Crisis Intervention Team (CIT) Training
TUCSON POLICE DEPARTMENT LESSONS IN BEHAVIORAL HEALTH COLLABORATION Arizona Problem Solving Courts Conference Prescott, Arizona April 28, 2015 TUCSON POLICE DEPARTMENT Captain Paul Sayre Sergeant Jason Winsky 27 years law enforcement experience 10 years law enforcement experience Oversee TPD’s Central Investigations Division Supervises the Mental Health Investigation and Support Team (MHIST) Helped develop MHIST team, currently oversee MHIST Unit Prior SWAT Commander LAW ENFORCEMENT LINK TO BEHAVIORAL HEALTH SYSTEM Kate Lawson Criminal Justice Manager Team assists individuals in crisis and/or with mental health disorders, wherever they are in the criminal justice system: court, jail, prison, probation, etc – including law enforcement 12 years experience in intersection of criminal justice and mental health BIG PICTURE TOPICS COVERED IN TODAY’S PRESENTATION Concept: How can law enforcement, within it’s scope and mandate of community protection, work with individuals in crisis or with a mental health disorder to improve public safety? Catalyst for Change: Legal Issues Impacting Law Enforcement Interactions with Individuals with Behavioral Health Concerns …Resulted in: Mental Health Investigative Support Team (MHIST) – Tucson Police Department …And how it Fits into the larger continuum of Crisis and Behavioral Health Systems Crisis Intervention Team (CIT) Training vs. Mental Health First Aid (MHFA) Training COURT RULINGS Regarding Law Enforcement and “Emotionally Disturbed Persons” EMOTIONALLY DISTURBED PERSON (EDP) EDP Court’s language Terminology for anyone who has a mental illness or is in some other way inhibited/incapacitated by crisis GLENN V. WASHINGTON COUNTY (2011) Hillsboro, Washington County – 2006 18 year old Lukus Glenn, a popular high school athlete, was intoxicated and distraught over a recent break-up Returned home at 0300 Angry, intent on riding his motorcycle Parents would not let him leave the house He began damaging property, including doorway that led out to the garage Prior to this event, Glenn had no history of violence or criminal activity GLENN V. WASHINGTON COUNTY Glenn held a 3 inch pocketknife to his neck and threatened to kill himself Mom called 911believing that “the police would have the expertise and experience to deal with an emotionally distraught teenager.” Call was dispatched as an armed domestic violence incident. GLENN V. WASHINGTON COUNTY Based on dispatch of “armed DV situation” Deputy goes directly to the house without conferring with other officers on scene or en route Deputy finds family sitting with Glenn, who still has knife at his neck Mother tells dispatcher “Don’t let him shoot him… They’re going to shoot him.” Second deputy arrives and begins shouting at Glenn, like first deputy, “Drop the knife or you’re going to die!” Second deputy also presented as “frantic and excited” and “only pursuing a course of screaming commands at Luke”. GLENN V. WASHINGTON COUNTY Family implored deputies to calm down Deputies ordered family to go back inside the house Sergeant radioed deputies to say “Remember your tactical breathing” Ordered a officer from neighboring department to “beanbag him” Lucas defensively retreats from direction of beanbag fire GLENN V. WASHINGTON COUNTY Deputies had independently determined if Glenn moved towards the house they would use deadly force Glenn (taking cover from bean bags) ran from garage towards only exit—the house Because he was headed toward house, where the other family members had been told to go, officers used deadly force Deadly force occurred less than four minutes after the first deputy arrived on scene Seconds before he was fired upon, Glenn said “Why are you yelling?” and “Please tell them to stop screaming at me!” GLENN V. WASHINGTON COUNTY Glenn bled out and died on the family porch within minutes. In 2007, Washington County Sheriff Rob Gordon released their results of their shooting board and determined No policies had been violated and “WCSO deputies involved in this incident performed as trained, followed established policies, and acted in a professional manner.” GLENN V. WASHINGTON COUNTY Court’s decision…. “…we have made it clear that the desire to quickly resolve a potentially dangerous situation is not the type of governmental interest…that justifies the use of force that may cause serious injury (Deorle).” “We also recognized in Deorle, that when dealing with EDP’s who is creating a disturbance or resisting arrest, as opposed to a