Skip to main content
NCBI home page
Psychiatry, Psychology, and Law logoLink to Psychiatry, Psychology, and Law
. 2023 Apr 20;31(1):57–75. doi: 10.1080/13218719.2023.2175066

Persons with mental disorders and suicidality in crisis or high-risk situations involving police negotiation: a systematic review

Bobbie Clugston a,b,c,✉, Carla Meurk a,c, Meredith Harris a,d, Philip Burgess a,d, Ed Heffernan a,c
PMCID: PMC10916924  PMID: 38455272

Abstract

Police negotiators respond to crisis and high-risk situations including mental health crises, but little is known about the nature, frequency and characteristics of these events. This systematic review examined literature about mental disorder and suicidality prevalence in negotiation events from peer-reviewed articles published within the last 20 years. Of 1455 articles identified, 11 met study inclusion criteria. Most contributed only indirect evidence using data on fatal police encounters, case reviews and analysis of communication techniques. Reliable prevalence estimates were not found, though findings suggest suicidality was a precipitating factor in more than half of events and was present during most events. Mental disorder (primarily substance use, mood and psychotic disorders) was also identified as a significant factor prior to and during events. Few articles described frequency or characteristics of these critical events. Further research is needed to inform frontline responses, resourcing and support pathways for police providing this crucial service.

Keywords: Crisis, mental disorder, mental health, mental illness, police, negotiation, suicidality, suicide

Introduction

Police are frequently the first responders to incidents in the community involving people with mental disorder or experiencing suicidality (Australian Institute of Criminology, AIC, 2013; A. Butler, 2014; Durbin et al., 2010; Hails & Borum, 2003; Kesic et al., 2013; Reuland, Schwarzfeld, & Draper, 2009). In Australia, approximately half of the population detained by police report a prior diagnosis of mental illness (43% for males and 55% for females; Productivity Commission, 2020). Additionally, people with mental illness attending an emergency department are 10 times more likely to be transported by police or correctional officers (7%) than people with other health conditions (0.7%; Australian Institute of Health and Welfare, AIHW, 2019). In certain circumstances, particularly where there is a threat of harm to the person or others, specially trained police known as ‘police negotiators’ can be involved (Grubb, 2020; Queensland Police Service, QPS, 2021). Police negotiators have the role of, where possible, resolving crisis and high-risk situations without fatality, injury or property damage (Augustin & Fagan, 2011; Call, 2008; Grubb et al., 2019; Hatcher et al., 1998). Despite the seriousness of these events, little is known about the nature, frequency and characteristics of police negotiator contacts.

Role of police negotiators

The type of events that police negotiators respond to are often defined across three primary categories: (a) hostage situations, where one or more persons are being held against their will as leverage for certain demands; (b) barricade-victim situations, where one or more persons are held against their will with no clear motive; and (c) barricade-no-victim situations where the perpetrator is barricaded with no other persons involved in the situation (Augustin & Fagan, 2011; Call, 2008; Hatcher et al., 1998). An additional category where police negotiators may be deployed is ‘high-risk situations’ where the threat of harm is such that police use of force, if used, is able to be fully justified (QPS, 2021). In high-risk situations, the decision to deploy police negotiators is reliant on a police judgement call about whether the matter can be resolved peacefully using negotiation (QPS, 2021).

Police negotiators utilise the specific law enforcement technique of crisis negotiation to communicate with people who are expressing an immediate risk of harming themselves or others (Augustin & Fagan, 2011; Hatcher et al., 1998; Vecchi et al., 2005). Modern principles of crisis negotiation for use by police forces were established in the mid-1970s in New York, United States (Feldmann, 2004) following two highly publicised siege events that resulted in large numbers of fatalities – the Attica Prison disturbance (1971, involving 43 losses of life) and the Munich Olympics siege (1972, involving 17 losses of life; Augustin & Fagan, 2011). Crisis negotiation principles were developed as a mechanism to reduce loss of life by using less lethal strategies to resolve sieges than were previously used by tactical police units (Augustin & Fagan, 2011).

The hypothesis underpinning crisis negotiation is that most crises occur for emotionally driven reasons, which can be modified or resolved through the use of verbal or other tactical (including use of force) strategies (Hatcher et al., 1998). Since the 1970s there have been many models of crisis negotiation developed for use by police negotiators worldwide, with models initially focusing on problem-solving approaches to crisis situations with the negotiator’s role being to: (a) separate the person from the problem (e.g. try to understand the person’s point of view, avoid blame, acknowledge emotions); (b) focus on the person’s interests and not their position (e.g. try to identify and understand the underlying interest; (c) generate options for resolution; and (d) use objective and rational criteria to resolve differences (R. Fisher et al., 2011; Vecchi et al., 2005). However, in the early 2000s it was recognised in the United States that the majority (over 90%) of all reported police negotiator incidents related to non-hostage crisis situations and not to the types of major hostage events upon which the negotiation principles had been based (Flood, 2003). As a result, there has been a revision of police negotiator principles internationally to focus on resolving a person’s heightened emotional state first prior to moving the person to a problem-solving approach to their crises or high-risk situation (Australian Federal Police, AFP, 2014; Vecchi et al., 2005).

The primary aim of crisis negotiation is to facilitate a positive resolution by using communication strategies to build relationships, buy time and delay actions of the person expressing an immediate risk of harm; allow negative emotions and impulses to diminish; promote rational thinking; and enable other solutions to occur (Hatcher et al., 1998; Knowles, 2016). Crisis negotiation is a dynamic process, which involves a mutual give-and-take relationship between the subject of the negotiation and the negotiator, during which some demands of the individual may be met in exchange for police requests (e.g. release of a hostage or surrender; Feldmann, 2004). In developing this relationship, the motivations and state of mind of the person expressing an immediate risk of harm need to be well understood so appropriate negotiation techniques can be deployed (Feldmann, 2004).

The extent to which a person subject to police negotiation is impacted by a mental disorder or suicidality is a key consideration in these situations. For crisis negotiation involving a person exhibiting suicidal behaviour, negotiators must identify resources (e.g. communication techniques such as rapport building, productive challenging or linguistic style matching, i.e. aligning language and sentence structures) that they can leverage so the person has choices and has the option to accept help (Sikveland, Kevoe-Feldman & Stokoe, 2020). An understanding during the negotiation of the person’s mental health and extent of any contact with mental health services may significantly impact the type of interaction and the resources relied on to benefit the negotiation or to support the person’s wellbeing following the event. It therefore follows that it is critical to understand not only the common emotional drivers associated with these events, including relationship issues and financial stressors, but also the presence of mental disorder or suicidality. Furthermore, understanding the prevalence of mental disorder and the extent of suicidality may well shape training and approaches to negotiation. Indeed, an evidence informed, planned and co-ordinated systematic response incorporating collaboration between mental health services and police was a prominent need identified by the Coroner in the Inquest into the deaths arising from the 2014 Sydney Lindt café siege, Australia’s most significant hostage event in recent history (Coroners Court of New South Wales, 2017).

