Crisis Intervention Teams train police officers to understand mental illness without resorting to violence.
By Daniel Ross / Yes! Magazine
Brandy Brown was in her kitchen when she heard the gunshots.
“I thought it was fireworks at first. But I looked outside and I saw a police car down the street. My first instinct was to get my nephew inside the house,” she said.
Brown shepherded her 4-year-old nephew inside her apartment in South Central Los Angeles before going to investigate, which is when she discovered that her friend Ezell Ford had been shot and killed by police.
People who should be receiving mental health services don’t have anywhere to turn.
“Once we knew it was Ezell who was dead, I remember that night being so emotional, especially when his mom came over to the scene. She just fell down on her knees, her hearing-aid fell out. It got trampled,” said Brown, a youth aid worker for a local nonprofit.
She paused at the memory, her large brown eyes turning misty; her daughter, her head covered in rainbow hair clips, played at her knees. “There were so many cop cars. There were so many police. When they put Ezell into the ambulance, I just remember thinking, ‘How can the police do something like that?’”
Tacit in Brown’s recollection is the more pointed question: Could nonviolent tactics have been used to subdue Ford or, for that matter, other mentally ill people?
Ford’s death in August at the hands of two Los Angeles Police Department officers—in the wake of Michael Brown’s killing in Ferguson, Missouri—was splashed across national headlines. Like Brown, Ford, 25, was unarmed, but he also had a history of mental illness. His family has filed a $75 million lawsuit against the city, claiming that he was complying with orders to lie on the floor; eyewitnesses corroborate this. The City claims that Ford tried to grab one of the officers’ guns during a struggle.
But substitute Ford’s name with that of other mentally ill victims of police shootings, and the stories take on macabre similarities.
Take recent events in Cleveland, for example: Tanesha Anderson, who suffered from schizophrenia, died after being allegedly slammed to the floor by officers. She was unarmed.
James Boyd, a mentally ill homeless man, was killed by police in Albuquerque, New Mexico. He apparently brandished two small camping knives at the time, while a video shows the police standing meters away from Boyd when they opened fire.
Many of the nation’s mentally ill fall victim to police officers who too quickly draw their weapons, or they become entangled within a criminal justice system that repeatedly incarcerates them and mistreats their illness.
In the United States, a reputed one in four people live with some degree of mental illness, ranging from depression to a diagnosed mental condition. And with 716 out of every 100,000 people incarcerated, no country incarcerates a higher percentage of its population. In 2012, it was estimated that there were more than 356,000 inmates with severe mental illness in prisons and jails.
In comparison, there were approximately 35,000 patients with severe mental illness in state psychiatric hospitals, meaning that the number of mentally ill in prisons and jails was 10 times the number in state hospitals. Prisons, in effect, have become surrogate mental health facilities.
Yet solutions to this problem exist.
A number of police departments are currently diverting the mentally ill away from prison and into treatment facilities through Crisis Intervention Team (CIT) programs that foster closer ties between police departments and local mental health systems.
Officers who have gone through a 40-hour CIT training course are significantly less likely to use force during crisis call-outs, while the partnerships forged between police and mental health departments provide officers with a valuable alternative to jail.
Both lives and money have been saved where CIT training has been implemented, yet only 15 percent of law enforcement jurisdictions in the United States have adopted the program. The question is: Why haven’t more police departments followed their lead?
“With CIT-trained officers, they try to get treatment established,” said Michelle Mata, who suffers from severe depression and suicidal thoughts. Mata, who lives in San Antonio, Texas, is a longtime advocate of CIT training and appears in “OverCriminalized,” a video series produced by Brave New Films about mental illness, drug abuse, and homelessness. She has seen how CIT training among local police officers has improved the lives of mentally ill people in her hometown.
“CIT officers are not only trained to protect themselves and the public, but they’re trained to protect the person who is in a crisis,” she said. “It gives me the opportunity to take back my life, take back my dignity. It reinforces to me that I’m worth saving.”
CIT programs are a remarkably effective solution on multiple levels. Where instituted, they have been proven to save millions of taxpayer dollars. Already, all but four states—Alabama, Rhode Island, Arkansas, and West Virginia—implement CIT training in at least one county.
Housing the largest CIT operation in the country, the Los Angeles Police Department is one of the few that has.
“They’re coming from all over the country and world to learn how we operate here in Los Angeles,” said Lieutenant Lionel Garcia, LAPD’s mental illness project coordinator.
There are approximately 5,000 patrol officers in the LAPD, all of whom have received some kind of mental illness training, according to Garcia. Currently, about 1,300 of those LAPD officers have received 40 hours of CIT training. Some would like to see that number expanded.
Many of the nation’s mentally ill fall victim to police officers who too quickly draw their weapons.
“Given the frequency with which police shootings involve people with mental illness, there needs to be more training than there is,” said Peter Bibring, a senior staff attorney at the ACLU of Southern California.
“What happens in places like LA is that they train specialized teams,” Bibring continued. “And that’s great when they’re called out. But officers don’t always know when a particular call or stop they make on the street is going to involve somebody with mental illness.”
