CIT

Smoky Mt News
Training cops to handle mental health patients

By Julia Merchant • Staff Writer

It had been a long day for Adam Meyer.

The young man who has battled mental health issues for most of his life had entered another period of crisis, and had been waiting more than 48 hours for a bed to open up at one of the state's mental health hospitals.

It had been a long day for the person accompanying Meyer as well. In almost all cases, a sheriff or a transport person hired by the sheriff's department must wait with a patient until they're admitted to a state hospital — sometimes for days.

What happened next is disputable. But Meyers' mother, Patricia Frisbee Meyer, alleges when her son reached up from his bed at Haywood Regional Medical Center to speak with his social worker, the transport worker misinterpreted his actions and choked him in a forceful restraint.
Haywood County Sheriff Tom Alexander says the department investigated Meyers' complaint and that appropriate action was taken. While he can't speak further on the matter, he would say that the long waiting times are hard on everyone involved.

"A lot of these people get upset when they're sitting for hours. They get agitated, and I don't blame them," he says. "It's not an excuse, but that's the fact of the situation."

Too little funding

Chalk it up to a misunderstanding or a broken system, but the bottom line is that what happened to Adam Meyer might have been prevented.

That's the mantra being used by advocates of the Crisis Intervention Team program, which aims to train law enforcement officers how to better deal with individuals suffering from mental health issues.

Supporters of the program say it's an invaluable tool to prevent misunderstandings and mistreatment of mental health patients. They're not claiming it will fix the system completely, but that it will make officers' jobs easier.

Through the CIT program, a local chapter of the National Alliance on Mental Illness or another agency pairs with sheriffs departments and mental health service providers to form a task force that studies current policies and procedures in place for handling mental patients. A 40-hour training session on a wide range of topics is then offered to law enforcement.

The state of North Carolina was so taken with the program that it set aside $2,000 to give to each local management entity (LME) — the organization in charge of overseeing a region's mental health system. In a 15-county LME like Smoky Mountain Center for Mental Health, which represents the western region, that breaks down to about $130 a county.

"The issue is, what can you do meaningful with $2,000? " says Tom McDevitt, area director for the Smoky Mountain Center.

McDevitt says his agency and others suggested that the state set aside the money that would be given to each LME and pool it together to create a training program.

"They should have kept their $50,000 and put on a series of three to four regionally sponsored CIT training sessions," McDevitt says.

But he says the state ignored that idea and instead doled the money out individually. As a result, LME's are limited on how much they can help law enforcement gain access to the training.
"The funding is not enough to implement the program," acknowledges Molly Richardson, director of emergency services for the Balsam Center.

As a result, Smoky Mountain has had to get creative.

"Our plan is to basically use that very small amount of money to at least try and have educational events for law enforcement in our area to at least learn what it's about," McDevitt says. "That's as far as we can go with that little bit of money."

Limited resources

Sheriffs departments appear to support the CIT concept.

"I think it will make the process more smooth," says Macon County sheriff Robbie Holland. "It will give those first on the scene additional training, and I fully support that."
Swain County Sheriff Curtis Cochran agrees that the training could better equip officers to handle encounters with mentally ill individuals.

"I'm sure that we would change our approach a lot of times if we knew exactly what we were dealing with. On commitments, all we know is what we're told," he says. "That's very limited information."

Debra Dihoff, executive director of NAMI North Carolina, says that "often, when symptoms become out of control, police don't know to recognize symptoms of mental illness."

Data compiled by the Memphis Police Department — the first in the nation to implement the program — showed that before training, 20 percent of encounters with mentally ill people resulted in arrest. After training, that dropped to 1 percent, according to Dihoff.

But as helpful as the CIT program may be, law enforcement budgets are already stretched — and they may not be able to justify training that isn't mandatory. They may also not be able to afford to spare manpower in already understaffed departments.

"The main reason we haven't done it is a lack of manpower, because we're a small agency. Whenever you say you have four people that want to take off to go to this training, those four people have to be replaced by four other people," Holland says.

That's easier for bigger agencies with 300 or more employees, like Wake or Pitt counties, says Alexander. But it's harder for rural agencies in WNC, which employ a much smaller number of deputies.

"I believe in training, but then sometimes, you have to weigh out the cost. The manpower and the ability to be able to get it — you can't stay in school all the time, because work goes on," Alexander says.

To make CIT training more accessible to law enforcement agencies, Alexander suggests getting it accredited through the state Sheriff's Standard and Training Commission. That way, it could become part of the mandatory curriculum.

Forming a partnership with a local community college could also help. Agencies often do this to complete other training. The community college receives a certain sum for attracting a certain class size. In exchange, the college might provide things like refreshments, a luncheon and class pins. The LME also steps in and provides curriculum notebooks.

In one case, the state NAMI organization offered to reimburse the gas costs accrued by law enforcement agencies in five rural counties that traveled to a regional CIT training.
All in all, a partnership between all interested parties could be the most effective way to ensure officers receive the training they need to deal with mentally ill individuals.

Can it be implemented?

But the Smoky Mountain Center says so far, forming a partnership has been challenging. Besides Holland, it doesn't appear than any other law enforcement agency west of Buncombe County has made CIT training a budget priority.

"We've already made overtures to try and give reimbursement for pay and registration to send law enforcement staff, particularly sheriffs," says McDevitt. "We had little to no interest in anybody wanting to go anywhere."

McDevitt says that besides crunches in budgets and staffing, departments worry that they won't have the funding or infrastructure to keep CIT in place. And what's the point in training if it doesn't effectively take root?

"They say, we'll get exposed to this, and not be able to do anything to put CIT place. Where's the infrastructure? We don't have this, we don't have that," he says. "My approach is yeah, that's a given, but we can do these two or three things that would be an improvement."

Like so many other aspects of North Carolina's mental health system, it seems that CIT training is another instance where the state is promoting something without setting up the appropriate infrastructure or funding to carry it out.

And the problems law enforcement has with the mental health system won't be fixed with CIT training alone. Long waiting times, for example, will only be helped by adding more state hospital beds, and teaching officers how to deal with mental patients in the short term won't address the lapse in long term care due to a shortage of psychiatrists.

"We can train our people how to pick them up and deliver them to wherever, but all the training you give these officers in the world — unless you train them to be psychologists or something — is not going to solve the problem," says Alexander. "That's what the mental health field needs to understand. Don't blame it on the deputies and police officers. We do the best we can."