Role of mental health professionals

Mental health professionals have been involved in police negotiation responses to varying degrees since the commencement of modern police negotiator tactics in the mid-1970s. This is in line with research from this time that reported apparent high rates of mental disorder amongst individuals involved in events requiring a police negotiation response; for example more than half of 245 reported hostage events (59%) in the United States from 1976 to 1983 were attributed to individuals with apparent mental disorder or emotional disturbance (Grubb, 2010). While the reported prevalence of mental disorder and emotional disturbance in individuals involved in police negotiation events has historically varied (Grubb, 2010), the role of mental health professionals in supporting police negotiation responses to these events has largely been maintained.

Four key roles have been identified within the research in relation to mental health professional input into police negotiation tactics: (a) consultation/advisory, (b) integrated mental health/police team, (c) lead negotiator, and (d) situation controller (Hatcher et al., 1998). Consultation and integrated roles operate as supportive functions for police to increase understanding and awareness of mental illness and the mental health system. A Hickman (2009) study examining the views of 73 negotiators found that the majority of negotiators supported the involvement of mental health professionals across a range of advisory-type roles including as a consultant (82%), to assess the perpetrator (90%), to provide counselling to victims (89%) and as part of post-incident reviews (71%; Hickman, 2009). In contrast, lead negotiation and control roles seek to implement mental health professionals as undertaking, or directing, the police role (Hatcher et al., 1998) and are not regarded as favourably. In the same Hickman (2009) study, 74% of negotiators (N = 73) considered that mental health professionals should not undertake a primary negotiation role (Hickman, 2009). There are inherent risks with mental health professionals undertaking a lead role in police negotiation, which include ethical issues for clinicians when deception or use of force is required, lack of clarity regarding roles and responsibilities and a potential for undermining the relationship between police and mental health services (Hatcher et al., 1998).

The consultant or advisory role of mental health professionals is most often considered within the literature. This role is generally undertaken by forensic psychiatrists or psychologists (Feldmann, 2004). This type of role is used regularly by police negotiators. In 1993, almost 40% of hostage negotiation teams within the United States utilised a mental health professional in a consulting or advisory capacity (W. M. Butler et al., 1993). The scope of a mental health professional’s role when consulting or providing advice to police negotiators can vary; however, its primary purpose is to assess the person who is the subject of the police negotiation (Feldmann, 2004; Greenstone, 2003; Porter et al., 2016). Consulting and advisory roles can occur during, before or after the police negotiation event, with some overlap occurring in these roles (Feldmann, 2004; M. Fisher & Ireland, 2010; Greenstone, 2003; Hatcher et al., 1998; Norton & Petz, 2012; Porter et al., 2016).

The literature identifies basic expectations of mental health professionals if they are to be engaged as consultants to police negotiators. These include adequate clinical training and expertise, understanding of forensic issues and basic negotiation skills, and knowledge of police and law enforcement agencies and how they operate (Feldmann, 2004). Of particular importance in this role is an understanding by the mental health professional of the limitations of their role, and specifically of the need to defer to the police lead or decision-maker on scene (Feldmann, 2004).

The role of mental health professionals in providing training to police negotiation teams has been identified as essential (Feldmann, 2004). Training provided by mental health professionals should include scenario-based training to role play and develop skills to respond to people with mental illness, as well as direct contact exposure through meeting with persons with lived experience of mental disorder and/or suicidality and visits to mental health services (Feldmann, 2004).

The 2014 Sydney Lindt café siege event called into question the role of mental illness, mental health professionals and police negotiation in a highly public forum. This hostage event occurred over 16 hours and resulted in three fatalities – one victim was the result of a shooting by Mr Monis, and two fatalities (including Mr Monis) occurred as a result of police intervention (Scott, 2020). In attempting to resolve the siege, the police engaged the advice of a consultant psychiatrist (Scott, 2020). Notwithstanding that Mr Monis was found to not have a mental illness by the State Coroner of New South Wales, the role of the psychiatrist was discussed in the report into the Inquest into the deaths arising from the siege. Specifically, the Coroner commented that:

It was apparent that the police commanders, police negotiators and the Consultant Psychiatrist . . . lacked a shared understanding of the limits of the psychiatrist’s role. It is essential that all those involved in responding to high risk situations have a clear understanding of each other’s roles. (Coroners Court of New South Wales, 2017, p. 301)

Although major siege events may be infrequent, they highlight the complexities that can arise in events requiring a coordinated response between police and mental health systems. Additionally, these events can be highly publicised and scrutinised by the media and the community (Feldmann, 2004), which may perpetuate existing stigma for people with mental disorder or experiencing suicidality.

Objective

Police agencies across the world acknowledge that police negotiators have a role in responding to people with mental disorder or experiencing suicidal behaviour in crisis or in high-risk situations (AFP, 2014; Grubb et al., 2019; McMains & Mullins, 2014; Queensland Health, 2017). To best meet the needs of this vulnerable population group, approaches to the critical role of police negotiation, including training and resource requirements, must be informed by evidence regarding the extent that mental disorder and suicidality may be impacting a person’s involvement in these crisis events. This systematic review was therefore conducted to identify and synthesise available research relevant to mental disorder or suicidality prevalence among people involved in police negotiation events.

Method

The review design is consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 statement and checklist (Moher et al., 2009).

Definitions

For the purposes of this review, the key terms of mental disorder and suicidality have been defined as follows:

  • (1) The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM–5) defines a mental disorder as

 . . . a syndrome characterised by clinically significant disturbance in an individual’s cognition, emotion regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. (American Psychiatric Association, APA, 2013)

Mental disorders include but are not limited to depression, bipolar disorder, schizophrenia and other psychoses and substance misuse disorder (APA, 2013; World Health Organization, WHO, 2011).

  • (2) Suicidality describes a ‘range of behaviours that include thinking about suicide (or ideation), planning for suicide, attempting suicide and suicide itself’ (World Health Organisation (WHO), 2014).

Eligibility criteria

Articles published in a peer-reviewed journal in English language and within the last 20 years (to ensure relative currency of research) were considered for the review.

Inclusion criteria

Articles were included if they:

  1. Focused on a police response where negotiation is involved, ranging from crisis negotiation to siege and hostage negotiations; and

    • Involved persons with a mental disorder recognised in DSM–5 (APA, 2013) or mental illness in the International Classification of Diseases–10th Edition (WHO, 2011), or experiencing suicidality; or

    • Involved persons who had contact with a mental health service prior to, or immediately after the police negotiation event; or

    • Involved mental health service support in the police negotiation.

Exclusion criteria

The following exclusion criteria were applied:

  1. The article reported that the victim of an event (e.g. a hostage) had a mental disorder or suicidality, but the perpetrator did not.

