Police and the mentally ill: What works best? Compassion on the force

By Nara Schoenberg

Chicago Tribune

The teen was physically imposing - 5-foot-10 and 240 pounds - and Houston police Officer Randy Crowder had been warned to expect a fight.

But on that day five years ago when Crowder responded to a call from the young man’s concerned mother, he didn’t see a criminal, or even a troublemaker.

There’s something else going on, Crowder recalls thinking. He suspected a mental health crisis. He asked the other officers to leave the room and introduced himself to the young man, using his first name, making eye contact and keeping a respectful distance.

“We talked about it a little bit, and he calmed down,” Crowder says. “I was able to get him to walk to my car, and we went to the [psychiatric hospital], and his mother went with us.”

At a time when police departments across the country are under fire for the alleged use of excessive force against African-Americans, better police response to people in mental health crisis is often cited as part of the solution. In Chicago, where police fatally shot college student Quintonio LeGrier and a 55-year-old bystander after LeGrier allegedly became combative, Mayor Rahm Emanuel has called for a review of the Police Department’s Crisis Intervention Team — or CIT — program, which provides mental health training.

But what does a state-of-the-art emergency response to a mental health crisis even look like? The answer is emerging, experts say, in cities such as Houston, which has been offering specialized mental health training to police since the early 1990s, as well as in studies that show positive results for the popular CIT model of officer training.

“The research suggests that [CIT programs] can work in terms of improving officers’ knowledge, their attitudes, their skill sets for responding,” says Amy Watson, an associate professor at the Jane Addams College of Social Work at the University of Illinois at Chicago.

“There’s some evidence that they can reduce use of force and injuries. There’s some evidence that they can reduce arrests of people with mental illness, and they can increase linkage to mental health services.”

In keeping with the CIT philosophy that “special people deserve special officers,” departments typically seek volunteers who are highly motivated and have excellent people skills, but some departments require all officers to participate.

Training lasts 40 hours, and officers learn the signs and symptoms of mental illness as well as skills for de-escalating conflict. Ideally, they also meet people with mental illnesses and their family members.

“It’s really 180 degrees different from traditional police training — and I’m not saying anything against traditional police training,” says Houston police Senior Officer Frank Webb, the senior trainer in the department’s mental health division.

“If someone’s psychotic, they may be having a very hard time hearing you, because they may have three or four voices in their head, in addition to your voice, so you have to be very patient. You may have to repeat yourself, talk in a calm tone of voice. Don’t assume that they’re just being obstinate if they don’t respond right away.”

Houston is one of six police departments nationwide singled out for their model mental health programs by the Council of State Governments Justice Center in partnership with the Department of Justice. The other departments are in Los Angeles; Madison, Wis.; Portland, Maine; Salt Lake City; and at the University of Florida.

Chicago offers good CIT training to the officers who receive it, but the program is “starved” for funds, Watson says. Chicago mental health advocates have voiced similar concerns.

Crowder, the Houston police officer, grew up with an uncle who had brain damage due to childhood encephalitis and who sometimes seemed drunk or disoriented, due to his disability. Once, his uncle was mistakenly arrested for public intoxication.

“They handcuffed him, took him to jail — he was scared to death,” Crowder says. “And I remember thinking, man, I wish police had more education and could recognize mental illness.”

Crowder says he’s dealt with many people with mental illnesses over the years, but the young man with the concerned mother stands out.

During two previous confrontations with the police who weren’t CIT-trained, the teen had been arrested and handcuffed, Crowder says. Once he had been shocked with a stun gun. He had bipolar disorder and had been prescribed medication, but he didn’t like to take it because it made him lethargic. Angry and frustrated, he would lash out by punching holes in the wall or putting his fist through the television set.

On that first visit, Crowder was able to take him to the hospital, where a doctor made some changes in his medication.

Several days later, the teen’s mother called again, and asked for Crowder specifically. Over time, he built a relationship with the young man, responding to about 10 police calls from his mom, accompanying mother and son to a meeting with a school counselor, and helping them connect with their local chapter of the nonprofit National Alliance on Mental Illness ( www.nami.org)

The teen started taking his medication and, after that first visit, Crowder never had to take him to the hospital again. The last time Crowder heard from his mom was a year and a half ago. The young man had a job and his mom said he was doing well.

“We don’t have that kind of time [for] every single call, but CIT has helped me a lot,” Crowder says. “I can tell the difference between a situation where I need to be a hard-core police officer and where I need to be a little more compassionate and understanding.”