Ariz. responders attend, graduate from crisis intervention team training

The five-day program taught responders about de-escalating situations and getting people help for mental health issues


By Caitlin Schmidt
The Arizona Daily Star

TUCSON, Ariz. — The 911 call references a distraught woman standing on a freeway overpass, and Tucson police Officer Joshua Camacho's instinct is to approach slowly and speak softly.

"Hi there, I'm Officer Camacho. What's your name?"

The young woman identifies herself as Melissa. Camacho comments that she seems upset, and asks what's going on.

Melissa says she's lost her job, worries she'll be kicked out of her home, and her boyfriend — the only person she knows in town — has left her.

"Well, Melissa, I'm afraid of heights," Camacho says. "Is it OK if we talk over here away from the edge, just so I can feel more comfortable?"

Melissa looks him in the eyes before shrugging in agreement, then walks with Camacho and his partner, Kenneth Riddle, until they are several feet away.

The officers ask Melissa if she has a friend or family member they can call. Maybe a case manager? Next, Riddle asks if she's heard of the Crisis Response Center.

She hasn't, but she makes it clear she doesn't want to go anywhere. She asks if there's anyone else she can talk to.

When the officers mention the Crisis Mobile Team — trained social workers who would come talk to her — the look in Melissa's eyes shows they've found a solution.

"Scenario over," she says, smiling at the first responders and evaluators gathered in the Southern Arizona Law Enforcement Training Center's administration building.

Camacho and Riddle are two of 57 first responders who graduated July 30 from Southern Arizona Crisis Intervention Team training, a five-day program that trains police, corrections officers, firefighters and dispatchers to safely de-escalate situations and get people help for mental health, substance use and other issues, instead of taking them to jail. Thanks to the coronavirus, last month's training was the first in 18 months.

Tools for the belt

The training has been taking place in Tucson since the early 2000s, but has gained traction and national attention since it was taken over in 2008 by Kate Vesely, Pima County's director of justice services.

She was joined several years later by Tucson Police Sgt. Jason Winsky, who heads up the department's Mental Health Support Team. In the years since, several co-facilitators from other agencies have signed on to assist.

The first four days of training were made up of speakers and sessions focusing on mental health and substance use disorders, and various populations, including youths in crisis, older adults, people experiencing homelessness, veterans with PTSD and people with autism and developmental disabilities.

On the final day, attendees ran through 10 different role-play scenarios to test out their new skills, which facilitators told them at the start of training were simply "extra things to put on that tool belt."

[RELATED: Training day: Documentary provides perspective on police mental health response]

Scenarios included people experiencing various mental health crises such as a veteran having a PTSD flashback, suicidal subjects including "Melissa," a drunk woman refusing to get down from the bar, a confused older adult and a pawn shop customer who was just mad — facilitators called that one the curveball.

After a week of learning about crises for which officers were trained to offer resources, a scenario involving a person who was just plain mad and didn't need any additional intervention felt too easy for most.

Attendees were also taught to use family and friends as a source of information whenever possible. But in one scenario involving a woman who was having a mental health crisis, the presence of her brother — who had information that his sister was on court-ordered treatment — only made the woman more upset.

When the program began, officers viewed being sent to CIT as a sentence for bad behavior, Vesely said.

About 12 years ago, the program switched to voluntary enrollment to ensure the best possible people trained to handle crises were working in the field.

"Ever since then, it's been a total game-changer," Vesely said. "We've seen the culture change, we have seen so much change just among the hearts and minds of the people that participate in this class."

These days, there are rarely cancellations and there is often a waitlist for the training that's typically offered three times a year. Since its inception in Pima County, more than 1,500 people have graduated from the course.

With representatives from TPD, Pima County Sheriff's Department, University of Arizona PD, Pima Community College PD, Sahuarita PD, Marana PD, Oro Valley PD, Tucson Fire and Casa Grande PD in attendance, Southern Arizona was widely represented during the first post-pandemic training.

And not all of the attendees were officers or deputies: Several corrections officers and dispatchers were also on hand to learn a set of skills that are in increasing demand amidst public outcry over law enforcement's use of force and about police accountability.

