Matthew Capodicasa’s play The Scenarios focuses on the actors taking part in crisis de-escalation trainings for police officers engaging with people with a mental health diagnosis.
Here is some background on the incidents of violence against and at the hands of people with a mental health diagnosis. All statistics are linked to sources. For Matthew’s insights from working as a part-time administrator for an organization that offered these trainings, take a look at his conversation with Studio Literary Director Adrien-Alice Hansel. You can also read more about these de-escalation trainings.
According to the National Alliance on Mental Illness, 21% of U.S. adults, or 52.9 million people, experienced mental illness in 2020.
For incarcerated people, those rates are much higher; the American Psychological Association reports that “64 percent of jail inmates, 54 percent of state prisoners, and 45 percent of federal prisoners” have reported mental health concerns.
Approximately half the people in U.S. jails and over one third of the population of U.S. prisons have been diagnosed with a mental illness.
People with a mental health diagnosis are 8-10 times more likely to be a victim of violence than the rest of the population.
People with mental illnesses are more likely to cause self-harm than to inflict harm on others.
People with a mental health diagnosis are “modestly” more likely than the rest of the population to commit an act of violence (2.9% of persons w a mental health diagnosis vs .8% of the rest of the population, per a 2012 APA study, in a correlation that the study characterizes as “modest”).
Roughly 5% of all crimes are committed by people with a mental health diagnosis.
The study found a significantly stronger relationship between mental and substance use disorders; when people with serious mental illness commit violent or aggressive acts, other factors besides the illness itself are often at play, most frequently co-occurring substance use. Per Dr. Kimberly Brown of Vanderbilt University: “If you have both a mental illness and a substance use diagnosis, the combination is synergistic and dangerous”
Per the 2022 MacArthur Violence Risk Assessment Study, only two clinical symptoms were associated with violent acts among psychiatric inpatients 20 weeks after discharge:
“Command hallucinations,” or psychotic voices telling a person to harm others
Psychopathy (characterized by a lack of empathy, poor impulse control, and antisocial deviance), which is not typically considered a serious mental illness.
Just as likely to play roles were a history of prior violence, binge drinking, a history of childhood physical abuse or neglect, having a father who abused substances or was convicted of a crime, displaying antisocial behavior, and scoring high on anger measures.
The National Council for Mental Wellbeing points out that the above studies were done within populations of folks receiving inpatient treatment (and then after their discharge). They hold that the general population of people with mental illness—which would include people who have never sought or required inpatient treatment for their diagnosis—is not more likely to be violent than the general public; that 2.9% rate has to do with methodology.
Police are usually the first to respond to someone in a mental health and/or substance abuse crisis. Between 21-38% of 911 calls are related to mental health or substance use; between 11-20% of all police contacts with the public involve persons with serious mental illness.
People with mental illness are 11.6 times as likely to experience use of force in interactions with law enforcement than those without mental illness.
Washington DC requires police officers to take a 16-hour ICAT training in addition to the 40-hour CIT training they receive as a part of basic training.
DC has a pending lawsuit against it that contends that DC’s emergency response system discriminates against people with mental illness by deploying armed police officers instead of appropriate care providers, bringing suit under the Americans with Disabilities Act.
NAMI held a virtual seminar called “More than a Number: The Impact of 988 on Reimagining Mental Health Crisis Care.”
It follows the fight to implement a 988 crisis hotline that will divert 911 calls to trained mental and behavioral health professionals. It tells the story about how many people died of heart attacks and in fires before the country established—and funded—911 services around the country, drawing inspiration from that story to reimagine how communities could offer mental health crisis care.