter or safety. Mental illness, for purposes of involuntary commitment, means substantial disorder of thought, mood, perception, orientation, or memory that grossly impairs judgement, behavior, capacity to recognize reality, or ability to 2 meet the ordinary demands of life. This definition can include people with dementia. 225.04 GENERAL PROCEDURES A. Inter-jurisdictional Procedural Agreement 1. The inter-jurisdictional procedural agreement creates a uniform protocol for managing and investigating events occurring within the jurisdiction of Outagamie and Winnebago County when a person needs to be committed to a medical facility. The premise of the agreement is to define the appropriate agency to: a. investigate the incident b. take ownership of the commitment c. provide subsequent follow-up. 2. Additionally, this agreement will provide a clear guideline for supervisors to follow when making jurisdictional decisions. 3. If a person presents to a treatment facility or is presented to a law enforcement agency, and fits the criteria for a Chapter 51.15 Emergency Detention, the agency who first contacts the person shall take the person into protective custody, and, if not done already, have them transported to an appropriate treatment facility. That agency will investigate the incident, file the commitment and provide for long-term follow-up as indicated, except: a. If a recent overt harmful act occurred in another jurisdiction, the agency providing law enforcement services for that jurisdiction shall be responsible for the commitment and investigation of the incident. Overt acts include any act that could or would likely cause harm or injury to the person. For the purpose of this detention is necessary. It does not include thoughts of suicide, threats of overt acts towards oneself, or any situation where a location of an event is unknown or irrelevant. 3 4. If an agency commits a person who lives in another jurisdiction under this protocol the investigating agency shall forward a copy of their report to that jurisdiction for information and subsequent follow-up if needed. B. Recognizing Abnormal Behavior 1. Officers expected to recognize behavior that is potentially destructive and/or dangerous to self or others. Officers may consult with a trained Oshkosh Police CIT Officer if available and/or may consult with a Winnebago County Department of Human Services Crisis Worker. If available, Officers may also consult with the Oshkosh Police Behavioral Health Officer and/or an available Social Worker. 2. The following are generalized signs and symptoms of behavior that may suggest mental illness although officers should not rule out other potential causes, such as reactions to narcotics or alcohol, or temporary emotional disturbances that are motivated by the situation. Officers should evaluate the following and related symptomatic behavior in the total context of the situation when making judgments about an commission of a crime. A mentally ill person may exhibit one or more of the following characteristics when in crisis: a. Mental disorders, including serious and persistent mental illnesses (depression, bipolar disorder, schizophrenia, and anxiety disorders) as well as personality disorders, b. Alcohol and/or drug abuse, c. Developmental disabilities, d. rders. 3. Officers are not expected to diagnose or treat any of these conditions. However, they need to be familiar with them so they can respond effectively to people who have one or more of them. C. Determining Danger 4 1. Not all mentally ill persons are dangerous, while some may represent danger only under certain circumstances or conditions. Officers may use several indicators to determine whether an apparently mentally ill person represents an immediate or potential danger to himself/herself, the officer or others. These include, but are not limited, to the following: a. The availability and/or threat by a person to use any weapons. b. Statements by the person that suggest to the officer that the individual is prepared to commit a violent or dangerous act. Such comments may range from subtle innuendo to direct threats that when taken in conjunction with other information may indicate a potential for violence. c. A personal history that reflects prior violence under similar or family, friends or neighbors may be able to provide such information. d. Failure to act prior to arrival of the officer does not guarantee that there is no danger, but is does tend to diminish the potential for danger. e. The amount of control that the person demonstrates, f. The volatility of the environment. D. Responding To The Mentally Ill Person 1. Police intervention may be required if the officer determines that an individual may be mentally ill and is a potential threat to himself/herself, officer or others. These guidelines should be followed in all contacts, whether on the street or during more formal interviews and interrogations. The following responses may include: a. Pre-Intervention Preparation. i. Find out as much as you can about the person/situation ii. Calm yourself iii. Center yourself and get focused iv. Develop a strategy for the intervention 5 b. Approach Safety Considerations. i. Watch for early warning signs ii. Watch for pre-attack postures iii. Do not presume compliance iv. Consider options to disengage and/or escalate v. Make a contact decision vi. Deploy resources vii. Evaluate the threat level viii. Consider officer/subject factors ix. Conduct a tactical evaluation x. Develop a plan on how to approach the contact xi. Recognize your personal limitations and consider having another officer take over if needed c. i. Move to where the person can see you and use an open stance ii. Avoid crowding the person, to the extent possible iii. Control distance and maintain bailout routes iv. Remain alert but try not to appear tense d. perception of reality. e. Try to establish rapport with the person. f. Explain your perception of reality. g. Move toward resolution of the situation. i. Keep the subject as calm as possible ii. Find out as much as you can about the situation iii. Use available resources to help with resolution iv. Remain realistic and honest in your response to the subject h. Document/Debrief. 