Neurodiversity & Law Enforcement, with Dr. Marsha D. Brown | EDB

Dr. Marsha Brown shares her work educating law enforcement on neurodiversity and mental health.

(20 minutes) Dr. Marsha D. Brown is a Florida Licensed Psychologist with specializations in forensic and clinical psychology. She has extensive experience in the assessment, evaluation, diagnosis, and treatment of children, adolescents, adults, and families across a variety of settings. Forensically, she conducts psychological evaluations in family, criminal, and civil court. Dr. Brown her work educating law enforcement officials in neurodiversity and dealing with people having mental health episodes.

For more about Dr. Marsha Brown: drmarshabrown.com

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Welcoming back Dr. Marsha Brown

HACKIE REITMAN (HR): Hi, I’m Dr. Hackie Reitman. Welcome to another episode of Exploring Different Brains. Today, we’re so lucky to have returning to us, Dr. Marsha Brown, the clinical and forensic psychologist. Marsha, welcome!

MARSHA BROWN (MB): Thank you, Thank you. It’s great to be here.

Educating law enforcement on neurodivesity

HR: You’re a member of the Broward County Sheriff’s crisis management teaching team. Can you tell us a little bit about that?

MB: So, the Broward Sheriff’s Office has something called crisis intervention team, where they basically teach law enforcement officers in Broward County. So it doesn’t have to be a BSO officer but it can be any law enforcement officer in a county, and they basically teach the officers how to interact with a person who is having some kind of mental health or psychiatric crisis. And so I am on the teaching facility for that and what I do with my part is I present on adult Mental Health. So basically it’s the idea of teaching officers how to recognize symptoms of mental illness. So when you’re interacting with a person and they’re doing certain things or they’re displaying certain behaviors, it should be kind of an indication that something is going on in terms of mental health with this person.

HR: And it takes up a good portion of your time I would imagine?

MB: That particular part of it, I actually don’t. I teach that every–whenever they need me, whatever the case may be. But it’s about one and a half hours of presentation that I do. Now I also teach outside of BSO and those are in my general seminars and those take out more of my time.

Dealing with mental health emergencies

HR: What are some of the biggest challenges that law enforcement face in dealing with a mental health crisis would you say?

MB: From the feedback that I’ve gotten with the officers I work with, it’s the idea of keeping people safe, keeping themselves safe, so if someone is behaving in a way that it’s clear that something’s not quite right. So they’re having some kind of mental health issue there in some sort of psychiatric crisis. So it’s very difficult for them in the moment to know whether or not the person is present at some kind of physical danger and how the officers are able to keep him or herself safe as well as keep the people around safe, as well as interacting appropriately with a person who needs help. And that seems to be the biggest challenge because they often said it’s a split-second decision in these situations to keep everybody safe and make sure it doesn’t escalate and get out of control.

Seeking help for loved ones

HR: What advice would you have for John Q public, who might be dealing with a family member or friend who’s not quite right, something’s a little bit–what advice do you give them?

MB: I’d like to break that down into two separate separate scenarios. So if you have a family member, for example, that you know has had some struggles with mental illness in the past then knowing what the symptoms are and if you’re starting to see those symptoms, trying to figure out if they’ve been taking their medication, find out when the last time they went to the doctor was, whatever the case may be. But also it’s helpful to have a plan if you have a family member who struggles with mental illness. So a plan for when they’re well, having a plan for–”okay, these are some of the things that happen when I’m not feeling well, I might say this or I might do this,” or whatever the case may be and developing the plan with them so that they’re part of that plan in terms of knowing who to contact, So do they have a psychologist? Do they have a psychiatrist? Do they have some kind of therapist that the family can together contact that person and say whoever, might be serious, is not doing great right now so let’s figure out what we need to do to bring her in to make sure that she gets her medication, or she needs to go on to the hospital making sure she gets into the hospital.

Now, if we’re talking about John Q public and there’s some like friend that you know that seems to be a little bit off, I would say find some sort of opportunity depending on how good of a friend it is. But, to talk to the person and to see if they’re doing okay, asking them how are you, what’s going on? That sort of thing. You know some people think that if you just kind of ignore it, it might go away. But I would say don’t do that because you never know just a quick question of “how are you, what’s going on, do you need anything, I’m here to listen,” can really make a huge difference in a person who’s struggling with their mental health. It can make a huge difference for them.

HR: And what is a good crisis line for people to call, should they be having themselves or someone close to them, a type of mental health crisis?

