By Rose Hoban
A 40-something-year-old woman is in her bedroom, screaming and crying, claiming the government is trying to kill her. Her parents call the police, looking for help. They tell the emergency dispatcher that she has a history of mental health problems and occasionally has crises like this one. They think she’s stopped taking her medications.
When they arrive, how should police proceed? Should they arrest her? Arrive with guns drawn?
Instead, police get information from her parents and then talk to her through her bedroom door, helping her calm down. She agrees to come out of her room and eventually gets into their car to go to a psychiatric facility for an emergency evaluation.
The scenario above is one that actually happened, said Eric Johnson from Alliance Behavioral Health, the local management entity newly mandated to coordinate mental health care in Wake County. Johnson and others coached a pair of officers through a role-play of this scenario and others near the end of a weeklong course that teaches police how to resolve issues for people with mental health issues.
Johnson said police officers face these kinds of scenarios all the time. To resolve them successfully, officers need skills to work with people in mental health crisis. And that’s where crisis intervention training (CIT) comes in. CIT is a special training designed to help police respond appropriately to the mentally ill.
A recent weeklong CIT session held at Wake Tech Community College included officers from the Raleigh Police Department, the Wake County Sheriff’s Department and members of the police forces of RDU Airport, Wake Tech and the State Capitol. The course is part of an effort to get more of North Carolina’s police officers trained in CIT.
Treatment, not trauma
According to a nationwide analysis done by Bloomberg News at the end of 2012, police killed at least 64 people with mental illness, including 26-year-old Clay McCall, who was shot and killed after he charged at a Charlotte Police Department officer with garden shears.
Just this past weekend, a Durham man being transported to a psychiatric hospital in Winston-Salem was shot dead after he overpowered a sheriff’s deputy and stole his vehicle.
CIT is an attempt to keep these incidents from happening. The training model was developed by Memphis police officers in the 1988 as a way of reducing the number of shooting deaths of people with mental illness. Since that time, deaths and injuries of both psychiatric patients and police officers in Memphis have plummeted, and the training model has spread around the country.
The 40-hour training program includes basic information about mental illnesses and how to recognize them, information about and visits to providers in the local mental health system, a review of laws and contact with people with mental health problems and their family members. The goal is to help officers learn to recognize potentially explosive situations and defuse them, getting people to treatment rather than jail, or worse.
“Basic CIT … is basically set up as a diversion model to keep low-risk offenders from going into the jail system on low-level crimes as opposed to getting them into the mental health system for services,” said Lori Ray, CIT coordinator for the Durham PD.
Ray said her CIT program typically diverts people who’ve committed low-level offenses such as trespassing and public intoxication into the mental health system.
She said that over a two-year period, her department responded to more than 5,600 mental health calls.
According to the U.S. Department of Justice, about 10 percent of police calls nationally are related to mental health crisis or substance-abuse issues.
“We also have diverted felonies using crisis intervention,” Ray said. She described the case of a 16-year-old who broke into a relative’s home to steal a cell phone. The CIT-prepared officer received information that the young man had a developmental disability and had been involuntarily committed in the past.
“The CIT officer spent three hours on this call, but it could have turned into a felony arrest,” Ray said. The officer spent his time “following up with the foster home, following up with the behavioral health team that he’s assigned to, following up with the school system, talking to the victims of the crime, who said that the boy knew better.
He would have gone to jail because he was 16 and been charged with a first-degree felony.”
Instead, the young man was diverted into more intensive treatment and kept out of jail.
“Our view as caregivers is the CIT training is a big plus to reduce the amount of violence that might be the normal reaction of a police officer coming in with a command presence and issuing orders that won’t be followed,” said Tom Hadley, a board member of the Wake County chapter of the National Alliance for Mental Illness (NAMI), who attended the weeklong training. “The normal officer might not recognize that there’s something else going on with this person. We’re trying to avoid violence from either side.”
Look for the pin
In North Carolina, about 22 percent of law-enforcement officers have been trained in crisis intervention since the first training took place in 2006, according to Deby Dihoff, head of NAMI NC. Dihoff said the goal is to get 25 percent of officers trained.
Ray said Durham has trained about 35 percent of its officers.
Wake Forest Police Department officer Teresa Gurley volunteered for one of the first crisis intervention training sessions in the state six or seven years ago, in large part because of her son Drew. Now 25, Drew suffered permanent brain injury after having meningitis as a toddler and has residual cognitive difficulties.
“I think the fact that Drew had a disability … I saw the need for crisis intervention for people with disabilities as well as mental health issues; the two go hand in hand,” Gurley said.
She brought Drew along when she spoke to the Wake County officers being trained last month.
“I wanted Drew to interact with some of the officers so they could see an individual with a disability who may not look like they have a disability, but once he begins talking, they’ll pick up on some things,” Gurley said.
“We’ve heard time and time again that as the state continues to cut funding for mental health, that officers in the field continue to come into contact with more and more people with mental health disabilities,” she said.
Drew attends Gateway Clubhouse in Garner, a center for people with mental health problems, and tells his friends there about his mom and about CIT.
“I tell them to look for the pin, because if you ever get in a situation, look for that pin,” Drew said, referring to the pin all CIT-trained officers wear. “I tell them to ask for a ‘CIT’ officer, and that they’ll be advocates for people who also have other cognitive disabilities, or any other disability.”
“I think all officers should have CIT training,” Gurley said.