Law Enforcement and Suicide Calls for Service: A Mixed-Methods Study of Suicide Attempts and Deaths.

INTRODUCTION: Suicide is a major public health issue, however, little is known about the characteristics/circumstances of suicide events. Data from law enforcement (LE) call reports are an important source of information related to suicide. Hence, this study explores suicide events captured in LE call reports. METHOD: This mixed-methods study used data from call reports collected in a metropolitan county in 2017 in a Midwestern state wherein LE responded to suicide incidents (N=213). Descriptive and bivariate analyses of quantitative data were used to assess differences between incident type (i.e. attempts vs. deaths). Themes of suicide emerged from the qualitative data. RESULTS: Findings revealed that suicide decedents tended to be male, older, and had at least one intrapersonal issue as a precipitating factor. The qualitative sections illuminated three themes across suicide attempts: self-harm as an autonomy seeking strategy; challenging claims of suicidality; and promising to not self-harm. CONCLUSIONS: Suicide incidents that rise to the level of crisis requiring a LE response is understudied in both the suicide and LE literature. Increasing the sophistication of call report documentation procedures would allow for communities to deepen their understanding of how suicide manifests and could create pathways to non-institutionalized care.

Racial Disparities in Access to and Utilization of Jail- and Community-Based Mental Health Treatment in 8 US Midwestern Jails in 2017.

Objectives. To examine the dual disproportionality that individuals with serious mental illness and people of color (PoC) occupy in the criminal-legal system.Methods. This study follows a cohort of 623 individuals who screened positive for mental health issues at booking in 8 Midwestern jails in 2017. We followed individuals through the jails' practices of jail-based mental health treatment, and we used Medicaid billing data to assess community-based behavioral health treatment engagement in the postyear period after jail release. The aim was to examine if an individual's race/ethnicity was associated with their access to jail- and community-based mental health treatment.Results. We did not find any racial disparities in jail-based treatment, although 3 community-based outcomes significantly differed. Compared with PoC, White people had 1.9 times greater odds of receiving community-based mental health and substance use treatment and 4.5 times greater odds of receiving co-occurring disorder treatment.Conclusions. Barriers that individuals released from jail face adversely affect PoC, resulting in reduced access to treatment. Critical race theory can expose the assumptions and functions of systems of care and the possible reproduction of implicit bias in potential solutions.