DAWN J. BENKO/FOR THE TIMES HERALD-RECORDCattaraugus County Sheriff Timothy Whitcomb talks to recruits about dealing with individuals suffering from mental illness at the police academy in New Windsor.
By Heather Yakin
(EDITOR'S NOTE: Part 2 of our special report will run in Monday's Times Herald-Record and at recordonline.com.)
NEWBURGH – The calls come in to police as someone acting strangely. They come in as disputes or petty thefts, or sometimes, assaults.
For newly minted New Windsor police Officer Frank Pierri Jr., the call came in this spring, on his second day on the job. The subject of the call was in mental distress, uncooperative, and refused to open the door when police arrived.
Pierri had a weapon in his arsenal that most cops don’t: In the police academy, he underwent 40 hours of crisis intervention team training, learning about mental illness and its manifestations, learning how to defuse tense situations and about the resources available in Orange County to people with mental illness.
Instead of yelling or using force to gain entry, Pierri started talking, getting the person to tell him about the problem that had triggered the distress.
“It automatically kicked in, what to do, how to speak,” Pierri said.
The person was in the throes of medical and alcohol-related crises.
“The more we talked, the calmer we all were,” Pierri said, and police were able to convince the person to go voluntarily to a hospital for treatment. “Everything we learned translated right onto the street.”
As the number of psychiatric hospital beds has dwindled over the years, police have increasingly become the front-line responders for people with serious mental illness. Interest in crisis intervention team training – known as CIT – has surged in recent years as law enforcement and mental health officials have looked to change a system that essentially criminalizes mental illness.
“We’re advocating to make it part of the mandatory (state) training for police officers,” said Port Jervis Police Chief William Worden, head of the Orange County Police Chiefs Association. “It’s really an attempt to provide professional and proactive resources to people in need.”
In Orange County, police and mental health officials are looking to divert people with mental illness out of the criminal justice system. The path to doing that involves close cooperation among law enforcement, mental health and social services.
City of Newburgh police got a grant to provide CIT training to officers. Orange County is working on a program – known as sequential intercept – that brings together all the players in the mental health and criminal justice systems to coordinate services and get people out of lockup and into treatment. And at the Orange County Police Chiefs Association Police Academy, they’ve parlayed a $10,000 grant secured by Assemblyman James Skoufis for New Windsor into CIT training for the past two schools of new recruits from departments in and around Orange County, with a third planned for fall.
The academy has trained about 80 current and new police officers in CIT . The number will climb to about 120 by the end of the year, said New Windsor Lt. Frank Pierri Sr., the academy director.
Encounters between police and people with severe mental illness are notoriously risky, said Darcie Miller, Orange County’s commissioner of social services and acting mental health commissioner, and everyone wants to reduce the risks.
The Treatment Advocacy Center, a national non-profit based in Arlington, Va., which seeks to eliminate barriers to treatment for severely ill people, issued a study in 2013 on justifiable homicides by police based on Department of Justice data that found roughly half of the people shot and killed by police annually suffered from mental health problems.
The Washington Post, which is tracking fatal police shootings, found that in the first six months of 2015, there were 462 such fatalities, of which 124 involved someone having a mental health or emotional crisis. In the majority of cases, the Post found, police were responding not to a crime, but to a call about erratic behavior.
Such encounters often become violent unnecessarily, said former New Windsor Police Chief Michael Biasotti, who’s also vice president of TAC and has helped with its studies. “A lot of times, it depends on how the mentally ill person interprets the actions of the officer.”
Police don’t always know what awaits them at a call.
"Many calls start out as just a general ‘disorderly person’ call,” said Sgt. Richard Carrion of the City of Newburgh Police Department. “There are many people we encounter in the community that wouldn’t rise to the level where we can take them for (emergency) evaluation, but they’re still suffering from mental illness.”
For instance, someone who is having a psychotic episode, said Peggy Spagnola, Vice President of NAMI-AMICO, Orange County's affiliate of the National Alliance on Mental Illness, which advocates for people with mental illness and their families. Someone in such an episode may hear voices commanding them to do things, and may not be able to follow what police are saying.
“When the police come, if they don’t know it’s a mental illness, they don’t know what to expect,” said Spagnola, who also contributes to the CIT training. With CIT training, “they know how to talk them down instead of escalate.”
“It’s about body language and openness and empathy,” Carrion said. “It increases the safety of the officer, the safety of the mentally ill person, the safety of the mentally ill person’s family."
The community view
A few months ago, Carrion said, City of Newburgh police had a panel discussion for the congregation at the Ebenezer Baptist Church.
“The very first thing they asked is, ‘there are a lot of people with mental illness in this city. What are you going to do to better deal with this?’” Carrion said. Three days earlier, the department had gotten the CIT training grant.
In 2013, Middletown officers shot and killed Lennord Whittle, who had a long-standing diagnosis of bipolar disorder, after he was involved in an altercation with an acquaintance. Police have said Whittle failed to drop a knife when so ordered.
In Newburgh, there have been questions as to whether mental health issues played a role in the events that culminated with Michael Lembhard’s death at the hands of police in 2012, and his family has long questioned the approach police took that day when they tried to arrest him on a warrant.
While it’s impossible to know whether something like CIT training would have changed the outcomes of those cases, no one – including the cops – wants another tragedy.
