In North Carolina, an 18-year-old diagnosed with schizophrenia was shot and killed by police who were responding during a crisis.
In Montreal, police reported that a 41-year-old man with an unidentified mental illness was brandishing a hammer when officers caught up with him — behaving erratically and smashing windows. When he jumped atop a squad car, officers shot him at least four times in the chest. He later died at a hospital.
A Dallas police officer was fired and assault charges recommended after he shot a mentally ill man. Video tape showed the man did not move toward the officer, as he had claimed.
And in Lodi, 43-year-old Parminder Singh Shergill, who struggled with depression and post-traumatic stress disorder, was fatally shot by police who were summoned by family members concerned about Shergill’s emotional state. Police say Shergill confronted them with a knife.
When police encounter a mentally ill person in crisis, the results are increasingly violent, even fatal. Yet some police agencies are embracing advanced mental health training aimed at resolving such confrontations with options other than deadly force. One well-regarded program is known as Crisis Intervention Training, or CIT, which aims to give officers advanced tools to defuse incidents involving mentally ill subjects through a 40-hour class.
Police academy graduates receive six hours of training focused on mental health during the 664 hours required for academy completion.
Can extra training save lives?
Devon Corpus, a licensed social worker in Monterey County, says yes. Corpus supervises a crisis team made up of specially trained counselors and law enforcement representatives certified in Crisis Intervention Training.
CIT teaches law enforcement personnel not only to recognize mental health disorders, developmental disabilities and similar problems, but how to interact with someone with such a disorder and ultimately defuse a situation without using potentially lethal force.
While this training program, which costs about $60 an officer, is available in many counties throughout California, it is not offered in Sacramento or San Joaquin counties. Such training is up to individual departments.
Corpus believes developing the training may lag because some police hold stereotypes of mental health representatives as Birkenstock-wearing hippies who just want everyone to get along — and some mental health representatives think police just want to shoot people.
“There needs to be a paradigm shift,” she said. “It takes someone to own their side that they need to learn more about the other side. When you come together and collaborate, you can get people help.”
Corpus, a licensed clinical social worker who served in the U.S. Army, has a unique viewpoint. Her father was a Vietnam War veteran and police officer, while her sister now works as a federal agent.
Responding to crisis
Crisis Intervention Training was developed in 1988 at the University of Memphis, after police killed a man with schizophrenia. “Still, 25 years later, we have these things happen,” Corpus said when told about the recent Lodi incident.
The primary goal of CIT involves calming people with mental illnesses who are in crisis and referring them to mental health care services, rather than using force or incarcerating them.
The program, endorsed by the National Alliance on Mental Illness, teaches some basics about mental illness, substance abuse disorders and developmental disabilities. Using role-playing, it explains how to recognize and then interact with someone with these conditions who is in crisis. It is taught by law enforcement peers, mental health professionals and even those who live with mental health conditions.
They talk issues such as medication or how a person who is hallucinating from not taking prescribed medication might act differently than someone on illegal drugs.
Once the officers graduate, they are certified and placed into the department’s computer-aided dispatch system so they can be sent out when specific calls come in. They also educate the community that CIT representatives are available if a family member having a mental health crisis is in need.
Corpus doesn’t know of any tangible studies that confirm whether departments with CIT programs have fewer arrests of mentally ill people or fewer being booked into jail. She said, however, that most will tell you there has been a reduction in officer wait time at hospitals, reduced injuries and fewer lawsuits.
Bringing more sensitivity
The closest agency to San Joaquin that offers the CIT program is Placer County, where the sheriff wanted to give deputies more expertise, said Cheryl Trenwith, a therapist who formerly coordinated the program.
“They were seeing people in the field and they were not sure whether that person had a disorder or was on drugs,” she said.
Ironically, the curriculum she helped develop offered a section on PTSD training, which Trenwith said was helpful for police officers as well, since many of them were retired military, a group among which PTSD is common.
The program succeeds because it has the support of officers who helped write the curriculum, Trenwith said. They were seeking to learn more about specific mental health disorders and how to treat those with mental illnesses with more sensitivity.
“I do believe the sheriff felt officers felt more comfortable and better prepared,” she said, adding that success was not measured by data. “If they feel more confident and able to manage people with mental illness or substance abuse disorders, to me that’s success.”
The behavior of people who are mentally ill can be confusing, she said, and can be especially challenging when officers have to make a quick decision.
In Monterey County, Corpus’ team has mental health professionals available at all times, not only to talk to first responders, but go out on calls and help diffuse a tense situation.
Once on scene, a CIT-certified officer would likely recognize a mental illness and be able to respond to the situation in methodical manner, using key words and asking specific questions related to medication or past incidents. If the person was acting out of paranoia, for example, the CIT-trained officer would know not to shine a flashlight in the person’s eyes to get their attention.
An officer might also draw on professional assistance if the person is threatening to hurt himself or herself.
However, Corpus cautions, all bets are off when a weapon is involved in a manner that threatens the officer, as the CIT program does not replace police weapons training.
“We tell people, ‘This is just a tool for your tool belt,’” she said.
Still, it could help.
