Sunday, June 6, 2010

Crisis Intervention Teams

Remember when you were interviewed for your police job and they asked, “Why do you want to be a [name of your agency here] police officer?” Somewhere in your response you probably said something about wanting to help people. That’s what your supposed to say, right?

Police work is one of the helping professions. Unfortunately, we don’t usually see the fruit of our helping actions. Sometimes we do, but not often. In the Bhagavad-Gita we are told, "The man who is devoted and not attached to the fruit of his actions obtains tranquillity; whilst he who through desire has attachment for the fruit of action is bound down thereby." I’m that “bound down” guy. I’d like to see a little more fruit.

Patrol officers arrest the same people, frequently for the same time over and over again. I arrested one guy four times for possession of cocaine in one year. I cite people for having open containers of alcohol over and over again. Same person, same place, same cheap, high octane booze. Most officers rather quickly become somewhat jaded (duh!) and this jadedness starts to creep into what Skolnik calls “the working personality” of the police officer.

In the broadest sense, though, every time we treat people with respect we “help” them. And, yes, we do arrest burglars, car thieves and rapists. Clearly, we help the community with every good arrest. Unlike landscapers or dentists though, we usually don’t have the luxury of standing back at the end of the day and saying, “wow, look what a good job I did today.” Humans kind of need least most of us do.

Enter the Crisis Intervention Team (CIT). Most of you probably haven’t heard of CIT, but it’s becoming quite popular, both in the U.S. and Canada. I just got back from the International CIT Conference in San Antonio Texas, and I came back with a crazy feeling that I can actually help people and see the fruit of that help.

What is CIT?
CIT consists of police officers taking the lead in fixing a big shit sandwich: the mental health system, specifically the criminalization of the mentally ill. Here’s what we know:

Nationally our jails of overflowing with mentally ill people, the vast majority of which have committed relatively minor offenses.
The fiscal impact this has on state and local governments is obscene.
The cost in moral currency is greater.
Through no fault of their own a lot of cops are killing mentally ill as a result of (a) the psychotic behavior of the individual and (b) the lack of training on the part of officers about how to manage psychotic behavior. A lot more cops are getting injured as result of this lack of training. Mental health consumers also get lumped up a lot.

CIT involves police departments partnering with community mental health and advocacy groups to ensure services for those experiencing a psychiatric crisis can get treatment.
CIT officers get 40 hours of specialized training in de-escalation techniques, signs and symptoms of mental illness, local resources, the stigma attached to mental illness and scenario training.
The end result is that CIT officers actually get that crazy guy HELP instead of arresting him.

Now, that would feel kind of good I would imagine.

At 2 AM you get a call involving a mentally disturbed subject walking in traffic. When you hear the dispatch you already know it’s Ol’ Joe. You get there, sure enough Ol’ Joe’s still out of his friggin mind. His pants are soiled, he’s talking about being followed by the CIA, you get the idea. Now, you have a choice: You could transport Joe to the local mental health clinic (or have him transported there), and wait two hours for him to be admitted, OR you could take him to jail on his $200.00 warrant for peeing in public. If you’re like me, Ol’ Joe’s going to jail. And, while that solves the problem - which is our raison d’etre - it doesn’t bare much of the “helper” fruit.

CIT officers have systems in place whereby there is “no wrong door.” That means the department works out an understanding with the psych. ward (or detox center), that they’re not going to make us wait. They open the door, take Joe, TREAT HIM, and then hook him up with other TREATMENT facilities for aftercare. That way Joe gets help and doesn’t go back to jail.

The conference was inspiring. I saw a whole bunch of cops there who really had their heads and hearts in the right place. They reminded me of myself about 15 years ago. Before I became a cop I worked for eight years in a large county jail as a mental health professional. I tried my hardest to help thousands of Joes. But they kept coming back to jail. I got pretty burnt out and cynical...and that was BEFORE I became a cop. The difference between me back then and these CIT cops now (young and old) was that they actually are helping people.

Those with mental illness can recover, and we can be apart of that. That’s pretty cool.

The last speaker at the conference was especially inspiring. Dr. Frederick Frese is an expert on mental illness. He used to be the Director of Psychology at Case Western Reserve and he recently completed a chapter in a scholarly book about mental illness. He was also a Captain in the US Marine Corpse and a fluent spanish speaker. I was impressed with the guy before he even hit the stage. Dr. Frese was hilarious and self-deprecating. He stormed around the podium, made some very good impressions mixed in with the latest research on major mental illness. Did I mention Dr. Frese has schizophrenia and that he spent the better part of ten years of his life on locked psychiatric wards. I walked out of there thinking about that bumper sticker, “Don’t Believe Everything You Think.”


  1. Dear Jeff,
    My late husband was a shrink. He was the first to identify (for me) the confluence of mental illness and petty, annoying crime, during the Reagan years.

    Much later, I volunteered in the VA Mental Health ward. I saw that many of the vets there, homeless, were actually spending huge amounts of effort trying to manage their mental health (well, then poorly, then not at all). The 'get a job' scenario is not possible when your security and your mental health management are always so contingent.

    Any program that gets their treatment faster and in a secure environment is going to cut down on misery for everyone as well as crime. What a great program.

    Plus, to your main point, it's always better for morale to work in a system that's not predestined to fail. Good post.

    Ann T.

  2. It has been heartening to see departments focusing more on how best to deal with the mentally ill. I've been privileged to witness training sessions for officers presented by NAMI (the National Alliance on Mental Illness) on this very topic, and I've been impressed.

    I might note that this kind of training has a side benefit, as well, by enabling officers to deal far more effectively with citizens who are dealing with a variety of life issues and stressors. They don't fall into the "mentally ill" category but, for a certainty, often benefit from many of the same techniques.

    Andy O'Hara
    Badge of Life

  3. Dear Jeff:
    I am not certain that I met you at the CIT Conference in San Antonio. I know I heard your name, "Shannon", being mentioned more than once during various conversations, quite favorably as I remember. I want to thank you for taking the time to write so very positively about your impression of the San Antonio gathering. I find so much enthusiasm among the attendees at the conference each year. Obviously I also want to thank you for your favorable comments about my closing presentation. Frankly, I am never really sure how my message is being received and I very much appreciate seeing your feedback about my talk as part of your overall description of the event. Again, thank you so much for attending and for taking the time to document your reaction to your experience in San Antonio. I am sure your words mean a lot to the many hard-working, good-hearted folks who have put CIT where it is today, and also to me, who really only has been an admiring by-stander, applauding the work of the early CIT founders and those who have been helping them during the past decade. All the BeST, Fred Frese

  4. I had CIT training a few months ago, and it was absolutely phenomenal. It literally took me to a different perspective in handling calls. We are trying to have as many people as possible attend the training. You are absolutely right that it can prevent many bad outcomes that are completely unnecessary.

  5. A crisis intervention method will work with all clients, or even all the time with any one client. There are so many different family structures, compositions, and culturally related belief systems.Florida Intervention Services