If you like this blog, you might also like my new book of the same name, from Eliezer Tristan Publishing. Now available on Amazon in both paperback and Kindle formats.

The relationship between law enforcement and mental health is, to say the least, fraught. It often seems that every other day we hear about a police officer shooting someone who is mentally ill or mentally disabled. Throw in the present militarization of police and the remains of a shoot-first-ask-questions-later culture, and you’ve got tragedies in the making.

The good news is that there are police departments around the country that are trying to revamp systems so that the needs of the mentally ill are considered and treated more sensitively. Part of this is in response to the fact that many jails and prisons have become de facto mental institutions. Part of it seems to be an offshoot of the community policing movement. Some of the programs sound progressive or at least promising. Others may be more dubious.

The effort I read about recently that struck me as dubious is Indianapolis’s approach. As the IndyStar reported, “Ten officers with the Indianapolis Metropolitan Police Department are testing out a tool designed to help them assess whether a person is exhibiting symptoms related to a possible mental illness.” The “tool,” or questionnaire, “is still being developed, so all officers are testing now is how easy it is to use and whether the questions that are part of the assessment aren’t too ‘technical’ or ‘cumbersome’ for officers in the field, IMPD Lt. Catherine Cummings said.” Which is probably a good thing, seeing that the tool uses “questions that medical professionals use to detect mental illnesses, according to [Paul] Babcock, [Director of the Office of Public Health and Safety (OPHS)].” It is designed to be used from a cell phone or laptop.

That does indeed sound technical and cumbersome, not to mention the fact that it is rather difficult to see how police officers would use it in the field. It’s hard to picture officers with cell phones and laptops filling out a questionnaire to determine if someone needs to go to jail or to the emergency room. The project is still in the testing phase, so it has a long way to go before it sees use in Indianapolis or elsewhere.

The Iowa approach seems more practical.  It is “a response to the increased burden law enforcement agencies face in trying to make America’s frayed mental health system function. The team helps get people into treatment before they spiral further out of control and wind up arrested for behavior rooted in their mental struggles.” Police officers, often in small towns where they know the people they serve and protect, do this partially by “bringing people in for court-ordered treatment….They also provide security at a threadbare courtroom at [the local medical center], where commitment hearings are held several days a week.”

One of the deputies says he “focuses on the fact that the people he’s tracking down are experiencing mental troubles that could happen to anyone. He doesn’t want them to feel like they’re being arrested. ‘These people are not criminals,’ he said. ‘They haven’t done anything wrong. They’re people in need of our assistance.'”

Mental health advocate and activist Pete Earley sees the problem as one requiring a number of solutions: “We still need to work on building supportive housing. We still need to push for expanding problem solving dockets (mental health and drug courts). We now need our judges and prosecutors to understand that individuals charged with both misdemeanors and felonies should be eligible for diversion because it is not the crime that should be the determining factor but whether or not the accused has a criminogenic personality. (Persons with chronic, serious mental illnesses often get charged with felony assault for resisting arrest.)”

He is undoubtedly right. But most of these approaches remain rather far in the future. Finding the political, municipal, departmental, and financial will to implement them is, for many jurisdictions, simply not possible.

And of course, the problems are hardly solely the fault of law enforcement. Sensitive, caring police officers exist nearly everywhere and people who work in correctional facilities recognize that their institutions have become substitutes for mental health treatment and that this is hardly a solution.

But at least some people in some places are beginning to address the problem.

One year on my birthday I woke up in Venice. The next year on my birthday I woke up in excruciating physical pain. For me, anyway, birthdays are like that–a crapshoot.

It’s been a long time since I really enjoyed birthdays (except for the one in Venice). As a young teen, I experienced a humiliating, traumatic event at a birthday party that triggered a severe depression. It wasn’t my birthday party, but it left me deeply wary of birthdays in general and birthday parties in particular.

Now my birthday is approaching again and I don’t know which way it’s going to go. Oh, I know I won’t wake up in Venice and I hope I don’t wake up in excruciating pain. But it’s going to be a crapshoot for sure.

You see, this year I’m walking that tightrope so familiar to people with bipolar disorder. Though I’ve been fairly stable through most of the year, now I find myself teetering. If I fall off to one side, there’s depression waiting to catch me. If I stumble the opposite way, hypomania beckons. One way or the other, I fear I’m going to be triggered.

Last week I wrote about my husband’s heart attack and how it was my turn to be the caregiver (https://wp.me/p4e9Hv-Kx). In that post I blithely claimed that I could handle the financial stuff for us. What I mean was that I could handle dealing with the bills and bureaucracy and the assorted financial frustrations that go with a medical crisis.

What I can’t do is make enough money to get us through it all. Dan hasn’t been able to work since his heart attack in late August. We’ve gotten by so far largely due to the generosity of family and friends, which I have been able to organize, track, budget, and spend. But now we’re running out of money.  And I’m afraid.

Naturally, I’m catastrophizing, one of my less-effective “coping” mechanisms. We might make the next mortgage payment, but after that I just don’t know. Even with Dan going back to work next month (we hope) and the small amount I make, I know it won’t stretch to cover the mortgage and all the other bills. I imagine that soon we will be living under the Third Street bridge and fighting stray dogs for cold french fries.

Plus, desperate finances, particular long-lasting and seemingly unrelenting, is one of my depression triggers. Dealing with our own finances at the same time as taking over my mother’s was deeply involved in the last major meltdown I experienced.

Dan is already taking up the slack, planning and coming up with ideas to get some more money to tide us over. But then I feel defeated, as though I’m not shouldering my weight in the caretaking department.

The ensuing chaos should descend right around my birthday. And I may descend right along with it.

On the other side of the tightrope lurks hypomania. My first book (on bipolar disorder) is getting closer to being published by Eliezer Tristan Publishing, which is a brainchild of Sarah Fader of Stigma Fighters. Publishing a book is a goal I’ve had for a good many decades and to have it about to happen is a real rush.

But. I can already feel myself planning fabulous things once the book exists. A launch party. T-shirts. Bookmarks. A promotional sign. Speaking engagements. Networking. Bookstore visits and author signings.  I may just be getting ideas that are beyond my ability to organize and pay for. I’ve already bought a top to wear to the not-yet-and-maybe-never-existing launch party. I may be planning things that I don’t have enough spoons to accomplish. I may be getting overwrought at the thought of reaching this goal and that way lies hypomania.

Or maybe depression, when reality doesn’t meet with my unnaturally inflated notions. Or both, I suppose. I have little experience with mixed states and may not recognize one until it bites me.

When my birthday comes, I may still be teetering this way and that. Or I may have either fallen or flown. I suppose it’s possible that I won’t lose my hard-won balance, though I’m not counting on it.

Whatever way it goes, it looks to be an interesting birthday. And not in the festive sense.