David Covington, from Arizona, described the "No Force First" approach to working with people in mental health crisis that eschews the use of restraints and seclusion.
David Covington, from Arizona, described the "No Force First" approach to working with people in mental health crisis that eschews the use of restraints and seclusion. Photo courtesy David Covington, Flickr Creative Commons

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By Rose Hoban

In 1987, when a police officer in Memphis killed a mentally ill man who was wielding a knife, the public outcry was strong and swift.

Now, 28 years later, that tragedy has given rise to a movement to teach police how to better deal with people with mental illness they encounter in the community. That movement is Crisis Intervention Training, the so-called “Memphis model” of policing that was developed in the wake of the 1987 tragedy. CIT is a curriculum to teach law enforcement officers how to recognize when someone is having a psychiatric episode, how to de-escalate these potentially explosive situations and how to keep people from jail when they need mental health treatment.

Badges from the Wake County law enforcement agencies that have CIT-trained officers were on display at Tuesday’s CIT Conference. Photo credit: Rose Hoban

This week, hundreds of law enforcement officers along with mental health advocates and providers convened at the McKimmon Center on the NC State University campus in Raleigh for a biannual conference on helping all those people work together better to serve North Carolinians with mental health problems.

“We now have about a 26 percent rate of officers around the state who have been trained since 2013,” said Jack Register, the incoming head of the North Carolina chapter of the National Alliance on Mental Illness. “The idea is that now we have people who understand that what they’re experiencing with someone is not criminality but psychiatric concerns.”

“If we all collaborate … we can save lives and help provide that support and safety net for the community,” said Rockingham County Sheriff Sam Page, who gave the keynote address at the conference Tuesday morning.

Successes and failures

Both Register and Page said CIT has begun to change the way law enforcement deals with people with mental health crises across the state. But they also both said the training needs to get into all 100 North Carolina counties. Currently, more than 22,200 police officers, sheriff’s deputies, corrections officers, paramedics, fire department personnel and others have been trained in CIT, but there are no officers trained in 16 counties.

For his part, Page said he wants all of his deputies to have the training.

“I always try to make sure I have deputies in each class. As long as I’m sheriff, we’re going to continue with support for CIT,” Page said. “And I’m here to encourage other chiefs and sheriffs that are here today to get involved in CIT.”

In his address, Page showed some video of successful interventions where his deputies had been able to resolve dangerous situations without violence.

“You have to slow down and take your time with the person and don’t rush the situation,” Page said. “Sometimes people are in a point in their psychosis that you can’t talk to them. But I found more often than not, we can talk to them and calm then down.”

He said this kind of interaction can save lives.

The evidence backs Page up: Research has shown that “police-based diversions” and CIT reduced the number of arrests for people with serious mental illnesses. In one study, the number of re-arrests for people with psychiatric problems dropped by 58 percent after officers were trained. The CIT training benefits officers too; other studies have shown that fewer law enforcement personnel were injured after training.

But Page also told of incidents where things didn’t end so well, including one incident with a suicidal man captured on film by a local news crew.

“He was already at the point where we couldn’t talk to him and when he … pulled the gun out and put it to his head, I tried to do everything I could to talk to this guy, to talk him down,” Page said.

Jails and prisons included

In one breakout session, Kim Simon from the Mecklenburg County Sheriff’s Office, described how her department has used CIT in county jails, along with intensive social and vocational rehabilitation services to prevent recidivism. She told how the county’s jail population had decreased by more than half in less than a decade.

Durham resident Pearlie Williams told people at the CIT Conference about how the mental health services she received in prison helped her recover from bipolar disorder and quit using drugs. Photo credit: Rose Hoban

“The benefits of rehabilitation are that it creates a healthier environment for individuals in custody,” Simon said. “It also improves safety and security of the facility because inmates are engaged in productive activity.”

But even though law enforcement officials have been getting trained to better handle people having psychiatric problems, there’s general frustration in the justice community about a lack of community services available for people with mental health problems once they’re out of custody.

“We can have people prepare to reenter society,” Simon said, “but when that person sets foot on Fourth Street, if there’s not an opportunity for them to reenter society or their community, they are going to recidivate.”

That frustration with the shortage of services, psychiatric beds and people to provide mental health services drove many of the conversations and sessions Tuesday. Register said the law enforcement community has supported getting more resources for psychiatric patients.

“There is a movement to increase urgent care behavioral health centers, to pay [emergency medical services] to divert from the ED and other common sense solutions like more inpatient beds,” wrote outgoing NAMI NC head Deby Dihoff in the conference program. “We must work together to keep people well, and in recovery, so that crisis episodes are minimized.”

Along those lines, the Department of Health and Human Services announced almost $1 million in funding for four programs across the state – in Asheville, Charlotte, Winston-Salem and Lumberton – aimed at serving mental health patients in crisis.

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Rose Hoban

Rose Hoban is the founder and editor of NC Health News, as well as being the state government reporter. Hoban has been a registered nurse since 1992, but transitioned to journalism after earning degrees...

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