How police can help mentally ill: Care in Taking Patients Urged

              Some months ago a friend asked me, as executive director of the State Mental Health As­sociation, for help in apprehend­ing a mentally ill young woman who was new to the community and who was making herself a nuisance by her behavior in a church congregation.
After an examination by a psychiatrist, commitment papers were prepared and it remained only for her to be identified, ap­prehended by the police, and taken to the hospital.
By prearrangement, my friend an<| I and two young police of­ficers converged on her as she was abouf to enter her house. She was asked to sit down in, a swing on the porch, which she did.
The purpose of this story is to report the behavior of the. .young officers for the next few minutes.
They doffed their caps and tol$ the woman that they had a writ from the coroner's office to take her to a hospital, They attempt­ed to persuade her to go, but she refused. One officer sat on a banister of the porch, The other, in Ms eagerness to clarify every­thing, squatted down into a sort of sitting position and explained every detail.
EASE, ASSURANCE
She still refused to go to the hospital, so the officers gave her art ultimatum that she could either go with them "like a lady" in the squad car or they would send for the wagon. They did call the wagon, and both the squad car and the wagon were drawn up tn front of the house. Again she refused to go, so they po­litely, but firmly, took hold of her arms and led her down the porch steps, still offering her the alternative of going in the squad car or the wagon.
She started in the direction of the squad car and then began to resist. They opened the door of the wagon and deftly slipped her inside, after quickly examining, her purse for any dangerous ob­jects she might be carrying.
When it was all over and she was being taken to the hospital, I asked one of the young officers where they had learned about mental illness and the handling of mentally ill people. He replied, "Oh, we have a little manual over in the department called, 'How To Recognize and Handle Abnormal People'."
I was greatly pleased to sed that this officer had benefited so much from learning about thej handling of mentally ill peopld from reading a manual, as this seemed to be his principal source of information.
I was much interested in the ease and asurance of the officers and I have no doubt these atti tu#s were helpful to the patient
Ease and assurance come frorr a knowledge of what to do. The officer who knows little about the mentally ill is apt to fear them unnecessarily. Fearing them, he does not handle them well, and his fear frequently is transmitted to the patient.
MAY BE EXCITED
Officers sometimes express ad­miration for the ease with which psychiatric aides in mental hos­pitals handle the mentally ill, even the very excited patient. They say they wish they could do as well. Such handling comes from experience, of course, but it comes partly from knowing what to do.
The doctor will say that the mentally  ill  patients   are  not
dangerous, that he has been in the hospital any number of years and that no patient has ever attacked him. He may even laugh-and say that people on the inside of mental hospitals are less dangerous than people on the outside.
The average, police officer knows that the doctor may be right about persons who are al­ready in the hospital, but he also knows the kind of patients he is called upon to apprehend and take to the hospital or to a place of detention.  They may
very well turn out to be excited individuals and either potential­ly or actually dangerous. There­fore, the officer should want to know everything possible aboul the handling of mentally ill people.
First of all, an officer should never go alone when he is called to handle a mentally ill person. It is no reflection on his bravery if he calls for help. He should never attempt to apprehend a mentally ill person without hav­ing at least one other officer with him, and it is much better to have three others. In fact, I would recommend that all po­lice departments, except in emergencies, require the pres­ence of three or four officers in apprehending a mentally ill person. This would protect the individual officer from having to prove that he is "brave" and |thus take undue risk. Also, and this is more important, a pa­tient may see he is overwhelmed by numbers and give up more easily. If the patient is afraid, he may even welcome a large number of officers as being bet­ter protection for him from his "enemies."
SOME ARE GUNNING
Whenever it is possible to take
advantage oi time, tne orncer should do so; The excited per­son does not usually stay that way very long. Often muc)l can be gained by going into a house, sitting down to talk with rela­tives, and asking questions con-cering the situation. It may even be desirable to accept a cup of coffee if one is offered. The ef­fect of time is strange, because the patient may come to rec­ognize the officer as a friend who has come to help rather than someone who has come to grab him and take him off to a mental hospital.
The patient should be reasoned with, whether he gives the ap­pearance of responding or not. Sometimes the officer will be astounded at how well the men­tally ill person's mind works. He can think of answers as East as the officer can give ex­planations. He may, in fact, "out-reason^ the_officer. This is partly because" he"has~been thinking~a [ong time about his problems and  has  worked  out  answers
to nearly anything the officer may say to him. This does not mean, however, that the officer will be tricked by a man who is. only cunning and not bal­anced or sane.
Here again,  there are great individual   differences.   It   has
been said that mentally ill people are just as different as people on the street are differ­ent from each other. Certainly we cannot expect the same kind of response from all mentally ill persons.
As further evidence of the full awareness of mentally ill people, 85 per cent of the men­tally ill in England are willing to go voluntarily to certain men­tal hospitals, while in this coun­try the number is far closer to two or three per cent in most communities. The difference is that mentally ill people in Eng­land know they are going to a hospital where every attention will be given to their care, whereas in this country they are unsure. The point is, they are aware of these matters, even though they are said to be of unsound mind.
FRIENDS IN NEED If it is necessary to tajke the patient against his will, he should be approached from both' sides and his arms and legs* grabbed simultaneously. Police; officers all know how to do this, DUt care must be.taken so that :he mentally ill person is re­strained in such a way that he will not be hurt any more than is necessary. At this point, it may be difficult for the indi­vidual police officer not to be too rough with the patient. He may "take out" on the patient some of his unconscious anger. He also may be a little ashamed of his own fear and overdo the harshness necessary to appre­hend the patient.
Sometimes a patient will quiet down when restrained. In fact, he may be glad that the police saved him from himself. The officers can take advantage of this situation by telling him they are his friends; that they have come to help him.
It is at times necessary to roll the patient in a sheet or quilt or some .other convenient article. Handcuffs may be used, but this must be done with care because violent patients \yill cut their wrists. Usually, a strait-jacket will not be available, and most police officers are not as skilled in the use of this mental hospital equipment as are nurses and psychiatric aides.
Once in a while, the mentally ill person should be approached as any other dangerous, violent individual. If 'he has a lethal weapon, the officer will have to use his own judgment.
Nobody asks the officer to take unreasonable risks, Nobody asks the officer to lay his gun PHOTO: DR LOYD ROWLAND ...gives views on problem