dangerous criminal, officers typically use less forceful tactics.” (notice the change in language) GLENN V. WASHINGTON COUNTY Ruling, continued: “The facts in this case, viewed in the light most favorable to the plaintiff, bear this out: Lukus did not respond positively to the officers’ forceful tactics, and just before officers fired the beanbag gun, Lukus pled, “Tell them to stop screaming at me’” and “why are you yelling?” The Court now expects a differentiated response from law enforcement. Or… “No excuse now – train your officers” LESSONS LEARNED FROM GLENN The Family hired a Subject Matter Expert, a former Bellevue, Washington Chief of Police. His professional opinion forms the basis for what should be our response to these situations with EDPs: 1. Slow it down, 2. Do not increase the subject’s level of anxiety or excitement, 3. Attempt to develop a rapport, 4. Time is on the side of the police SHEEHAN AND HAYES 9th Circuit Opinions Duty to Care-Now Extends to Actions PRIOR to critical incident ADA Application-If Upheld, Will Change American Policing Forever SO – ON ONE HAND WE HAVE NEW EXPECTATIONS ON USE OF FORCE… BUT – ON THE OTHER HAND, GROWING PUBLIC SAFETY CONCERNS… CREATION OF THE MENTAL HEALTH INVESTIGATIVE SUPPORT TEAM MHIST TYPICALLY POLICE HAVE TO BALANCE THE TWO... Public Safety Community Service …MHIST SEEKS TO FIND SOLUTIONS FOR BOTH Community Safety Accountability Treatment Recovery CREATION Pima County Sheriff’s Department – 2013 Tucson Police Department – 2013 Teams: Sergeant Detective(s) Patrol Officers (Transport) WHY Law enforcement recognized the need to take a different approach to mental health issues related to law enforcement The wave of mass shootings and the increased mental health related calls served as a catalyst for taking a fresh look PURPOSE Public Safety Community Service Risk Management But also… It’s the right thing to do. FUNCTION Mental Health Court Order Transports “Title 36” in Arizona Specialized training to avoid going hands-on Locate/transport before order expires Investigations Circumstance code Patterns of behavior Problem-solving with mental health treatment Title 36 petitions MHIST = CIT PHILOSOPHY IN ACTION Has to be a better way to approach problem Need to Decrease risk to officers/deputies Decrease risk to community Decrease waste of taxpayer dollars BREAK THE CYCLE MHIST AREA OF INTERVENTION Law Enforcement Many people suffering from mental health issues fall between the cracks of the system They always become the burden of law enforcement MHIST Justice System (Courts) Behavioral Health OUT WITH THE OLD… Old Way New Way Patrol Officers Serving COE Orders 100 % service rate on mental health orders Court Ordered Evaluations orders served before expiring = 30% Patrol officers would look for the quickest, easiest solution to a situation with a mental health nexus Often resulting in arrest and incarceration As a result, the Pima County Jail is now the largest behavioral health facility in southern Arizona The problems continue Mental health facilities and providers communicating with law enforcement One central location for patrol to go to for answers to problems Law enforcement talking to law enforcement CALL TRIAGE Calls where there is not a threat to public safety (danger to self) are handled as they always have been-referred to the appropriate mental health provider Voluntary committal Involuntary committal Referral to various providers Calls for service where there is a criminal component, and the person is a threat to others (public safety) Routed to the MHST Unit for follow up A full criminal/mental health investigation is conducted where appropriate A unique 2-pronged process is initiated MHST INVESTIGATION SUCCESSES “Jose” Jose is a Marine veteran and a student at Pima Community college Jose perceived he was assaulted in the school library (unfounded) He began making threats towards PCC personnel Outcome Kept out of jail Compliant with treatment SUCCESSES “Maria” Young woman in her 20s, lives at home with her parents Tucson City Court – Mental Health Court Diversion (misdemeanor charges) Repeatedly calls 911 requesting transport to the Crisis Response Center Find that she is bored and wants out of the house TPD participate in Adult Recovery Team (ART) meeting, along with treatment provider Develop crisis plan that includes TPD differentiated response WITH A CIT TRAINING PROGRAM + A MENTAL ILLNESS/CRISIS RESPONSE PROTOCOL A Best Case Scenario But If the Outcome Is Bad Anyway… Officer is able to