NAVAL POSTGRADUATE SCHOOL - Mental Illness Policy Org
NAVALPOSTGRADUATESCHOOLMONTEREY, CALIFORNIATHESISMANAGEMENT OF THE SEVERELY MENTALLY ILLAND ITS EFFECTS ON HOMELAND SECURITYbyMichael C. BiasottiSeptember 2011Thesis Co-Advisors:David BrannanPatrick MillerApproved for public release; distribution is unlimited
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REPORT DOCUMENTATION PAGEForm Approved OMB No. 0704-0188Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instruction,searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Sendcomments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, toWashington headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington DC 20503.1. AGENCY USE ONLY (Leave blank)2. REPORT DATE3. REPORT TYPE AND DATES COVEREDSeptember 2011Master’s Thesis4. TITLE AND SUBTITLE Management of the Severely Mentally Ill and its5. FUNDING NUMBERSEffects on Homeland Security6. AUTHOR(S) Michael C. Biasotti7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES)8. PERFORMING ORGANIZATIONNaval Postgraduate SchoolREPORT NUMBERMonterey, CA 93943-50009. SPONSORING /MONITORING AGENCY NAME(S) AND ADDRESS(ES)10. SPONSORING/MONITORINGN/AAGENCY REPORT NUMBER11. SUPPLEMENTARY NOTES The views expressed in this thesis are those of the author and do not reflect the official policyor position of the Department of Defense or the U.S. government. IRB Protocol number NPS IRB# NPS.2011.0049-IR-EM2-A.12a. DISTRIBUTION / AVAILABILITY STATEMENTApproved for public release; distribution is unlimited13. ABSTRACT (maximum 200 words)12b. DISTRIBUTION CODEAAs a result of the events of September 11, 2001, law enforcement agencies nationwide have been assigned a plethoraof terrorism prevention and recovery related duties. Many federal documents outline and emphasize duties andresponsibilities pertaining to local law enforcement. The prevention of acts of terrorism within communities hasbecome a focal point of patrol activities for state and local police agencies. Simultaneously, local law enforcement isdealing with the unintended consequences of a policy change that in effect removed the daily care of our nation’sseverely mentally ill population from the medical community and placed it with the criminal justice system. Thispolicy change has caused a spike in the frequency of arrests of severely mentally ill persons, prison and jailpopulation and the homeless population. A nationwide survey of 2,406 senior law enforcement officials conductedwithin this paper indicates that the deinstitutionalization of the severely mentally ill population has become a majorconsumer of law enforcement resources nationwide. This paper argues that highly cost-effective policyrecommendations exist that would assist in correcting the current situation, which is needlessly draining lawenforcement resources nationwide, thereby allowing sorely needed resources to be directed toward this nation’shomeland security concerns.14. SUBJECT TERMS Law enforcement, severe mental illness, homeland security, law enforcementresources, assisted out-patient treatment, homeless population, prison overcrowding, New WindsorPolice Department17. SECURITYCLASSIFICATION OFREPORTUnclassified18. SECURITYCLASSIFICATION OF THISPAGEUnclassifiedNSN 7540-01-280-550015. NUMBER OFPAGES15516. PRICE CODE19. SECURITY20. LIMITATION OFCLASSIFICATION OFABSTRACTABSTRACTUnclassifiedUUStandard Form 298 (Rev. 2-89)Prescribed by ANSI Std. 239-18i
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Approved for public release; distribution is unlimitedMANAGEMENT OF THE SEVERELY MENTALLY ILL AND ITS EFFECTS ONHOMELAND SECURITYMichael C. BiasottiChief of Police, New Windsor Police Department, New Windsor New YorkBS, Mercy College, Dobbs Ferry New York, 1986Submitted in partial fulfillment of therequirements for the degree ofMASTER OF ARTS IN SECURITY STUDIES(HOMELAND SECURITY AND DEFENSE)from theNAVAL POSTGRADUATE SCHOOLSeptember 2011Author:Michael C. BiasottiApproved by:David BrannanThesis Co-AdvisorPatrick MillerThesis Co-AdvisorHarold A. Trinkunas, PhDChair, Department of National Security Affairsiii
