Mental Health Foundation of New Zealand says ART trials must stop

Retrieved from Social Science Research Network website: https://papers.ssrn.com/abstract=2927829
This study explored the relationship between suspected mental illness and officer-involved shootings, using data from an independently sourced database. The results showed that African Americans were more likely to be victims of fatal officer-involved shootings, and this likelihood increased for those who displayed signs of mental illness. These findings highlight two important issues: the collection of data regarding officer-involved shootings should include details regarding signs of mental illness, and documentation of the type of mental health issues involved in these incidents should be improved. 

JAMA Network Open, 1(7), e184945–e184945. https://doi.org/10.1001/jamanetworkopen.2018.4945

Importance: Police violence is reportedly widespread in the United States and may pose a significant risk to public mental health. To examine the association between 12-month exposure to police violence and concurrent mental health symptoms independent of trauma history, crime involvement, and other forms of interpersonal violence exposure. This cross-sectional, general population survey study of 1221 eligible adults was conducted in Baltimore, Maryland, and New York City, New York, from October through December 2017. 

Participants were identified through Qualtrics panels, an internet-based survey administration service using quota sampling Past 12-month exposure to police violence, assessed using the Police Practices Inventory. Subtypes of violence exposure were coded according to the World Health Organization domains of violence (ie, physical, sexual, psychological, and neglectful). Main Outcomes and Measures Current Kessler Screening Scale for Psychological Distress (K6) score, past 12-month psychotic experiences (World Health Organization Composite International Diagnostic Interview), and past 12-month suicidal ideation and attempts. Of 1221 eligible participants, there were 1000 respondents (81.9% participation rate). The sample matched the adult population of included cities on race/ethnicity (non-Hispanic white, 339 [33.9%]; non-Hispanic black/African American, 390 [39.0%]; Hispanic/Latino, 178 [17.8%]; other, 93 [9.3%]), age (mean [SD], 39.8 [15.2] years), and gender (women, 600 [60.0%]; men, 394 [39.4%]; transgender, 6 [0.6%]) within 10% above or beyond 2010 census distributions. 

Twelve-month prevalence of police violence was 3.2% for sexual violence, 7.5% for physical violence without a weapon, 4.6% for physical violence with a weapon, 13.2% for psychological violence, and 14.9% for neglect. Police violence exposures were higher among men, people of color, and those identified as homosexual or transgender. 

Respondents reported suicidal ideation (9.1%), suicide attempts (3.1%), and psychotic experiences (20.6%). The mean (SD) K6 score was 5.8 (6.1). 

All mental health outcomes were associated with police violence exposure in adjusted logistic regression analyses. 

Physical violence with a weapon and sexual violence were associated with greater odds of psychotic experiences (odds ratio [95% CI]: 4.34 [2.05-9.18] for physical violence with a weapon; 6.61 [2.52-17.36] for sexual violence), suicide attempts (odds ratio [95% CI]: 7.30 [2.94-18.14] for physical violence with a weapon; 6.63 [2.64-16.64] for sexual violence), and suicidal ideation (odds ratio [95% CI]: 2.72 [1.30-5.68] for physical violence with a weapon; 3.76 [1.72-8.20] for sexual violence). 

Conclusions and Relevance: Police violence was commonly reported, especially among racial/ethnic and sexual minorities. Associations between violence and mental health outcomes did not appear to be explained by confounding factors and appeared to be especially pronounced for assaultive forms of violence.

Violence and Gender, 3(3), 150–156. https://doi.org/10.1089/vio.2015.0049

In the United States, the nexus between mental illness and shootings has been the subject of heated argument. An extreme expression of one point of view is that “guns don’t kill people, the mentally ill do.” This article seeks to demonstrate the falsehood of this argument, by examining the real-world experience of two comparable societies. Australia and Great Britain are both Anglophone nations with numerous points of commonality with the United States, including high rates of mental illness and significant exposure to popular culture that perpetuates the stigma of the mentally ill as a violent threat. However, in Australia, it is difficult to obtain firearms, and a mentally ill person behaving aggressively is unlikely to be able to harm others. 

