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Another sign safety net frayed

The failure to provide adequate treatment for the mentally ill manifests itself in many ways, including higher rates of homelessness, street crimes, substance abuse and broken homes. Now, we can add another troubling symptom to that list — more fatal confrontations between the mentally ill and law-enforcement officers.
While definitive statistics are hard to come by, both mental-health and police professionals see anectdotal evidence of the trend and can recount cases nationwide, according to a story in the Wall Street Journal. Its report follows an earlier study by newspapers in Portland, Maine, that concluded more than half of the people who died in confrontations with police had mental health problems.
Don’t blame police. As a recent article in the Post explained, many law-enforcement agencies, including those in this community, have officers with crisis intervention training to deal with these situations, and they coordinate those efforts with health professionals. In follow-up reviews, the vast majority of these shootings were ruled justified because the officer’s life or the safety of bystanders was jeopardized by a potential assailant with a weapon.
Better crisis training does help officers defuse some situations involving mentally unstable subjects. That was the case in May 2009, when police peacefully ended a tense standoff with former Spencer Mayor Alicia Bean, who was struggling with mental health issues and would later take her own life. But better training can’t offset what the WSJ describes as a “a narrowing range of treatment options that has shifted more responsibility for the mentally ill to law officers, jails and prisons.”
That applies in North Carolina, which has struggled with mental health reform since a 1999 U.S. Supreme Court ruling that states had to treat people in less-restrictive settings. Lawmakers envisioned — or hoped — that decentralization and the shutdown of some state institutions would result in increased treatment access at the community level. Reality hasn’t matched the promises of reform. The most recent attempt at improvement divides the state’s counties into 11 regional organizations that operate similarly to managed-care insurance companies, with patients directed toward health-care providers who contract with the state.
Perhaps this newest plan will yield better results. But with much of the state focus on cutting costs, families and mental-health advocates say many in need of care are still running into barriers. That’s borne out by the number of mentally ill in homeless shelters or crowding hospital emergency rooms and jails. Too many plunge through the safety net, and violent encounters with cops are another symptom of a larger problem.

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