225.05 ADULT INTERVENTION OPTIONS A. Based on the overall circumstances and judgements of the potential for violence and harm, officers have the following intervention options: 1. Take the adult into custody for an involuntary Emergency Detention by Law Enforcement Officer. If an officer has cause to believe that a person is mentally ill, drug dependent or developmentally disabled, and the subject evidences behavior which constitutes a substantial probability of 6 physical harm to self or others based on specific and recent dangerous acts, attempts, threats, omissions, and/or statements observed by the officer or reliably reported to the officer, the officer shall take the person into protective custody as set forth in §51.15, Wisconsin Statutes if it is needs. The officer must contact the Winnebago County Department of Human Services to have them approve the need for detention prior to the final placement of the person. This contact and the DHS representatives decision will be documented on Appendix A - Statement of Emergency Detention by Law Enforcement Officer Form (ME-901) and submitted with the report. a. If the investigating officer did not witness the dangerous conduct, the officer must obtain a statement from a reliable witness. b. Officers must complete Statement of Emergency Detention by Law Enforcement Officer Form (ME-901) upon arrival at a medical facility (Appendix A). Winnebago County Department of Human Services staff will determine which approved treatment facility the person will be detained at under Chapter 51. A copy of the Statement of Emergency Detention by Law Enforcement Officer Form (ME-901) must be included in the patient record. Some patients will be transported by ambulance to, or self-report to, Aurora Hospital for medical treatment. When this occurs the patient will usually be transferred to Mercy Medical Center or another approved treatment facility for a mental health commitment once they receive medical clearance. i. If the medical clearance will require a hospital stay for the patient, and the person will be left and transferred later, the officer must complete the Statement of Emergency Detention by Law Enforcement Officer Form (ME-901) right away and indicate the date and time the individual was detained at the first medical facility. The form must be faxed to the Corporation Counsel, as soon as possible by the Shift Commander. 7 ii. The detention commencement date and time begins when the person is first taken into custody by the officer. A copy of the emergency detention form must be included in the patient record so that it can go with the patient when transferred to another facility. c. Supervisors shall be contacted by the officer to approve the detention. d. The decision to place a person on an emergency detention under Chapter 51 of the Wisconsin Statutes requires a reasonable belief by the officer that this is the least restrictive alternative A person should not be placed on an emergency detention if they agree to voluntarily consent to evaluation, diagnosis, and treatment that the officer reasonably believes would stabilize the individual and remove the substantial probability of physical harm, impairment, or injury to himself, herself, or others. That person can be placed on an emergency detention at a later time if the person refuses treatment and the person meets the criteria for detention. Oshkosh Police Officers must reasonably believe the individual would be unable or unwilling to cooperate with voluntary treatment when making a decision whether or not to place them on an involuntary emergency detention. e. Oshkosh Police officers are responsible to initiate an emergency detention and complete the appropriate forms for any emergency room patient that qualifies, providing that the person has not yet been admitted to in-patient. When a person who is an in-patient as a result of a voluntary admission becomes so violent that the hospital staff cannot care for him/her, Oshkosh Police Officers may initiate an emergency detention based on information from by the treatment facility may also be appropriate. f. Emergency committal forms and incident reports shall be faxed to the Corporation Counsel Attorney as soon as possible by the Shift Commander. The Court Clerk will file the original committal form and incident report in the appropriate court on the same or next business day. 8 g. Regarding procedures for the transfer of custody of cooperative and non-combative adults being placed on an Emergency Detention at Mercy Medical Center, the Officers shall complete the required paperwork for the Emergency Detention. i. When the paperwork is completed and the person is cooperative and non-combative, the Officers shall ensure that they make contact with emergency room staff and notify them that custody is being transferred and that the Officer is leaving the facility. ii. The Officer does not need to remain in the emergency room until a determination is made as to the location of the emergency detention placement, and our departure is not dependent on the availability of hospital security personnel to monitor the subject. iii. Before leaving the hospital, contact shall be made to a supervisor to advise them of your intent to leave the hospital and a summary of the committed discussed. iv. These procedures do not apply to persons that are being arrested on charges that would otherwise require incarceration, if not for the need for an emergency committal. In those circumstances, officers will stay with the person at Mercy Medical Center until being placed on the Behavioral Unit. v. The Officer may be called back to Mercy Medical Center and will assist in transporting the patients to another treatment facility, if necessary, and may request the assistance of the transportation. vi. Procedures at Aurora Hospital do not change as a result of this. h. Oshkosh Police should be notified when a patient under emergency detention or protective custody has left the medical facility unauthorized. Upon recovery of the patient, he/she will be returned to the medical facility. 9 2. Take the person into protective custody as set forth in §55.06, Wisconsin Statutes and follow the same procedures above. Complete a Statement of Emergency Protective Placement (GN-4000) (Appendix C). Law Enforcement officers or social workers may initiate Emergency Protective Placements. The Winnebago County Department of Human Services does not have to approve these, but Officers should contact them to advise them of the placement. 3. Take the person into custody for a criminal act that was committed; or 4. Seek a voluntary emergency evaluation and admission at an appropriate facility. If a person does not appear to be in acute crisis, has not acted to harm himself/herself, has not formulated a lethal plan to harm and an emergency detention may not be necessary. Consultation with the Winnebago County Department of Human Services is recommended for optional voluntary placement coordination, or placement is a crisis center. 