On the contrary, police are almost the only people routinely armed in Australian communities and are often too ready to use firearms against the mentally ill. In Britain, guns are even more difficult to obtain, and operational police are not usually armed. The authors examine statistical data on mental illness, homicide, and civilian deaths caused by police in all three nations. They also consider media and popular opinion environments.
 
They conclude that mental illness is prevalent in all three societies, as is the damaging stigma of “the dangerous madman.” However, the fewer people (including police officers) who have access to firearms, the safer that community is.

Contexts, 17(2), 70–72. https://doi.org/10.1177/1536504218776970

Police fatally shot almost 2,000 people in the U.S. from the beginning of 2015 to the end of 2016. Much of the news coverage about fatal police encounters has focused on the race of the individuals killed by police, overlooking the fact that a quarter of those killed exhibited signs of mental illness…

The Lancet, 393(10179), 1412–1413. https://doi.org/10.1016/S0140-6736(18)33043-5 

Jacob Bor and colleagues (July 28, 2018, p 302)1 found that there was a causal relationship between exposure of black Americans to police killings of unarmed black people and deterioration of their mental health.

This is an important research endeavour, but we are concerned the methods used in the study could undermine an important message. The authors used data from the Mapping Police Violence (MPV) database.
 
In these data, citizens holding a toy weapon (eg, pellet gun, air rifle) or “alleged to be armed by the police, but multiple independent witnesses maintain the person was unarmed,” are coded as unarmed.

 Criminology & Public Policy, 14(2), 253–276. https://doi.org/10.1111/1745-9133.12127

Research Summary: This study examined all “use-of-force” reports collected by the Portland Police Bureau in Portland, Oregon, between 2008 and 2011, to determine whether their encounters with people with mental illnesses are more likely to result in injury to officers or subjects when force is used. Although several factors significantly predicted the likelihood of injury to either subjects or officers, mental illness was not one of them. 

Policy Implications Police consider interactions with people with mental illnesses to be extremely dangerous (Margarita, 1980). Our results question the accuracy of this belief. As such, this “dangerousness” assertion may result in unnecessary stigmatization that may prevent people with mental illnesses from accessing needed services (cf. Corrigan et al., 2005) as witnesses or victims of crime. 

Policies that reduce stigma may help increase police effectiveness. Furthermore, efforts should be made to increase the availability and accuracy of data on this issue.

Criminology & Public Policy, 16(1), 309–340. https://doi.org/10.1111/1745-9133.12269

Research Summary: We analyzed 990 police fatal shootings using data compiled by The Washington Post in 2015. After first providing a basic descriptive analysis of these shootings, we then examined the data for evidence of implicit bias by using multivariate regression models that predict two indicators of threat perception failure: (1) whether the civilian was not attacking the officer(s) or other civilians just before being fatally shot and (2) whether the civilian was unarmed when fatally shot.
 
The results indicated civilians from “other” minority groups were significantly more likely than Whites to have not been attacking the officer(s) or other civilians and that Black civilians were more than twice as likely as White civilians to have been unarmed.  

Policy Implications We implore the U.S. government to move forward with its publication of a national police use‐of‐force database, including as much information about the officers involved as possible. We further suggest police departments use training programs and community activities to minimize implicit bias among their officers.

Injury Prevention. https://doi.org/10.1136/injuryprev-2019-043467

Background: Previous officer-involved shooting (OIS) research has focused primarily on antecedents to fatal shootings, with few studies investigating injury more broadly. Our study examined the factors associated with fatal or non-fatal injury to both civilians and officers during OIS incidents, to better understand how harm might be reduced in the most extreme law enforcement scenarios. 

Methods: Data included 281 officers involved in 177 unique shooting incidents recorded by Dallas Police Department between 2005 and 2015. Bivariate logistic regression and multivariable generalised estimation equation analyses were used to investigate incident characteristics associated with fatal or non-fatal injury to civilians and officers. 

