Monday, September 12, 2016

Crisis Intervention Teams: changing the way local law enforcement responds to individuals experiencing a mental health crisis

According to a study conducted by the Treatment Advocacy Center, “…an estimated 1 in 3 individuals transported to the emergency room for a psychiatric crisis is taken there by police.” The same study reports that “…individuals with severe mental illness generate no less than 1 in 10 calls for police service and occupy at least 1 in 5 of America’s prisons and jail beds.”

Deputies from the St. Mary’s County Sheriff’s Office frequently respond to calls in which a mentally unstable individual is in various forms of stress including illness, drug use or abuse, or a combination of all three. These situations are challenging and complex, and law enforcement officers across the country deal with them on a daily basis. In St. Mary's County, patrol deputies can respond to them multiple times during a twelve-hour shift.

To address mental health issues, agencies across the region are working together to advance a progressive approach called Crisis Intervention Team (CIT) Training. The Sheriff’s Office, working in partnership with the National Alliance on Mental Illness and the Mental Health Core Service Agencies for St. Mary’s, Calvert and Charles Counties in Southern Maryland, has met the 20-25% recommended implementation of CIT for an agency, with 36 deputies, one captain, and seven correctional officers CIT certified.

Although all deputies have gone through Mental Health First-Aid, an eight-hour course designed to help deputies identify, understand and respond to signs of addiction and mental illnesses, the Sheriff’s Office reports that there is a need to advance deputies through the CIT course as well, known as the Memphis Model.

The Memphis Model is considered the “gold standard” crisis intervention response for individuals in a mental health crisis. It is a large-scale collaborative program between the community and law enforcement and includes a 40-hour advanced officer training component. The Memphis Model approach improves safety in the community while it provides an opportunity for jail diversion and treatment for individuals experiencing distress.

The history of CIT in St. Mary’s County dates back to 2005, when Connie Walker, a retired Navy Captain living in Leonardtown, became an advocate for veterans and other individuals suffering from mental illness. After her eldest son had returned from serving overseas in Iraq with a diagnosis of Post-Traumatic Stress Disorder and major depression, Walker took a 12-week family psychoeducation course offered in Baltimore by the National Alliance on Mental Illness (NAMI). In 2006, she became the founder and first president of NAMI Southern Maryland (NAMI SoMD) and ultimately became the president of NAMI Maryland. It was during the early days of NAMI SoMD that Walker heard about the unique approach the Memphis Police Department was using, called Crisis Intervention Training (CIT).

After undergoing testing in Memphis, CIT was piloted nationwide in an effort to enhance police officers’ ability to de-escalate situations and more productively respond to individuals experiencing a mental health crisis.

The long-standing practice in Southern Maryland had been to transport individuals in a mental health crisis to hospital emergency rooms or jail. CIT offers law enforcement a new way to deal with non-traditional police calls for mental health services. The new approach helps to de-escalate tense situations for both the individual and law enforcement.

Walker’s commitment to CIT was reinforced after a local incident where an individual suffering from a mental illness was fatally shot.  This tragedy resonated with Walker, and she asked for a meeting with Sheriff Cameron to discuss adding CIT to the regular training schedule for St. Mary’s County deputies. 

Walker is quick to point out that Sheriff Cameron did not need any convincing. “Sheriff Cameron was so progressive in having that meeting and hearing me out. As soon as we discussed CIT and he reviewed the methods and outcomes where CIT has been put into practice elsewhere in the nation – he recognized the benefit in implementing CIT here,” Walker said. “Sheriff Cameron took the ball and ran with it. I’ll always be grateful for his dedication to beginning this training effort with the Maryland State Office of Forensics. That office delivered basic mental health crisis intervention training for St. Mary’s County deputies; and while it wasn’t the Memphis Model – it was certainly more than had ever been received here before – and it began just a few months after Sheriff Cameron agreed to meet with me.”

A few months later, the Sheriff had his deputies attend the training suggested by Ms. Walker. Since its inception, the training developed into what is now formally labeled Crisis Intervention Team Training.

Since then, the Sheriff’s Office has made further strides and remains committed to advancing their Crisis Intervention Teams. Capt. Daniel Alioto and Sgt. Raddatz continue to lead the agency’s efforts in Crisis Intervention Team enhancement.  The two deputies were the first to receive CIT training through Montgomery County and are also members of the nine-person hostage negotiation team, where all members are CIT certified.

“With increasing regularity, members of our agency have community contact with persons in crisis, with a mental illness or co-occurring disorders. We recognize the need to be prepared and ensure the safety of all participants involved.  We will continue to train and equip our deputies and correctional officers with the necessary tools to respond to such encounters,” said Captain Daniel Alioto.

In June, St. Mary’s County School Resource Officers attended the training and in November, additional shift commanders, special operations division deputies, patrol deputies, correctional officers, and detectives are scheduled for CIT.

“The Core Service Agency for mental health has grant funds that can be used for further development of CIT teams. Our goal is to regionalize the training and build a strong network of collaboration between everyone – law enforcement, Core Service Agencies (CSA), and the community,” said Karyn Black, Director, Charles County Core Services Agency.

Black also emphasized, “Ideally, there would be mobile crisis teams and walk-in crisis centers available at all hours. However, we do not have the resources in Southern Maryland. Instead, we are developing an engagement and linkage program to follow-up on law enforcement referrals and help individuals access community-based behavioral health services. The CSAs are working to encourage existing behavioral health providers in Southern Maryland to cooperate more with individuals referred by law enforcement.”

Funded through Crisis Intervention Training grant funds provided through the Charles County Core Service Agency by the Behavioral Health Administration at the Department of Health and Mental Hygiene, Sheriff Tim Cameron, Capt. Daniel Alioto and Sgt. Bill Raddatz attended the CIT Team International Training Conference held in Chicago in April.

“The conference enhanced the Sheriff’s Office crisis prevention program with a better understanding of the population we serve and the needs of those suffering from mental illness and substance abuse disorders or experiencing a mental health crisis,” Raddatz said.

Sheriff Cameron added, “The Sheriff’s Office recognizes emergency situations, suicide attempts and mental health crises as a priority in the community. Our goal is to respond to individuals with an efficient, effective, respectful and compassionate approach that helps them maintain their dignity. We will continue to work with advocacy groups, the mental health providers, and the community to enhance our CIT program.”



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