Mental Health and Police Interactions in Utah
The Utah Bee sat down with three members of our community who are specially trained to deal with mental health crisis situations to talk about how law enforcement engages with the public during these events.
Ron Bruno is the Director of CIT Utah and the Executive Director of CIT Utah Incorporated. He is also the VP of CIT International and has been a Utah Law Enforcement Officer for more than two decades.
Christine Nelson is the Supervisor of the Mobile Crisis Outreach Team of Washington County. She is the CIT Regional Coordinator representing mental health in Washington County. Christine also sits on the Advisory Council for CIT Utah. She has been working in mental health for more than twenty-five years.
Roger Nelson is a Therapist at Southwest Behavioral Health Center and is a Member of the Mobile Crisis Outreach Team of Washington County. He has over twenty-five years of specializing in mental health issues among Utah’s youth, specifically in autism spectrum disorders, transgender issues, substance abuse and family cohesion.
What kind of training does an officer get at the police academy to specifically deal with mental health calls?
Ron: It has changed over the years, but even when I was trained, over 20 years ago, I had mental health training at the police academy. Over the years it has evolved. There is more training now.
We are finding that if you teach de-escalation tactics as a stand-alone skill and talk about it from an officer-safety aspect, not from a you-need-to-get-these-people-help aspect, it is well received.
Christine: Best practices state that when you first go through the police academy, you learn basic skills to deal with mental health calls and de-escalation. But then you should get your feet under you as an officer, understand what police work is, get a couple of years of experience, and then return for advanced Crisis Intervention Team (CIT) training.
Ron: Yes, there are sources that discuss the benefits of not training all officers in CIT skills. This white paper was put out by the National Council and CIT International discussing best practices of not training all officers. Here is another in the IACP’s One Mind Campaign that addresses the same issue.
What is Crisis Intervention Training (CIT)?
Ron: CIT is a program that started in Memphis that creates teams of people made up of law enforcement officers and mental health specialists who have specific training to respond to calls with mental health issues present.
At the turn of the century, CIT’s introduction to Utah was triggered by two shooting incidents in downtown Salt Lake City. The National Alliance of Mental Illness (NAMI) Utah director approached the Division of Substance Abuse and Mental Health who then joined. They approached Salt Lake City PD to talk about how law enforcement responds to these situations.
When it began, members of law enforcement services were being trained from all over the state. They were learning the de-escalation skills, but they were not forming partnerships with behavioral health services in their own areas. We realized CIT needed to be taught on a regional basis. St. George Police Department and Southwest Behavioral Health helped pilot a regional program. It was successful, and the program has spread across the state of Utah.
When do mental health specialists get called out to be involved in incidents?
Ron: What we need to do is have every officer understand and utilize de-escalation techniques. We need to make sure that every officer has the skills to identify somebody with a behavioral health issue to de-escalate that situation. Then, we want that officer to reach out to a CIT officer who has such knowledge about the resources. That it’s not just, “I need to have this person get the help at this building,” but to the point that he thinks, “ I need to have this individual work with a specific social worker.” And then he can call that social worker and say, “Chris, can you work with this individual? This is what I’ve got; what do you recommend I do at this very moment?” That is the kind of relationship we want between a CIT officer and a mental health professional.
Christine: All officers should have de-escalation training while at the academy. During an extended incident, any officer on site can determine that de-escalation alone is not working and that a CIT officer is needed. The officer can have one called out. At that point, the CIT officer will determine if additional help is needed and can call out a specific mental health professional or professionals who can become a part of the ongoing solution for this person.
Ron: Mobile Crisis Outreach Teams (MCOT) take two individuals, a clinical specialist such as a Licensed Clinical Social Worker (LCSW) and team her up with a peer specialist, and the two become a team. The thing that is really cool about that is that now those MCOT teams respond to hundreds of calls for service. If we did not have them, police would have to respond. They are being called out in place of police and in addition to police officers.
CIT officers actually get to know the members of the mental health community. So, they know the families, they know the individuals, they know the needs, and trust can be built. Is that correct?
Christine: Yes, we go out and do safety plans that are specific to each person. One of the best things we can do for a family that has complex mental health needs is to put a team together to help them. So, we organize with community members: a neighbor, someone from the school, someone from the police department, a therapist, someone from Division of Services with People with Disabilities (DSPD), a bishop or a priest. I’m going to need whoever their people are.
You bring in people beyond the police department and even beyond mental health specialists; so, when a situation flares up, you have resources to call on.
We start families with really formal resources and supports, but we are working to move them toward independency, and we are moving them toward informal support.
Roger: The more that an individual or family is dependent on formal resources, the higher the cost. The more that family can rely on informal support: family members, clergy, neighbors, the less expensive the care and support for that family.
When you respond to calls of youth with mental health issues, is it different than responding to adults with mental health issues?
Christine: I think so. I think you have the same presenting problems, but I think we do more with kid gloves.
Roger: Yeah, there are a couple of elements that are a little bit different. Adults have certain rights that kids don’t have. Kids will have a custodial parent who is also a party to what’s happening, versus an adult presenting symptoms who has rights independent from what their family wants from them.
Ron: And from a law enforcement side, yes, there is a difference, because you have a developing brain, which is completely different to deal with. Youth are used to having authority figures telling them what to do. When you go out with an adult, it can be such a conflict right off, because there is not that expectation.
If you have a family member with a mental illness, how can you get in front of a possible situation with police?
Ron: Family members can call most law enforcement agencies and ask them to flag their address for specific issues. The number you would call regarding a non-emergency mental health issue would be your local mental health authority’s Crisis Line number. It is different in each region. However, the University Neuropsychiatric Institute’s (UNI) crisis line number is available for the entire state if no other crisis line is available 801-537-3000.
The Unified Police Department of Salt Lake County has an autism registry, which means that family members of autistic children can go to these agencies and ask, “Can you put this into the data base?” To do that you can call into your local non-emergency number or there is an online registry found here.
This is a video for training law enforcement on how to interact with autistic citizens. There are also helps regarding how citizens can help law enforcement keep families members with mental illness safer.
The Utah Bee will follow up on this important topic. If you disagree with this article or have something to add, let us know!
This is the first article in the series on this subject. Additional articles will link back to others already posted in this series. If you feel that there is something missing from this ongoing conversation that you would like to contribute please feel free to submit an article.