Local police often are the first line of defense when a patient is suffering from a behavioral health crisis. With that in mind, providers are looking to strengthen ties with law enforcement.
The University of New Mexico’s department of psychiatry and behavioral sciences, for instance, is closely collaborating with the Albuquerque Police Department to improve patient outcomes, including 24/7 contact with officers and continued education for both police officers and physicians.
The collaboration was highlighted in a June article in The American Journal of Psychiatry by Mauricio Tohen, M.D., chairman of the department of psychiatry at UNM; Nils Rosenbaum, M.D., medical director of the Albuquerque Police Department's behavioral health division; and Detective Matthew Tinney of the APD's crisis intervention unit. The article states, “Over the past 20 years, the number of hospital beds has been cut, and interactions between psychiatric patients and law enforcement have increased.”
UNM provides psychiatric emergency services with a psychiatrist and trainee attending at all times in case a patient needs hospitalization or crisis intervention. APD officers can call these doctors for consultation or bring patients to psychiatric emergency facilities for help.
The success of this unofficial partnership hinges on communication, and Tohen attributes this to the fact that the APD is one of the few, if not the only, police departments in the country to staff a full-time psychiatrist. Rosenbaum has been salaried for nearly three years and, as far as he knows, is the only full-time psychiatrist on a police department.
Tohen acknowledges that there can be barriers between hospitals and police departments, such as with patient confidentiality. For example, after a patient is checked in, officers may want to know whether and when that patient will be released, facts that hospitals keep confidential.
“The biggest challenge is the different cultures and the different sensitivities that each culture has, and the misunderstandings between those two cultures,” Rosenbaum says.
He adds that hospital networks should find people within a department who are receptive to the idea and start a conversation there. “People get intimidated by police, which is understandable, but, really, they want to participate, and there are always a few champions in every department who really want to help with collaboration between mental health and the police and the community.”
Education is another key component of the partnership. The Crisis Intervention Team Knowledge Network, a collaboration between the APD and UNM's Project ECHO (Extension for Community Healthcare Outcomes) that is funded through a federal grant, provides continued training for officers across the country. Every week, APD’s crisis intervention team hosts a 90-minute videoconference that includes two or three psychiatrists from UNM or other health networks and the police department. The event begins with a short lecture on a topic, and then police officers and psychiatrists discuss how to handle similar cases.
The APD has conducted these conferences with police departments in Chicago, New York, Seattle and throughout New Mexico. Any department can contact them to coordinate one.
The APD and UNM also collaborate in the university setting, where medical students join police on home visits. Rosenbaum also teaches a class called “Communication in the Trenches,” educating medical students on how to communicate with challenging patients who are seeking drugs, for example, or who are experiencing mania.
Rosenbaum says he expects to expand on the partnership with UNM; he has been involved with UNM his entire career. “As a profession, we should go where the illness is, and then try to get it to where it should be, in treatment and therapies and out of the criminal justice system.”