  2. Literature reviews (both systematic and narrative) were excluded. However, original source material from literature reviews was considered for inclusion if the study criteria were met.

  3. Media articles, commentaries, editorials and conference abstracts were excluded.

Search strategy

The search method involved Boolean searching of free text in conjunction with the use of subject or concept headings, which are used to identify articles by topic rather than just free text. Truncation techniques to broaden search fields and ‘expansion’ application for subject headings within free text were also applied where applicable. A combination of health and criminal justice databases were searched: namely Medline, Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL), CINCH and CENTRAL-Cochrane Library. The searches were initially conducted during 5–12 February 2020 and updated using the same method in 26–30 August 2021 (due to a period of absence by one of the investigators, BC). A snowball search strategy of citations, authors and references in articles located through the database searches was utilised to identify additional articles, including through identifying original source studies included in systematic reviews. Contact was also made with the Queensland State Negotiator Coordinator to obtain additional articles relating to police negotiators that may have been relevant to the review.

The search string was: (‘Mental disorders’/exp [MeSH/CINAHL headings] OR ‘mental health’ [MeSH/CINAHL heading] OR ‘mental*’ OR ‘mental disease’/exp [Emtree] OR ‘mental disease’ OR ‘suicide’ [MeSH/CINAHL heading] OR ‘suicide, attempted’ [MeSH], OR ‘suicid*’) AND (‘police’ [MESH/CINAHL heading/Emtree] OR (‘police’ AND ‘negotiation’ [CINAHL heading]) OR ‘negotiating’ [MeSH] OR ‘negotiat*’ OR ‘threat*’ OR ‘extort*’ OR ‘crisis intervention’ [MeSH/CINAHL heading/Emtree] OR ‘crisis’ OR ‘violence’ [CINAHL heading] OR ‘violence’/exp [MeSH/Emtree] OR ‘violen*’ OR ‘kidnap’ OR ‘lethal’ OR ‘hostages’ [CINAHL heading] OR ‘hostage’/exp [Emtree] OR ‘hostage’).

Information sources

An inclusive approach to research design was taken due to the limited availability of research in the area and an understanding that available research would include retrospective analyses of routinely collected data, case studies or qualitative interview data. Therefore, articles with any of the following designs were included: randomised controlled trials (RCTs), case reports, cross-sectional, case-control, observational and mixed methods studies and service descriptions.

Data extraction and quality appraisal

The search returns were managed in Endnote X9, and inclusion and exclusion criteria were applied. Screening of all articles was undertaken by one investigator (BC), and included articles had data extracted into Excel. The following variables were collected for each article: year, location, aim, design, research questions, type of data collected and type of analysis undertaken, comparison group (Y/N), nature and frequency of police negotiator event, nature and frequency of mental disorder or presence of suicidality, limitations, and conclusions.

Two investigators (BC and CM) independently undertook a quality assessment of each included article using the Mixed Methods Appraisal Tool (MMAT; Hong et al., 2018; Pace et al., 2012; Souto et al., 2015). The MMAT is a specifically designed checklist and tool that allows the appraisal of studies with differing methodologies to occur concurrently (Hong et al., 2018; Pace et al., 2012; Souto et al., 2015). Where required, discussion between BC and CM occurred to reach consensus on included articles.

Analysis

Data were synthesised qualitatively and were presented according to thematic headings.

Results

The literature search identified 1455 unique articles (1450 through the database search after removing duplicate records, and a further five identified through snowball searches of references, authors and citations). Following a title and abstract review, 14 articles remained and were assessed using the MMAT. Following assessment, 11 articles met the study criteria (Moher et al., 2009; see Figure 1).

Figure 1.

Figure 1.

Open in a new tab

PRISMA flow diagram.

Of the 14 articles included for MMAT appraisal, eight were quantitative, three were qualitative, one article was described as a critical analysis, one was a process evaluation, and one was described as a service description. Two out of eight quantitative articles met all criteria, and the remaining six met all but one relevant criterion. All were included as the criteria not met related to response rate, which was not applicable to the data sources used in each study (routinely collected data). One out of three qualitative articles met all but one relevant criterion, but the other two did not meet two relevant criteria. The criteria not met in each article related to potential research bias and in the latter two articles (Sikveland et al., 2020; Spence & Millot, 2014) related to the approach of the research (limited methodological consideration for generalisability) rather than quality, and this did not therefore exclude the studies from further narrative synthesis. All were included. Three articles did not did not meet any of the MMAT screening criteria and were therefore excluded from further assessment and narrative synthesis – one article was categorised as a critical analysis (Scott, 2020), one article was categorised as a service description (Porter et al., 2016), and one article was categorised as a process description that included a review of the literature (Vecchi et al., 2019; see Appendix).

Study characteristics

Four articles were from the United States. Two articles were from the United Kingdom, and two articles were from Australia. One article was from Scotland. Two articles related to two Western nations, with one article relating to the United States and Canada, and one article relating to the United States and the United Kingdom. Articles primarily related to descriptive analyses of routinely collected police and criminal justice agency data (Grubb, 2020; Kesic et al., 2012; Lord, 2010, 2014; McLeod et al., 2014), or linguistic analysis of the transcripts of communications that occurred between negotiators and individuals experiencing suicidality (Rogan, 2008, 2011; Sikveland et al., 2020). The remaining articles involved a review of case examples (Mohandie & Meloy, 2010) and semi-structured interviews of police negotiators who had responded to individuals experiencing crisis situations (Grubb et al., 2019; Spence & Millott, 2014; see Table 1).

Table 1.

Characteristics of included articles.