de-escalate the situation Officer should be able to say: Person is taken to crisis center and/or referred to community treatment “I am knowledgeable of and considered use of de-escalation techniques and community resources. Financial Savings I still could not have handled the situation any other way.” “Breaking the Cycle” – avoid future interactions Positive Community Policing Officer time Jail Days Criminal Case Proceedings Avoid going “hands on” Improved liability Improved safety PREPARING ALL OFFICERS FOR SOME PREPARING SOME OFFICERS FOR ALL Ensuring behavioral health and crisis training needs are met for public safety AUDIENCE POLL How familiar are you with CIT? Do you have a CIT program in your community? Who facilitates? How long is the training? How familiar are you with Mental Health First Aid (MHFA) training? CONTINUUM OF MENTAL HEALTH TRAINING CIT & MHFA PHILOSOPHY All Officers receive basic mental health training (Example: MHFA) De-Escalation & Crisis Intervention Mental Health Basics & Community Resources Some officers receive intermediate (Example: CIT) Voluntary Participation Aptitude for the Population Specialized Units – Advanced Training SWAT Negotiators MHIST Teams COMPARING MHFA & CIT – TRAINING FOR EVERY STAGE CIT MHFA “Advanced” Training Introductory Officers with 18+ months patrol Appropriate for academy and new officers Relies on experience on the street to provide context Voluntary Can be made mandatory training for all officers and employees No history of discipline related to excessive force within last three years Certified instructors through National Council required 40 hours 8 hours CORE ELEMENTS Voluntary Not “charm school” No history of excessive force within 3 years Some patrol experience 18 months+ recommended No academy/post-academy MHFA Fidelity to Memphis Model IS OBJECTIVE OF CIT TO ALWAYS USE DEESCALATION? No, purpose of CIT is to give experienced officers: TOOLS FOR THE TOOL BOX Objective: Provide skills to be able to de-escalate individuals and situations, when appropriate Does not override tactical training Officer and citizen safety is always paramount MENTAL HEALTH FIRST AID (MHFA) Established in 2001 in Australia Like CPR, designed to be quick response for emergent situations “First responder” 8 hours Includes certification Specialized modules Law Enforcement Veterans Spanish RESULTS SUMMARY Law Enforcement Training Specialized LE Teams (MHST) A responsive Crisis System Facility 24/7/365 phone line MAC teams Communication between Law Enforcement, Criminal Justice System & Mental Health Treatment Support & Buy-In from Consumers & Advocates (NAMI) WORKING AT AN INTERSECTION – NOT A PARALLEL Behavioral Health working with Law Enforcement to Achieve Better Outcomes for Clients WHOSE GOAL – TREATMENT, OR POLICE? Productive Citizen Engaged in Treatment CHANGING OPINIONS - CHANGING LIVES “If a mentally ill person has done something wrong, they should go to jail” “When a mentally ill person is arrested, it represents a failure of the mental health system.” “I’m not going to help the police catch my client.” GOALS OF BEHAVIORAL HEALTH TREATMENT NOT AT ODDS WITH JUSTICE SYSTEM “Accountability is therapeutic” -Kate Lawson Involvement with the justice system can be the point of intervention for client With the right interventions, and the right collaborations with the justice system, justice contact can become the support system needs to obtain recovery Goals of the CJ Team 1. Improve client’s lives 2. Save taxpayer dollars 3. Improve public safety Court • Treatment provider – send med sheet and case management notes to jail • Jail – bridge medications, identify SMI, housing • CPSA – Assign to Mental Health Court or Docket • Mental Health Courts – Diversion Eligible? Coordinated Probation? • Treatment – monitoring treatment compliance, additional support Remedy • CPSA – MHC coordination, treatment advocacy, Court liaison • Community Re-Integration (Coordinated Jail and Prison Releases) • Other Supports: NAMI, Family reunification, other support systems Recovery • Continued coordination with Probation or Parole HOPE Sequential Intercept Model Arrest • Coordination with Law Enforcement, MHIST • CPSA Criminal Justice team: Contact at Initial Appearance, Notify Provider & Jail Healthcare, Identification & notification to treatment providers, release planning, communication with court QUESTIONS – DISCUSSION – DANCE OFF? [email protected] [email protected] [email protected]
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