We had just exited the Urgent Psychiatric Center (UPC) when the radio announced an armed robbery in process at a convenience store just over a mile away. Nick and I jumped into his police cruiser and took off. My body slammed back into the seat from Nick’s swift acceleration and I barely noticed the scenery as my peripheral vision dropped away, my brain focused intently on the narrow view straight ahead of us. It was a pure adrenaline rush, my heart racing as Nick flipped on the lights and siren, his police car screaming down the street. This was definitely not what I expected when I agreed to spend the evening with Phoenix Police Officer Nick Margiotta.
I was brand new in my role with Magellan Health Services overseeing the clinical system of care and wanted to see how the system worked first-hand. Was it safe, effective, and person-centered? Was it accessible? I met Nick through our community governance board, and he brought a wealth of experience and passion from his work as the city’s Crisis Intervention Coordinator. He suggested we spend a night on the street, with him dressed as a regular police officer and me in plain clothes as a ride-along without announcing our positions to anyone. Think “Undercover Boss,” and it seemed like a great idea.
As we rolled onto the scene of the armed robbery, we saw that another patrol car, which had arrived before us, was blocking the car that held the two armed men. We stopped in the street about 40 yards away and Nick and I got out and stood behind our doors. (Well, I stood behind the door after Nick yelled at me to get out of the line of fire!) It was dark, there was a lot of yelling, lights, a bunch of guns, and I was struck by what felt like chaos in the situation. Fortunately, the two men were safely taken into custody; the whole event did not take more than five minutes.
As Nick turned back towards the patrol car, he noticed a middle-aged Native American male, intoxicated, sitting with his legs in the street. We walked over and Nick began engaging him about his interest in getting some support that evening. The man was initially quite belligerent. What I didn’t realize as we engaged with this person was Nick was working to transition himself, too. He had felt what I felt during the attempted robbery. Cops are human, after all, and just moments earlier there had been real danger which had internal, physiological impacts on him just like me. With a new found respect for the skills of CIT-trained law enforcement, we transported the individual, connecting him with the local Community Bridges center, which has a detoxification unit.
Over the course of that shift, we interfaced with more than 15 individuals who were experiencing mental health and addictions issues. Less than 30 minutes earlier we were at a local apartment complex visiting a friend of Nick’s who has Schizophrenia, but was in recovery and had been clean from Heroin for more than two years. While we were there, we received a “pick-up order” for another individual in that same location who was on court-ordered treatment and needed to be transported to the UPC. After a brief discussion with that person, she agreed and we took her to 2nd Street and East Roosevelt.
I was struck by the near-instant transitions Nick was able to effectively navigate, from command and control of armed robbers to engagement and collaboration with those in behavioral health crisis. Crisis Intervention Team (CIT) does not turn law enforcement into social workers; they will always be cops first and foremost. However, more than 2,000 jurisdictions have adopted CIT and put it to use in developing more integrated and responsive community systems. It equips law enforcement with knowledge regarding the signs and symptoms of mental health and addiction, tools for effectively engaging individuals, and the resources to divert them from being sent to jail.
Five Key Pillars Crisis Intervention Team (CIT)
|Officer Training||The most visible component, the 40 hour, week-long training is most effective when officers have volunteered. In addition to a primer for behavioral health, generally two days are devoted to crisis de-escalation.|
|Community Collaboration||A partnership of local advocates, law enforcement, and behavioral health providers formed the Memphis model. This community bridge has been one of the strongest elements of the program over time.|
|Robust Crisis System||An integrated system that is focused and responsive to the needs of law enforcement is mandatory. Unless access to care is quick and responsive and hand-offs are smooth, the program will not result in decreased incarcerations.|
|Behavioral Health Staff Training||Building positive working relationships between law enforcement and behavioral health means also training the mental health and addiction community of providers. Riding along with law enforcement can be a big eye-opener.|
|Advocate Training||The local NAMI provided the energy and moral leadership that made the Memphis model so successful, and including peers, family members, and advocates is critical to embed a program in the community.|
Ten years ago, 17 of us from the greater Atlanta area, including law enforcement, behavioral health providers, and NAMI leaders, traveled to Memphis, the “CIT Mecca,” to learn how to implement a statewide program in Georgia. The original founders of the program, Major Sam Cochran and Dr. Randy Dupont, were heavily involved and inspirational leaders. Naturally, as a part of the training, I did a ride-along with a local cop, Officer James.
James described his evening shifts as making trips into Mogadishu and recounted several harrowing stories of shoot-outs in which he had been involved. He added that working with individuals with mental health and addictions issues was easy; as he received excellent training through CIT and he proudly wore the unique badge that identifies these specially trained officers. I asked him about the most challenging situations faced by law enforcement.
James mentioned two scenarios, both of which occurred on our shift. In the first, we were called to the scene of a break-in, and we didn’t know if the perpetrators were still there. I remember being extremely anxious as he went inside and I stayed in the vehicle. It was palpable.
However, the worst situation happened later that evening. Two officers on the southwestern side of the city were shot through a door as they served a warrant. I remember hearing almost the entire play-by-play over the radio as cops from all over the city raced at break-neck speed to the scene.
I’ve been on two police ride-alongs with CIT trained officers, and they were both wild rides! Yet, I saw both of these officers demonstrate compassion and finesse while working with individuals and families who were struggling with behavioral health crises. And, in both cases, I saw responsive behavioral health systems that focused on quick accessibility and humane, transitional hand-offs that helped avoid unnecessary trips to jail.
It’s easy for behavioral health professionals to disregard our brothers and sisters in law enforcement, but working together we are creating better community support systems (see December 2013 article from Spokane). How do you start making a difference in your own area? I would suggest starting with an evening or night shift in a patrol car observing the challenges and opportunities first hand.
*Note: David Covington co-authored this blog with Nick Margiotta. Nick is a member of the board of directors for CIT International and chair of its public awareness committee.