Author Country Study design Purpose
Grubb et al. (2019) United Kingdom Semi-structured interviews of 15 police negotiators and analysis using a grounded theory approach Identifies the nature and situational characteristics of events responded to by police negotiators.
Grubb (2020) United Kingdom Descriptive study using data from a 24-month period trialling a police negotiator centralised database Provides a descriptive analysis of police negotiator deployments, including socio-demographic and behavioural profile of subjects; situational characteristics of events; and resolutions.
Kesic et al. (2012) Australia Descriptive study using data linkage across use of force, police and mental health databases. Examines the situational environment of fatal force encounters, including context of incidents; criminal, psychiatric and psychological backgrounds of subjects; behavioural characteristics and mental state during the event; and range of responses.
Lord (2010) United States Descriptive study using data relating to cases involving police negotiation responses to suicidality as recorded on the Federal Bureau of Investigations (FBI) Hostage Barricade Data System (HOBAS), which holds police negotiation data from across the United States Examined the prevalence of mental health treatment histories, including treatment type (illness, alcohol or other drug) and modality (duration, inpatient or community setting, repeat engagement with treatment) for individuals involved in suicide crisis events responded to by police negotiators.
Lord (2014) United States Quasi-experimental analysis of violent deaths data, informed by narrative records to compare police response to ‘suicide by cop’ events. Compares the responses by police in use of force incidents that result in ‘suicide by cop’ with incidents that do not result in ‘suicide by cop’ and considers the possible influences on the outcomes.
McLeod et al. (2014) Australia Descriptive data-linkage study of police mental health transfers, police law enforcement contacts, and public mental health records. Describes the prevalence of potential provoked police shootings and compares characteristics of completed provoked police shootings and potential provoked police shootings with self-inflicted suicides.
Mohandie and Meloy (2010) Canada and United States Retrospective file review of officer involved shooting events and quasi-experimental comparisons of negotiator incidents. Identifies the hostage, barricade and suicide intervention cases within a sample of officer involved shootings and describes incident characteristics, intervention efficacy and outcomes.
Rogan (2008) United States Linguistic analysis of the communication by the person the subject of the police negotiation in transcripts of four police negotiator incidents involving persons experiencing suicidality. Identifies linguistic factors communicated by the person experiencing suicidality that vary across suicide and surrender incidents.
Rogan (2011) United States Linguistic analysis of the transcripts of six police negotiator incidents involving persons experiencing suicidal behaviour Compares the communication styles of the person experiencing suicidality with the police negotiator across suicide and surrender incidents to identify the patterns, and extent, of linguistic style matching across incident types.
Sikveland et al. (2020) United Kingdom and United States Linguistic analysis of the audio from two datasets: (1) police negotiator events involving persons demonstrating suicidal behaviour, and (2) an emergency call involving a person experiencing suicidality. Describes and compares the communication practices of police negotiators in the United Kingdom with emergency call dispatchers in the United States to identify linguistic factors that are used to bring about positive behavioural change in persons experiencing suicidality.
Spence and Millott (2014) Scotland Semi-structured interviews of police negotiators. Explores the attitudes and support needs for police negotiators involved in suicide negotiation in relation to their preparation for suicide intervention, the nature of their related support needs, coping mechanisms and their role within the context of suicide prevention.
Open in a new tab

Note: n = 11.

Evidence of mental disorders and suicidality

Two articles described the prevalence of mental disorders and suicidality in police negotiation events using routinely collected police negotiator data. The first article, by Grubb (2020) used a pilot database established by two police negotiator units in the United Kingdom over a 24-month period from January 2015. Grubb reported that suicidality was the most frequent precipitating factor for the event (n = 85, 51.2%), followed by the presence of a mental disorder (n = 74, 44.6%). Further, the majority of events were categorised as being related to emotional motivation (78.1%) rather than goal or objective directed. In terms of factors being experienced by the person during the event, police negotiators identified mental disorder as being present in 14 (8.4%) of 166 events. Suicidality remained a consistently high factor throughout the event at 44% (n = 77).

The second article, by Lord (2010) analysed 356 cases involving suicidality occurring between 1993 and 2006 that were recorded in the Federal Bureau of Investigations (FBI) Hostage Barricade Data System (HOBAS), which holds police negotiation data from across the United States (Van Hasselt et al., 2005). Lord reported that almost three quarters (n = 202, 73.7%) of cases involved a person who had previously received some sort of treatment for mental illness. Further, he reported that a third of the cases (n = 93, 33.9%) involved a person who had received inpatient treatment. Additionally, Lord found a significant relationship between the number of times a person was involved in a suicide event and prior treatment history, with more than half of the people involved in two or more events receiving mental health treatment (n = 23, 52.3%). This compares with people involved in only one event being less likely to have had a mental health treatment history (n = 3, 13.6%). Lord also found that at the time of the event, there was a significantly higher likelihood of reported alcohol use by people who had previously received inpatient treatment for mental illness than by those who had not received treatment or who had only received community treatment (χ2 = 11.72, p < .05).

Police negotiator experiences

Two studies utilised semi-structured interviews to gain an understanding of the experiences of police negotiators (Grubb et al., 2019; Spence & Millott, 2014). Spence and Millott (2014) explored the attitudes and support needs of 16 police negotiators involved in suicide negotiation in Scotland. This study found that police negotiators considered responding to individuals with a mental disorder as being a core function of their role. Suicide crisis events were described anecdotally by the interviewees as making up the majority of call-outs for the police negotiators (Spence & Millott, 2014).

Grubb et al. (2019) found similar evidence through semi-structured interviews of 15 negotiators in the United Kingdom. In this study, incidents responded to by negotiators were classified into different categories based on the core characteristics of the event, with 12 core categories being identified. Incidents categorised as involving individuals experiencing suicidality due to a personal, emotional or psychological crisis were described as the main event type responded to by negotiators, compared with other event types such as hostage situations. Interviewees also described mental health concerns, particularly psychosis or substance misuse, as an important factor in the risk assessment of the event, which is undertaken by the negotiator when responding (Grubb et al., 2019)

Negotiation communication styles for persons with mental disorder or experiencing suicidality

A focus on communication styles between negotiators and individuals who are the subject of a police negotiator event provided indirect evidence about the prominence of mental disorder or suicidality in negotiator incidents. Consistent with the aim of crisis negotiation to facilitate a positive resolution by using verbal strategies (Feldmann, 2004; Sikveland et al., 2020), three studies focused on the importance of effective communication by police negotiators when responding to people with mental disorders or suicidality. Firstly, Sikveland et al. (2020) analysed audio from two datasets: (a) 14 police negotiator events involving persons with suicidal behaviour in the United Kingdom that occurred between 2016 and 2018, and (b) a 17-min emergency call from the United States involving a person who had recently absconded from a mental health service and who was experiencing suicidality. In these analyses, they sought to identify linguistic factors used to bring about positive behavioural change in persons experiencing suicidal behaviour. It was found that police negotiators (and emergency dispatchers) were more effective when interacting with people experiencing suicidality if they used a ‘challenging’ communication style that was logical and grounded in local context and reality for the person experiencing the crises than if they used communication that was based on non-specific or global directions, which may be able to be discounted by the person in crisis. Sikveland and colleagues (2020) conclude that questioning individuals during an event can be undertaken by negotiators and lead to successful negotiation, provided the questioning is based on logic and reasoning that is relevant to the person in crisis, and that the person does not feel as though they are being viewed as irrational or illogical in relation to their decisions.

Rogan (2008, 2011) also considered communication styles in his analyses of suicidality and crisis negotiation techniques in studies in 2008 and 2011. In a 2008 study of the transcripts of four police negotiating events from the United States involving people experiencing suicidality, Rogan found linguistic differences in communication styles depending on whether an event resulted in a death by suicide or not. Rogan identified that language used by the person experiencing suicidality, which was subsequently coded as aggressive (e.g. hate, kill), inhibiting (e.g. block, constrain), physical being (e.g. ache, sleep) and seeing (e.g. saw, look), was present to a greater extent in surrender incidents than in suicide incidents. Rogan (2008) concluded that a person’s emotional state, as evidenced in the language being used, provided police negotiators with important information that could be beneficial when planning responses to police negotiator events.

