By Maddie Hanna
Concord Monitor
CONCORD, N.H. — The man was lying in his bathtub, digging a razor into his arm and dragging it from wrist to elbow when Sgt. Stephen Burke opened the door to the apartment.
The Rochester sergeant saw a man determined to kill himself. But he and the two other police officers in the apartment that day in March didn’t charge forward to force him to stop.
Instead, they fired a Taser at him, again and again, until the blade finally slipped from his fingers. Only then did the officers rush to the tub, restraining the man until an ambulance came to take him to the hospital.
At the time, Burke had more than two decades of experience as a patrol officer. But he credits a weeklong program that trained him to handle people having mental health crises with keeping the encounter from turning deadly.
“If you invade somebody’s personal space, they’re going to respond,” Burke said. Before going through crisis intervention training, he would have been more likely to enter the bathroom immediately, putting himself — and the other officers — in close enough range to be in danger.
The officers would have to defend themselves, Burke said. “And we’d kill him.”
Burke runs Rochester’s Crisis Intervention Team, a group of 14 patrol officers specially trained to respond to mental health calls and to de-escalate dangerous situations. The training follows a model that started in Memphis, Tenn., in 1988, and has proven successful across the country.
In a 2004 study by the Technical Assistance and Policy Analysis Center for Jail Diversion that reviewed 28 police departments with specialized training, several departments reported increased officer safety and a drop in fatal shootings.
“Some agencies have deemed the information in the training so critical that they have delivered the 40-hour course to all officers,” according to the study.
But it’s not a requirement. Rochester and Manchester have the only two crisis intervention teams in the state. And the recent string of shootings by the police involving people who were mentally ill — four this year that resulted in three deaths — hasn’t prompted law enforcement officials to call for a change.
“I think the law enforcement community has been working very hard to improve outcomes with mental illness-related calls,” said Attorney General Michael Delaney, whose office reviewed each of the shootings and determined that the officers were justified.
Delaney said he’s interested in working with law enforcement officials to improve encounters between the police and people with mental illness but said there isn’t money for a statewide training program.
All police recruits get training to respond to situations involving mental illness at the police academy, which also offers refresher courses. Whether officers complete additional training on mental illness depends on the department.
Some agencies have sent officers to 40-hour crisis intervention training programs but have not formed teams. Others have policies that require officers to complete less-intensive programs on mental health issues every few years or when they decide the training is needed.
Still others don’t require any specialized mental health training at all.
Police chiefs interviewed for this story said tight budgets would make it difficult for departments to provide additional training.
But several police chiefs, particularly those in larger communities, noted that informal training happens all the time — whether through ongoing conversations with the local mental health agencies or interactions between officers and people with mental illness.
And when a situation escalates to a point where someone’s life is in danger, it doesn’t matter whether the person holding the gun is mentally ill, police chiefs said.
“We’re law enforcement officers. We’re not mental health clinicians,” said acting Concord police Chief John Duval. “Law enforcement’s role is to protect the public.
“And that’s difficult, because what you’re doing is merging criminal behaviors and mental health behaviors, and I think people want to separate those,” he said. “But the lines often cross.”
Preparing recruits
Regardless of what their departments offer, all new recruits get special training on mental health issues at the police academy: 16 hours for full-time officers and eight hours for part-timers.
That’s a big increase from the four hours full-time officers used to get. The academy decided several years ago that recruits could use more training to handle people who are mentally ill, said Capt. Robert Stafford of New Hampshire Police Standards and Training.
Representatives from the National Alliance on Mental Illness present the training, which includes lectures and practical scenarios.
Officers also hear from people with a mental illness. One of them is Ken Braiterman, a consultant with the state chapter of the National Alliance on Mental Illness who also writes and lectures on recovery from mental illness and trauma.
He instructs the recruits on de-escalation techniques: Approach from a 45-degree angle, rather than head on, and keep your hands visible. Say your name. Try to engage the person. Don’t whisper to another officer.
And throughout the interaction, take your time, Braiterman tells them. “There is a quick and easier way,” he tells the recruits, “and a right way.”
Years ago, Braiterman lived in North Carolina and worked as a cab driver. He wasn’t yet stable on medication, and one night after work he went for a walk — “a healthy way to keep the voices from banging around in my head.”
It was 4 a.m. when a police cruiser pulled up beside him. Braiterman answered the officer’s questions — what was his name, where did he live, why was he out so late — but was caught off- guard when the officer asked about his landlord and he threw out a fake name.
The officer left, but telling the fib sent Braiterman into a panic. He thought he’d be thrown in jail. He wouldn’t be able to make bail, and he would have no friends or family nearby to ask for help.
The point, he said, is that officers who haven’t been exposed to mental illness won’t understand what kind of reaction they might trigger. The recruits are receptive to his message, he said.