Garcia argued that it would be logistically unfeasible to put all LAPD officers through a 40-hour CIT training program—a point that Bibring doesn’t counter. Nevertheless, the negative coverage his force has received in recent times—such as that garnered by the shooting of Ezell Ford—has made the department take notice, Garcia said.
“Once we heard what they were saying, our position was, ‘OK, let’s evaluate what they’re saying—let’s not get defensive about the issue,’” he said.
In the 12 years since the LAPD employed CIT training, Garcia believes he has seen a marked improvement in how the department serves mentally ill people in Los Angeles. Of the approximately 13,000 crisis calls that the LAPD receives a year, around 2 percent require dispatched officers to engage in some kind of force.
“That 2 percent is very low relative to many cities,” he said.
In broader national terms, the push for federal adoption of CIT programs is steadily gaining traction. Last spring, the National Alliance on Mental Illness (NAMI) submitted testimony to a Senate judiciary subcommittee hearing calling for nationwide expansion of CIT programs to reduce fatal events involving police and mentally ill people.
Working at the root of the problem
Two weeks after Hurricane Katrina hit New Orleans, Paton Blough was hit by what he describes as the mother of all psychotic episodes.
“I ended up being arrested for the first time in my life, at age 29,” said Blough of the incident in Birmingham, Alabama, where he fled police in a high-speed chase along an interstate highway, his shotgun wedged between the console and the passenger’s seat.
“It was my full belief that the police were trying to kill me,” Blough said. “But it was my mental illness making me believe that I was invincible, that I was in charge of the situation, when I wasn’t.”
Because the police officers didn’t show up at his subsequent trial, Blough was charged with reckless driving only. He was fined $75 and released. But the incident marked the beginning of more than three years of continued run-ins with the law, a result of his rapid-cycling bipolar disorder, which brought about delusions and hallucinations. Blough returned to Greenville, South Carolina, where not six months later he was arrested again.
“I’m walking down the street thinking that the whole world was against me,” he said. “That night, the police were trying to get me into their car, trying to shut the door, and I was thinking the car was going to blow up, so I was fighting with all I had. I was cuffed with leg irons and handcuffs when I was [electrically stunned] in the back of the police car. It was very violent. It took seven officers to arrest me.”
Blough received eight different charges, including police assault, resisting arrest, destruction of county property, and not identifying himself. His troubles didn’t end there. He continued to suffer four more manic episodes—two involved violent arrests, but two others calm arrests.
“Each time there were calm arrests was because the police officer stayed calm also,” he said.
In 2008, the tides shifted. He went through Greenville’s Mental Health Court program, was ordered into therapy, and found a foothold in their mental health system. After he completed the court-ordered program (not a CIT), all charges related to previous psychotic episodes were expunged from his record. “My criminal record wasn’t a reflection of me but my mental illness,” Blough said.
His life was back on track, and he remarried in the spring of 2010. But in August of that year, he read in the newspaper how Andrew Torres, a mentally ill man in Greenville, was electrically stunned by police during an arrest and later died. Torres’ death prompted Blough to contact the Greenville Police Department to offer his help with their newly instituted CIT program.
Remembering how pivotal peaceful, verbal de-escalation tactics had been to his nonviolent arrests, Blough—who now belongs to the South Carolina National Alliance on Mental Illness (NAMI) State Board—wanted to spread a message of empathy versus aggression to a police department where, up until 2010, only a dozen or so officers received mental illness training.
Since 2010, when CIT was instituted in Greenville, the difference has been as stark as night and day, said Lieutenant Stacey Owens, who supervises the department’s CIT program.
It’s really a systemic problem that our mental health departments are so underfunded and fragmented and broken.
“When I began my career in law enforcement in 1992, there was not a lot of training in South Carolina in how to take control of a situation or how to talk with someone who was suffering from mental illness,” said Owens. He continued:
Police officers tended to simply agree with whatever the person was saying. For instance, if an individual was hallucinating or stated they were seeing strange objects in their house, some officers would say, “What’s wrong with you? There’s nothing on that wall.” Some officers would act is if they could see whatever the individual said they were seeing. It was hard [to find] what technique would work best, and it was hard with no training [to know] what technique would work best.
CIT training, he said, teaches law enforcement officers how to approach the situation from a different angle.
“They train you to be truthful and to say, ‘I believe you see those things, but I don’t see them.’ So you’re not lying, but you’re giving some credibility to the individual,” said Owens.
“When we arrive at a scene, we only know that we’ve got someone acting in a strange manner,” said Owens. “We don’t get to hear and see the side of the story of where they’re coming from or what they’re dealing with on a day-to-day basis. So to hear some of these stories and to hear from some of these people [through our training], that really helps me understand a little bit better.”
In 2013, Greenville saw 168 incidents related to CIT crises. Of those incidents, officers used some type of force only 15 times. Equally significant, only three individuals were incarcerated. The rest were taken to a mental health facility, a hospital, or officers left them at the scene of the call-out.
Mental health impact
The original blueprint for the 40-hour, one-week CIT training model was developed 25 years ago in Memphis, Tennessee, after a call came through of a 26-year-old man armed with a large knife. He was cutting himself and threatening other family members. After a brief encounter with the dispatch officers, the young man died as a result of several gunshot wounds.
