[NYAPRS Enews] MHW: NY, TX Tackling Community Crisis Via CIT, Restoration Center

[Briana Gilmore]

NYAPRS 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 NYAPRS' friend Don Kamin.

New York, Texas Tackling Community Crises Via CIT, Restoration Center
Mental Health Weekly; Vol 25 Num 30, August 3, 2015

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.

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).

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.

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.

Don Kamin, Ph.D., director of the newly formed Institute for Police, Mental Health and Community Collaboration in New York, 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.

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, New York 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."

"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."

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.

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."

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."

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.

"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.

"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."

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.

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.

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.

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.

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.

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.

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.

http://www.mentalhealthweeklynews.com/

-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://kilakwa.net/pipermail/nyaprs_kilakwa.net/attachments/20150803/379a382e/attachment.html>