Defusing crises dispelling myths

from The Oregonian, by Aimee Green

As Clackamas County sheriff's deputies file into the community meeting room at Chez Ami Apartments, a 40-unit residence for people with mental illnesses, residents eye them carefully.

Two years ago deputies responding to a call of a resident disturbing the peace shot and killed the woman after she charged them with a knife. The residents, a Clackamas County mental health worker has advised the deputies, are still a little on edge.

The visit is part of the sheriff's office's third semiannual training devoted to teaching officers how to better handle encounters involving people who are mentally ill, who often don't respond well to traditional police commands and techniques and who might act unpredictably at times of crisis.

The sessions begins.

A woman with ice-blue eyes and bangs pinned back with a sparkly clip asks the deputies why they have to carry guns. Guns, she says, petrify her. She's seen what police do with them on TV.

The police officers assure her they use their guns only in true emergencies --not like the actors on TV.

Another resident wants to know whether police stereotype mentally ill people.

"Do you automatically put us in a box?" she asks.

"Do you think mentally ill people have hotter tempers than other people?" asks another.

And another resident chimes in: "Don't you have a code --1151 or something --to refer to us?"

"It's 1234," answers one of the deputies, adding that the categorization is only used so police can better help the person in mental crisis. "The police officer will hear that and start asking questions: 'How are you doing?' 'What do you need?' "

By the end of the exchange, the room appears to have warmed some. The residents appear a little more relaxed, and the police officers, too.

The training --known as Crisis Intervention Training --was held late last month. It is the third since Clackamas County Sheriff Craig Roberts took office in January 2005 and said his office must better equip deputies to deal with the increasing number of calls about people in mental crisis.

Roberts said he recognized the need a few years ago as a detective when he responded to the call near Oregon 212 in the Boring area. Roberts showed up to find a suicidal man who'd doused himself with two cans of gasoline and was holding a cigarette lighter.

"I thought 'This is absurd,' " said Roberts, realizing he didn't have training to draw upon. Roberts was able to talk the man into surrendering but felt he was grasping for what to say or do.

Jail data show that as many as 28 percent of Clackamas County Jail inmates have a diagnosed mental illness. But officials say the true percentage of inmates who have mental illnesses --diagnosed or not --is probably much higher.

Sgt. Nick Watt, who helped developed the crisis intervention course, estimates that 50 percent of the calls he responds to involve someone with mental health issues a suicidal person, a car thief on mind-altering methamphetamine, or a combative person yelling at anyone who passes by.

The dangers of police encounters with mentally ill people have been highlighted recently by high-profile incidents in the Portland area, including the September death in police custody of James P. Chasse Jr., a man police thought was on drugs or drunk but who actually suffered from schizophrenia.

In Clackamas County, there have been several incidents in which police shot and killed people acting irrationally or exhibiting mental problems --including Clint Carey, a 24-year-old Carver man who in 2005 duct-taped a knife to his hand and then charged at deputies; Fouad Kaady, a 27-year-old Gresham man who was reportedly growling, naked and non-compliant to police commands in 2005; and Joyce Staudenmaier, the Chez Ami resident shot in 2004, who had battled schizophrenia for nearly three decades.

Clackamas County's 40-hour class teaches participants about the gamut of mental illnesses and the drugs used to treat them. Participants hear mental health experts' advice on how police should approach and speak to people with mental disorders. They also act out scenarios they might encounter in the field.

Portland, and in more recent years, Washington and Marion counties, also have crisis intervention training. Portland Mayor Tom Potter recently said he wants every patrol officer on the Portland Police force to go through the city's 40-hour course, which during the past 12 years has been voluntary.

And starting in January, the state's police academy will increase classroom instruction on how to interact with mentally ill people from three hours to 12. Students seeking a basic police officer certification also will undergo eight to 10 hours of scenario-based training.

In Clackamas County, 75 members of law enforcement --including about three dozen sheriff's deputies and three dozen officers from police departments including Lake Oswego, Oregon City, Canby and Sandy --have been through the sheriff's training. Roberts said his goal is to train all 91 of his patrol deputies in the next few years. So far, he's about a third of the way there.

Sharing experiences

After a few days of intensive classroom training, the Clackamas County class breaks into small groups to tour apartments and group homes of people with mental illnesses; Portland Adventist's psychiatric ward, where police often bring people who are threatening to harm themselves or others; and the Hooper detox center in Portland, where police drop off people intoxicated by drugs or alcohol.

The visits give officers opportunities to interact with people with mental illnesses and those who treat them.

A Milwaukie group home manager tells visiting officers that it's a good idea to turn off overhead lights and sirens when responding to incidents at her group home. Lights and sirens can stir bad memories.

A woman who suffers from depression tells officers that she doesn't like handcuffs because they make her feel like a criminal. And a man tells officers that a little bit of leeway goes a long way with him --he still remembers the officer who let him keep his chewing tobacco in his mouth as he was driving to jail.

At the Chez Ami Apartments, resident Susan Funk tells the deputies that she's happy to talk to them about her police encounters because she wants them to see what she's like 80 percent of the year.

"You only know me when I'm freaking out, and that's why I come to these (trainings)," says Funk, 40, who was diagnosed 17 years ago with bipolar disorder.

Funk is clear-headed, witty and pointed in her conversation with deputies. She says if they happen to encounter her on a bad day, they should try to treat her with respect. She doesn't respond well to harsh commands or force.

"Try to be nice to me if you can," she said. "Try not to corner me. Because that would make me feel like I want to fight and struggle."

Funk also shares her take on the small number of police encounters that go bad.

"It's not only a failure of police," Funk says. "It's also a failure of family, the community and the mental health staff who have not been able to intervene."

Not just a police issue

Funk's statements about mental health officials, family and friends stepping in before a person with mental illness reaches a state of crisis ring true with Watt, who helped develop the class. Watt, the Clackamas sergeant who helped develop the program, says that clearly many people who need help aren't getting or seeking the help --and police are the ones called at the last minute when mentally ill people act out in troubling ways.

Officers can't force a mentally ill person to seek treatment unless that person is presenting a safety threat. In those cases, police try to find a hospital placement, but Watt says too often beds at Portland-area hospitals are full. Once, Watt says, the only bed he could find for an emotionally disturbed person was in Roseburg, 175 miles south.

What's more, admittance to a hospital for psychiatric help might only be a short-term fix, because psychiatric staff release the person once the immediate threat has passed. Too often, mental health experts say, people refuse additional treatment.

Police and mental health officials attribute the rise in mental health-related calls to a fundamental change in philosophy about how to treat people. People with severe mental illnesses used to be institutionalized, said Jessica Leitner, program manager for the county's behavioral health division.

But closing Dammasch State Hospital in the mid-1990s signaled a change in that philosophy in Oregon: Mental health experts came to believe that people with mental health issues were best placed in smaller community treatment facilities, group homes or their own homes.

Having more people with mental health issues living in the community, however, makes contacts with local police more likely.

Eric Cederholm, who has been diagnosed with chronic depression and post-traumatic stress disorder, was eager to talk to crisis-intervention class participants during their visit to his Milwaukie group home. He wants to offer them support.

While training is good, he said, he wants them to know that they won't always be able to talk a mentally ill person through a crisis.

Cederholm said he was determined to die in June 2005 when he pointed a gun at a Milwaukie Police officer, and the officer shot him in the arm, narrowly missing his chest. He still has the scar.

"I was hell-bent," Cederholm tells the class participants. "Some poor (guy) had to shoot me. I'm sure it ruined his day."