A MENTAL HEALTH NEWSLETTER FOR LAW ENFORCEMENT PROFESSIONALS
 

Mental Health Association of Greater St. Louis A United Way Agency

In this issue . . .

By David Klinger, Associate Professor of Criminology and Criminal Justice at UM-St. Louis. Prior to pursuing a career in academics, Professor Klinger worked as a street cop in the Los Angeles, CA, and Redmond, WA, police departments. Into the Kill Zone is available at local bookstores, Amazon.com and most other web stores.

Fortunately, most police officers (about 90%) never shoot anyone during their law enforcement careers. For those cops who do, however, the experience can be a rough one. Anyone who has spent any time in police work has heard stories of (or from) officers whose lives have been turned upside down by shootings; especially those that suspects didn’t survive. While such tales are a common aspect of the police landscape, they do not tell the entire story of what happens to cops who pull the trigger. I know this because I have devoted considerable time and energy over the last several years to studying how police officers react in the wake of shooting incidents. Between 1997 and 1999, I interviewed 80 police officers from 19 different law enforcement agencies in four states who had shot suspects in the course of their duties. Since that time, I have analyzed the information I collected, made numerous presentations based on what I learned, and penned a recently-published book called Into the Kill Zone: A Cop’s Eye View of Deadly Force that tells in the officers’ own words how their shootings affected them. 

Among the key findings of the research I conducted is that a sizable majority of the officers I interviewed suffered no notable long-term problems from their shootings. Just 20% of them reported experiencing two or more negative reactions such as having problems sleeping, being fearful, or feeling guilty three months after their shooting. Along the same lines, many officers reported very little or no disruption at any time following their shootings; 18% percent said they had just a single negative reaction during the fist day after it occurred and another 20% had no negative reactions whatsoever during this time frame. That a substantial majority of shooters reported no notable long-term problems and a sizable minority had no notable short-term difficulties should not be taken to mean that shootings don’t take any toll on most officers, however. Indeed, if 38% of the shooters had either no or just one negative reaction in the 24 hours following the event, then 62% of them had two or more during this time period. In other words, nearly two out of every three of the cops I spoke with reported that their shooting caused them some notable difficulties. 

What can we make of all these numbers?  The first point I would like to emphasize is that the 38% figure indicates that shooting someone causes no real consternation for many officers. A second key point is that the shift in the notable disruption figure from 62% in the first 24 hours to just 20% after three months indicates that most officers who do have some difficulties following a shooting are able to integrate the event into their lives as time passes. A final point is that the 20% notable disruption after three months indicates that shootings do, in fact, take a substantial toll on some officers who pull the trigger. 

Police officers, police administrators, and mental health professionals who deal with the police should keep these points in mind when considering how officers might react in the wake of a shooting. The evidence shows there is no single way that officers deal with what they have done; there is no single way cops live with killing. 

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Correction: The July edition of Street Talk incorrectly identified the March 2004 CIT training as the third; it was the second.

During the week of July 26, more than 40 officers completed the third offering of the Crisis Intervention Training (CIT) program at St. Louis County and Municipal Police Academy. This brings the total number of CIT-trained officers to 155. For more information about CIT, read Sgt. Barry Armfield’s column, CIT Corner, immediately following.  If you are interested in becoming a CIT officer or your municipality would like to join the ranks of CIT-trained departments, contact Major Robert Trittler at 314-615-2551. 

Congratulations to the newest CIT officers!

 
Congratulations to the July, 2004 CIT Graduates

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By Sgt. Barry Armfield,  a St. Louis County Police Officer for 31 years, with assignments in all patrol divisions including Tactical Operations.  He is the CIT supervisor for the West County Precinct, Chair Person for the CIT Training Committee and a member of the CIT Executive Committee.

CIT Corner is a new column that will appear regularly in Street Talk. CIT-trained officers will contribute articles to the column for the purpose of sharing information about the successes and expansion of CIT (Crisis Intervention Training) in the metropolitan area. 

