CIT gives officers new tools for crisis response

SANDPOINT - Local sheriff's deputies and police officers will be the first to tell you that theirs is the last face a person in mental crisis wants to see at the doorstep.

The crisis can be heightened when someone wearing an imposing uniform drives up in a patrol car. The belt covered in all manner of weaponry only makes the situation seem more threatening.

All of which means law enforcement - which usually is first on the scene when someone stops taking his or her medication, suffers a psychotic episode or threatens suicide - is at a disadvantage from the moment it first arrives.

From the officer's perspective, it isn't always clear that mental illness is present. An individual in crisis can appear to be amped up on meth, inebriated, physically threatening, incoherent, uncooperative, or all of the above to the untrained eye. This perceptual disconnect led to the fatal shooting of a mentally ill person in 1988 after a response by Memphis law enforcement personnel.

A national movement, called Crisis Intervention Training (CIT) sprung from that tragic mistake, as Memphis took the lead to turn things around.

Last week, seven members of local law enforcement, emergency first response and mental health circles returned from a weeklong CIT training session in Athens, Ohio. While there, they learned new skills for working with the mentally ill.

 "As it stands right now, law enforcement are the first responders to any crisis involving mental illness, whether that's schizophrenia or someone who is suicidal," said Bonner County Sheriff's Deputy Mitch Parnell, who attended the training and serves as Region I Law Enforcement Coordinator for CIT training. "Unfortunately, we don't have the benefit of a treatment facility up here, so if we take that person into protective custody, we end up transporting them to Coeur d'Alene."

And because a judge must decide what happens from that point on, the mentally ill person is driven right back to Bonner County for a hearing.

"That creates a lot of undue stress, because they have to be transported in a patrol car and, by policy, handcuffed," Parnell explained. "What we're hoping to put in place is a situation where transportation to Coeur d'Alene is no longer necessary."

Until very recently, a person with mental illness who was taken into custody was moved to Kootenai Behavioral Health because there was no place else to go. Bonner General Hospital (BGH) now has a "safe room" where those individuals can he held until their court hearing, which partially deals with the transportation issues. But with no psychiatrist or psychiatric nurses on staff, the room is like using a Band-aid to treat a disease.

"In this community, we don't have the infrastructure we should have to help these people," said Tim Fry, a patrol officer with the Ponderay Police Department. "We're called in to intervene when a person is a threat to themselves or others and we're effective at doing that. The problem is, once we take somebody in on a mental hold, it's the rest of our shift and that's a huge drain on resources."

By Idaho State Law, the mentally ill cannot be incarcerated during the period between being taken into custody and appearing before a judge. That means if the facility in Coeur d'Alene is full - which often is the case - an officer must stay with the person in the safe room at BGH until the hearing takes place.

A different approach, CIT classes showed, is taking a little more time to defuse a mental crisis on the front end.

"These calls take more time and officers need to know that it's OK to take that time if it means they can de-escalate a situation," Parnell said.  "Traditionally, law enforcement is used to being hands-on, so if we can work on our verbal skills, that's a good thing.

See CTI, Page 3

"I'd much rather talk somebody into my patrol car than physically assist them," the sheriff's deputy added.

Still, the officers need additional support once they respond to a call.

"That's one thing we're working to change - getting more resources locally," said Parnell.

He envisions a combination of public-private partnerships and state funding, both of which could be a tough sell in an economic downturn. In the meantime, according to Fry, simply having new techniques for handling mental crises is a major improvement for the people who get called to deal with them.

"Despite the fact that we don't have the resources at this point, CIT still gave us a lot of tools we can use in these situations," he said. "One of the things I learned was how to talk to someone who's having a psychotic episode. We've always been taught to maintain a six-foot safe zone when we're talking to someone. But once I understand the person is having a crisis because of mental illness, I can use personal discretion and temper my response."

While the group was in Athens, Ohio, it learned about what Dr. Ann Wimberley, president of NAMI Far North - the regional chapter for the National Alliance on Mental Illness - called a "SAMI Court."  The acronym stands for Substance Abuse Mental Illness Court, which, if implemented in Bonner County, would extend the efforts of the successful Drug Court program that already exists here.

"To have one court that deals with both is a wonderful idea," Fry said. "Because the substance abuse issues are often a natural outgrowth of the mental illness."

Joining Wimberley, Parnell and Fry at the CIT classes were Deputy Charles Newsome of the Bonner County Sheriff's Corrections Department; Holly Bonwell of Region I Adult Mental Health; Regina Sherman from Boundary Volunteer Ambulance; and Chrystal Beachy of ACES - a private mental health service based in Coeur d'Alene.     Barely a week has passed since the group completed the 40-hour course, but Parnell already is lining up classes to pass the new skills along to his colleagues in law enforcement. Those classes, he pointed out, are designed to take care of the people on both sides of a critical encounter.

"It's a fine line between officer safety and learning how to communicate with an individual in crisis," the deputy said. "A lot of it is an awareness thing for the officers. It's a way to open their eyes up to the fact that this is a disease - a mental disease."

The first local training session is scheduled for Feb. 9-13 in Sandpoint, with as many as 30 participants involved.

The next step, Wimberley said, will be to carry that message to a wider audience.

"CIT is also a coalition that assesses what services are available in the community," she noted. "And if it's determined to be the right direction, how best to transfer an individual from law enforcement to mental health care."

In the law enforcement field, CIT is now considered a best practice for dealing with situations involving mental illness. The program has been implemented in 26 states and has been adopted on an international level, Wimberley said. NAMI Far North has been the catalyst for bringing the training to this region.

"We started working on this about a year and a half ago, because there was so much frustration about how things were," she said.

NAMI Far North provides support, education and advocacy for people with mental illness, their families and friends. The group meets on the third Wednesday of every month from 6-8 p.m. at the Bonner General Hospital classroom (there will be no meeting this month).

For information, visit www.nami.org/sites/namifarnorth