Abstract
Understanding the decision-making process of police officers when responding to mental health calls is essential for optimizing the training they receive to engage with persons with a mental illness (PMI) and/or persons experiencing a mental health crisis. Research on officer decision-making in mental health contexts is lacking, and police officers’ subjective experience of this response is rarely represented. Using a qualitative approach, the current study aimed to provide a description of the decision-making processes of police officers responding to mental health calls, including decisions to appraise the situation as a mental health call and an enhanced understanding of the ways in which current mental health education and training influences police officer decision-making. Data was collected through semi-structured interviews with 30 police officers from two municipal police forces in Atlantic Canada. Interviews were transcribed and analyzed using thematic analysis. Four overarching themes were conceptualized and connected to describe the decision-making process. These themes focus on the initial information from dispatch that officers consider, participants’ on-scene observational cognitions, external dynamics that constrain decision-making, and how experience drives response rather than training due to insufficiency in the latter. Findings from this study contribute insight into the unique experience of police officers, which is essential for improving the education and training officers receive and, ultimately, enhancing client outcomes.
![](https://cdn.statically.io/img/media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs11896-024-09656-z/MediaObjects/11896_2024_9656_Fig1_HTML.png)
Similar content being viewed by others
Data Availability
Due to the sensitive nature of the research, supporting data is not available.
References
Adelman J (2003) Study in blue and grey: Police interventions with people with mental illness: A review of challenges and responses. Can Ment Health Assoc BC Div. https://cmha.bc.ca/wp-content/uploads/2016/07/policereport.pdf
Akinci C, Sadler-Smith E (2019) ‘If something doesn’t look right, go find out why’: How intuitive decision making is accomplished in police first-response. Eur J Work Organ Psy 29(1):78–92. https://doi.org/10.1080/1359432X.2019.1681402
Allen Consulting Group (2012) Police, Ambulance, and Clinical Early Response (PACER) evaluation: Final report. https://www.health.vic.gov.au/publications/police-ambulance-and-clinical-early-response-pacer-evaluation-report
Andersen JP, Boychuk E, Di Nota P, Back D, Poplawski S (2018) Decision model for police encounters: A science-based approach for decision-making in police encounters. Final report to the Ministry of Community Safety and Correctional Services. University of Toronto. https://hartlab.net/wp-content/uploads/2020/11/Decision-Model-for-Police-Encounters_Public-User-Guide_c-i-2020.pdf
Baldwin S, Bennell C, Andersen JP, Semple T, Jenkins B (2019) Stress-activity mapping: Physiological responses during general duty police encounters. Front Psychol. https://doi.org/10.3389/fpsyg.2019.02216
Bertilsson J, Niehorster DC, Fredriksson PJ, Dahl M, Granér S, Fredriksson O, Dahl M, Granér S, Fredriksson O, Mårtensson M, Magnusson M, Fransson P-A, Nyström M (2019) Stress levels escalate when repeatedly performing tasks involving threats. Front Psychol. https://doi.org/10.3389/fpsyg.2019.01562
Blais E, Landry M, Elazhary N, Carrier S, Savard AM (2020) Assessing the capability of a co-responding police-mental health program to connect emotionally disturbed people with community resources and decrease police use-of-force. J Exp Criminol 18:41–65. https://doi.org/10.1007/s11292-020-09434-x
Bohrman C, Blank Wilson A, Watson A, Draine J (2018) How police officers assess for mental illnesses. Victims Offenders 13(8):1077–1092. https://doi.org/10.1080/15564886.2018.1504844
Bolger PC (2015) Just following orders: A meta-analysis of the correlates of American police officer use of force decisions. Am J Crim Justice 40(3):466–492. https://doi.org/10.1007/s12103-014-9278-y
Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101. https://doi.org/10.1191/1478088706qp063oa
Braun V, Clarke V (2019) Novel insights into patients’ life-worlds: The value of qualitative research. Lancet Psychiatry 6(9):720–721. https://doi.org/10.1016/S2215-0366(19)30296-2
Brown SG, Daus CS (2015) The influence of police officers’ decision-making style and anger control on responses to work scenarios. J Appl Res Mem Cogn 4(3):294–302. https://doi.org/10.1016/j.jarmac.2015.04.001
