TEMPO: A contemporary model for police education and training about mental illness

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Abstract

Given the increasing number of interactions between police and people with mental illnesses (PMI), there has been widespread interest in the development of education for police about how best to interact with PMI. This paper reflects the review of current practice in a variety of jurisdictions across Canada as well as in the United States (U.S.), the United Kingdom (U.K.) and Australia; it proposes a comprehensive model of learning based on the literature that addresses not only the content in the narrow sense but also the importance of broader contextual knowledge and understanding in developing effective education and training. Embedded in the principles articulated in the Mental Health Strategy for Canada, the TEMPO (Training and Education about Mental illness for Police Organizations) model is a multilevel learning strategy for Canadian police personnel. Learning objectives and key principles are articulated in order to ensure the model is applicable to a wide range of police agencies and individual jurisdictional needs. In addition to providing a firm basis of factual knowledge for police personnel, the resultant model embraces a human rights/anti-stigma philosophy, provides for a range of education appropriate to diverse police audiences, emphasizes a systems approach to police/mental health liaison activities and addresses issues related to the delivery and implementation of police education and training.

Introduction

From 2007 to 2011, the Mental Health Commission of Canada (MHCC), through its Mental Health and the Law Advisory Committee (MHLAC), undertook a series of projects related to police interactions with people with mental illnesses (PMI).3 In Canada, as in many countries, there has been a significant increase in the number of such interactions over recent years and, concomitantly, increased concerns about some of the outcomes. The overall goal of the MHCC projects was to identify ways to increase the likelihood of these interactions having improved outcomes for all involved. Consistent with the goals of the MHCC and the 2012 Mental Health Strategy for Canada (Mental Health Commission of Canada, 2012), these improved outcomes are intended to reflect the goal of ensuring that PMI are able to engage fully in all aspects of social and economic life, and that they have access to a full range of services and supports. Strategic Priority 2.4 speaks directly to the need to reduce the over-representation of PMI in the criminal justice system and provide appropriate services, treatment and supports for those who are in that system.

The involvement of PMI in the criminal justice system begins with encounters with police. While the majority of interactions between police and PMI do not involve criminal activity (cf. Belleville Police Service, 2007), there is little doubt that the increased number of interactions between police and PMI positions police as the de facto portal to the criminal justice system. Thus, there is a need for police personnel to be knowledgeable not only about the signs and symptoms of mental illnesses and the appropriate intervention and interaction strategies, but also of the broader social system within which these interactions occur. The idea that police should receive education and training related to mental illness is not novel; indeed a review of international practices indicates that such is widespread.

Coleman and Cotton's (2010a) review of a wide range of programs both in Canada and internationally suggests that most existing education programs for police personnel include:

  • signs and symptoms of major mental illnesses and other disorders affecting cognitive or emotional status;

  • indications for the presence of substance abuse;

  • assessment of suicidal intent;

  • behavioral management strategies including de-escalation techniques;

  • applications of mental health legislation; and

  • access to services appropriate to the circumstance of the PMI.

However, while it is tempting to be content with outlining content for curricula, such curricula do not occur in a vacuum. No matter how well designed and complete a curriculum is, it will only result in improved outcomes if it reflects the appropriate guiding principles, if it embraces the relevant literature, if the learning is effective, and if it engages the right people in the right social and organizational contexts.

The proposed model, the TEMPO (Training and Education about Mental Illness for Police Organizations) model, was developed in seven steps. First, in order to determine existing Canadian police/mental health learning programs, systematic analyses were conducted of programs both at the police basic training/academy level (Cotton & Coleman, 2008) as well as at the ‘in-service’ or advanced level within Canadian police organizations (Coleman & Cotton, 2010a).

Second, a comprehensive international literature review was conducted concerning police education and training regarding police contact with PMI. This was targeted primarily at Canada, the US, the UK and Australia. The review identified research and evaluations that had been completed including recommendations about content, design and duration of effective police/mental health learning programs.

Third, the factors and influences were explored that might have a specific effect on the nature of police contact with PMI but which have not been traditionally addressed in police/mental health learning programs. These included such factors as police discretion and ethical decision-making, police attitudes about mental illness, and stigma related to mental illness as well as concepts of procedural justice and police use-of-force.

Fourth, occurring simultaneously with steps 1–3 inclusive, an innovative qualitative and quantitative study of the experiences of PMI with police was conducted. This study examined the nature of interactions between police and PMI from the viewpoint of the PMI; it delineated their recommendations about the way in which police might best interact with members of their community (Brink et al., 2011).

Fifth, based on analysis of the above, the preliminary design of a contemporary model of police/mental health learning for Canadian police personnel, congruent with the strategic direction of the Mental Health Strategy for Canada, the fundamental principles of contemporary-policing, and with principles of contemporary adult learning was developed.

Sixth, an expert panel further refined the principles of the model. Members of this group included specialist police officers; police educators; professionals with knowledge of mental illness and mental health services; and police leaders as well as PMI themselves.

Finally, the penultimate version of the model was reviewed to determine its consistency with the newly released Mental Health Strategy for Canada, to ensure adherence to the principles ascribed to in that document.

Section snippets

Existing programs

There are a wide range of extant education and training programs; a few are identified here in order to provide a brief overview of the environment from which TEMPO emerged. (For a more fulsome discussion, see Coleman and Cotton (2010a)).

The TEMPO model

As noted earlier, TEMPO is derived from a combination of a literature review, programs and stakeholder input, consultation with subject matter experts, inclusion of key principles from the model of contemporary-policing and the Mental Health Strategy for Canada, as well as principles of adult education and learning. It is an aspirational model, and one that has yet to be tested. However, it reflects the current state of knowledge; it builds upon and expands existing models. Most importantly, it

Conclusion

There is little debate about the necessity of education and training for police personnel concerning the importance of facilitating appropriate interactions with people with mental illnesses and related disorders. The proliferation of materials to support such learning testifies to the prominence of this issue in many jurisdictions. However, in spite of the widespread development of education programs ranging from less than an hour in length to a full week, there is little general agreement

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