Camacho, a six-year veteran of TPD and a SWAT team member, said members are encouraged to take the course, and he thought it would be valuable training for his patrol division at Operations Division South.

He said he's responded to many 911 calls where he's had to de-escalate a person in mental health crisis. He thought CIT's scenario-based training was realistic and would help prepare officers for real-world situations.

"I think humanizing the badge, being personable, and finding something that we can relate to with someone in crisis is important in de-escalating situations," Camacho said. "The biggest takeaway for me was learning about the various number of resources that were available to the public that I am now able to offer to community members I come in contact with."

During a session about legal issues, Winsky talked about potential inclusions in the pending George Floyd Act, including the end of qualified immunity, which protects police from being individually sued for their actions unless they violated a "clearly established" statutory or constitutional right.

When Winsky asked for a show of hands as to who was familiar with the term "qualified immunity," almost every hand in the room shot into the air. He said later that this response was a change from previous classes, where very few people were familiar with the term, indicating a shift in the landscape.

"I don't know in the last 10 years that I've ever seen a class that came in this dialed in to what's going on in the world around them and so hungry for information and tools to have better outcomes for persons in crisis," Winsky said. "They're actively seeking the training out because they know the world has changed. They know they're seeing more mental health issues, more substance abuse issues and more people experiencing psychosis out on the street. They want the tools to be able to respond to those people in a thoughtful and caring way."

This class had more knowledge of mental health, legal issues and situations in which use of force can be prevented than previous classes, Winsky said, allowing facilitators to move on to more advanced parts of the training faster.

"Younger officers and deputies out there are educated and engaged in a way I've never seen before," Winsky said. "They're coming in with a lot more cultural knowledge about mental health issues."

Understanding through experience

Speakers and presenters included clinicians and experts, and throughout the week, attendees learned about services in Pima County to assist various populations, like the Crisis Mobile Team and the Crisis Response Center, a 24/7 open-admission facility where officers can take people — voluntarily or involuntarily — for a mental health evaluation.

They learned how to recognize substance use disorders and various types of mental health conditions, and also heard stories from people with experience.

Danny Howe told of his journey from "county time to county dime," and how he channeled his experiences in the justice system to a career. Howe is a workforce development specialist at Pima County One-Stop System and the owner and director of The Earnest House, a group of transitional houses for people reentering society.

"Being able to help someone who can never repay me has been my driving force for the last 10 years," said Howe, who told the group how he went from selling drugs to selling people, as his job at Pima County allows him to connect people with the best job to suit their skill set.

John McGrath, a social worker with the Veterans Affairs, came to talk to attendees about veterans and PTSD, including the science behind it and how to handle someone experiencing that type of crisis.

He also shared his own story with the trainees, who went from late-afternoon fidgety to riveted in a matter of minutes.

In 2013, McGrath — a newly promoted sergeant with UAPD — was deployed to Afghanistan with the Army Air National Guard. One night, the rocket fire was particularly bad, and McGrath became convinced he was going to die. While he survived the night and the rest of his deployment, he developed PTSD.

McGrath said he started engaging in risky behavior — a common response to a traumatic incident. When he came back to the U.S., he started drinking to be able to sleep through the night, and then drinking to get through the day. Less than a month after his return, his supervisors started pressuring him to come back to work, and when he went to the VA for help, it was denied. He was told it was because he was still active-duty.

In February 2014, McGrath made headlines after he crashed his patrol car into a traffic sign and then a cement wall on the Interstate 10 frontage road near Speedway. He said he didn't remember the week leading up to the incident, but he quickly realized the life he knew was over.

"Being a cop was everything to me," he said.

Soon, McGrath found himself alone with a loaded gun in his mouth. He said the only thing that stopped him from pulling the trigger was the thought of his father cleaning up after his gruesome death. He got help and went back to school, and now works to help others avoid the kind of crisis he went through.

He gave attendees his personal phone number, saying he'd be there to help each take the first steps to get help, should they ever need it.

"Respect and dignity"

TPD Sgt. Darrell Hussman, who works in the Mental Health Support Team unit, ran through basic and advanced de-escalation techniques, telling attendees to try to relate to what the person in crisis is going through.