In his 2011 study, Rogan analysed the linguistic styles of people demonstrating suicidal behaviour and police negotiators in six transcripts of events from the United States to identify linguistic indicators that may match across negotiators and people who are the subject of the event and to consider any variation between events that resulted in a death by suicide and events where the person survived. Rogan found little overall variation between event types in linguistic cue behaviour but found that linguistic style matching between subject and police negotiator fluctuated in events that resulted in death whereas events where the person survived followed a pattern of increase in matching until the end stages of negotiation. Rogan concluded that this is consistent with other police negotiator research that has identified that during events that result in a fatality, negotiators are less likely to be able to maintain or direct the dynamics of the communication.

Police-provoked shootings

Four articles examined fatal police interactions (Kesic et al., 2012; Lord, 2014; McLeod et al., 2014; Mohandie & Meloy, 2010). These articles were included in this review because they were based on study samples that included events that were, or could reasonably have been, responded to by police negotiators. Firstly, Kesic et al. (2012) linked police use of force, police encounter and mental health databases from Victoria, Australia for the period from 1980 and 2008 and found mental disorder to be present in more than half (n = 26, 57.8%) of fatalities of people involved in crisis or high-risk events. Of the 15 cases that were classified as ‘suicide by police’ events (i.e. the person demonstrated an intent, verbally or behaviourally, to die through police shooting), police negotiators were involved in the police response 40% of the time (n = 6). Kesic and colleagues found that within the ‘suicide by police’ cohort, chronic mental or physical illness was described as a factor in 60% (n = 9) of cases, and similarly substance use disorder was described as a factor in 60% (n = 9) of cases. In a third of the ‘suicide by police’ cases (n = 5), a prior record of suicidal behaviour had been recorded for the person.

Using data from the United States and Canada, Mohandie and Meloy (2010) examined 84 police-provoked shootings between 1998 and 2006 and found 49% (n = 41) had a confirmed or probable mental disorder based on data collected by police at the time of the event (e.g. historical medical information) and observations recorded by police during the event (e.g. self-reported prior mental health contact or behaviours). They identified that the most prevalent disorder present during the crisis event was psychosis (hallucinations or delusions; n = 16, 19%). In just over half of the total cases examined (n = 43), it was found that police negotiation tactics were used to try to resolve the event. In 36% of cases (n = 30), formal negotiation occurred in combination with other crisis responses (i.e. first responder initiated action), with formal deployment of negotiators more likely to occur for events over 1 hour duration (Mohandie & Meloy, 2010).

A similar data linkage approach used by McLeod et al. (2014) specifically examined ‘mental health crisis events’ responded to by police in Victoria, Australia between December 2009 and July 2010. They found that 62% (n = 57) of individuals involved in potential ‘police-provoked shootings’ (i.e. the person died due to police intervention) during a mental health crisis had a mental disorder. Of these events, 42 had an outcome description available with six describing the outcome as ‘formally negotiated’. Only one event described the use of specialised crisis negotiators in the response (McLeod et al., 2014). Disaggregation of the Australian data to identify mental illness symptomology showed substance use disorder (n = 22, 48.9%; n = 6, 10.5%; Kesic et al., 2012; McLeod et al., 2014), mood disorder (n = 8, 17.8%; n = 20, 35.1%; Kesic et al., 2012; McLeod et al., 2014) and psychosis (n = 6, 13.3%; Kesic et al., 2012) as being most prevalent.

With respect to suicidal behaviour, Lord (2014) found that 28.2% of police-provoked shootings cases from 17 states in the United States of America occurring between 2004 and 2008 involved a person with history of suicidal behaviour compared with 1.6% of non-police-provoked shootings cases. During the event, Lord found that suicidal intent was demonstrated through verbal and/or behavioural means in almost all cases (n = 259, 98.8%). Similar rates were found by Mohandie and Meloy (2010) who identified that suicide was discussed in 89% (n = 56) of incidents they reviewed, which included hostage, barricade and cases involving fatal deliberate falls.

Discussion

Despite the significant benefits for individuals who are the subject of police negotiation, police negotiators and the community in terms of safe outcomes that could be realised through an improved understanding of the role of mental disorder and suicidality in police negotiator events, the current available literature in this area is very limited. Further, the heterogeneity in research methods and the reliance on inferred evidence from studies of events reduce the utility of the research. For example, in some studies police negotiator responses could not clearly be isolated from other types of police response. These problems precluded the possibility of undertaking a quantitative meta-analysis of prevalence of mental disorder and/or suicidality among individuals involved in police negotiator events. Notwithstanding these limitations, overall, the findings of this systematic review suggest that mental disorders and suicidal behaviour are highly prevalent among people who are the subject of police negotiation. Qualitative studies of police negotiator experiences and communication styles during negotiator events reveal suicidal behaviour and mental disorder as prominent themes. This is an area that requires further study with a focus on prevalence estimates and outcomes. Such evidence would be extremely useful to inform police negotiator training, interventions and collaborations with mental health services.

Prevalence estimates

In this systematic review we identified only one article that directly reported prevalence estimates for mental disorder and suicidal behaviour amongst police negotiator events (Grubb, 2020). A further article reported prior mental health treatment history in events involving people experience suicidality, rather than the presence or absence of mental disorder, as an indicator of mental disorder prevalence during these events (Lord, 2010). This is in stark contrast to the plethora of well-established evidence linking interactions between people with mental disorders and front-line community police responses (A. Butler, 2014; Puntis et al., 2018; Shapiro et al., 2015; Steadman et al., 2000). Grubb (2020) identified that suicidal behaviour was the most frequent reason identified as a precipitating factor for a police negotiator event (n = 85; 51.2%), followed by the presence of a mental disorder (n = 74; 44.6%). Grubb’s finding that emotional motivation was also a high precipitating factor for events (78.1%) is consistent with the development of police negotiator service models that focus on resolving emotional issues first, before attempting behaviour change in the person carrying out the event (R. Fisher et al., 2011). Grubb’s findings are, however, limited by a lack of generalisability as they rely on data from only two police negotiator units in the United Kingdom.

Lord’s (2010) findings that nearly three quarters (n = 202, 73.7%) of police negotiator events responding to suicidal behaviour involved a person who had previously received some sort of treatment for mental illness are also consistent with the emphasis that police departments have on engaging mental health services in their police negotiation responses (Grubb et al., 2019; McMains & Mullins, 2014). Of particular relevance is Lord’s (2010) finding regarding the significant relationship between prior mental health inpatient treatment involvement and repeat contact with police negotiators (n = 23, 52.3%). A limitation of both Grubb’s and Lord’s findings is that they are based solely on data completed by police negotiators, meaning that information being analysed is subject to data errors (e.g. missing or incorrect information as it is reliant on the quality of information that police may be able to gather at the time of the event), and health considerations such as mental health diagnosis have not been independently verified against clinical records.