Results: Civilian injury occurred in 61% and officer injury in 14% of unique OIS incidents. In adjusted models, multiple shooting officers increased the odds of injury to both civilians (adjusted OR (AOR): 3.22, 95% CI 1.39 to 7.50) and officers (AOR 4.73, 95% CI 1.64 to 13.65). Odds of civilian injury were also significantly higher during the daytime and among non-Hispanic white compared with non-Hispanic black and Hispanic/Latina/o civilians, although a majority of OIS incidents (79%) involved non-Hispanic black or Hispanic/Latino/a civilians. Odds of officer injury were significantly higher for detectives compared with patrol (AOR=9.32, 95% CI 1.85 to 47.03) and during off-duty versus on-duty shootings (AOR=5.23, 95% CI 1.37 to 19.99). 

Conclusions: Both civilians and officers are at risk for injury during OIS incidents, though to different degrees and with unique risk factors. Additional research is needed to understand whether these results are replicated elsewhere and to further understand the mechanisms of injury.

Police Practice and Research, 18(3), 306–321. https://doi.org/10.1080/15614263.2017.1291592

The study analyzed the situational characteristics of 112 incidents where police used firearms to handle high threat situations. 

Most shooting incidents emanated from usually uneventful tasks, e.g., handling burglaries or disturbances. The assailants were commonly armed with firearms (26%), sharp (27%) or blunt objects (10%). 

The incidents were regularly short-lasting (in 39% were shots fired ≤3 s from threat emerged) and occurred at short distances (in 42% at distances ≤3 m).
 
Predominantly, the first responders had to address the situation and did so with warning shots or, equally common, with fire-for-effect shots (40%) or a combination thereof. 

Psychological stress was manifested as feelings of panic at some point and as motor skill alterations, e.g., firing without using sights and with one hand only. 

Analysis of these incidents shows that all field duty police officers should receive training in handling potentially life-threatening, sudden, close-range attacks.

Journal of Police and Criminal Psychology, 34(2), 175–183. https://doi.org/10.1007/s11896-018-9285-x

Police officers are both at risk of exposure to trauma and experiencing PTSD and are more likely to come into contact with people with mental illness than community members. As a result, the extent and predictors of mental health stigma is an issue of concern among police officers; however, little prior research on stigma has focused on police officers. 

The present study examined the predictors of mental health stigma among police officers, including the experience of trauma and PTSD symptoms. Active duty police officers (N = 296) were recruited through an online survey and completed measures of trauma exposure, PTSD symptoms, and a number of dimensions of stigma (negative stereotypes, attributions, intended behavior, and attitudes toward seeking help). 

Findings supported that police officers experience high rates of trauma exposure and higher rates of current PTSD than the general population. Endorsement of negative stereotypes about people with mental illness was higher among police officers than the general population. Contrary to what was expected, officers meeting criteria for current PTSD endorsed more stigma about mental illness, even when controlling for common demographic predictors of stigma, including gender and knowing someone with a mental illness. 

Findings have important implications for the training of police officers regarding mental illness.

JAMA Psychiatry, 75(7), 669–670. https://doi.org/10.1001/jamapsychiatry.2018.0528

The media-driven notion that mentally ill people pose a danger to others appears to be encrusted like a barnacle on the concept of mental illness submerged in the public mind. Meanwhile, epidemiological studies estimate that the overwhelming majority of the 44.7 million US adults with a mental illness are not violent toward others, but that 1 in 4 psychiatric patients are subjected to crime in a given year. 

That changes the story. The discovery that people with psychiatric disorders are far more frequently the targets, rather than the perpetrators, of crime has become a key talking point for advocates who would debunk the dangerousness myth.
 
Until recently, the data to support this rhetorical reversal have come from relatively small samples of patients with psychiatric conditions and have relied on participant recall of being subjected to crim
 
Now, a new study from Denmark published in this issue of JAMA Psychiatry confirms that the onset of mental illness significantly increases risk of experiencing crime, using longitudinal registry data on a national cohort of more than 2 million individuals with independent measures of specific psychiatric diagnoses matched to police records of reported crime.