Cops and the Mentally Ill


Newly minted New Windsor (NY) police officer Frank Pierri Jr. got the call on his second day on the job.

Someone was in mental distress, uncooperative—and refused to open the door when police arrived.

But Pierri had a weapon in his arsenal that most cops don't.

In the police academy, he underwent 40 hours of crisis intervention team training, learning about mental illness and its manifestations, learning how to defuse tense situations, and about the resources available (in the region) to people with mental illness.

Instead of yelling or using force to gain entry, Pierri started talking, getting the person to tell him about the problem that had triggered the distress.

“It automatically kicked in, what to do, how to speak,” Pierri said.

The person was in the throes of medical and alcohol-related crises.

“The more we talked, the calmer we all were,” Pierri said, adding that police were able to convince the person to go voluntarily to a hospital for treatment.

“Everything we learned translated right onto the street.”

As the number of psychiatric hospital beds has dwindled over the years, police have increasingly become the front-line responders for people with serious mental illness. Interest in crisis intervention team training – known as CIT – has surged in recent years as law enforcement and mental health officials have looked to change a system that essentially criminalizes mental illness.

“We're advocating to make it part of the mandatory (state) training for police officers,” said Port Jervis Police Chief William Worden, head of the Orange County Police Chiefs Association. “It's really an attempt to provide professional and proactive resources to people in need.”

New Approach

In New York's Orange County, police and mental health officials are looking to divert people with mental illness out of the criminal justice system. The path to doing that involves close cooperation among law enforcement, mental health and social services.

City of Newburgh police got a grant to provide CIT training to officers. Orange County is working on a program – known as sequential intercept – that brings together all the players in the mental health and criminal justice systems to coordinate services and get people out of lockup and into treatment.

And at the Orange County Police Chiefs Association Police Academy, they've parlayed a $10,000 grant secured by [New York State] Assemblyman James Skoufis into CIT training for the past two schools of new recruits from departments in and around Orange County, with a third planned for fall.

The academy has trained about 80 current and new police officers in CIT. The number will climb to about 120 by the end of the year, said New Windsor Lt. Frank Pierri Sr., the academy director.

Encounters between police and people with severe mental illness are notoriously risky, said Darcie Miller, Orange County's commissioner of social services and acting mental health commissioner, and everyone wants to reduce the risks.

The Treatment Advocacy Center, a national non-profit based in Arlington, Va., which seeks to eliminate barriers to treatment for severely ill people, issued a study in 2013 on justifiable homicides by police based on Department of Justice data that found roughly half of the people shot and killed by police annually suffered from mental health problems.

The Washington Post, which is tracking fatal police shootings, found that in the first six months of 2015, there were 462 such fatalities, of which 124 involved someone having a mental health or emotional crisis. In the majority of cases, the Post found, police were responding not to a crime, but to a call about erratic behavior.

Such encounters often become violent unnecessarily, said former New Windsor Police Chief Michael Biasotti, who's also vice president of TAC and has helped with its studies. “A lot of times, it depends on how the mentally ill person interprets the actions of the officer.”

Police don't always know what awaits them at a call.

“Many calls start out as just a general 'disorderly person' call,” said Sgt. Richard Carrion of the City of Newburgh Police Department. “There are many people we encounter in the community that wouldn't rise to the level where we can take them for (emergency) evaluation, but they're still suffering from mental illness.”

For instance, someone who is having a psychotic episode, said Peggy Spagnola, Vice President of NAMI-AMICO, Orange County’s affiliate of the National Alliance on Mental Illness, which advocates for people with mental illness and their families. Someone in such an episode may hear voices commanding them to do things, and may not be able to follow what police are saying.

“When the police come, if they don't know it's a mental illness, they don't know what to expect,” said Spagnola, who also contributes to the CIT training. With CIT training, “they know how to talk them down instead of escalate.”

“It's about body language and openness and empathy,” Carrion said. “It increases the safety of the officer, the safety of the mentally ill person, the safety of the mentally ill person's family.”

Likely Victims

The bulk of people with serious illness are significantly more likely to be victimized than to commit an offense. Those who do end up in jail have usually been charged with petty offenses, Biasotti, Carrion and others agree.

Appropriately diverting people with mental illness out of the criminal and juvenile justice systems is a hallmark of CIT training, said psychologist Don Kamin, the chief of clinical and forensic services for Monroe County's Office of Mental Health, a master trainer on mental health curriculum for police, and director of the state's newly formed Institute for Police, Mental Health and Community Collaboration.

“It helps the police handle mental health crises, and it really makes the mental health system more accessible and more understandable to everyone,” Kamin said. “It's a needless expenditure to put these people in jail.”

…Newburgh city police average about a dozen mental illness-related calls per week, Carrion said, although not all are in crisis.

“Hospital beds are in such short supply today that when a mentally ill person is brought in for treatment, the doctor in the emergency room has to triage, and say 'I've got 10 beds that are full and five people in the emergency room who need treatment.' They get treated quicker and released sicker than they would if there were enough beds,” Biasotti said. “We're lucky if they're held 72 hours.”

In 1955, at the peak of hospitalization, there were 558,992 in-patient beds in state hospitals in the U.S. for people with severe mental illness. By 2005, the number had fallen to 50,509. By 2010, another 14 percent of those beds had been cut by the states, according to the Treatment Advocacy Center.

There are, in the U.S., 10 times as many people being treated for mental illness in jails or prisons than in hospitals, Biasotti said.

Local police and mental health groups view CIT training as a way to stem the tide, by giving cops a way to refer people in need to other resources.

“The communication and de-escalation skills you're learning, you don't have to just use them on people with mental illness,” Carrion said.

“Any time you don't have to put hands on people, the community appreciates it.”

…Experts are divided on whether CIT training should be part and parcel of basic police academy training or a specialized training for specialized units. Kamin strongly advocates the latter because he believes officers need experience to effectively judge real-world situations.

In a final report completed in May, the President’s Task Force on 21st Century Policing recommended that CIT be as part of both recruit and in-service training for all officers. Orange County is forging ahead.

“Doing it in basic school makes it part of the culture,” Biasotti said.

Dealing with people comes with the territory of policing.

“Part of our job, for better or worse, is social work,” Carrion said. “You can't arrest your way out of every problem.”

Heather Yakin, a reporter for the Middletown (NY) Times Herald-Record, is a 2014-2015 John Jay/Langeloth Health and Justice Reporting Fellow. This is an abridged version of part 1 of a two-part series completed as part of her fellowship project. For the full article, and part two, of the series, please click HERE. Heather welcomes readers' comments.

Comments are closed.