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���������� Note: The article below is a continuation of one we sent from MHW last week, and goes into detail about the scope of the Institute for Police, Mental Health and Community Collaboration started by ����������’ friend Don Kamin.

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New York, Texas Tackling Community Crises Via CIT, Restoration Center

Mental Health Weekly; Vol 25 Num 30, August 3, 2015

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A recent analysis in The Washington ��Post about the number of fatal shootings in the first half of 2015 involving the police and people with mental illness has sparked an important conversation in the field about the need for ��more police ��training ��on how to interact with ��people living with mental illnesses and increased collaborations ��involving�� ��law enforcement, ��advocacy ��and ��mental health communities.

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The WP compiled a database of every fatal shooting by police, including shootings involving people with ��mental illness. In response to the WP analysis, “Distraught People, Deadly Results,” ��a subsequent WP article, pointed out that police in the United ��States kill�� ��a ��person ��with mental illness every 36 hours (see MHW, July 27).

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Legislation ��to�� ��address ��these challenges is starting to take hold. Pennsylvania Gov. Tom Wolf recently signed a new law requiring district ��judges and police ��to ��receive training in mental health, autism and intellectual disabilities, all of which can affect a person’s ��behavior and interactions with ��law ��enforcement, the Pittsburgh Post-Gazette reported July 21.

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While ��crisis intervention training (CIT) has picked up across the country since its inception in Memphis, Tenn., in 1987, it is not enough. The National Alliance on Mental Illness (NAMI) ��estimates there ��are 2,800 CIT programs nationwide and 18,000 law ��enforcement agencies across the country.

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Don Kamin, Ph.D., director of the newly formed Institute for Police, Mental Health and Community Collaboration in ����������, is working ��to ��implement ��CIT ��programs across the state. “The funding ��[for the programs] was allocated by the state legislature that began in ��last year’s ��budget ��and ��was ��continued and ��increased ��in ��the current state budget,” Kamin told MHW.

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The Institute officially opened in the fall of 2014, he said. “There were several localities across the state that had ��developed CIT programs,” said Kamin, adding that he helped develop ��one ��in ��Rochester, ��N.Y., ��in 2004. “Despite that, however, ���������� had and still has far fewer than many other states that have statewide CIT ��initiatives,” he said. “Nevertheless, I am so pleased that we have begun ��the ��task of ��bringing New York state up ��to the standard that is being set by other states.”

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“I ��am a strong proponent ��for CIT, but it isn’t the cure-all,” said Kamin. “People get focused on police training ��and ��oftentimes ��CIT ��gets overly simplified for police training. Training is absolutely necessary, but it is not sufficient.”

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Collaboration ��is ��essential between all stakeholders — including law enforcement, the mental health community�� ��(both�� ��providers�� ��and overseers, like county officials), family ��members, advocates and ��consumers of services, said Kamin. An important goal is “making the mental health ��system more understandable and accessible,” he said.

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Kamin added, “While CIT training for law enforcement is an integral part of improving responses to citizens with mental illness, it is only by continuing the collaborative dialogue between ��law ��enforcement, mental health ��system representatives, and consumers and advocates ��that systems will ��continue to improve and reach their maximum effectiveness.”

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The numbers cited in ��the WP analysis are very concerning, said Kamin, a psychologist. “From my perspective, ��it’s important to note that police respond appropriately to mental health crises all day long; we just don’t hear about that,” he said. “Some of the criticism is well-deserved.”

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Kamin explained that the Institute is currently working ��on a systems mapping exercise — a structured���� ��exercise�� ��where all the stakeholders are present and discuss (and literally map) the emergency services system that exists in each locality. It’s usually done on a county- wide ��basis to respond to those in mental health crises, he said.

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“It’s an important tool for identifying each stakeholder agency’s role within the larger system, and to identify the strengths and challenges within the system,” Kamin said. To date, the Institute has completed two separate one-week ��trainings (i.e., in two different localities). “We have another scheduled for the end of August and three more already scheduled for the fall, with another two localities to be scheduled this fall,” he said.

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“We need to understand what’s working well and what isn’t,” said Kamin. “We do not want to set up a system where we’re relying on the police to be the de facto mental health worker. The big part of the issue is that we need to have more [people] accessing evidence-based practices or programs that we know work.”

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An integrated approach

The field ��points to�� restoration centers as ��an emerging trend and helpful alternative sites for people in crisis. Dan Abreu, senior project associate for Policy ��Research Associates, which operates the Substance Abuse and ��Mental Health ��Service Administration’s ��GAINS Center, told MHW that it’s very cost-effective to have a facility set up like a restoration center.

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One of the earlier adaptors of restoration centers, Abreu said, is Bexar County in San Antonio, Texas. The ��center’s ��crisis unit allows officers to drop off people with mental health or addiction disorders and be back on the street within a half hour, as ��opposed to being in the ER ��for hours, said Abreu.

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Leon ��Evans is ��president ��and CEO of the Center for Health Care Services (CHCS) that runs The Restoration ��Center, an integrated clinic that provides psychiatric care, substance abuse services, transitional housing and ��primary care services. The center is open 365 days a year, 24 hours a day.

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CHCS also provides a jail diversion program and CIT. “The program is training officers to recognize the signs and ��symptoms of mental illness in highly emotional situations,” ��Evans told MHW. If officers think a person has a mental illness or an addiction, they can bring them to the center for treatment rather than jail, he said. “Police officers are given additional skills they can use to make our communities safer,” said Evans.

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A component of the training involves psychiatrists and other mental health experts instructing officers about ��mental illness–related ��issues. There’s also role-playing, Evans said. “Rather than tackle someone, they’re taught to step back and listen to the kids and use a lower voice,” he said. “If you don’t pass role play, you do not receive a certificate.

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After training, officers receive a refresher course every two ��years, Evans said. CIT has been so successful, said ��Evans, that the sheriff has incorporated it into the Bexar County Sheriff’s Academy, he said. “Most communities do not like to take the time with law enforcement training,” Evans said.

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Evans said the center works effectively ��with ��the ��community, ��including churches, health care providers, families and consumers, and with NAMI, local and national. The strong community partnership has resulted in positive outcomes for the community, he noted. Bexar County boasts an 85 percent reduction in homelessness and a ��50 percent reduction in emergency rooms visits, he said. Additionally, the county has seen about $50 million in savings to the community since 2008, according to the CHCS website. ��

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