by Chuck Hoven
(Plain Press, April, 2016) Participants in a meeting of the Mental Health Response Advisory Committee (MHRAC) offered their input to on how to improve the interactions between police and community members when police are called to respond to “crisis situations”. At the March 23 meeting held at Stella Maris on Washington Avenue, MHRAC member Common Pleas Court Judge Hollie Gallagher defined “crisis situations” as incidents “involving mental illness, addiction, substance abuse, developmental disability, or some other overwhelming personal crisis.”
MHRAC invited people who have had first hand experience interacting with Cleveland Police in “crisis situations” to share what has happened when police responded to a 911 call, and share what the interactions with police, and those in crisis, were like in those situations. Participants were asked to make policy recommendations to help put in place police policies and practices to help to improve outcomes in future interactions between police and people experiencing crisis in the city of Cleveland.
Mental Health Response Advisory Committee member Ed Stockhausen of the Mental Health and Addiction Advocacy Coalition welcomed those attending the meeting. Stockhausen noted that this was the third public session held to gain public input. In addition to the public meetings, Stockhausen urged participants to fill out a survey the group created to gather additional input. He promised that the committee would use the input from the meetings and surveys to help them compile their recommendations.
A representative of the Alcohol, Drug Addiction and Mental Health Services (ADAMHS) board explained to participants that the United States Justice Department, empowered by Violent Crime and Law Enforcement Act of 1994, entered into a settlement agreement (the consent decree) with the City of Cleveland which includes changing policies and procedures when Cleveland Police respond to crisis situations.
Gabriella Celeste of the Schubert Center for Child Studies at Case Western Reserve University expressed concern about informing police that there is a mental health crisis when they are responding to a call. She suggested that whenever a call comes in, that dispatchers ask “Is there a mental health issue involved?”
A former dispatcher participating in the discussion suggested that all dispatchers should receive Crisis Intervention Team (CIT) training. She also suggested that all personnel involved at each step, from the 911 operator, to the dispatcher, to the police officer responding to the call, should be able to identify that they are responding to a mental health crisis. She also said that dispatchers should know which officers are CIT trained in order to direct calls properly.
A City of Cleveland representative responded that half of the City of Cleveland’s 80 dispatchers have already received CIT training.
A representative of the ADAMHS Board offered an overview of the 40-hour classroom CIT training. It includes providing information on available community resources, an overview of signs and symptoms of mental illness, substance abuse and opiate addiction, communication strategies and de-escalation strategies. A police officer, who completed CIT training also indicated that officers also receive a list of drugs that persons with mental illness may be taking.
While there were a number of calls for all police officers to receive CIT training, Judge Gallagher said the best outcomes are achieved when “people involved volunteer.” She said then you get “people with an inclination toward this kind of work.”
Several people said they are fearful of calling the police because of what might happen. One person said, “the person calling for a problem ends up being taken to jail, because police not understand the nature of the crisis.” Another person with Post Traumatic Stress Disorder said he is pre-judged because of his past behavior. He said when he called 911 because his mother was having a stroke he was asked multiple questions that had more to do with his previous behavior than the issue at hand. A committee member suggested that callers be reassured that “help is on the way, before additional questions are asked.”
A related incident came from veteran who said even though charges were dropped having to do with his past behavior, the incidents keep coming up on the screen when he calls police. He said he suffers from PTSD and because of what is showing up on the dispatcher’s screen, he finds himself surrounded by police when calling for help. He said because of his PTSD he is uncomfortable in crowds and the multiple police cars responding triggers a “fight or flight” response, creating a dangerous situation. He suggested that the CIT training include a portion on the needs of veterans.
A participant in the Stella Maris drug treatment program shared his experience of trying to resuscitate an overdosing friend because they were “scared to call police and get arrested or have the person overdosing getting arrested.”
A police officer, who said he had served on the Heroin Task Force, said police distinguish between fatal and non fatal overdoses. He said in non fatal overdoses, less than 1% of the persons involved are prosecuted. He urged calling 911 in the case of an overdose. He related his experience seeing the drug Narcon (Naloxone) administered. The drug helps restore breathing to those overdosing. “It is mindboggling – how it works,” said the officer. He also said that currently police officers do not administer Narcon, just Emergency Medical Service responders administer the drug. Several people called for police officers to be trained to administer the drug and have it available, as they are often the first responders to the scene of an overdose.
Participants at the meeting also shared some positive responses by Cleveland Police to crisis situations. One woman credited police with saving her life. Members of the Depression, Bipolar Wellness Alliance said police responding to 911 calls about suicidal members “made us feel safer.” They praised police officers for calling them back the next day to tell them that the person that threatened suicide is receiving help.
Several persons related incidents of being handcuffed, treated roughly or ending up in jail when when police responded to a call for help with a mental health crisis. One woman asked, “Why are the cuffs necessary?” She suggested she would rather be put in an old fashioned straight jacket than in handcuffs.
Another person suggested that putting handcuffs on a person with PTSD can trigger a violent response.
A member of the Depression Bipolar Wellness Alliance told of a member who was cuffed, beaten, thrown to the ground and had a foot placed on his neck when police responded to a call for help based on one of his delusion that “Chinese had placed a bomb in his car.” They asked how officers could be trained to de-escalate rather that escalate such a situation and link a person to care rather than jail.
Another policy recommendation that came out of the discussion was that CIT officers need to have a more readily visible identification marker than a small pin on their uniform that says “CIT”. Suggestions included a brightly colored arm band or different color uniform that people in the city would be alerted means the officer is a member of the Crisis Intervention Team.
An ADAMHS staff member described a new program that will pilot in the Second Police District where mental health professionals from Frontline will accompany police officers when they respond to calls having to do with a mental health crisis.
There was also a discussion about dispatchers and police involving family members in their quest for more information about a person in a mental health crisis. Asking questions such as what medications the person has been prescribed and knowledge by CIT officers of why those medications may be prescribed for example could aid in the method of response taken by the officer, one participant suggested. A CIT officer said relying on family and friends for information is a big part of their training.
Another woman related a positive experience with a Cleveland Police Officer, who rather than arresting her when she was driving while in a manic state, asked for her husband’s phone number. The officer called the husband, who was able to get a friend to go meet his wife at the scene and drive her home. The woman suggested that when possible, officers get information from the person experiencing a mental health crisis that will allow them to contact family members or friends to help deescalate the situation.
In wrapping up the meeting, members of the Mental Health Response Advisory Committee said they will work on creating their draft of policy recommendations and procedures for Cleveland Police responding to crisis situations. They plan to have meetings in May to get public comment on the draft recommendations. They hope to submit a final report to the federal court by August. The new policy recommendations are expected to be in place by August 22nd.
Committee members urged persons who have had direct experience interacting with Cleveland Police because of a crisis situation involving “mental illness, addiction, substance abuse, developmental disability, or some other overwhelming personal crisis” to fill out the committee’s public survey online at: http//bit.ly/CLECrisisResponseSurvey. Committee members said they will continue to check for input from additional surveys as they engage in writing their draft recommendations during the month of April.