Release of mentally ill people must be coordinated effort

Friday, October 19, 2018

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Dear Editor,

The Independent Commission of Investigations (INDECOM), while optimistic about the efforts to reintegrate individuals who may be mentally ill, is concerned that the intended move may exacerbate lethal confrontations with the police.

It is accepted that care at the community level is preferred, but this initiative must have the needed resources, such as sustainable development of community health services, adequately trained mental health professionals to assist police operations, and the deployment of less lethal weapons when members of the security forces are dealing with mentally ill people.

The aim of the reintegration should be to prevent, to the greatest extent possible, a migration from an institution like Bellevue into the criminal justice system or, worse, being killed or injured.

INDECOM's concern arises from the issue of police personnel using guns in confrontations with mentally ill persons. In the last year (September 2017 – 2018), 15 individuals suffering from mental illnesses were shot and either killed or injured by the police.

The social support system must be strengthened to enhance the reintegration strategy, which extends far beyond familial and community health care. It must determine how these individuals will be monitored; the preventative measures for relapse; and who within the family, community or security forces has been sufficiently (not basic) trained in de-escalation tactics against an aggressive mentally ill person, who may or may not be threatening another's right to life.

Members of the security forces frequently come in contact with mentally ill people and must be provided with the essential resources to contain any situational conflict that may arise. Currently, the police lack sufficient or appropriate less lethal devices for the restraint of mentally ill people. A taser, for example, is one such suitable alternative.

Release of mentally ill persons must be a coordinated effort which will allow for restraint from a distance and includes the minimisation of the risk of injury or death. A clear policy for the use of non-lethal measures would however need to be implemented.

The commission, in its 2012 annual report, titled 'Safeguarding the Right to Life', wrote extensively on the issue of deinstitutionalisation of the mentally ill, best practices to adopt when dealing with the mentally ill, as well as made recommendations both to the Government and commissioner of police. The commission's third quarterly report in 2017 also addressed police tactics in dealing with mentally disturbed persons.

The recommendations to the police force was that a programme be developed “to train, refresh and monitor the memberships' appreciation of the operational policy regarding dealing with persons who are mentally ill. This could include the development of aide memoire booklet, simulation drills, and continuous liaison with mental health professionals in the division”.

The recommendations to Parliament, ministers of health and security were for the implementation of “at least two medical response teams for each region consisting of police officers with specialised training in dealing with the mentally ill and with psychiatric aides... These teams should be on call on a 24-hour basis”. It was further suggested that ongoing refresher courses for the security forces be provided on how to deal with mentally ill people.

Now more than ever, with the pending discharge of 400 patients, it is critical that a strategic approach is utilised to safeguard their right to life.


1 Dumfries Road

Kingston 10

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