“I think all police are opening up,” he said. “Nobody thinks the criminal justice system is where sick people belong, but it’s too often the only option, because society doesn’t want to deal with what’s wrong. They want the police to keep it out of sight and out of mind.”
Braiterman doesn’t tell the recruits what to do if their lives are in danger. He and Elaine de Mello, the training and services manager for the state chapter of the National Alliance on Mental Illness, tell recruits that officer safety is the first priority.
But most mentally ill people aren’t violent, and most mental health calls don’t involve weapons, de Mello and Braiterman said. Recruits “need to hear what they are going to run into every day,” Braiterman said.
“If there is a weapon, all bets are off,” he said. “But usually there is not a weapon.”
‘Nothing’s 100 percent’
When there is a weapon, however, crisis intervention training doesn’t replace the need for a gun, police officers say.
Burke, the Rochester sergeant, tells how officers in his department have used their training to resolve situations without violence: the time he talked a suicidal man with a knife into throwing it away and going to the hospital peacefully; the time another officer, Justin Livingstone, negotiated with a man who had been holding his girlfriend at knifepoint.
“He had a blanket over his arm and was holding a knife to her,” Burke said. He said the man had told his girlfriend: “Before they have a chance to shoot me, I’m going to stick this knife through you.”
But while Livingstone was able to talk the man into surrendering without using force, that won’t happen in every dangerous case.
“We deal with a human element that’s so dynamic and different,” Burke said. Some people, he said, are “either so schizophrenic, or so deep in a psychosis . . . you’re still going to have to resort to lethal force or physical force. Nothing’s 100 percent in this type of work.”
The police are also forced to respond to situations that haven’t been resolved in other ways, Burke said. “When all the mental health stuff goes out the window because it doesn’t work, the police get called,” he said. “We don’t have the option to say we’re going to walk away.”
Police chiefs repeatedly pointed to that problem in interviews, saying more training won’t bring anto shootings by the police.
“It’s very hard, if not impossible, to assess a situation in a moment’s notice,” said Winchester police Chief Gary Phillips, whose officers were present when a Swanzey officer shot and killed a suicidal man armed with a knife in June.
“And unfortunately, many of these types of situations are happening quickly, and they’re very volatile,” Phillips said. “The training comes into play, and it’s basically a matter of are people’s lives in jeopardy. And then you have to respond to that.”
His department does not require training for mental health calls beyond what officers receive at the police academy. Neither do Hillsboro or Salem, whose officers have also been involved in shootings this year.
Crucial dialogue
Written department policies vary widely on dealing with people with mental illness. The state police, who were involved in a fatal shooting earlier this year in Manchester, have a policy related to involuntary admissions to the state psychiatric hospital, but not for responding to mental health calls.
Hillsboro has a policy for “Dealing with Diminished Persons” that was drafted in August, three months after a woman with a gun was shot and killed by a town police sergeant in her home.
The Concord Police Department, whose officers shot and killed a schizophrenic man wielding a hatchet in March, has a draft policy that it began working on before the shooting, said Duval, the acting police chief.
“We recognize that we have probably a higher population of individuals who have to live with and suffer from the effects of mental illness, by virtue of the resources that are around us,” Duval said. All the department’s officers underwent training on handling mental health calls between late 2009 and early 2010.
Duval said he meets regularly with representatives from Riverbend Community Mental Health to discuss what his department and the mental health center are doing right and how they could better work together. “It’s ongoing training, if you will,” he said.
That kind of dialogue is critical to the success of initiatives like crisis intervention training, said Rochester police Chief David Dubois.
Besides resolving dangerous situations without violence, the training aims to divert more mentally ill people from the criminal justice system into treatment, and the mental health agencies “were very willing and anxious to work with law enforcement on this,” Dubois said. “They see it as a benefit to them also.”
To Dubois, the benefit to his officers is fewer repeat offenders. With the ability they gain to recognize mental illness and the connections they make to the local mental health system, officers can better connect people with treatment programs, which “reduces the likelihood of them being a continuous problem for us,” Dubois said.
Overall, “it gives officers, in my opinion, a much higher level of confidence in dealing with mental health issues,” he said.
Dubois said the department drew from its overtime budget to cover shifts for officers while they completed the required 40 hours of training. He decided to make the investment only after getting an endorsement from “somebody who would be hard to convince this was worth doing” — Sgt. Burke.
Burke, who went to crisis intervention training in Portland, Maine, in early 2008 before going to another training in Memphis, said he wasn’t always receptive to changing his ways. As police officers, he said, “our experience is everybody knows how to do our job better than we do. We really tune people out.”
And there’s an even greater resistance to training on topics like mental illness, Burke said. “I think mental health training is looked at as touchy-feely, and it’s foreign to police officers.”
But he’s convinced the two fields have to work together. “If you talk to a psychologist, psychiatrist, when a situation gets so dangerous, who do they call? They call the police,” Burke said. “It always reverts back to us.”
Copyright 2011 Concord Monitor/Sunday Monitor