Education is the key, Spagnola said. “The person is just a person with an illness,” she said. “It’s an illness of the brain, like any other organ of the body.”
When people are in the throes of an exacerbation of severe mental illness, such as schizophrenia or bipolar disorder, they can act out in ways that are frightening to outsiders or even, on occasion, become violent. Still, with a scarcity of in-patient psychiatric treatment beds, only those who pose an immediate threat of harm to themselves or others will likely be admitted to a hospital.
Even with CIT training, police need to be able to connect people with services, another aspect of the training. Otherwise, people may end up back on the streets acting out, and could end up in jail if that involves a crime.
“That revolving door is what we’re trying to stop,” Miller said. “It’s very dangerous for people with mental illness.”
The bulk of people with serious illness are significantly more likely to be victimized than to commit an offense. Those who do end up in jail have usually been charged with petty offenses, Biasotti, Carrion and others agree.
Appropriately diverting people with mental illness out of the criminal and juvenile justice systems is a hallmark of CIT training, said psychologist Don Kamin, the chief of clinical and forensic services for Monroe County’s Office of Mental Health, a master trainer on mental health curriculum for police, and director of the state’s newly formed Institute for Police, Mental Health and Community Collaboration.
“It helps the police handle mental health crises, and it really makes the mental health system more accessible and more understandable to everyone,” Kamin said. “It’s a needless expenditure to put these people in jail.”
First, police need to de-escalate the situation, a cornerstone of CIT, by speaking calmly, using non-threatening body language, rather than rushing in to use force.
If police can calm down the person and the situation, then they can talk services, Carrion said. In his office at the City of Newburgh Police Department, he pulled out a three-ring binder packed with names and numbers for the county’s treatment and support programs.
“It’s great to have all these resources. I can just flip through a book and say ‘we can call her,’” Carrion said. “These are issues that need to be addressed, and to be able to point people in the right direction is going to be incredibly beneficial to us.”
Thomas Bolzan, Orange County’s deputy commissioner of mental health, said police “want to know that if they go on a call with a mentally ill person, that they’ll be able to hand them off to a mental health professional, and that they’ll get the help they need.”
On July 3, a distraught woman had climbed to the roof of a three-story building in the City of Newburgh and was threatening to jump. Officer Jeffrey Perez, a member of the city’s newly trained CIT team, began talking with her. He was able to calm her and talk her down from the roof, and then rode with her in the ambulance to Orange Regional Medical Center in the Town of Wallkill so she could be evaluated.
Pierri Sr. said the hope is that people will see that the police can help them, and that will build trust.
“Everybody now is on the same page,” he said.
What the cops see
Newburgh city police average about a dozen mental illness-related calls per week, Carrion said, although not all are in crisis.
“Hospital beds are in such short supply today that when a mentally ill person is brought in for treatment, the doctor in the emergency room has to triage, and say ‘I’ve got 10 beds that are full and five people in the emergency room who need treatment.’ They get treated quicker and released sicker than they would if there were enough beds,” Biasotti said. “We’re lucky if they’re held 72 hours.”
In 1955, at the peak of hospitalization, there were 558,992 in-patient beds in state hospitals in the U.S. for people with severe mental illness. By 2005, the number had fallen to 50,509. By 2010, another 14 percent of those beds had been cut by the states, according to the Treatment Advocacy Center.
There are, in the U.S., 10 times as many people being treated for mental illness in jails or prisons than in hospitals, Biasotto said.
Local police and mental health groups view CIT training as a way to stem the tide, by giving cops a way to refer people in need to other resources.
“The communication and de-escalation skills you’re learning, you don’t have to just use them on people with mental illness,” Carrion said. “Any time you don’t have to put hands on people, the community appreciates it.”
How the training works
The idea of people with mental illness may be abstract for officers at first – “those people,” said trainer Mark Giuliano, director of community support in Westchester County. But as the training progresses, they see trainers talking about relatives who are ill, and they see how this can affect anyone.
“It really humanizes things,” Guliano said.
The recruits spend the week learning types of illnesses, the signs, and how to handle them. They watch videos, and hear from families and from people who have mental illness. They role-play to hone their de-escalation skills. They learn why people might self-medicate with street drugs, or might not comply with orders. They learn about state mental health laws, and where to refer people who need help.
On Aug. 6, during a break from learning about post-traumatic stress disorder from Cattaraugus County Sheriff Timothy Whitcomb, recruits Jonathan Ortega – in basic training at the academy for City of Newburgh police - and Christopher Valastro – in training for the Sullivan County Sheriff’s Office - said they realize this is something they’ll need and use once they’re on the street.
“It’s really good information that you can apply to just about any problem,” Valastro said.
“Going into detail really makes you understand what it is,” Ortega said.
The experts are divided on whether CIT training should be part and parcel of basic police academy training or a specialized training for specialized units. Kamin strongly advocates the latter because he believes officers need experience to effectively judge real-world situations. In a final report completed in May, the President's Task Force on 21st Century Policing recommended that CIT be as part of both recruit and in-service training for all officers. Orange County is forging ahead.
“Doing it in basic school makes it part of the culture,” Biasotti said.
Dealing with people comes with the territory of policing.
“Part of our job, for better or worse, is social work,” Carrion said. “You can’t arrest your way out of every problem.”