Qualitative evidence

The findings based on recordings or transcripts of police negotiator events are useful as they identified mental disorder and suicidal behaviour as prominent themes in negotiator communication; however, they do not provide data about the prevalence or type of mental disorder (Rogan, 2008, 2011; Sikveland et al., 2020). However, these findings highlight the importance of needing to understand a person’s emotional state at the time of the crisis event. For example, Rogan (2008) comments that his findings are not consistent with expected results in relation to individuals who survive a suicidal event expressing more anger and emotion than those where the event results in death, and emphasises the need for police negotiators to attend to the person’s emotional state as evidenced by the person’s verbal cues. In addition to the articles included in this review, there is a body of research by, for example Sikveland and Stokoe (Sikveland & Stokoe, 2020; Stokoe & Sikveland, 2020) that was not included in this review due to its more specific focus on communication techniques used by police negotiators. This area of research does, however, highlight the value in quantitatively analysing police negotiator contacts with persons with mental disorder or experiencing suicidality to inform future research directions and police responses.

Spence and Millott’s (2014) and Grubb’s (2019) findings from semi-structured interviews of police negotiators identified that negotiators viewed suicidal behaviour and emotional or psychological crisis as the most common reason for a police negotiator response. When compared with events involving hostages, there was a consistent finding that crisis responses form the majority of police negotiator work. Additionally, people experiencing suicidality or emotional or psychological crises were also described as being involved across all different incident types, including those where hostages are involved, with one negotiator describing all events as involving a person in some sort of emotional crisis (Grubb et al., 2019).

Indirect evidence

This review included articles related to ‘suicide by police’ and police-provoked shootings as evidence of indirect estimates of mental disorder and suicidal behaviour. This is because the data used in these articles included events that were, or that could reasonably have been, responded to by police negotiators. Additionally, as this review was not interested in the impact that police negotiation had on an event outcome, but rather focused on the characteristics of people involved, it was determined, on balance, that including these articles was important to ensure estimates of mental disorder and suicidal behaviour amongst the cohort of people likely to be involved in police negotiator events were considered as part of the overall evidence currently available. These studies suggest that 50% or more of people involved in these events have a mental disorder (Kesic et al., 2012; McLeod et al., 2014; Mohandie & Meloy, 2010). Of further interest from these studies is the unknown rates of mental disorder, which may identify a significant gap in understanding of this cohort. For example, Mohandie and Meloy (2010) found that in just over a third of cases they reviewed (n = 31, 37%), the mental health history of the person involved was not known, and in 46% (n = 39) it was not known whether the person had any prior admissions to hospital due to mental health issues.

Estimates of a history of suicidal behaviour were varied in the police-provoked shooting studies, ranging from 14% (Mohandie & Meloy, 2010) to 28% (Lord, 2014). As with the gap for mental disorder history, Mohandie and Meloy (2010) also identified 74% of individuals in their study who had an unknown history, which may have contributed to this variance. The consensus of suicidal behaviour being present at the actual time of the event is, however, greater, with most individuals demonstrating verbal or behavioural (or both) suicidal intent to police during police-provoked shooting events (Lord, 2014; Mohandie & Meloy, 2010). As well as the reservations outlined earlier in relation to whether a dedicated police negotiator response occurred in the events included in these studies, a significant limitation relating to generalisability exists as they rely on a very particular cohort, and it remains unclear what proportion of negotiator events involve individuals with the primary goal being a police-provoked shooting. Additionally, unless also linked with a health dataset, lethal intervention death register studies generally rely on a criminal justice agency assessment of a mental disorder being present, rather than a clinical assessment. This may result in an over-, or under-, estimation of the prevalence of mental disorders for individuals involved in these events.

Siege events

Importantly, this review identified a major gap in the literature in relation to the prevalence of mental disorder amongst individuals involved in potentially the highest risk police negotiator events (i.e. hostage and terrorism-driven sieges). This may be, in part, because only a small number of these high-risk events occur each year (Scott, 2020; The State of Queensland, 2020). However, while these events are rare in occurrence, their significance cannot be underestimated in terms of impact to the people involved and the broader community. As identified during the inquest into the 2019 Lindt Café Siege in Sydney, ensuring that there is clarity in relation to the role of mental health professionals, if any, when supporting police negotiators is critically important (Coroners Court of New South Wales, 2017; Scott, 2020). Police negotiator events involve substantial individual, police and community risk and significant resources. Establishing clearer evidence about the role of mental disorder and suicidal behaviour in these high-risk events, as distinct from other policing responses, will enhance the capability across police and mental health services to engage and respond to these events. The potential benefits to individual and community safety in terms of outcomes, as well as ensuring appropriate use of finite police and mental health resources, warrant further research is this important area.

Limitations

The broad approach to the study inclusion criteria within this review may be a potential limitation. On balance, however, it was considered important to include quantitative articles and articles that provided indirect evidence in the review as they reflect the research approach primarily used within this field of research, which deals with serious and high-risk events affecting vulnerable people that are not easily (or ethically) able to be replicated or adapted as may occur in more traditional research methods.

This systematic review was limited to peer-reviewed publications. We did not include grey literature as it is limited by methodological issues including, for example, potential barriers to identifying specific police negotiator activity within publicly reported police organisational data.

Conclusion

Findings from this systematic review suggest that mental disorder and suicidal behaviour are likely to be significant factors amongst those who become subject to police negotiation, but the current evidence is very limited. It remains important to focus research on the higher risk factors that may form part of a police negotiation event, rather than relying on evidence from research into other police interactions with individuals with mental illness. This is important due to the potential risk factors for the individual, the police and the community if all interactions are considered by research in a homogeneous way.

Further studies should therefore focus specifically on prevalence estimates of mental disorder and suicidality among police negotiator events. In addition, future studies should aim to systematically identify police negotiator events that involve individuals with mental disorders or suicidal behaviours and describe the type of mental health symptomatology, including prior contacts with mental health services. A description of these factors will assist with developing appropriate support from mental health services and clinicians to police negotiators who appear to have a primary role in responding to mental health crises in the community and will establish an evidence base that can be used to inform future service responses and roles for mental health professionals. This information will be critical to the development of evidence-informed training and intervention in events that are high risk and have significant importance to individuals, services and community.

Ethical standards

Declaration of conflicts of interest

Bobbie Clugston has declared no conflicts of interest

Carla Meurk has declared no conflicts of interest

Meredith Harris reports personal fees from RAND Corporation outside the submitted work in the past 3 years.