“The training gets (officers) into the mindset of looking at situations differently,” Corpus said. “They might be more patient or cautious than they were before.”
Could something like this have made a difference when Parminder Singh Shergill’s mother called Lodi police that Saturday morning in January when her adult son was causing a disturbance?
Possibly, according to Mark Merin, the attorney who is representing Shergill’s family. Lodi police, he said, knew Shergill was coping with PTSD and depression. He was receiving treatment for both at a Veterans Administration hospital and a local doctor.
Merin said that Lodi police had responded approximately four times in seven years to his home for calls regarding his mental health issues and had even taken him to the VA hospital in Stockton on at least two occasions.
“I think the family expected that’s what would happen when they called that day,” Merin said this week. “He needed help, that was clear. Police should have approached him that way — as someone needing assistance.”
However, in a press release issued six hours after the Jan. 25 incident, police said Shergill was armed with a knife and charged at responding officers with it, leading them to shoot him.
The incident is under investigation by Lodi police, the California Department of Justice and the San Joaquin District Attorney’s Office.
Weapons change the approach
Untreated, severe mental illness is an increasing factor in officer-involved homicides, according to a study by the National Sheriffs’ Association and the Treatment Advocacy Center. That reflects on the need for more and better mental health care, so someone doesn’t get to the point of needing police intervention.
“Justifiable homicides involving people with untreated mental illness are a symptom of our failed mental illness treatment system,” said Doris A. Fuller, executive director of the Treatment Advocacy Center. “Fewer officers would come under attack and fewer people with mental illness would die from these encounters if more people with mental illness were getting the treatment they need when they need it.”
Merin points to a December decision Ninth District Circuit Court of Appeals that officers have a duty to use the least amount of force necessary, including talking, when responding to a call regarding a mentally unstable person.
And retired Galt Police Lt. Jim Uptegrove, who teaches at the Public Safety Training Center in Sacramento, said officers are required to receive continued education, which should include mental health training.
He admits, however, there is no standard. He is unfamiliar with CIT.
“We did our own training out of a need,” Uptegrove said.
In Galt, because officers often work with more than half a dozen care homes for mentally ill adults, there is specialized training that helps them identify people with specific conditions and know where to transport them if they were a danger to themselves or others. If they were not doing anything illegal, aside from loitering or panhandling, officers would often take them back to the home, Uptegrove said.
Uptegrove said officers strive to be careful and sensitive, but when a weapon is involved, they must act quickly and decisively.
“Mental illness or not, officers are dealing with the situation as it unfolds,” he said. “There aren’t going to be any allowances because the person has mental illness.”
Still, Galt police have created a network among officers, care home operators and Sacramento hospitals to be able to identify care home clients so that police can be responsive to their needs and, in turn, the care homes can work with the police department, Uptegrove said.
In Lodi, officers have worked with San Joaquin County Behavioral Health Department for specific training and with doctors through a mobile health evaluation team, according to Lt. Sierra Brucia. They have visited the homeless, for example, to ensure they’re receive medications for any mental illness.
All officers receive annual mandatory mental health training; the latest session was held last month. It was taught by a mental health representative and included what to look for in people with clinical disorders, when someone with mental health issues can be admitted to a hospital and how to fill out paperwork so that someone suffering from a mental condition can get help, Brucia said.
He is not familiar with CIT, specifically.
“But any additional training could be beneficial for our department,” he said. “You have to take into account cost, personnel.”
Similar annual training provided by mental health professions that focuses on mental health awareness is available for the San Joaquin Sheriff’s Office, but is not mandatory, according to Deputy Les Garcia, the department’s spokesman.
Still, he said, it educates deputies to recognize certain signs and provides them with resources to help those they serve.
They also connect with a crisis worker who is on call at all times and will respond to the scene. If that person is unable to respond, someone demonstrating certain conditions will be transported to mental health locations in Stockton for evaluation, Garcia said.
Like ‘armed social work’
Law enforcement officials will likely encounter more mentally ill people as the number of patients in community settings goes up.
Five decades of closing psychiatric hospitals has forced large numbers of deinstitutionalized patients into the criminal justice system, according to the Treatment Advocacy Center.
In 1955, there was one psychiatric bed for every 300 Americans. By 2005, there was just one psychiatric bed for every 3,000 Americans, according to U.S. Department of Health and Human Services data.
In Southern California, police departments are creating Psychiatric Emergency Response Teams to help handle mentally ill people more safely, according to police trainer Steve Albrecht, who has authored five tactical books for law enforcement.
This typically involves a clinician riding with a specially-trained officer whose sole job is to work with mentally ill, he said.
The San Joaquin County Sheriff’s Department is working with Behavioral Health on a grant for the PERT program, according to Garcia, who had few details. The sheriff wrote a letter of support of the program in Dec. 2013.
“The emphasis is sort of like ‘armed social work’ where the clinician tries to find treatment programs, better family support and medical care for the chronically mentally ill person, while the officer provides protection and evaluates for criminality issues,” said Albrecht, a retired San Diego police officer. “These teams create better solutions for long-term problematic people, and use less deadly force in the process.”
Contact reporter Jennifer Bonnett at email@example.com.