The Autism News

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By: JO CIAVAGLIA | Bucks County Courier Times

Police in four Bucks towns soon will be trained in a jail diversion program designed to prevent violent interactions between cops and people with mental illness.

The strange voices that Julie hears four hours a day are sometimes loud and overlap making it hard to focus when other people, like police officers, are speaking to her.

Julie has schizoaffective disorder, a common chronic mental illness that can result in suicidal or manic behaviors. A few times when she experienced a mental break, police were called.

Seven years ago, four police officers barged into her hotel room, she said. They were screaming orders, which scared Julie since she didn’t think she was doing anything wrong.

The next thing she knew, the officers surrounded and handcuffed her and dragged her out of the hotel.

“It was very embarrassing and demoralizing,” said Julie, who didn’t want her last name used. “It was a terrible experience.”

Also a common one for people with mental illness or brain disorders such as autism spectrum disorder who find themselves on the wrong side of the law, mental health advocates say. Such police interactions have the potential to escalate quickly, putting at risk police and the individuals.

To avoid these scenarios, four Bucks County police departments are piloting a program used in more than 500 communities nationwide called a Crisis Intervention Team, or CIT. The jail diversion program is designed to improve police interactions involving people with mental or brain disorders.

Bensalem, Bristol, Bristol Township and Northampton patrol officers will be the first in the county formally trained in CIT later this year, according to county officials. The officers already have completed an introductory session during which they heard people like Julie talk about their police encounters.

Since February, three fatal shootings by police have occurred in Bucks County, all later determined as justified. The most recent involved a Middletown police officer who killed a brick-wielding man who had first assaulted a teen outside the Oxford Valley Mall in April.

Police later learned that Tommy Lovett, 21, had a history of learning disabilities and had served two years of probation for assault charges two years earlier for a similar attack at a group home where he lived.

The Memphis Police Department was the first to create a team of trained officers who respond to mental crisis calls. The model emerged from a partnership between the police, the city’s National Alliance on Mental Illness chapter, mental health providers and two universities.

Since the model was adopted in 1988, only two Memphis officers (who had no CIT training) have shot mentally ill suspects. The department also has seen significant declines in mentally ill individuals in jail custody, injuries among police officers and people with mental illness, and involuntary commitments.

The Bucks County CIT task force was created last July after almost two years of groundwork, including meetings with local mental health and law enforcement officials and families.

In conjunction with its implementation, the county has started enhancing mental services, including expanding crisis center hours, hiring more crisis center security and a nurse practitioner who can prescribe medications, which could avoid an involuntary mental health commitment.

County officials hope the CIT program can relieve some of the overcrowding in the county prison by removing people with mental or behavior disorders who would be better addressed in a treatment setting.

Mental health workers regularly identify county inmates with serious mental illness, and in many cases their criminal charges can be directly connected with their illness, said Bernard McBride, director of the county’s behavior health system.

In the last year alone, McBride knows of three county criminal court cases involving police encounters with adults with autism disorders.

An estimated 4 percent to 8 percent of county prisoners have major, chronic mental illness or other brain disorders, said Harris Gubernick, Bucks County prison director. While a low number, managing them requires the most time and resources, Gubernick said.

“That doesn’t mean everyone with a mental health problem doesn’t belong here,” he added. “It’s knowing which one is which.” Learning curve

The calls that cops say they dread the most are the involuntary mental health commitments, better known as a 302.

The confrontations are unpredictable. The individuals are irrational, unstable and uncooperative. If the calls occur when mental health provider offices are closed, police are left with only two options: arrest or commit to a short-term psychiatric hospital. But the involuntary commitment process can take hours, which takes the officer off the street.

“It’s easier to get a commitment for a crime than to get them into the hospital,” Gubernick said.

This is how people experiencing a mental crisis end up in jail, mental health advocates say.

Also, how police approach a situation involving a person in crisis can inadvertently escalate tensions, mental health professionals and advocates say.

Police are trained to quickly take control of a crime scene, but shouting orders and directions can heighten feelings of paranoia and defensiveness, especially if the person is delusional, mental health professionals say. People with mental disorders may avoid eye contact, which police could interpret as deceitful or disrespectful. Police could have prejudices or stereotypes about mental illness too.

What CIT training does is give police officers a deeper understanding of the major mental illnesses and developmental disabilities, symptoms, medications and techniques for deescalating situations, said Bensalem Director of Public Safety Fred Harran, who has undergone CIT training.

“Mental illness is a disease; it’s not something they can shake off,” Harran said.

Bensalem has responded to an increasing number of calls involving mental illness recently. The calls increased 11 percent between 2007 and 2008, and, at the current rate, could rise 18 percent this year, Harran said.

The training emphasizes creating closer relationships between law enforcement and the mental health system so they can work together and direct a person into treatment, and if appropriate, avoid criminal charges.

Bucks County NAMI chapter member Agnes McFarlane doesn’t believe many police realize how their actions are interpreted those experiencing a mental break.

“They just don’t always understand what is going on. They take it as disobeying their order or resisting.” said McFarlane, who also serves on the CIT task force. “People who don’t have that experience in the family or study it or treat people, they don’t know what to expect.”

Keep calm

Most who have police run-ins describe the experience as negative, said Julie, a peer support counselor at Lenape Valley Foundation, the county’s crisis mental health service provider and a CIT task force member.

To understand the mind of a person experiencing a psychotic break, think about how you feel when a police car is following you, she said. If you feel nervous and anxious, imagine hearing voices or having hallucinations, too.

If the person is paranoid, an aggressive, approaching officer might elicit a defense response. Police sirens can be scary and distracting. Memory lapses are common.

“When someone is in a psychotic state of mind, they have a hard time following directions so police may need to repeat themselves,” she said.

At introductory trainings, Julie has told police officers that speaking calmly and using simple, direct statements is the best approach. Don’t lie. Don’t be in a hurry. Don’t treat the person like a child. Talk directly to the person, not just their family or friends.

Simple advice, but it does work, she said.

A few years ago – when Julie had another psychotic break – the police officer who appeared at her door had a smile on his face. He introduced himself, explained why he and the other officers were there, and asked Julie to go with them. He even used the word, please.

“I wasn’t afraid at all,” she said. “I know it’s hard to go into a potentially dangerous situation with a smile on their faces, but smiling and a calm demeanor might help sooth the person.”

Source: http://www.phillyburbs.com/news/news_details/article/262/2009/july/05/training-police-to-think-differently-about-mental-illness.html

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