Philip Burgess has declared no conflicts of interest

Ed Heffernan has declared no conflicts of interest

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary Material

Supplemental Material
TPPL_A_2175066_SM5410.docx (18.7KB, docx)

References

  1. American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). American Psychiatric Association. [Google Scholar]
  2. Augustin, D., & Fagan, T. J. (2011). Roles for mental health professionals in critical law enforcement incidents: An overview. Psychological Services, 8(3), 166–177. 10.1037/a0024104 [DOI] [Google Scholar]
  3. Australian Federal Police (AFP). (2014). Ready to listen. AFP Platypus Magazine, 116, 4–13. [Google Scholar]
  4. Australian Institute of Criminology (AIC). (2013). Police shootings of people with a mental illness. AIC. https://aic.gov.au/publications/rip/rip34 [Google Scholar]
  5. Australian Institute of Health and Welfare (AIHW). (2019). Mental health services in Australia - services provided in emergency departments 2017-18 tables. AIHW. [Google Scholar]
  6. Butler, A. (2014). Mental illness and the criminal justice system: A review of global perspectives and promising practices. International Centre for Criminal Law Reform and Criminal Justice Policy, University of British Columbia. [Google Scholar]
  7. Butler, W. M., Leitenberg, H., & Fuselier, G. D. (1993). The use of mental health professional consultants to police hostage negotiation teams. Behavioral Sciences & the Law, 11(2), 213–221. 10.1002/bsl.2370110210 [DOI] [PubMed] [Google Scholar]
  8. Call, J. A. (2008). Psychological consultation in hostage/barricade crisis negotiation. In Hall H. V. (Ed.), Forensic psychology and neuropsychology for criminal and civil cases (pp. 263–288). CRC Press. [Google Scholar]
  9. Coroners Court of New South Wales. (2017). Inquest into the deaths arising from the Lindt Café siege Glebe. Coroners Court of New South Wales. [Google Scholar]
  10. Durbin, J., Lin, E., & Zaslavska, N. (2010). Police-citizen encounters that involve mental health concerns: Results of an Ontario police services survey. Canadian Journal of Community Mental Health, 29(S5), 53–71. http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104950077&site=ehost-live 10.7870/cjcmh-2010-0034 [DOI] [Google Scholar]
  11. Feldmann, T. B. (2004). The role of mental health consultants on hostage negotiation teams. The Psychiatric Times, 21(14), 26. [Google Scholar]
  12. Fisher, M., & Ireland, C. A. (2010). Consultancy and advising in forensic practice (pp. 91–107). John Wiley & Sons, Ltd. [Google Scholar]
  13. Fisher, R., Ury, W., & Patton, B. (2011). Getting to yes: Negotiating agreement without giving in. (3rd ed., updated and revised ed.). Penguin. [Google Scholar]
  14. Flood, J. J. (2003). A report of findings from the Hostage Barricade Database System (HOBAS). Crisis Negotiation Unit, Critical Incident Response Group, FBI Academy. [Google Scholar]
  15. Greenstone, J. L. (2003). How to be a mental health consultant to a law enforcement hostage and crisis negotiation team. Journal of Police Crisis Negotiations, 3(1), 121–130. 10.1300/J173v03n01_09 [DOI] [Google Scholar]
  16. Grubb, A. (2010). Modern day hostage (crisis) negotiation: The evolution of an art form within the policing arena. Aggression and Violent Behavior, 15(5), 341–348. 10.1016/j.avb.2010.06.002 [DOI] [Google Scholar]
  17. Grubb, A. R. (2020). Understanding the prevalence and situational characteristics of hostage and crisis negotiation in England: An analysis of pilot data from the national negotiator deployment database. Journal of Police and Criminal Psychology, 35(1), 98–111. 10.1007/s11896-020-09369-z [DOI] [Google Scholar]
  18. Grubb, A. R., Brown, S. J., Hall, P., & Bowen, E. (2019). From “sad people on bridges” to “kidnap and extortion”: Understanding the nature and situational characteristics of hostage and crisis negotiator deployments. Negotiation and Conflict Management Research, 12(1), 41–65. 10.1111/ncmr.12126 [DOI] [Google Scholar]
  19. Hails, J., & Borum, R. (2003). Police training and specialized approaches to respond to people with mental illnesses. Crime & Delinquency, 49(1), 52–61. 10.1177/0011128702239235 [DOI] [Google Scholar]
  20. Hatcher, C., Mohandie, K., Turner, J., & Gelles, M. G. (1998). The role of the psychologist in crisis/hostage negotiations. Behavioral Sciences & the Law, 16(4), 455–472. [DOI] [PubMed] [Google Scholar]
  21. Hickman, D. (2009). An assessment of hostage negotiators’ attitudes toward mental health professionals’ involvement in hostage negotiation. ProQuest Dissertations Publishing. [Google Scholar]
  22. Hong, Q. N., Pluye, P., Fabregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M.-P., Griffiths, F., Nicolau, B., O’Cathain, A., Rousseau, M.-C., & Vedel, I. (2018). Mixed Methods Appraisal Tool (MMAT) version 2018 user guide. McGill Department of Family Medicine. [Google Scholar]
  23. Kesic, D., Thomas, S. D. M., & Ogloff, J. R. P. (2012). Analysis of fatal police shootings: Time, space, and suicide by police. Criminal Justice and Behavior, 39(8), 1107–1125. 10.1177/0093854812440084 [DOI] [Google Scholar]
  24. Kesic, D., Thomas, S., & Ogloff, J. (2013). Estimated rates of mental disorders in, and situational characteristics of, incidents of nonfatal use of force by police. Social psychiatry and Psychiatric Epidemiology, 48(2), 225–232. 10.1007/s00127-012-0543-4 [DOI] [PubMed] [Google Scholar]
  25. Knowles, G. J. (2016). Social psychological dynamics of hostage negotiation: Forensic psychology, suicide intervention, police intelligence/counterintelligence, and tactical entry. Journal of Criminal Psychology, 6(1), 16–27. 10.1108/JCP-01-2016-0001 [DOI] [Google Scholar]
  26. Lord, V. B. (2010). The role of mental health in police-reported suicides. Journal of Police Crisis Negotiations, 10(1–2), 191–204. 10.1080/15332581003799711 [DOI] [Google Scholar]
  27. Lord, V. B. (2014). Police responses in officer-involved violent deaths: Comparison of suicide by cop and non-suicide by cop incidents. Police Quarterly, 17(1), 79–100. 10.1177/1098611114522040 [DOI] [Google Scholar]
  28. McLeod, L. C., Thomas, S. D. M., & Kesic, D. (2014). The frequency and nature of resolution of potential police provoked shooting encounters. International Journal of Law and Psychiatry, 37(4), 383–389. 10.1016/j.ijlp.2014.02.009 [DOI] [PubMed] [Google Scholar]
