Reaching out to the Mentally Ill

Article excerpt

Q: What impels law enforcement departments, mental health agencies and elected officials to train police officers to deal with the mentally ill?

A: Tragedy

In Tampa, Fla., the fatal shooting of 39-year-old David Montgomery, a paranoid schizophrenic, alerted the city to the need to develop a welltrained response to mental health emergencies. David's parents have assisted in establishing the city's first Crisis Incident Team (CIT) training sessions as a memorial to their son.

CIT training identifies a person who needs mental health treatment. This works to prevent the person from ending up in jail on charges of "disturbing the peace"-or dead.

Other municipalities are considering or already have started such programs. Portland, Ore., is building a new Central Admitting Center to handle emergency mental health cases. Authorities in Austin, Texas; Orlando, Fla.; and Knoxville, Tenn., are conducting studies for a program.

Pinellas County, Fla., which encompasses several cities and has 15 law enforcement agencies, has already held two training sessionswith approximately 30 officers graduating each time.

The potential for tragic encounters between police and the mentally ill has grown as mental institutions have been closed and their patients have been introduced into societysometimes without suitable support back-up. Sometimes patients do not receive appropriate medication, sometimes community treatment cannot cope with the burden, and sometimes mental health budgets are cut by legislators unaware of the problems. In addition, in some cases parents have not been allowed to contribute insight to the cases.

Police officers are taught to respond to individuals breaking the law or causing social disturbances. However, mentally ill persons can sometimes appear to be endangering the public or the safety of the officers-but their actions are symptoms of mental illness rather than a deliberate response.

In the few seconds an officer has to act on a perceived threat, much can be set in motion: a sick person may be killed, a family shattered, police reputations ruined, government officials blamed, and cities held financially accountable. It is a scenario that responsible governments take seriously.

Tampa Mayor Dick Greco and city law enforcement representatives are deeply committed to their new program. The city sent representatives to Memphis to examine its tenyear old program, after which Captain Rick Duran, of the Administrative Division, returned prepared to set up a partnership with mental health professionals. Representatives of mental health agencies and the police attended preliminary meetings setting up the one-week, 40-hour training sessions for officers; cooperation and pro-bono teaching assistance issues were soon ironed out.

Terry W. Cox, Program Manager of Mental Health Care, Inc., an emergency care service in Tampa, helped establish the training. He likened the effort to the effort of defending a bridge. "You can't just hold one side of the bridge," he said. "You have to hold both sides. When we have the police on one end and the mental health people on the other, it's strong."

Duran worked with Cox and other mental health professionals to design a 40-hour program that would sensitize and inform officers. The first day of the training was devoted to general information about identifying mental health problems. The second day looked at mental health care from the point of view of those needing help and their families; officers visited sites where care is being given and had an opportunity to speak to those currently being served.

On the third day, mental health care professionals gave specific descriptions of mental health problem situations such as violence or suicide, and conducted scenarios that permitted officers to react to on-site problems. The fourth day included discussions of the legal mechanisms needed to restrain and/or aid disturbed persons and the special dispositions for the homeless and elderly. …