Every day, police departments throughout the country encounter people with mental illness. Officers must stabilize volatile situations, build quick rapport with troubled people, make what amounts to a rapid psychiatric assessment and keep the surrounding public safe. It’s a tall order.
That’s where crisis intervention training comes in. It helps officers recognize people with conditions like schizophrenia or bipolar disorder, protect people with autism or dementia from wandering into danger, keep suicidal people from harming themselves and prevent armed people experiencing psychotic episodes from hurting others.
[See: 9 Things to Do or Say When a Loved One Talks About Taking Their Life.]
In November, the Montgomery County Police Department allowed two U.S. News reporters to attend sessions during a weeklong training in Rockville, Maryland, that the county’s Police Department Chief J. Thomas Manger described as “all about getting more tools” to officers who deal with mentally ill people on the street.
Packed Agenda
This crisis intervention training, or CIT, encompassed a packed 40 hours that could easily fill a college semester, admits Officer Scott Davis, coordinator for the Montgomery County CIT program. On the first day alone, officers heard from a teen with autism, had a schizophrenia-like experience with distressing voices, learned about suicide and violence prevention and discussed practical matters such as emergency petitions and hospital-related issues.
In one seminar, Officer Laurie Reyes, the autism/intellectual and development disabilities officer for Montgomery County, explained that with autism, people sometimes show no fear of consequences, have verbal limitations and are sensitive to light and touch.
Reyes brought in a 14-year-old boy with autism with whom she’s worked. “Understand that we don’t respond to directions right away,” the teen said. Things like loud voices or noises make him feel uncomfortable, he explained.
Officers also donned headsets to experience what it is like to hear voices. It started as low, indeterminate whispers from one voice. Before long, there were multiple voices, male and female, some agitated, others denigrating, laced with obscenities.
Maria Zammichieli, a psychologist with the Montgomery County Crisis Center, asked officers: “Can you imagine what it’s like for people who hear voices who have no idea when they’ll stop or when they’ll start?”
The training “is needed now more than ever for cops,” said participant Detective Frank Tona of the Charles County [Maryland] Office of the Sheriff. “The training taught us to recognize and assess the symptoms of mental illness, while at the same time keeping the patient, citizens and your fellow officers safe.”
Nationwide Need
Increasingly, law enforcement agencies are providing training to their officers on how to peacefully resolve encounters with people with mental health issues, says Louis Dekmar, first vice president of the International Association of Chiefs of Police and chief of police in LaGrange, Georgia. More than 2,500 police departments now hold regular CIT trainings nationwide.
“Mental illness has become criminalized because ultimately it’s the police who are dealing with these individuals,” Dekmar says, pointing to the dramatic reduction in psychiatric treatment beds in public hospitals in the last six decades — from more than 500,000 in the 1950s to fewer than 50,000 nationwide today, although the U.S. population has doubled.
Interest in CIT continues to grow amid a series of highly publicized police-involved shootings, followed by widespread community anger. Mental illness of some sort is often a factor:
— An analysis by The Washington Post found that one-quarter of the 462 people shot to death by police nationwide during the first six months of 2015 were suffering from a mental or emotional crisis. Most of these people were armed, and police were called by family members or others who reported that the person was behaving in an erratic manner.
— A review that the Los Angeles Police Department released publicly in March, reported by the Los Angeles Times, found that 14 of the 38 people shot by LAPD officers in 2015 were mentally ill.
— An Atlanta Journal-Constitution series documented that at least 25 percent of the 184 people police officers fatally shot in Georgia since 2010 showed some signs of mental illness.
Dekmar says crisis training has helped officers in his department resolve more encounters peacefully. The LaGrange Police Department began providing crisis intervention training to its officers around 2004. Before the training, officers used force during arrests between 100 and 120 times a year. Post-training, the department has averaged between 48 and 60 uses of force a year, the chief says.
Multiple police encounters aren’t uncommon for people with mental health issues. The LaGrange police department identified 25 such people who officers had arrested 200 times combined. In 2013, LaGrange officials launched a mental health court program, providing treatment options instead of incarceration. Since then, the 25 people have been arrested three times collectively. The shift is “what happens when police understand the mental health issue,” Dekmar says.
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Team Response
The Montgomery County Police Department has been providing CIT training for 16 years, Davis says. Officers are exposed to a variety of perspectives, including insights from community members as well as a speaker from the National Alliance on Mental Illness. Midway through CIT training, officers visit two area mental health facilities.
CIT classes are held in the Montgomery County Crisis Center, which provides 24/7 services to people in need, by phone or in person. The center, operated under the Department of Health and Human Services, also offers a Mobile Crisis Outreach team that will respond anywhere within the county to provide emergency psychiatric evaluations. Police can turn to the team for expert consultation, and therapists may be incorporated to provide a dual response. Behavioral health technicians, licensed clinical social workers and psychologists may also bring their expertise to the scene.
Real-Life Quandaries
On the last day of training, the classroom atmosphere was mostly relaxed as officers acted out on-the-street scenarios with trainers in character as people in a mental health crisis. Responses were evaluated and critiqued by Crisis Center therapist Mary Witteried and colleagues, along with police trainers. The exercise provided a chance for participants to zero in on less-helpful behaviors, like multiple officers speaking simultaneously and adding to the sense of chaos. Scenarios such as the following, taken from real-life cases, posed “What would you do?” challenges:
— The call comes in from a group home: A resident is acting strangely. When the officers arrive, the person is soaked in sweat and urine and doesn’t respond when asked if he’s diabetic or is taking medication. Bystanders aren’t sure. Cops get an emergency petition, and the person is rushed to the hospital. It turns out the person, whose blood sugar was above 500, had diabetes-induced psychosis. Despite officers’ intervention, the person died two days later.
— The well-to-do man calls repeatedly. He’s been hearing things through walls, and certain his house will be burglarized, keeps changing the locks. In need of treatment for his delusions, he’s afraid to leave his home. Officers performing in the scenario reassure him they’ll keep an eye on his belongings while he’s gone to make it easier to get him to help. But therapists disagree with this solution — it’s not a realistic use of manpower. Lying to the man will erode credibility. However, the officers defend their approach — you do what must to wrap up the case. Instead, a veteran suggests, tell him you’ll be sure to lock up after everyone leaves. Reassuring but truthful.
[See: 10 Concerns Parents Have About Their Kids’ Health.]
These are just some of the quandaries that police officers deal with on a routine basis. “By nature, officers try to go out there and help people anyway,” Davis says. “That’s why we signed up for the job.”
It’s better to be polite during cases, he says, for instance calling people “sir” or “ma’am” and not trying to be tough. He advises helping people save face a bit — if possible, showing up in casual khakis and official polo shirts instead of full uniform. Or avoiding handcuffing people in the street in view of their neighbors.
During tense encounters, he says, it’s good to “slow things down, let people vent, let people do their thing. If they want to cuss for a couple more minutes, that’s fine. If they’re not hurting somebody else — me or themselves — then we’re OK with that.”
For Davis, it helps to put himself in another’s shoes. “I couldn’t even begin to imagine what a lot of these individuals go through,” he says. “With their battle with hearing distressed voices; auditory hallucinations. [They] didn’t sign up for that. They didn’t say, ‘This is how I want to live my life.’ You’ve got to try and get them help. Show a little bit of understanding; a little bit of empathy.”
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How Crisis Intervention Training Helps Police Deal With the Mentally Ill originally appeared on usnews.com
