Training for Mental Health Response

Scanning the news over the past few months we have noticed a growing uptick in the number of stories involving first responders and calls involving Mental Health Issues. This got us wondering: What is going on? Are these types of calls for service being placed in a new category? Have they been underreported in the past due to negative public perception? Is mental health (finally) being recognized as a true health issue, not a social issue among the less fortunate in our society? We were shocked and amazed at what we found.

Shocking Stats

One in four adults and 10 percent of children in the United States will suffer from a mental health illness this year. Mental disorders are more common than heart disease and cancer combined — the leading causes of death.

Among all Americans, 36.2 million people paid for mental health services totaling $57.5 billion in 2006. This means the average expenditure per person was $1,591. Within this group, 4.6 million children received mental health services totaling $8.9 billion. The average expenditure per child was higher than that for the average American at $1,931.” NIMH

“You’re more likely to see someone having a panic attack than you are to see someone having a heart attack,” says Linda Rosenberg, CEO of the National Council for Community Behavioral Healthcare (National Council).

First A Definition

Dictionary.com defines the term “first aid” as emergency aid or treatment given to someone injured, suddenly ill, etc., before regular medical services arrive or can be reached.When you add the words “mental health” in front of it, it doesn’t necessarily change its meaning, it simply redirects it towards assisting someone who may be experiencing a mental health crisis–such as helping an individual who is having a panic attack, contemplating suicide or has overdosed on drugs or alcohol. (EMS World)

The National Impact of Mental Health Disorder

    • Approximately 5 percent of U.S. residents have a serious mental illness,and 10 to 15 percent of jailed people have severe mental illness.[2]
    • An estimated 7 percent of police contacts in jurisdictions with 100,000 or more people involve the mentally ill.[3]
    • A three-city study found that 92 percent of patrol officers had at least one encounter with a mentally ill person in crisis in the previous month,[4] and officers averaged six such encounters per month.
    • The Lincoln (Nebraska) Police Department found that it handled over 1,500 mental health investigation cases in 2002, and that it spent more time on these cases than on injury traffic accidents, burglaries, or felony assaults.[5] 
    • The New York City Police Department responds to about 150,000 “emotionally disturbed persons” calls per year.[6]

Common Response Solutions

Responders (police, firefighters and EMTs) encounter people with mental illness in many different types of situations, in roles that include criminal offenders, disorderly persons, missing persons, complainants, victims, and persons in need of care. According to one Texas study,[7] the five most frequent scenarios are as follows:

    • A family member, friend, or other concerned person calls the police for help during a psychiatric emergency.
    • A person with mental illness feels suicidal and calls the police as a cry for help.
    • Police officers encounter a person with mental illness behaving inappropriately in public.
    • Citizens call the police because they feel threatened by the unusual behavior or the mere presence of a person with mental illness.
    • A person with mental illness calls the police for help because of imagined threats.

These are the most common situations in which responders encounter people with mental illness. It is important to realize, though, that when police officers handle some of these situations they do not always realize that mental illness is involved (such as a shoplifting or a disorderly person). Officers may try to handle the situation as usual (by giving directions, issuing commands, or making an arrest, for example) but not get the cooperation or compliance expected, sometimes leading to escalating tension. This highlights the importance of training in mental illness recognition as well as crisis management techniques.

Other Related Problems

Problem of people with mental illness is closely connected to three other problems; 1) Homelessness, 2) Drug Abuse, and 3) Alcohol Abuse- Here are several statistics:

    • Honolulu study found that 74 percent of law violators who the police believed to have a mental disorder were also homeless.[15] 
    • In London, about 30 percent of minor offenders referred for admission to a station-house diversion program for the “mentally disordered” were living on the streets.[16]

Solutions

Mental Health First Aid is a groundbreaking public education program that helps the public identify, understand, and respond to signs of mental illnesses and substance use disorders. Mental Health First Aid USA is managed, operated, and disseminated by three national authorities — the National Council for Community Behavioral Healthcare, the Maryland Department of Health and Mental Hygiene, and the Missouri Department of Mental Health. So far, 60,000 people have been trained in 43 states and Washington, D.C. There are 2,100 trainers, says Meena Dayak, council vice president of marketing and communications.

Participants in the training learn how to detect a number of mental illnesses — including schizophrenia, bipolar disorder, psychosis, substance use disorders, depression, anxiety and eating disorders — and how to respond to people who have them. Their response is guided by a five-step action plan, termed “ALGEE,” which stands for:

    1. Assess for risk of suicide or harm.
    2. Listen nonjudgmentally.
    3. Give reassurance and information.
    4. Encourage appropriate professional help.
    5. Encourage self-help and other support strategies.

One of the program’s main goals is to erase the stigma associated with mental health illnesses. “It wasn’t long ago that cancer wasn’t openly spoken about,” says Linda Rosenberg, CEO of the National Council for Community Behavioral Healthcare (National Council). “Mental illness is the last illness that people talk about in whispers.” But that will change, she says, once Mental Health First Aid becomes as common as CPR training — something she sees as inevitable.

Crisis Intervention Training (CIT)

CIT Training is a training program developed to help police officers react appropriately to situations involving mental illness or developmental disability. There are two nationally recognized organizations supporting CIT programs. Both organizations recognize the need for first responder mental health training. Suicide attempts and mental health crisis concerns are recognized as a priority. The organizations have established programs for disseminating recommended standards for developing, implementing and sustaining crisis intervention programs.

CIT Success Stories

    1. Las Vegas Metro Officer named CIT Officer of the Year – Brooke Lavin
    2. Every department in Maine “should strive to maintain at least one CIT officer per shift,”
    3. Mental health squad backs up law enforcement

Mental Health Response, Recent News

    • The NYPD’s Poor Judgment With the Mentally Ill—The death of Shereese Francis has rekindled a decades-long debate over the NYPD’s treatment of the mentally ill. As the first responders to all sorts of emergency calls, police officers are on the front line for just about every social problem in the city, and mental illness is no exception. The department estimates that it handles nearly 100,000 calls for “Emotionally Disturbed Persons” every year—hundreds a day. Every few years, one of those calls goes so badly that somebody dies. (continue…)
    • School Student was BipolarThe family of a Cal State San Bernardino graduate student who was fatally shot by campus police Saturday released a statement late Tuesday confirming that the man was bipolar and enrolled as a disabled student when he was killed. (continue..)
    • Officer Sentenced In Death Of Man With Mental Disabilities—A police officer was sentenced Thursday to more than four years in prison for using excessive force against a mentally disabled janitor who died after being erroneously suspected of stealing money from an ATM. (continue…)
    • Houston cops accused of deadly force on unarmed, disabled man“The Department of Justice announced on Wednesday that its civil rights division is investigating allegations that Houston police officers used excessive force against unarmed suspects including the killing of an emotionally disturbed, double-amputee.” (continue…)

For more in-depth research and study on Mental Health we encourage you to visit and read the following excellent reports.

  1. People with Mental Illness / Center for Problem-Oriented Policing (COPS) – http://www.popcenter.org/problems/mental_illness/print/
  2. Governments Discover Need for Mental Health First Aid / www.Governing.com
  3. World Health Organization report “Human Resources And Training Mental Health
Endnotes:
[2] Lamb, Weinberger, and Gross (2004): 108. [Abstract only]
[3] Deane et al. (1999). [Full text]
[4] Borum et al. (1998): 401. [Abstract only]
[5] Lincoln Police Department (2004).
[6] Waldman (2004). [Full text]
[7] Peck (2003): 6. [Full text]
[15] Green (1997): 476.
[16] James (2000): 538.

 


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