Chan JF, Andersen JP (2020) The influence of organizational stress on reported depressive symptoms among police. Occup Med 70(7):496–502. https://doi.org/10.1093/occmed/kqaa141
Coleman TG, Cotton D (2010) Police interactions with persons with a mental illness: Police learning in the environment of contemporary policing. Mental Health and the Law Advisory Committee, Mental Health Commission of Canada. https://hiddenheroes.mentalhealthcommission.ca/sites/default/files/Law_Police_Interactions_Mental_Illness_Report_ENG_0_1.pdf
Coleman T, Cotton D (2014) TEMPO: A contemporary model for police education and training about mental illness. Int J Law Psychiatry 37(4):325–333. https://doi.org/10.1016/j.ijlp.2014.02.002
Compton MT, Bahora M, Watson AC, Oliva JR (2008) A comprehensive review of extant research on Crisis Intervention Team (CIT) programs. J Am Acad Psychiatry Law 36(1):47–55. https://pubmed.ncbi.nlm.nih.gov/18354123/
Compton MT, Bakeman R, Broussard B, Hankerson-Dyson D, Husbands L, Krishan S, Stewart-Hutto T, D’Orio BM, Olivia JR, Thompson NJ, Watson AC (2014) The police-based crisis intervention team (CIT) model: Effects on officers’ knowledge, attitudes, and skills. Psychiatr Serv 65(4):517–522. https://doi.org/10.1176/appi.ps.201300107
Dane E, Pratt MG (2007) Exploring intuition and its role in managerial decision making. Acad Manag Rev 32(1):33–54. https://doi.org/10.2307/20159279
Davidsen AS (2013) Phenomenological approaches in psychology and health sciences. Qual Res Psychol 10(3):318–339. https://doi.org/10.1080/14780887.2011.608466
Godfredson JW, Thomas SDM, Ogloff JRP, Luebbers S (2011) Police perceptions of their encounters with individuals experiencing mental illness: A Victorian survey. Aust NZ J Criminol 44(2):180–195. https://doi.org/10.1177/2F0004865811405138
Hassell KD (2020) The impact of Crisis Intervention Team training for police. Int J Police Sci Manag 22(2):159–170. https://doi.org/10.1177/2F1461355720909404
Heslop L, Stitt L, Hoch JS (2013) Trends in police contact with persons with mental illness. http://capg.ca/wp-content/uploads/2013/05/Trends-in-Police-Contact-with-Persons-with-Mental-Illness-Report-for-LPSB-2013.pdf
Hine KA, Porter LE, Westera NJ, Alpert GP, Allen A (2018) Exploring police use of force decision-making processes and impairments using a naturalistic decision-making approach. Crim Justice Behav 45(11):1782–1801. https://doi.org/10.1177/2F0093854818789726
Huey L, Anderson J, Bennell C, Campbell MA, Koziarski J, Vaughan AD (2021a) Caught in the currents: Evaluating the evidence for common downstream police response interventions in calls involving persons with mental illness. FACETS 6(1):1409–1445. https://doi.org/10.1139/facets-2021-0055
Huey L, Ferguson L, Vaughan AD (2021b) The limits of our knowledge: Tracking the size and scope of police involvement with persons with mental illness. R Soc Can. https://rsc-src.ca/en/research-and-reports/covid-19-policy-briefing/mental-health-policing/limits-our-knowledge-tracking
Jenkins B, Semple T, Bennell C (2020) An evidence-based approach to critical incident scenario development. Policing: Int J 44(3):437–454. https://doi.org/10.1108/PIJPSM-02-2020-0017
Kahneman D (2003) A perspective on judgment and choice: Mapping bounded rationality. Am Psychol 58(9):697–720. https://doi.org/10.1037/0003-066X.58.9.697
Kahneman D, Klein G (2009) Conditions for intuitive expertise: A failure to disagree. Am Psychol 64(6):515–526. https://doi.org/10.1037/a0016755
Kemparaj U, Chavan S (2013) Qualitative research: a brief description. Indian J Med Sci 67(3–4):89–98. https://pubmed.ncbi.nlm.nih.gov/24231397/
Klein GA (1993) A Recognition-Primed Decision (RPD) model of rapid decision making. In: Klein GA, Orasanu J, Calderwood R, Zsambok CE (eds) Decision making in action: Models and methods. Ablex, pp 138–147
Klein G (2008) Naturalistic decision making. J Hum Factors Ergonom Soc 50(3):456–460. https://doi.org/10.1518/2F001872008X288385
Krishan S, Bakeman R, Broussard B, Cristofaro SL, Hankerson-Dyson D, Husbands L, Watson AC, Compton MT (2014) The influence of neighborhood characteristics on police officers’ encounters with persons suspected to have a serious mental illness. Int J Law Psychiatry 37(4):359–369. https://doi.org/10.1016/j.ijlp.2014.02.006
Koziarski J, O’Connor C, Frederick T (2021) Policing mental health: The composition and perceived challenges of co-response teams and crisis intervention teams in the Canadian context. Police Pract Res 22(1):977–995. https://doi.org/10.21428/cb6ab371.032b351b
Krameddine Y, Silverstone P (2015) How to improve interactions between police and the mentally ill. Front Psych 5:186. https://doi.org/10.3389/fpsyt.2014.00186
