First Responders Practice Crisis Management - News - @

First Responders Practice Crisis Management

Patients with mental illness present unique challenges


Dawn Gagnon/BDN Staff Bangor | | Thursday, September 29, 2011

BANGOR, Maine -- A middle-aged woman is sitting on the ground outside an auditorium that has been closed for hours. Sitting cross-legged on the ground and rocking herself, she is inadequately dressed for the cold and says she is waiting for her mother, who is inside at an Elvis concert.

Elsewhere, members of a campus police department are sent to look into reports that a woman is interfering with traffic. When they arrive, a woman who identifies herself as "Trixie McNaughty" is dancing to music no one else can hear. She tells officers she has been living under a bridge. Despite efforts to get her to safer ground, she continues to weave in and out of the roadway, flirting with officers and waving and calling out to passers-by.

In another community, emergency rescuers find themselves dealing with a woman who entered a stranger's home to use the telephone. She insists she must call the president of the United States, who has been talking to her through her television. She claims that because she didn't follow his instructions, a tsunami and hurricanes occurred, killing hundreds of thousands.

These are just some scenarios police officers, emergency medical responders, corrections officers and others who deal with the people in crisis face on any given day, at any given hour, in any given city or town, Bangor police Sgt. Paul Edwards said this week during crisis intervention team training at Dorothea Dix Psychiatric Center.

The training program, offered by the National Alliance on Mental Illness, is based on the "Memphis Model," which led to the establishment of the first crisis intervention team after the shooting of a man with a serious mental illness by a police officer in Memphis, Tenn.

The death brought together police, the Memphis chapter of the National Alliance on Mental Illness, the University of Tennessee Medical School and the University of Memphis, who joined forces to improve police training and procedures in response to mental illness and other crises.

These crises are the result of a variety of problems, including mental illness, prescription medications, drug abuse, trauma and stress.

"We are dealing with this every single day, every week, all day and all night," Edwards said. Though not all incidents are what would be considered a full-blown crisis, appropriate response and intervention can help prevent a problem from getting worse, he said.

"We try our best to de-escalate the situation and get people the help they need," he said.

The idea behind the training, he said, is to equip those most likely to be the first to respond with techniques they can use to de-escalate a crisis before it gets out of hand, reducing the need for force or jail and the likelihood that the incident will result in injury or death.

Nineteen people working for area public safety agencies completed the 40-hour course, taught by Edwards, Maine's 2006 CIT Officer of the Year and supervisor of his department's team, and fellow instructors Ted Hunt, a crisis worker with Community Health and Counseling; and Lanee Barnes, a trainer with NAMI Maine and a part-time Hallowell police officer.

Some of the de-escalation techniques participants learned included using a soft voice, not being confrontational and getting down to the person's level to create what Edwards described as an even playing field.

How to recognize and approach situations involving people in crisis - including people experiencing trauma or who have mental health conditions or substance abuse problems - without having to resort to force or jail were some of the strategies that graduates learned, Edwards said.

They got a chance to apply some of what they learned on "actors" - namely their instructors and Dorothea Dix staff - during a series of role-playing exercises on Thursday and Friday. Afterward, they were critiqued by their instructors and fellow students.

Barnes, who became involved in the CIT movement after the suicide of her 14-year-old son, said she sought training and became an instructor because of the way in which her own family tragedy was handled by CIT-trained police officers.

She now uses what she learned on the job, including how to recognize a mental health crisis for what it is.

According to Edwards, CIT training is not required by most public safety agencies and most of those who have taken the course in Maine have done so on a volunteer basis. Instructors and guest speakers they bring in for segments of the training also are volunteers.

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