MB: Well there are a couple of lines if we’re talking about a mental health crisis in terms of suicidality. So if they’re feeling very depressed and they are not sure that they want to be around anymore, and they are thinking of ways to hurt themselves, or anything like that, I would say the National Suicide Lifeline is helpful for people to go to. I would say if it’s something else that’s going on, just go to your local probably because it depends on where you are, but just go to your local Mental Health Center, whatever that may be. In most cities, they have something like we have here in Broward County is 2-1-1, and if you call them they can get you to absolutely any resource you could ever imagine. So finding whatever that hotline is in your area. Some places it’s 4-1-1, some places it’s a little bit different no matter where you are. So I would say, finding out what that number is, during times that you’re well so that you just have it on hand when you’re not doing so well.

Stigma and the law

HR: What effect does the mental health stigma have when it comes to law enforcement in the justice system?

MB: In terms of when they’re interacting with people who have mental illness?

HR: Yeah, in other words, like if I go before the judge and they say I have “X” and I’ll pick the diagnosis. How does that stigma affect the judge in the handling and so forth, or you if you’d like, if it’s better, back up and just tell us about the justice system and mental health as it exists today.

MB: Yes, that’s a really good question. So there is a huge stigma attached to mental illness and having a mental illness. And we know that there are a couple things in play in terms of mental illness. There aren’t as many resources as there is demand for mental health treatment. And so people who have a mental illness are much likelier to encounter the police before they actually get help in the community, or go into a hospital. And so what ends up happening is the police are the front line, and they’re basically running into people who are struggling with mental health issues, who have a mental illness all over the place, and so they’re more likely to be arrested because of some behavior that is caused or exacerbated by their mental illness. And so a lot of times people don’t understand what’s going on. So if they’re meeting, as you said, John Q Public in the middle of the street, and they’re doing something that they’re doing because they’re mentally ill but it’s making other people uncomfortable, those people are likely to call the police. And then when the police show up, the police may or may not understand how to interact with them. But they may be, instead of taking to a hospital, they might be arrested and put into jail.

So that stigma has a lot to do with it because people don’t really understand mental illness. A lot of people in the general public don’t understand mental illness, they don’t understand what it looks like and they’re very, sort of, afraid of what people are doing when they have a mental illness. So there’s that part of it that has to do with stigma. Once they get into contact to the police, depending on how much the police know about interacting with a person with mental illness, depending on the situation, the police may or may not understand, they may or may not handle the situation in a way that is helpful for the person who is struggling with their mental illness. And then once you get into court, a lot of places have mental health courts. So they have judges who are the judges and State Attorney assistant public defenders and other attorneys who are trained in mental health and mental illness, and recognizing what’s going on. And we have amazing judges here in Broward County who understand that and who are part of mental health court. And so they understand some of the challenges that people have when they struggle with a mental illness and they come into contact with the legal system. So they’re able to, instead of being punished, they can go and have treatment, they can be put in a program, they can take the steps to get the treatment they need so that they can be reintegrated into the community and not have to spend a ton of time in jail when treatment is what they need as opposed to punishment.

Neurodiversity & incarceration 

HR: Now let’s take that a step further because by virtue what you just said about the system, now let’s go into a place that you visit sometimes to try to be of help. Now let’s go into the prison population now. Now it sounds like it’s going to be mental health on steroids in there.

MB: Inside of the jail?

HR: Yeah, I mean imagine prisoners themselves a larger percentage, and correct me if I’m wrong, I would I would guess based on what you said that a larger percentage of the population within the prison themselves have significant mental health issues. Is that what you found, or no?

MB: Yes, yes and that’s what the research tells us as well. There are people with mental illness are over-represented in the jail and prison populations. So a large proportion of people who go in and have had some kind of mental illness in their lifetimes, and then a large proportion of them also are experiencing either recent or current mental health symptoms as well. And then so yes, you have a lot of people who have mental health issues who are in the jails and prisons.

HR: Let’s talk about, in your experience, if you would, the intersection of mental health issues with neurodiversity such as autism, Alzheimer’s, various neurological and developmental entities.

MB: Yes, do you mean, kind of the co-occurrence of the disorders? So that you talked about is a little bit about people who are on the autism spectrum. So I see that a lot in some of the kids that I work with who were on the spectrum, but they also have things like ADHD, which is very highly of co-occurring. Sometimes they have other disorders as well when that has to do with conduct, whether that has to do with Iike mood symptoms or whatever the case may be. So there is a great deal of overlap between the neurodiverse and people who are struggling with mental illness.