Livingston JD (2016) Contact between police and people with mental disorders: a review of rates. Psychiatr Serv 67(8):850–857. https://doi.org/10.1176/appi.ps.201500312
Livingston JD, Desmarais SL, Verdun-Jones S, Parent R, Michalak E, Brink J (2014) Perceptions and experiences of people with mental illness regarding their interactions with police. Int J Law Psychiatry 37(4):334–340. https://doi.org/10.1016/j.ijlp.2014.02.003
Marsden M, Nigam J, Lemetyinen H, Edge D (2020) Investigating police officers’ perceptions of their role in pathways to mental healthcare. Health Soc Care Community 28(3):913–921. https://doi.org/10.1111/hsc.12922
McNeilly G (2017) Police interactions with people in crisis and use of force: OIRPD interim systematic review report. Office of the Independent Police Review Director. https://www.oiprd.on.ca/wp-content/uploads/Police-Interactions-with-People-in-Crisis-and-Use-of-Force-Systemic-Review-Report-March-2017-Small.pdf
Morrow SL (2005) Quality and trustworthiness in qualitative research in counseling psychology. J Counseling Psychol 52(2):250–260. https://doi.org/10.1037/0022-0167.52.2.250
Novy M (2012) Cognitive distortions during law enforcement shooting. Act Nerv Super 54(1–2):60–66. https://doi.org/10.1007/BF03379584
Okoli J, Watt J (2018) Crisis decision-making: The overlap between intuitive and analytical strategies. Manag Decis 56(5):1122–1134. https://doi.org/10.1108/MD-04-2017-0333
Okoli JO, Watt J, Weller G (2022) A naturalistic decision-making approach to managing non-routine fire incidents: Evidence from expert firefighters. J Risk Res 25(2):198–217. https://doi.org/10.1080/13669877.2021.1936609
Pelfrey WV, Young A (2020) Police crisis intervention teams: Understanding implementation variations and officer-level impacts. J Police Crim Psychol 35:1–12. https://doi.org/10.1007/s11896-019-9314-4
Power N, Alison L (2019) Decision inertia in critical incidents. Eur Psychol 24(3):209–218. https://doi.org/10.1027/1016-9040/a000320
Schulenberg J (2016) Police decision-making in the gray zone: The dynamics of police–citizen encounters with mentally ill persons. Crim Justice and Behav 43(4):459–482. https://doi.org/10.1177/2F0093854815606762
Seo C, Kim B, Kruis NE (2021) A meta-analysis of police response models for handling people with mental illnesses: Cross-country evidence on the effectiveness. Int Crim Justice Rev 31(2):182–202. https://doi.org/10.1177/2F1057567720979184
Tartaro C, Bonnan-White J, Mastrangelo MA, Mulvihill R (2021) Police officers’ attitudes toward mental health and crisis intervention: Understanding preparedness to respond to community members in crisis. J Police Crim Psychol 36:579–591. https://doi.org/10.1007/s11896-021-09459-6
Thayer JF, Hansen AL, Saus-Rose E, Johnsen BH (2009) Heart rate variability, prefrontal neural function, and cognitive performance: The neurovisceral integration perspective on self-regulation, adaptation, and health. Ann Behav Med 37(2):141–153. https://doi.org/10.1007/s12160-009-9101-z
Verhage A, Noppe J, Feys Y, Ledegen E (2018) Force, stress, and decision-making within the Belgian police: The impact of stressful situations on police decision-making. J Police Crim Psychol 33(4):345–357. https://doi.org/10.1007/s11896-018-9262-4
Violanti JM, Charles LE, McCanlies E, Hartley TA, Baughman P, Andrew ME, Fekedulegn D, Ma CC, Mnatsakanova A, Burchfiel CM (2017) Police stressors and health: A state-of-the-art review. Policing: Int J 40:642–656. https://pubmed.ncbi.nlm.nih.gov/30846905/
Wittmann L, Dorner R, Heuer I, Bock T, Mahlke C (2021) Effectiveness of a contact based anti-stigma intervention for police officers. Int J Law Psychiatry. https://doi.org/10.1016/j.ijlp.2021.101697
Wood JD, Watson AC, Fulambarker AJ (2017) The “gray zone” of police work during mental health encounters: Findings from an observational study in Chicago. Police Q 20(1):81–105. https://doi.org/10.1177/10986
Funding
Canadian Psychological Association.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
The authors have no relevant financial or non-financial interests to disclose. Partial financial support was received from the Criminal Justice Psychology Section of the Canadian Psychological Association.
Ethical Approval
Approval was obtained from the ethics committee of the University of New Brunswick. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.
Consent to Participate
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Freeze, S.M., Campbell, M.A. Police Officer Decision-Making During Mental Health Calls: A Qualitative Study. J Police Crim Psych 39, 358–369 (2024). https://doi.org/10.1007/s11896-024-09656-z
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11896-024-09656-z