"Treat them with that respect and dignity that they need," Hussman reminded the group. "These are people. I know for me personally, in my experience a lot of times, I'll put them in a category, like 'crazy.' As I started getting with the MHST unit, I realized these people are struggling. These people, at times, are hurting."

Hussman told attendees it's OK for them to address the issue at hand and not shy around it. If a person is hearing voices, it's OK to ask them what the voices are telling them to do. Telling the person "that must be scary" can make a big difference in forming a connection, Hussman said.

When dealing with PTSD and flashbacks, it's important to orient the person to the day, time and place. And no matter how frustrating it might be, he said, always answer informational questions, no matter how rudely a person asks.

[RELATED: Roundtable: How to develop a successful mental health intervention program]

He also spoke about recognizing post-traumatic stress — different from PTSD — and what to do about it, sharing his own experience with depression.

"We do so much for everyone on the outside, there's so much we don't do internally," Hussman said, saying officers tend to work on keeping up the facade that they're fine, versus the foundation that actually keeps them grounded and fine.

Vesely told the story of a police lieutenant in New York who died by suicide after a widely-publicized incident involving a man in mental crisis who fell to his death after being shot with a stun gun.

As he told the story, a corrections officer got out of her seat, crying quietly as she slipped out the door in the back of the room.

She walked past two co-facilitators who are on their departments' mental health unit teams, Pima Sheriff's Sgt. Erin Gibson and Oro Valley police Officer Sonja Hudson. They exchanged glances and motioned to follow the woman outside.

A while later, muffled laughter could be heard from outside, and soon after, the three filed back into the room. While they missed most of the session, Gibson and Hudson did exactly what the instructors advised attendees to do: Look out for one another, and if something doesn't seem right, ask.

"What people remember is how you make them feel," Vesely told the group.

"These are the conversations"

Seven-year TPD veteran Antwoine Robinson, a lead patrol officer at Operations Division South, was all-in on the training from the first morning. He had questions for nearly every speaker and was one of the most active participants.

"Crisis intervention is always the way I thought law enforcement should go," said Robinson, who has always wanted to be a hostage negotiator. "We're responding to people at their worst times. It's never a good time when someone calls 911."

Robinson said that while he and his fellow officers are well-trained in safety tactics to protect themselves and the community, there haven't been a lot of conversations about how to connect people in crisis with actual resources.

"Nationwide, we haven't come up with a system yet to approach the little in-between things, the mental health issues that are going on across the nation," Robinson said. "So if law enforcement is going to be the key to getting people into crisis intervention and to some type of behavior health specialist to be evaluated, so be it. If we can get them resources prior to them even getting to the justice system, then let's do it."

[RELATED: Persons in mental health crisis: A primer for police response]

He said he was most surprised by the sessions that included feedback from family members of people who have gone through crisis. When officers respond to a call about a person in crisis, they don't typically address the needs of the family member who made the call, he said.

"Our expectation is when we provide the resources for mental health ... we kind of put the burden on the rest of the family to ensure that this person is seeking the right resources," Robinson said. "But we never offer resources for the family members. That was something big that kind of stood in my mind this past week."

Robinson said there are regular discussions in TPD about how to handle crisis situations, both before and after, and that "Monday morning quarterbacking" has become a regular part of the work.

"A lot of times, we'll take completely justified videos ... but then we'll dissect it even more than that, and we'll go into how can we have not put ourselves in this situation to justify using that type of force in the first place, because that's what we want to do in every situation," Robinson said.

"CIT is more comprehensive, more intuitive and something for me and the other individuals in the class to take back to our squad and our division, but these are the conversations that we're already having in a lot of these briefings and when we're on scene."

Vesely, whose father is a retired police officer, said it seems that Southern Arizona is at a pivot point.

She said everyone involved knows they can't arrest their way out of the problem anymore, and the idea is to get officers to want to take the opportunity to help a person get treatment or support instead of taking them to jail.

That means it's important to make sure a system is in place that makes resources readily available in a crisis, no matter what time of day.

"We're looking at problem solving as the future," she said.

___

(c)2021 The Arizona Daily Star (Tucson, Ariz.)

McClatchy-Tribune News Service

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