“A community outcry of this event prompted the mayor of Memphis to assemble a community task force to direct a safer community crisis response,” said Major Sam Cochran, former coordinator of the Memphis Police Services Crisis Intervention Team.
Implemented the following year, the Memphis CIT program brought about immediate results. For example, before the introduction of CIT training, the injury rate for officers was 0.035 per 1,000 events. Three years later, the officer injury rate fell to 0.007 per 1,000 events. The arrest rate of the mentally ill had also dropped: In 2000, the CIT arrest rate in 100 randomly drawn calls was 2 percent—significantly lower than the estimated national average of 20 percent.
Looking at how the Memphis model succeeded, Cochran is keen to emphasize the close ties between the police and local mental health providers.
“Although many partnerships are in place, the structured foundation of CIT is framed with the partnerships of law enforcement, mental health providers and advocates, which is where NAMI [National Alliance of Mental Illness] comes in.” The stronger those partnerships, the better the entire mental health system in Memphis, he said. “The fostering of community partnerships is an absolute must. CIT is not a law enforcement program—it’s a community program.”
The recidivism rate for mentally ill felons who don’t receive treatment can be as high as 75 percent.
In contrast to Memphis, where only selected officers receive CIT training, in San Antonio all police officers must go through a 40-hour CIT training program before hitting the streets.
Before the introduction of CIT training, San Antonio had the option of taking mentally ill people to hospitals for treatment—but the incentives weren’t there for officers to take that route, said officer Joe Smarro, of the San Antonio Police Department.
“It was much easier and quicker to book mentally ill offenders for petty misdemeanors, fabricated crimes,” he added. “Or we would take them on a cursory ride to the next town and drop them off and say, ‘Good luck to you,’”
Smarro found himself returning time and time again to the same call-outs involving the same people and the same set of circumstances.
“But when we take them into treatment, plug them into the right resources, and try to find them some kind of family support who will re-buy into this because we now have resources to help them, the chance that they will never call the police again goes up significantly,” he said.
In San Antonio, police officers were spending between eight to 14 hours in the emergency room per mental illness case before the CIT program. The force spent approximately $600,000 in overtime. And it cost $2,295 per case to take a mentally ill person to jail.
In contrast, after CIT started it costs $350 per case to take a mentally ill person to a treatment facility. Officers are in and out of treatment centers within 15 minutes. And over the past five years, taxpayers have been saved $50 million, according to Leon Evans, president at the Center for Health Services at San Antonio.
“Treatment works. But treatment doesn’t work in jail or prison or emergency rooms or out on the street,” he said, stressing the collaborative relationship between the local mental health services and police departments in San Antonio.
He said that the recidivism rate for mentally ill felons who don’t receive treatment can be as high as 75 percent. “But for these mentally ill felons who get treatment with me, guess what [the recidivism rate] is in Bear County? It’s 6.6 percent,” said Evans. “And these are not my numbers. These are numbers produced by the Criminal Justice System here in Texas.”
The broader picture
What’s needed is a wholesale look at the nation’s mental health, not just police departments, said Laura Usher, CIT program manager for NAMI.
“It’s really a systemic problem that our mental health departments are so underfunded and fragmented and broken,” she said. “People who really should be receiving mental health services don’t really have anywhere to turn. They wind up encountering police as a result.”
Similarly misplaced are any squabbles over the initial costs involved with instituting CIT training, Usher said, especially in light of the overall costs involved with incarcerating mentally ill people.
Of those roughly 2.23 million jail or prison inmates, one in five live with mental illness.
“If you look at the costs to your county government, your state government, or to your community as a whole, the cost of not acting is much bigger,” she said. “It’s much more expensive to have people in jail or prisons. It’s much more expensive to have people in emergency rooms or on the street or in homeless shelters than it is to provide them with good crisis intervention services and the care they need.”
The ACLU’s Peter Bibring agrees that the issue is a complex one, and believes that CIT training alone won’t solve the problem of excessive police tactics.
“But it’s one way to help bring use of force down,” he said. “And given the high number incidents involving people with mental illness, it’s a very important one.”
For Brandy Brown, not a day goes by when she doesn’t think about her friend. “Every time I looked out the window, I used to see him in front of the store outside my apartment,” she said. “That’s one of the hardest things about him being gone.”
And the fallout from Ford’s death has left its mark on Brown’s daughter, who now imitates the “Hands up, don’t shoot” maxim she heard during subsequent demonstrations over Ford’s killing.
“When I first heard her say it, I was hurt because my baby is only one year old,” Brown said. “And what should she know about ‘Hands up, don’t shoot’?”
Brown swivels her daughter on her lap so as to look her in the eye. “It’s for us to make it better for them, so they don’t have to endure the same things that we had to.”
Daniel Ross wrote this article for YES! Magazine. Daniel is a Los Angeles based writer. He is frequently featured in The Guardian, Truthout, VICE, and The Huffington Post, among others. Follow him at @1danross.
This article was produced in partnership with Brave New Films.