Police Trained to Intervene In Mental Health Crises

There are calls some on-duty police dread more than others—a report of a man about to jump from a bridge onto a busy freeway, for example, or an apparently psychotic person who is becoming more and more agitated while walking along the same stretch of sidewalk.

In Rochester, N.Y., however, a growing number of officers rush to these situations equipped with the knowledge that they have a good chance of intervening effectively and thus save lives.

They are members of the Rochester Police Department's Emotionally Disturbed Persons Response Team (EDPRT) and are bringing the skills and knowledge they have acquired through an intensive two-week course onto the streets and into the homes of Rochester.

“The officers are better able to work with those in crisis and keep potentially dangerous situations from getting out of control,” said Cedric Alexander, Ph.D., deputy chief of police for the Rochester Police Department.

Alexander worked as a police officer in Miami for 20 years before deciding to pursue a doctorate in psychology. He then taught for a time in the University of Rochester's Department of Psychiatry. Several years ago, Alexander returned to law enforcement.

After a couple of incidents in 2002 in which two men who had been exhibiting signs of psychosis died during or shortly after coming into contact with city police, Alexander decided to take action.

Those incidents, he said, “are the kinds of opportunities you use to step back and say, Is there something we can do to enhance training and reduce the likelihood of those situations happening again?”

Program Strengthens Community Ties

Alexander relied on his experience as a clinician and educator to develop a curriculum for a training program that addresses the many aspects of mental illness that intersect with police work—psychopathology, assisted outpatient treatment, mental health courts, and medications, for example. He also developed course material on empathy, ways in which to respond to people who are hearing voices, and police stress.

Alexander recruited a number of local experts, including his former colleagues at the University of Rochester's Department of Psychiatry, to teach the course. Instructors include psychiatrists, psychologists, social workers, mental health consumers, and members of the police force.

The course has been offered twice so far—in March 2004 and last January. Pupils have included Rochester police, officers from a number of other departments in Monroe County, N.Y., the Monroe County Sheriff's Department, and parole and probation officers.

Police who pass a written examination at the end of the course become certified by the Rochester Police Department to join the EDPRT, of which there are 42 members.

Clinician Relationships Crucial

Through the training program, the police department has forged relationships with area hospitals and mental health clinicians, according to Alexander.

“If we take a person off the street and into one of the emergency departments or psychiatric units, the staff members know who we are, and we have a great working relationship with them,” he said. “Many of the folks working in the hospitals have helped to instruct these officers through the program.”

One of those instructors is Laurence Guttmacher, M.D., chief of psychiatry and acting clinical director of the Rochester Psychiatric Center. He said he teaches the officers “a kind of DSM-IV 101” in which he describes various psychiatric disorders and discusses their causes and treatments.

Guttmacher is also an associate dean and associate professor of psychiatry at the University of Rochester.

It was there that he heard a grand-rounds presentation about the EDPRT training program earlier this year. “I thought it was the greatest thing since sliced bread,” he told Psychiatric News. He subsequently became involved in the course as an instructor.

As part of his EDPRT duties, Guttmacher critiques the officers during role-playing exercises staged to sharpen their skills in dealing with people who have mental illness.

He also spends time talking to the officers about posttraumatic stress disorder (PTSD) and how to recognize any signs and symptoms in themselves.“ This group is at high risk for PTSD,” he noted. “Imagine what it is like to respond to murder scenes, rapes, or devastating auto accidents day after day.”

Guttmacher observed, “The officers are excited to learn this material... .What struck me is how much they want to understand mental illness.”

Some police who are not trained to deal with people with mental illness“ tend to blame and otherwise stigmatize people with mental illness due to a lack of education,” Guttmacher observed.

Police `Totally Transformed'

As commander of the EDPRT and one of the instructors, Sgt. Eric Weaver has witnessed the benefits of the course firsthand.

“By the end of the course, I saw a group of about 50 people who were totally transformed,” he said. “From day one to day 10, I saw a complete shift of attitudes and a reduction of stigma” among the officers.

“There is a great deal of compassion and understanding that springs from the course,” he added.

According to Weaver, one of the most compelling sessions is one in which consumers from the local branch of the National Alliance for the Mentally Ill stand in front of the law-enforcement officers to discuss their experiences with mental illness.

“You can hear a pin drop when a consumer is speaking about what it is like to live with schizophrenia,” he noted. Weaver explained that listening to a person with mental illness who is not in crisis is destigmatizing. “On the job, we normally only see people when they are in crisis,” he explained.

Perhaps even more compelling is the part of the course in which Weaver talks with the officers about his own struggles with mental illness.

He was diagnosed in 1996 with major depression. “I was suicidal—I was hospitalized five times in 1996 and then again in 1998,” he said. “I share my experiences because a lot of the officers have these issues too.”

Weaver emphasized that the EDPRT training program “isn't just a police course; it's a human-being course.” ▪