Mental health issues and policing community

On May 7, 2018, the Washington County Emergency Management training room was filled with 15 trainees for a week-long Crisis Intervention Team (CIT) training. They were there to learn more about de-escalating dangerous situations and to promote safety for both law enforcement officers and the public.

CIT is a collaborative effort between law enforcement and mental health to assist law enforcement officers in handling situations with individuals who have behavioral health problems. The first ever CIT training began in Memphis, Tennessee in 1988, a year after a 27-year-old man with significant mental health issues was shot and killed in that city. Following this event, the Memphis Alliance on Mental Illness, the Memphis Police Department, two local universities, and local mental health providers joined forces to develop and implement a training for the purpose of “developing a more intelligent, understandable, and safe approach to mental health crises events.” Although this first CIT training was the result of a significant collaboration, there were two major criticisms – (1) the recipients of mental health services, past or present, were not involved in the planning or presentation, and (2) only officers who volunteered were trained. This meant that no first-hand knowledge of behavioral health issues (i.e., addictions, delusions, the desire to kill oneself, experience of a manic episode) were ever presented. Although training only volunteer officers meant that these new trainees were probably committed to what they were learning, it also meant that CIT trained officers were not always available when there was a crisis, especially in small towns. So, after the changes were made, officers were then provided with opportunities to hear, first hand, the experiences of individuals and their families with substance use and mental health problems.

Although no two CIT programs are the same, they all have similar components. The first day of Washington County’s CIT training begins with a discussion of the goals, purposes, benefits, and necessity of having a Crisis Intervention Team training, along with a presentation about various mental illnesses. It is important for officers to be aware of some of the symptoms of mental illnesses and how best to respond or not to respond to them. For example, if a person has psychosis, one of the symptoms may be “auditory hallucinations.” That person may hear voices talking to him/her that only exist in that person’s mind. This can seriously interfere with an officer’s ability to communicate with the person. Although hearing voices could happen for more than one reason, it would be important for the officer to try to gain that person’s attention and ask, “Are you hearing another voice (or voices) besides mine?” If the person indicates that s/he is hearing another voice or voices, the officer may want to ask, “What are those other voices telling you?” It would then be appropriate for the officer to ask that person to try to focus on his/her voice only. However, it would not be appropriate for the officer to deny that the person is hearing voices or to deny what those voices are telling him/her to do. Later in the training, the officers were given the opportunity to experience what it may be like to be a person who is “Hearing Voices” and were given headphones. While using the headphones and listening to voices that steadily increase in volume, the officers were asked to perform both verbal and nonverbal tasks. After this simulation, the group discussed what it was like to struggle through required tasks while hearing distracting voices.

In order to better understand what a person may go through who has a behavioral health issue or what a family member may experience, two panels of community members talked about his/her difficult first-hand experiences, leaving time at the end for officers to ask questions of the panel members. These panelists talked about what was helpful to them and what was not. Several of the panelists had involvement with one or more of the officers but they had not heard their stories. One of the officers wrote, “It took a lot of guts [for a panelist] to stand up in front of a roomful of officers and to talk about his journey through drug addiction.”

After many of the topics were presented and discussed (i.e., psychosis, dementia, bipolar disorder, suicide attempts), the officers participated in scenarios that gave them an opportunity to practice what they had learned. They were asked to resolve a situation in which a person was threatening to jump off a bridge, a person was sitting on a bench in a park who did not know where he lived or how he got there, or a teen had barricaded herself in a bedroom and would not come out. After each scenario, officers discussed what they liked about the way another officer or officers resolved the situation and shared alternative ways that the situation could have been resolved. On one of the evaluations, an officer wrote, “A helpful feature of the training was role-playing throughout the curriculum.”

The officers’ favorite presenter over the past four years of training has been Captain Bryan Cooper from the Athens County Sheriff’s Department who discussed “First Responders’ Risks and Well-Being.” He currently serves as a commander for Ohio Peace Officer Training Academies. His main focus was on keeping law enforcement officers safe and mentally/emotionally well. He shared his own experience with PTSD (Post Traumatic Stress Syndrome) due to an incident on the job and what he needed to do to get ready to go back to work. One of the officers wrote on his evaluation, “I didn’t realize that more officers die from suicide than from line-of-duty deaths due to stressors on the job.”

Washington County’s CIT Committee is proud of its four trainings and has already begun planning for Washington County’s 2019 training.

Karen E. Binkley, Ed.D., is president of the Washington County Behavioral Health Board.

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