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Mental Health First Aid saves lives, big bucks

June 2, 2010
by Lindsay Barba, Associate Editor
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R.I. officers learn to recognize and mediate mental health incidents, avoid costly crises

By the year 2020, the National Council expects that its Mental Health First Aid program will be just as well-known as CPR and First Aid. But for now, the program is becoming increasingly popular with law enforcement in the state of Rhode Island.

After a series of unfortunate incidents involving mentally ill individuals and local police officers who were ill-equipped to deal with them, Carole Bernardo, MS, training coordinator at LifeWatch EAP, suggested integrating the 12-hour Mental Health First Aid program—which she had just been certified to teach—into Rhode Island’s Municipal Police Training Academy curriculum.

“I was observing a stress management training that was taking place at the academy and just got to talking to them,” Bernardo says. “I went over the lesson plan and they were very interested.”

That was nearly two years ago. Since then, the academy has filled every one of its Mental Health First Aid classes. But it took a bit of effort to shape the program to meet the needs of police officers, who have substantially different needs and concerns than those of other typical Mental Health First Aid audiences, which include private-sector employers, hospital and healthcare workers, and the general public.

“My recommendation was that it sounded like a decent program, but that any training program involving just a practitioner, without a police officer to relate it to police work and procedural issues, may flop,” says Lt. Joseph Coffey, who now joins with Bernardo as the program’s co-trainer. In order to increase the relevance of the training to law-enforcement personnel, the pair revamped the program’s materials to fit their target audience.

“She focused more on the signs, symptoms, and response suggestions and I made sure that everything we covered related to current police concepts regarding safety, use of force, discretion, handcuffing, and transportation,” Coffey says.

Coffey and Bernardo use their tailored program to teach new and veteran officers alike how to:

• Recognize a person struggling with mental illness (This may involve recognizing and identifying medications the person might possess or individual behaviors typical of mental illness.);
• Weigh their options when responding to incidents (This might involve making referrals to community resources or decisions to transport suspects to care, whether voluntarily or involuntarily.); and
• Understand the requirements of mental health law and how they relate to police procedures (This might involve understanding issues of personal privacy and managing them throughout the process of reporting or writing up an incident.)

The training is facilitated through lectures, PowerPoint slides, interactive exercises, and videos. One exercise requires officers to think and perform tasks while wearing headphones that beep loudly or make other distracting sounds. This exercise simulates the difficulty experienced by individuals with a mental illness who are expected to respond to an officer’s questions or react calmly in tense situations even as they hear voices or hallucinate.

“We also have videos they watch and then critique what the officers in the video did or what they could have done better,” Bernardo says. “It’s interesting because a lot of them will share situations that have happened to them, and this opens up a great dialogue with everybody in the classroom.”

While raising awareness of mental illness, the program also helps to strengthen relations between law enforcement and local providers, who are invited into the classroom to receive the Mental Health First Aid certification alongside the officers.

“Police and clinicians alike talk to us about the relevance of what we’re saying and how surprised they are by the amount of equally shared frustrations,” Coffey says. “We’re presenting a program, but at the same time building more positive relationships between groups that sometimes clash.”

The program is helping to redefine historical trends in other ways, too. According to Coffey, police have not been widely known as a community resource in the past, but their new skills have helped to establish them as such. “Now you have a police resource at your fingertips to enable these people to get help,” Coffey says. “That’s key for any community because if the person doesn’t get help, the police may be responding to a crisis-type situation in the future that nobody benefits from.”

The increased awareness will not only help to identify and meet mental health needs in the community, but alleviate the high costs associated with housing individuals with mental illness in the criminal justice system. According to a study by the Technical Assistance and Policy Analysis (TAPA) Center for Jail Diversion in 2005, mentally ill inmates cost the justice system up to seven times more than other suspects to accommodate.

“I’ve been in public safety for over 30 years, and I can tell you that probably for every dollar we’re putting in, we’re saving tens of thousands,” says Chief Anthony Silva, executive director of the Municipal Police Training Academy. “Not only in medical costs, but for the police department, it’s got to be [saving] hundreds of thousands.”

Other police departments have followed suit, recognizing the high value—both fiscal and moral—of preparing their officers for mental health crisis situations. The Seattle Police Department announced last month that it will hire a full-time, grant-funded mental health counselor to respond to incidents alongside officers, while several departments across the nation—including Seattle—offer mental health crisis training to their officers.