Meth Trip Or Mental Illness? Police Who Need To Know Often Can鈥檛 Tell
The dispatch call from the Concord, N.H., police department was brief. A woman returning to her truck spotted a man underneath. She confronted him. The man fled. Now the woman wanted a police officer to make sure her truck was OK.
鈥淗ere we go,鈥� muttered Officer Brian Cregg as he stepped on the gas. In less than three minutes, he was driving across the back of a Walmart parking lot, looking for a man on the run.
鈥淭here he is,鈥� said Cregg. The officer pulled to a stop and approached a man who fit the caller鈥檚 description. Cregg frisked the man, whose name was Kerry. NPR has agreed to use only Kerry鈥檚 first name because he may have serious mental health and substance use problems.
鈥淲hy were you lying on the ground under a truck?鈥� Cregg demanded.
Kerry, head hanging, rocked back and forth, offering quiet one-line answers to Cregg鈥檚 questions. There鈥檚 a contest, Kerry said. The prize was a new pickup truck, and he just had to find the truck with a key hidden underneath. He said he had searched three so far.
鈥淜erry, did you take anything today?鈥� Cregg asked. 鈥淵ou鈥檙e not acting right.鈥�
鈥淣o, no,鈥� said Kerry, shaking his head forcefully. 鈥淚鈥檓 just stressed out.鈥�
Cregg watched Kerry, looking for signs 鈥� is this meth or a mental health problem? Over the past three or so years, as 聽in New Hampshire and across the U.S., it鈥檚 become hard to tell. Police in many areas of the country where meth has maintained a steady presence have more experience making an assessment, but in Concord and many parts of the Northeast, the onslaught of meth is new.
Concord police say they need to know whether they鈥檙e dealing with a mental health issue or drugs 鈥� or both 鈥� because it can make a difference in determining the best response.
Concord may send six to eight officers to subdue someone darting through traffic who is high on meth. The calming techniques these officers learned during training for a mental health crisis intervention don鈥檛 seem to work as well when someone is out of control on methamphetamine. Several officers are recovering from injuries sustained during meth-related calls.
鈥淪tay right there for me, all right?鈥� Cregg told Kerry. 鈥淚 like you too much 鈥� stay right there.鈥�
Cregg walked a few steps away from Kerry to speak to one of two other officers called to the scene. It turned out this was the third time in the past few months that alarmed drivers had reported finding Kerry under their car. Cregg decided Kerry鈥檚 delusions were mental health issues and didn鈥檛 call for more backup.
Kerry, now cuffed, climbed into the back of Cregg鈥檚 cruiser, and they headed for the station. Kerry鈥檚 suspected crime: prowling.
鈥淗ey, uh, Kerry 鈥� man, you feel like you want to go up to the hospital to speak to somebody?鈥� Cregg asked a version of this question four times.
鈥淣o, no,鈥� Kerry said repeatedly, 鈥淚鈥檝e been through that route years ago; don鈥檛 want to do it again.鈥�
Kerry said later that getting stuck in a hospital emergency room 鈥� waiting days, maybe weeks for an opening in a psych treatment program 鈥� makes his anxiety much worse.
Concord police arrest Kerry for prowling in Concord, N.H., after a witness identified Kerry as the person who鈥檇 been looking underneath cars in a shopping mall parking lot.(Jesse Costa/WBUR)
At the station, Cregg found something that changed his view of the day鈥檚 events.
鈥淲hat is that, Kerry?鈥� Cregg asked, pulling a tiny plastic bag of glistening white shards out of Kerry鈥檚 coin pocket. It appeared to be meth. 鈥淭his explains a lot.鈥�
Cregg said what he thought was psychotic behavior likely had more to do with meth.
But 鈥渙n that call, they mimicked each other. I wasn鈥檛 able to tell at first,鈥� Cregg said.
That may be because Kerry is one of the聽 coping with both a mental health problem and a substance use disorder. In this particular case, not being able to tell what fueled Kerry鈥檚 delusions didn鈥檛 cause any problems for him or the police. Things never got out of hand. But Concord Police Chief Bradley Osgood said calls triggered by meth are often more challenging than this one.
鈥淲ith somebody that鈥檚 high on methamphetamine, you want to treat them a little firmer and control them,鈥� Osgood said, 鈥渂ecause they often are very volatile and aggressive, and you just want to treat that hostility differently.鈥�
With meth now accounting for 60% of drug seizures in Concord, police say they often default to that firmer approach. Some mental health advocates worry that may mean police are using too much force with their clients.聽, a retired major in the Memphis Police Department who co-founded and now helps lead CIT International, a crisis intervention program that includes training for police, said officers aren鈥檛 making a diagnosis.
鈥淭he officer鈥檚 foremost [concern] is 鈥楬ow do I open up communications? How do I get compliance in order to accomplish safety?鈥欌�� Cochran said.
There are visual signs of longer-term meth use that are less likely to show up among mental health patients: skin wounds and scabs, rotting teeth, dilated pupils. But addiction medicine specialists agree it is difficult to determine what鈥檚 going on, at first glance, with someone who appears extremely agitated.
鈥淭he possession of methamphetamine may be a clue, but teasing out the acute effects of methamphetamine versus a long-standing mental illness may take a longer period of time,鈥� said , an assistant professor of medicine at Yale School of Medicine. She noted that the effects of meth can last 72 hours or longer.
Surging meth use is relatively new in New England. On the police force, Cochran dealt for years with this issue of meth鈥檚 effects mimicking mental health issues. He said slowing things down and diffusing fear can work when dealing with people high on meth.
鈥淏ut let鈥檚 be real, there are some individuals that are so sick,鈥� Cochran said, that 鈥渙fficers find themselves having to act immediately to protect safety. Sometimes that may mean a hands-on approach.鈥�
Cochran and another mental health advocate,聽, an associate professor of psychiatry at the University of Arizona, say the goal is to only use force as a last resort.
鈥淎nd then, ideally,鈥� Balfour said, 鈥渨hether it鈥檚 meth or mental health or both 鈥� you鈥檙e going to be able to take that person to somewhere where they are going to get treatment 鈥� and not to jail.鈥�
Balfour is also chief of quality and clinical innovation at . The organization operates a network of psychiatric crisis centers in Arizona where, instead of making an arrest, police can drop off anyone 24 hours a day who is out of control on meth or who has a mental health condition. Balfour said 20% of adults seen at Connections test positive for meth.
Kerry was due in a New Hampshire court last week, where a judge could have ordered drug treatment or an evaluation. Kerry didn鈥檛 show up for that arraignment 鈥� but said he is trying to reschedule.
This story is part of a partnership that includes , and .