5. Provide the individual and family members with referrals on available community mental health resources. An officer can make a mental health referral when the circumstances do not indicate that the individual must be taken into custody for his own protection or the protection of others. Supervisors must be contacted to approve the referral as a resolution. 6. Release and/or release to family or caregiver 7. Crisis Intervention can be contacted by calling the Crisis Intervention Hotline at (920) 233-7707 for assistance from trained health professionals. The Crisis Intervention worker will assist the investigating officer in evaluating the patient and assessing the legal options available for placement in the least restrictive environment. 8. Officers should consider including the Behavioral Health Officer, if available, in the decision making process and follow-up. 9. The incident must be thoroughly documented in a written incident report with resolution option explained. 10 B. Mentally ill persons may present conditions for transportation that dictate special care and attention, but it should not be assumed that mentally ill persons do not need to be restrained for transport. Using restraints or handcuffs on a mentally ill person can aggravate their aggression. Officers should be aware of this fact, but should take those measures necessary to protect officer safety and the safety of the person being transported. Officers are further guided by procedures outlined in Policy 205 Transporting Persons in Custody and Policy 201 Use of Force. C. Contact a Winnebago County SDepartment supervisor to make transportation arrangements for adult emergency committals that are placed in facilities outside the City of Oshkosh. Generally, a Winnebago County Department Deputy may provide the transportation, with an Oshkosh Police Officer riding along. If they are not available, Oshkosh Police Officers may conduct the transport to the facility, with Supervisor approval. The Winnebago County artment is responsible for transportation for court ordered transfers. 225.05 JUVENILE INTERVENTION OPTIONS A. Under circumstances when a juvenile comes to the attention of Oshkosh Police Department officers because they are presenting with the potential for self- harm or harm to others, that juvenile can be evaluated by a mental health professional 24 hours a day, 7 days a week. B. Officers should evaluate juveniles using the same criteria listed in 225.05 Adult Intervention Options. Officers should speak with a crisis worker to help them in the decision making process. In addition: 1. If the juvenile has admitted to ingesting drugs or alcohol, or appears to be under the influence of drugs or alcohol, that juvenile should be taken to the appropriate medical hospital for medical clearance or treatment, if needed. 2. If the juvenile has committed any overt act of violence toward self or others, or has threatened self or others and refuses to voluntarily cooperate with a mental health assessment process, some type of detention may be necessary. 11 a. The detention would either be at an approved facility under Chapter 51, if there were questions as to the mental health status of the juvenile. The detention might also be to a secure detention facility under Chapter 938, if there is no reason to believe that b. If the juvenile has acted out or has caused some minor property damage, but has calmed down and is cooperative throughout the decision making process, that juvenile would not necessarily need to be detained. 225.07 ALCOHOL OR ANOTHER DRUG INCAPACITATION A. Pursuant to Wisconsin §51.45(11)(a), an intoxicated person may come voluntarily to an approved public treatment facility for emergency treatment. 1. Officers may assist a person who appears to be intoxicated in a public place and to be in need of help to his or her home, an approved treatment facility or other health facility, if such person consents to the proffered help. B. Pursuant to Wisconsin §51.45(11)(b), a person who appears to be incapacitated by alcohol or another drug shall be placed under protective custody by a law enforcement officer. 1. Officers shall either bring such person to an approved public treatment facility for emergency treatment or request a designated person to bring such person to the facility for emergency treatment. a. If the person who appears to be incapacitated by alcohol or another drug is a minor, the Officer is authorized to take them into custody under Chapter 48 or Chapter 938. 2. If no approved public treatment facility is readily available or if, in the judgment of the Officer, the person is in need of emergency medical treatment, the Officer shall take such person to an emergency medical facility. 3. The Officer, in detaining such person or in taking him or her to an approved public treatment facility or emergency medical facility, is 12 holding such person under protective custody and shall make every reasonable effort to protect the person's health and safety. 4. In placing the person under protective custody the Officer may search such person for and seize any weapons. 5. Placement under protective custody under this subsection is not an arrest. No entry or other record shall be made to indicate that such person has been arrested or charged with a crime. 6. A person brought to an approved public treatment facility under this paragraph shall be deemed to be under the protective custody of the facility upon arrival. 7. The Officer shall contact the Winnebago County Department of Human Services to inform them of the incapacitation, although approval is not needed for the incapacitation. 8. The Officer shall complete Appendix C Protective Custody Report. A copy will be left with the person, facility staff, and will also be included in the 225.08 TRAINING A. In order to prepare officers for responding to persons with mental illnesses in an appropriate manner, the Oshkosh Police Department shall provide training to agency personnel. The appropriate training will be conducted and documented for all entry-level personnel, as well as refresher training provided to all agency personnel annually. B. The Behavioral Health Officer will also conduct training for Officers on mental health-related topics, as needed and will evaluate mental health-related police training offered for Officers in conjunction with the Sergeant of Professional Development. 13