Workshop on untreated severely mentally ill seeks solutions

More than 25 nationally known experts in public safety, criminal justice and mental health attended an “Addressing Untreated Severe Mental Illness” workshop March 29-30 that was hosted by the Naval Postgraduate School Center for Homeland Defense and Security in Washington, D.C.

The goal was to explore whether the Center may benefit the various disciplines represented by offering a homeland security-related curriculum to address what has become an increasingly frequent issue as well as to bring together professionals in an open-discussion setting to potentially sow seeds of collaboration.

Participants included practitioners, psychiatrists, academics, municipal administrators, non-profit advocacy groups, law enforcement, fire and EMS experts who work with this vulnerable population. They discussed programs that have been successful, as well as those that have not and identified best practices to expound upon.

“One of the main problems identified after 9/11 was the stove piped culture of many government agencies,” said CHDS Senior Adviser David O’Keeffe. “One of the barriers to addressing untreated severe mental illness is that in 2017 agencies are once again operating in stovepipes in terms of their budgets, resources and response to this issue. So the workshop was a neutral educational forum to bring experts together to work collaboratively on this complex problem.”

Events such as the June 2016 Orlando nightclub shooting that killed 49 illustrate the intersection of mental health and terrorism as the alleged gunman was said to have pledged to a terrorist group and had mental health issues, a finding not uncommon to many high-profile shootings that are initially linked to terrorism. (Photo from NPR)

Untreated severe mental illness has increasingly become a homeland security issue gaining urgency among CHDS students and alumni alike. Events such as the June 2016 Orlando nightclub shooting that killed 49 illustrate the intersection of mental health and terrorism. The alleged gunman was said to have pledged to a terrorist group and had mental health issues, a finding not uncommon to many high-profile shootings that are initially linked to terrorism.

“When you look at common denominators of these types of events, people usually talk about ISIS or radicalization or global trends,” O’Keeffe said. “We’re devoting all these resources to what-if attack and disaster scenarios when there is something happening every single day in this country that is resulting in significant loss of life, devastating families and overwhelming public safety resources. It is real, tangible and we can actually do something about it.”

CHDS alumnus Michael Biasotti, who played a leading role in organizing the workshop, wrote his master’s degree thesis on the toll taken by law enforcement agencies in addressing residents who are severely mentally ill and since his retirement as a police chief has worked tirelessly on the matter.

“Across all these public safety spectrums we have high utilizers of multiple systems,” Biasotti said. “We see people rotate in and out of hospitals and jails, not getting the coordinated care they need to prevent the revolving door system they become stuck within. CHDS is a good fit for this discussion because when you talk about homeland security and public safety, the drain on emergency services resources becomes really high on their student’s list of concerns.”

The international intelligence community is voicing concerns regarding the difficulties involved in forecasting mentally ill lone actors.  Reflective of the importance of the topic is that it repeatedly arises in CHDS classroom discussions and writings. The related statistics are alarming:

• Studies have indicated that at least 10 percent of all homicides committed within the United States involve a suspect with untreated severe mental illness.
• The Washington Navy Yard Shooting, Virginia Tech University Shooting, Congresswoman Gabrielle Gifford Shooting, Aurora Colorado Shooting, Santa Monica College Shooting, The Orlando Night Club Shooting are just a few incidents of untreated severe mental illness involvement in mass shootings, totaling 120 murders.
• Mother Jones magazine reported in December 2012 that 63 percent of mass shooters between 1982 and 2012 had mental illness.
• Green Bay police reported responding to between 20,000 and 32,000 calls for service, mental illness related, every year amounting to 25 to 40 percent of the 80,000 annual calls received.
• CHDS master’s degree alumnus Pat Walsh told a Santa Barbara, California, committee that 30 to 40 percent of all calls for service responded to in the community of Lompoc, where he is Police Chief, involved the mentally ill.
• A National Sheriff’s Association study found that at least half of the attacks on officers were by people with a mental illness who were not taking prescribed medications.

The consequences are keenly felt by patients and families. Statistically speaking, family members are more likely to be victims. Statistics indicate that of the approximately 4,000 homicides where someone killed their own family member, 29 percent were by someone with a severe mental illness. And multiple studies have shown the seriously mentally ill are anywhere from six to twenty-four times more likely to be victims of crime, according to a June 2016 study by the Treatment Advocacy Center.

During the workshop, numerous data points showed a need for education and collaboration, among law enforcement, EMS, judges, mental health directors, probation/parole, service providers, NGOs as well as state and federal partners.  Already, the workshop has met one goal, the experts in attendance report they have subsequently shared information, and voiced that they had never met together before to exchange ideas.

“All of the disciplines represented play a vital role in helping to make much needed changes to a very flawed, disconnected system,” noted Dr. Tracey Skale, Chief Medical Officer, Greater Cincinnati Behavioral Services. “Many of us made great connections at the meeting and are enthusiastic about next steps.”

The next step for CHDS is gauging the feasibility of a multi-day course related to the topic to provide leaders the educational foundation to begin addressing the problem in their communities. In the meantime, untreated severe mental illness will be piloted as a module of the Executive Leaders Program beginning with a May session.

“This issue is causing so many interrelated problems on so many different levels, that it is affecting the operational depth of not only emergency services, but across the entire range of governmental systems nationwide,” Biasotti said. “Something has to be done. I know that CHDS has the unique ability to provide a forum that takes people out of their usual comfort zone and opens them up to addressing these issues from a multi-disciplinary approach, which is sorely needed in this case.”