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ABSTRACTAs a result of the events of September 11, 2001, law enforcement agencies nationwidehave been assigned a plethora of terrorism prevention and recovery related duties. Manyfederal documents outline and emphasize duties and responsibilities pertaining to locallaw enforcement. The prevention of acts of terrorism within communities has become afocal point of patrol activities for state and local police agencies. Simultaneously, locallaw enforcement is dealing with the unintended consequences of a policy change that ineffect removed the daily care of our nation’s severely mentally ill population from themedical community and placed it with the criminal justice system. This policy changehas caused a spike in the frequency of arrests of severely mentally ill persons, prison andjail population and the homeless population. A nationwide survey of 2,406 senior lawenforcement officials conducted within this paper indicates that the deinstitutionalizationof the severely mentally ill population has become a major consumer of law enforcementresources nationwide.This paper argues that highly cost-effective policyrecommendations exist that would assist in correcting the current situation, which isneedlessly draining law enforcement resources nationwide, thereby allowing sorelyneeded resources to be directed toward this nation’s homeland security concerns.v
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TABLE OF CONTENTSI. INTRODUCTION.1 A. PROBLEM STATEMENT .2 B. RESEARCH QUESTIONS .5 1. Primary Question.5 2. Secondary Question .5 C. LITERATURE REVIEW .6 D. HISTORY OF THE ISSUE .7 1. Results of Policy Change .12 2. Law Enforcement Workload .13 3. Homeless Population Strain on Law Enforcement .14 4. Severely Mentally Ill as Crime Victims .15 5. Prison and Jail Overcrowding .15 6. Extent of Mentally Ill Population in Jails and Prisons.17 7. Direct Acts of Untreated Mentally Ill as Homeland SecurityIssues .18 8. Impact of Treatment Programs .19 9. Anosognosia .20 10. Opposition to Court-Ordered Psychiatric Treatment.22 11. The States’ Stances .22 12. The International Experience .23 II. METHODOLOGY .27 A. SURVEY DESIGN AND DELIVERY .28 B. SURVEY SUMMARY.30 III. RESULTS AND ANALYSIS .33 A. QUESTION 1 .33 B. QUESTION 2 .34 C. QUESTION 3 .35 D. QUESTION 4 .37 E. QUESTION 5 .38 F. QUESTION 6 .40 G. QUESTION 7 .41 H. QUESTION 8 .43 I. QUESTION 9 .45 J. QUESTION 10 .51 K. QUESTION 11 .52 L. QUESTION 12 .54 M. QUESTION 13 .55 N. QUESTION 14 .56 O. QUESTION 15 .66 P. QUESTION 16 .68 Q. QUESTION 17 .69 vii
R. S. T. U. V. IV. QUESTION 18 .71 QUESTION 19 .73 QUESTION 20 .74 QUESTION 21 .75 QUESTION 22 .77 FINAL REVIEW .79 A. OPERATION RED EYE.80 B. POLICY RECOMMENDATIONS .83 C. SUMMARY OF RECOMMENDATIONS.84 APPENDIX A. IACP LETTER OF ENDORSEMENT.87 APPENDIX B. THE SURVEY.89 APPENDIX C. WRITTEN RESPONSES TO OPEN ENDED QUESTION #8.93 APPENDIX D. WRITTEN RESPONSES TO OPEN ENDED QUESTION #9.103 APPENDIX E. WRITTEN RESPONSES TO OPEN ENDED QUESTION #14.111 APPENDIX F. RESULTS BY STATE (HYPERLINK).127 APPENDIX G. RESULTS BY POPULATION (HYPERLINK) .129 LIST OF REFERENCES .131 INITIAL DISTRIBUTION LIST .137 viii
LIST OF FIGURESFigure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. Figure 7. Figure 8. Figure 9. Figure 10. Figure 11. Figure 12. Figure 13. Figure 14. Figure 15. Figure 16. Figure 17. Figure 18. Figure 19. Figure 20. Figure 21. Figure 22. Figure 23. Figure 24. Figure 25. Figure 26. Figure 27. Figure 28. Figure 29. Numbers of Patients in Psychiatric Hospitals 1950–2005 (From Torrey,2010) .8 United States Population 1950–2005 (From United States Census Bureau,2005) .9 Question 1 .33 Question 2 .35 Question 3 .36 Question 4 .38 Question 5 .39 Question 6 .41 Question 7 .43 Question 8 .44 Word Cloud of Responses Regarding Causes of Increased Presence ofMentally Ill Within Calls for Service.45 Question 9 .46 Word Cloud From Participant Responses Regarding Amount of TimeCommitment .49 Question 10 .51 Question 11 .53 Question 12 .54 Question 13 .56 Word Cloud Created From Participant Responses to Question 14.57 National Results to Question 14 .58 Question 14 .62 Question 14 .63 Question 15 .67 Question 16 .68 Question 17 .70 Question 18 .72 Question 19 .74 Question 20 .75 Question 21 .76 Question 22 .78 ix