HR: We’ve interviewed William Packard, who wrote a book on neurodiversity in the prison system. And very interesting that not only the inmates, but any of the Corrections Officers themselves to get attracted to that kind of work have both mental health and some degree of neurodiversity issues.

MB: So, in the jails and prisons, just having not only the inmates but also the Corrections Officers, they have all sorts of that, and can sometimes struggle with mental illness. I would say that makes sense. I’m not at all surprised by that for a couple reasons. One, because you know jails and prisons are not great places to care for one’s mental health. Not for the people who are being detained there, or for the people who are officers there. It’s just such a place that has so much stress for everybody who’s in there and it’s just a place where there are specific rules and regulations that you have to follow. You’re constantly dealing with people who have great mental health issues as we talked about, they’re over-represented in the jail population for the officers that you know their biggest concern is just making sure that everybody’s safe. And it’s more about detaining and behavioral control, but for some people who end up in there like the people who have severe mental illness, behavioral control is not what they need, they need treatment. They needed somebody to come in. They leave proper medication, they need to have therapy, they needed to have a bunch of other things and I think that what ends up happening is it ends of being an us-versus-them mentality which is really stressful for everybody involved.

But I think that especially for Corrections Officer’s, there’s not a great focus on mental health care. And if they’re not feeling well or they’re feeling depressed whether they’re feeling anxious or whatever the case may be, that’s not something that generally they can just go to their supervisors Wednesday, “Hey listen I need a couple hours, I’m feeling a little bit nervous. I’m not sure why,” or “I’m feeling depressed” or whatever the case may be. A lot of people don’t feel comfortable because they don’t have any places to say I’m not doing well mentally, I’m depressed, or I’m stressed out, or I’m overwhelmed, or I’m really anxious or whatever the case may be that it’s not part of the vocabulary. And that’s not part of the discussion. I think that we should talk about the mental health of Corrections Officers because that is a very, very high stakes, highly stressful job, and I think when you put people who you know have all of these all these expectations, all of these sort of things that they need to do and with a bunch of people who are not behaving the way that they’re told, not necessarily because they don’t feel like it, because they’re unable to, because their mental illness, those two things don’t really go well together.

Tips for law enforcement to recognize mental health challenges

HR: What are some of the tips and tools you give to law enforcement? As to how to recognize mental health issues?

MB: That’s a really good question. So for one of them is the way that a person approaches you. So for example, if they are talking really fast, if they’re speaking so fast that you can’t understand what they’re staying or maybe they’re talking fast but they’re also switching topics constantly, and you can’t really make sense of what they’re saying, that may be a sign that they could be manic. Okay, or for example, if they are saying things that don’t really make sense and seem a little bit off, if they say something involving, like if someone is following them or the government is keeping track of them or if somebody’s implanting a chip in their brain or anything like that, sometimes obviously those things happen. But, if they’re government and the chip especially, that tends to be a side of mental illness, and not really what’s going on. But if they’re talking about following them, maybe. You just have to get more information. If someone is really sad and depressed and crying and they seem despondent, that is also a sign. So just little things when people are interacting with you and maybe they’re not able to make eye contact, maybe they’re not able to be understood whatever the case may be, just understanding that there could be something going on, in terms of mental illness or mental health crisis.

HR: And that also goes with when I was out in San Francisco, the police there– there’s an educational video in conjunction with the autism people so that for instance; They had an autistic young man looking down and saying “The reason I’m not looking you in the eye is not because I’ve stolen something, or I’m being disrespectful. I have autism and I just can’t look you in the eye and that kind of thing. Again, you get into that intersection of neurodiversity with mental health issues.

MB: Absolutely, being able to recognize when that’s going on, as supposed to–and I think that sometimes the idea is that if a person is not complying with orders, then, they need to be forced to comply. Well there are some people that aren’t able to do so not because of shear willfulness, But because they have certain challenges and I think that for some law enforcement, they are trained in terms of, for example, coming into contact with other children or adolescents or adults who are on the spectrum and understanding that, you know, the spectrum is quite long and that different people have different abilities and different challenges. And I think that’s actually a good point ‘cause I think that we could also do more to just sort of educating people on that, especially with law enforcement.

HR: How can people learn more about you? And what you do?

MB: You can go to doctormarshabrown.com. That’s my website, or you can follow me on twitter, Instagram. It’s at @drmarshabrown.

HR: Well Dr. Marsha Brown, thanks for being here again. It’s been a pleasure to have you here at another episode of Exploring Different Brains. We hope you’ll come back yet again!

MB: Thank you for having me.