Thirty-one years ago, I was in a small-town jail cell in southeastern Alaska.
The town of about 1,400 hosted six bars. I was there at police request. Seated opposite me was a young man: anxious, ill at ease and wild-eyed. He had entered a bedroom through a window naked startling the female occupant. Luckily, the husband was absent because the home security system was a loaded .357.
The responding officer was a crisis intervener, ahead of his time, before crisis intervention teams, or CITs. I had been asked to facilitate transferring the young man for an evaluation. It would require flying him out in a single-engine airplane. Scraping his cerebral barrel for rational remnants, I convinced him to accept handcuffs and leg restraints. The over-water route, surrounded by mountains and glaciers plunging to the sea, dictated no disruptions en route.
In U.S. cities with a population of more than 100,000, police contacts with the mentally ill are about 7 percent of all contacts. The average officer on patrol in Memphis or Knoxville, Tenn., will encounter the mentally ill about six times a month. Similarly, New York City police dispatchers phones ring about every six minutes with issues involving mental health. Many of these contacts end up in the metal motel jail cells. A few, likely psychotic and menacing, are shot dead. Their evaluations are post-mortem.
As Linda Lute documented in the May 19 Durango Herald, CITs are an attempt to change this. With citizen input, the Durango Police Department and the La Plata County Sheriffs Office (other agencies, too) have been on board with CIT of Southwest Colorado since 2002.
The model originated in Memphis after a shooting in 1988. Here, a training course is presented annually, open to police, jailers, dispatchers and others. The one-week, 40-hour course emphasizes recognition of mental illness and de-escalation techniques, a more compassionate approach, with earlier connection to the mental-health system.
Albuquerques CIT has reduced the incidence of incarceration of the mentally ill to fewer than 10 percent and injuries to 1 percent. SWAT team calls were reduced by 58 percent. Handling these contacts is a very difficult job; alcohol, drugs (street and prescription) and other substances may be involved, often requiring a stop at the ER (which may be prolonged) to sort this out. The options then become detox, hospitalization and jail. Informal solutions, such as release to a responsible party and outpatient follow-up, are possible if the situation appears low risk to the individual and the community.
In one study of those hospitalized with severe mental disorders, 20 percent had been arrested in the previous four months. If hospitalization cannot be accomplished (for instance, because of violent behavior), the police have a plan B, a signed complaint and a ticket to jail.
In Durango, three to five CIT-trained officers are available per shift, and it is almost certain that one will respond to a mental-health-related problem. However, it is of great help to them if callers inform dispatch of the possibility or presence of mental illness. We pay either the healers or the jailers sometimes both.
www.alanfraserhouston.com. Dr. Fraser Houston is a retired emergency room physician who worked at area hospitals after moving to Southwest Colorado from New Hampshire in 1990.