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LIST OF TABLESTable 1. Table 2. Table 3. Table 4. Table 5. Table 6. Table 7. Table 8. Table 9. Table 10. Table 11. Table 12. Table 13. Table 14. Table 15. Table 16. Table 17. Table 18. Table 19. Table 20. Table 21. Table 22. Table 23. Table 24. Table 25. Table 26. Degree of Deinstitutionalization: Public Psychiatric Beds per Population,1955 and 2004–2005 (Torrey, Geller, & Staff, 2008) .9 Number of Public Psychiatric Beds Needed to Meet Minimum Standardsof Treatment (Torrey, Geller, & Staff, 2008) .11 Question 1 .34 Question 2 .35 Question 3 .36 Question 4 .38 Question 5 .40 Question 6 .41 Question 7 .43 Question 8 .44 Question 9 .46 Question 9 .47 Question 10 .52 Question 11 .53 Question 12 .55 Question 13 .56 National Results Question 14.59 Massachusetts Filter Response Question 14 .62 Arizona Filter Response Question 14 .63 Question 15 .67 Question 16 .69 Question 17 .70 Question 18 .72 Question 19 .74 Question 21 .76 Question 22 .78 xi
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LIST OF ACRONYMS AND ABBREVIATIONSAOTAssisted Outpatient TreatmentBJSBureau of Justice StatisticsCIACentral Intelligence AgencyCSLLEACensus of State and Local Law Enforcement AgenciesFBIFederal Bureau of InvestigationIPInternet ProtocolLEMASLaw Enforcement Management and Administrative StatisticsNYSACOPNew York State Association of Chiefs of PoliceNYSSANew York State Sheriffs AssociationIACPInternational Association of Chiefs of Policexiii
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ACKNOWLEDGMENTSThis thesis would not have been possible without the assistance of many people;people who saw both the importance of the program offered by
HOMELAND SECURITY Michael C. Biasotti Chief of Police, New Windsor Police Department, New Windsor New York BS, Mercy College, Dobbs Ferry New York, 1986 Submitted in partial fulfillment of the requirements for the degree of MASTER OF ARTS IN SECURITY STUDIES (HOMELAND SECURITY AND DEFENSE) from the NAVAL POSTGRADUATE SCHOOL September 2011
1.3 This Guide 6 2. Understanding mental illness 7 2.1 About mental illness 7 2.2 Facts about mental illness 7 3. Managing mental illness in the workplace 9 3.1 Effective communication strategies 9 3.2 Reasonable adjustments 11 3.3 Examples of reasonable adjustments to address the effects of a worker's mental illness in the workplace 13
3.2 european Policy 12 3.4 Happiness and wellbeing debates 14 4.0 Concepts and definitions: what is mental health? 15 4.1 Dual continuum model of mental health 16 4.2 Measuring mental health 17 5.0 Benefits of mental health promotion 19 5.1 Benefits of preventing mental illness 19 5.2 Benefits of promoting positive mental health 22
50 Signs of Mental Illness: A Guide to Understanding Mental Health by Dr. James Whitney Hicks- This book outlines treatments and symptoms of mental illness in a clear way to allow for students to understand each illness. It can also help students who may be struggling with menta
The course consists of eight modules on different topics in mental health. There are introduction modules and modules on helping people with their drug treatments, other . ill and making a better recovery from the illness. Understanding mental illness Person with higher chance of mental illness D6 Slide
Sexual Victimization of SMI offenders in Jails/ Prisons 1 in 12 male inmates with mental illness vs 1 in 33 male inmates without mental illness reported sexual victimization by another inmate within the last 6 months. Among those with mental illness, females with 3 times more
Mental h. ealth problems: A mental health problem can also imp. act an individual’s cognitive, emotional or social abilities, but may not meet the criteria for a diagnosable mental illness. Mental health problems are said to occur as a result of life stressors, and are usually less severe and of shorter duration than mental illnesses.
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2013 AMC 8 Problems Problem 1 Amma wants to arrange her model cars in rows with exactly 6 cars in each row. She now has 23 model cars. What is the smallest number of additional cars she must buy in order to be able to arrange all her cars this way? Solution Problem 2 A sign at the fish market says, "50% off, today only: half-pound packages for just 3 per package." What is the regular price .