  29. McMains, M., & Mullins, W. (2014). Crisis negotiations managing critical incidents and hostage situations in law enforcement and corrections (5th ed.). Routledge. [Google Scholar]
  30. Mohandie, K., & Meloy, J. R. (2010). Hostage and barricade incidents within an officer-involved shooting sample: Suicide by cop, intervention efficacy, and descriptive characteristics. Journal of Police Crisis Negotiations, 10(1–2), 101–115. 10.1080/15332581003799737 [DOI] [Google Scholar]
  31. Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Reprint – preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Physical Therapy, 89(9), 873–880. 10.1093/ptj/89.9.873 [DOI] [PubMed] [Google Scholar]
  32. Norton, S. C., & Petz, M. (2012). Hostage negotiators: Managing psychological stress. Journal of Police Crisis Negotiations, 12(1), 28–38. 10.1080/15332586.2011.623021 [DOI] [Google Scholar]
  33. Pace, R., Pluye, P., Bartlett, G., Macaulay, A. C., Salsberg, J., Jagosh, J., & Seller, R. (2012). Testing the reliability and efficiency of the pilot Mixed Methods Appraisal Tool (MMAT) for systematic mixed studies review. International Journal of Nursing Studies, 49(1), 47–53. 10.1016/j.ijnurstu.2011.07.002 [DOI] [PubMed] [Google Scholar]
  34. Porter, S., Rose, K., & Dilley, T. (2016). Enhanced interrogations: The expanding roles of psychology in police investigations in Canada. Canadian psychology/Psychologie canadienne, 57(1), 35–43. 10.1037/cap0000042 [DOI] [Google Scholar]
  35. Productivity Commission. (2020). Mental health, report no. 95. Productivity Commission. [Google Scholar]
  36. Puntis, S., Perfect, D., Kirubarajan, A., Bolton, S., Davies, F., Hayes, A., Harriss, E., & Molodynski, A. (2018). A systematic review of co-responder models of police mental health “street” triage. BMC Psychiatry, 18(1), 256–11. 10.1186/s12888-018-1836-2 [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Queensland Health. (2017). Mental health support of police negotiator program - model of service. Queensland Health. [Google Scholar]
  38. Queensland Police Service (QPS). (2021). Operational procedures manual. Queensland Police Service. [Google Scholar]
  39. Reuland, M., Schwarzfeld, M., & Draper, L. (2009). Law enforcement responses to people with mental illness: A guide to research-informed policy and practice. Council of State Governments Justice Center. [Google Scholar]
  40. Rogan, R. G. (2008). Linguistic indicators of suicidality in crisis negotiations. Journal of Police Crisis Negotiations, 9(1), 34–54. 10.1080/15332580802494144 [DOI] [Google Scholar]
  41. Rogan, R. G. (2011). Linguistic style matching in crisis negotiations: A comparative analysis of suicidal and surrender outcomes. Journal of Police Crisis Negotiations, 11(1), 20–39. 10.1080/15332586.2011.523302 [DOI] [Google Scholar]
  42. Scott, R. (2020). The Sydney Lindt café siege: The role of the consultant psychiatrist. The Australian and New Zealand Journal of Psychiatry, 54(3), 244–258. 10.1177/0004867419853886 [DOI] [PubMed] [Google Scholar]
  43. Shapiro, G. K., Cusi, A., Kirst, M., O’Campo, P., Nakhost, A., & Stergiopoulos, V. (2015). Co-responding police-mental health programs: A review. Administration and Policy in Mental Health, 42(5), 606–620. 10.1007/s10488-014-0594-9 [DOI] [PubMed] [Google Scholar]
  44. Sikveland, R. O., Kevoe-Feldman, H., & Stokoe, E. (2020). Overcoming suicidal persons’ resistance using productive communicative challenges during police crisis negotiations. Applied Linguistics, 41(4), 533–551. 10.1093/applin/amy065 [DOI] [Google Scholar]
  45. Sikveland, R. O., & Stokoe, E. (2020). Should police negotiators ask to “talk” or “speak” to persons in crisis? Word selection and overcoming resistance to dialogue proposals. Research on Language and Social Interaction, 53(3), 324–340. 10.1080/08351813.2020.1785770 [DOI] [Google Scholar]
  46. Souto, R. Q., Khanassov, V., Hong, Q. N., Bush, P. L., Vedel, I., & Pluye, P. (2015). Systematic mixed studies reviews: Updating results on the reliability and efficiency of the mixed methods appraisal tool. International journal of Nursing Studies, 52(1), 500–501. 10.1016/j.ijnurstu.2014.08.010 [DOI] [PubMed] [Google Scholar]
  47. Spence, W., & Millott, J. (2014). An exploration of attitudes and support needs of police officer negotiators involved in suicide negotiation. Police Practice and Research, 17(1), 1–17. 10.1080/15614263.2014.961455 [DOI] [Google Scholar]
  48. Steadman, H. J., Deane, M. W., Borum, R., & Morrissey, J. P. (2000). Comparing outcomes of major models of police responses to mental health emergencies. Psychiatric services (Washington, D.C.), 51(5), 645–649. 10.1176/appi.ps.51.5.645 [DOI] [PubMed] [Google Scholar]
  49. Stokoe, E., & Sikveland, R. O. (2020). The backstage work negotiators do when communicating with persons in crisis. Journal of Sociolinguistics, 24(2), 185–208. 10.1111/josl.12347 [DOI] [Google Scholar]
  50. The State of Queensland. (2020). Queensland Police Service annual report 2019–2020. The State of Queensland. [Google Scholar]
  51. Van Hasselt, V. B., Flood, J. J., Romano, S. J., Vecchi, G. M., Fabrique, N. D., & Dalfonzo, V. A. (2005). Hostage-taking in the context of domestic violence: Some case examples. Journal of Family Violence, 20(1), 21–27. 10.1007/s10896-005-1506-2 [DOI] [Google Scholar]
  52. Vecchi, G. M., Van Hasselt, V. B., & Romano, S. J. (2005). Crisis (hostage) negotiation: current strategies and issues in high-risk conflict resolution. Aggression and Violent Behavior, 10(5), 533–551. 10.1016/j.avb.2004.10.001 [DOI] [Google Scholar]
  53. Vecchi, G. M., Wong, G. K. H., Wong, P. W. C., & Markey, M. A. (2019). Negotiating in the skies of Hong Kong: The efficacy of the Behavioral Influence Stairway Model (BISM) in suicidal crisis situations. Aggression and Violent Behavior, 48, 230–239. 10.1016/j.avb.2019.08.002 [DOI] [Google Scholar]
  54. World Health Organization (WHO). (2011). ICD-10: International statistical classification of diseases and related health problems (10th revision, 2010 ed.). World Health Organization. [Google Scholar]
  55. World Health Organisation (WHO). (2014). Preventing suicide. World Health Organization. [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Supplemental Material
TPPL_A_2175066_SM5410.docx (18.7KB, docx)

Articles from Psychiatry, Psychology, and Law are provided here courtesy of Taylor & Francis

RESOURCES