In 1998, police officers shot a man who lunged at one officer who was trying to coax him from the roof of a building. Although the man had a history of mental illness, prior to its onset, he was a respected schoolteacher. This incident triggered a widespread controversy and received much coverage in the local press. The public debate over this and other similar cases led to an examination of the appropriate role for law enforcement agencies in dealing with people in a state of mental or emotional distress. Traditionally, law enforcement officers are the first to respond to crisis situations involving individuals with mental illnesses and, therefore, must receive training on how to resolve these situations more efficiently and with greater sensitivity.
ONE AGENCY'S EXPERIENCE
Monterey County, California, known for its scenic beauty, encompasses more than 2 million acres and has a resident population of more than 400,000. In addition to over 2 million visitors attracted to the county each year, estimates for the year 2000 included a homeless population of 2,915 men, women, and children, with a transient population of 6,835, and showed that approximately 22 percent of this homeless population had some form of mental illness. (1) The Monterey County Health Department serves approximately 4,000 residents with mental illness. Statistically, this figure represents 50 percent of the affected residents living in the communities of Monterey County. The county has 16 different law enforcement agencies, two state prisons, two federal police agencies, four state agencies that have patrol functions, a district attorney's office, and a county probation office. All of these agencies, subject to a mental health critical incident response requirement, have limited resources to deal with a mental health crisis situation.
The Monterey County Police Chiefs Association decided to combine their resources and create a standardized training program to develop a better response capability to mental health crisis situations. Members of the association recognized that addressing the training issues of first responders only represents a small component of having a better response capability. They involved the county health department as an equal partner in creating the countywide program. The association concluded that the program must contain three parts in order to be a success--a first-responder certified training program; agreements/protocols of cooperation between law enforcement and the local emergency medical services; and a medical doctor and a psychiatrist assigned to assist the commander on the scene. Without these three components in place and full agreement between agencies, a comprehensive plan to deal with mental health crisis situations could not be complete.
The Training Program
The committee reviewed a number of programs, including the Memphis model. (2) Three individuals from Monterey County, including an employee of the county mental health department, were sent to a critical incident training (CIT) academy developed by the San Jose, California, Police Department. Using this CIT as an outline, upon graduation, these key workers developed a similar training course specifically designed for the needs of Monterey County. They concluded that an integrated, countywide program would have to serve the various population centers and account for the distance between all agencies in Monterey County. They needed to adapt the San Jose training program to meet the specific and unique conditions of all jurisdictions in Monterey County. Consequently, an oversight committee, chaired by the chiefs association designee, was created and included the three graduates of the San Jose CIT Academy. Their task involved molding the Memphis/San Jose CIT model into a germane product for Monterey County to i ncorporate into the training protocol program that included the mental health …