Police Departments across the country are frequently called to crisis incidents involving persons with mental illness.  Sometimes these situations are high risk and can lead to tragedy. 

Realizing the need for a specialized law enforcement team that could effectively, compassionately and safely deal with persons involved in mental health crisis, a Crisis Intervention Training (CIT) program was developed by the St. Louis County Police Department.  With cooperation from mental health organizations such as the National Alliance for the Mentally Ill, Mental Health Association of Greater St. Louis, Missouri Department of Mental Health, Behavioral Health Response, BJC Behavioral Health, private individuals specializing in mental health, and the St. Louis County Counselor's Office, a coordinating council formed and a program was developed for the first crisis intervention team in the St. Louis area. 

Selected officers and supervisors who have an interest and desire to become CIT officers are sent to a 40-hour academy-based POST-approved training.  This is an intensive specialized course that provides officers with the skills, methods and tactics to safely de-escalate incidents involving persons who are in a mental health crisis.  Upon receiving this specialized training, officers return to serve in a patrol capacity, but are available to respond to and handle mental health crisis situations. 

The benefits of the Crisis Intervention Training are:

• Greater efficiency in obtaining care for persons involved in a mental health crisis.
• Significant decrease in injuries, death and community dissent.
• Reduction of recidivism and arrests by diverting individuals with a mental illness to the proper mental health facility and/or the St. Louis County Mental Health Docket or the St. Louis County Jail Diversion Project.
• An increase in officer skills and on-scene expertise in responding safely to crisis situations, increasing citizen confidence in reporting incidents.
• Increased cooperation between criminal justice and mental health systems.
• Established responsibility and accountability.
• Improved satisfaction from the person with mental illness and from family members.
• Increased officer safety.

The CIT program is currently available to departments in St. Louis County by contacting Major Robert Trittler at 314-615-2551 or RTrittler@stlouisco.com. 

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By Susan McArthur, MSW, LCSW,  Assistant Director of the Housing Resource Center.

Have you come into contact with homeless people in the line of duty?  How can you be sure? 

In everyday life we often see people that have families and jobs, but no home. In the St Louis metropolitan area, the majority of our homeless people are single mothers with children. These are not the homeless people you find sleeping on park benches or over sidewalk vents. Yet they go through the same difficulties as those who are considered chronically homeless. The U.S. Department of Housing and Urban Development’s definition of chronic homelessness is someone who is unaccompanied, has a disability, and has been homeless for more than one year or had several episodes of homelessness over the past three years. These people are the men and women we think of as the visibly homeless because they can be seen in public, but nationwide, they represent only about 10% of our homeless population.  

Whether you are working with families or individuals, there are a few things to consider when working with homeless persons.  As humans, they have the right to make their own decisions so long as they are not hurting themselves or others. We like to think that if they chose to go into emergency shelter, we would be able to get them in with no problem. Unfortunately, the community has lost over 100 shelter beds, mostly in the county, in the past two years. Agencies have been forced to close their doors due to budget cuts and the rising costs of staffing programs. 

How to access emergency shelters 

In St. Louis City and County, there are two approaches to getting people into shelter programs.  There are a number of shelters that participate in the City or County Homeless Services Networks.  In order to get referred into one of these programs, the homeless individual must call the Homeless Hotline at 314-802-5430. The hotline is available from 8 a.m. to 8 p.m., 365 days a year. When a family contacts the hotline, a referral is made based on the needs of the family and the availability of shelter.  

The hotline is operated by the Housing Resource Center, located at 800 N. Tucker, inside the Partnership Center. It is open to clients Monday through Friday from 8am to 4pm.  

The other approach is to contact "independent" shelters that choose not to be part of the Networks. Each “independent” shelter sets its own hours and eligibility requirements, so a phone call is necessary to determine if a person is appropriate for the program and if room is available.

There are several “independent” shelters in St. Louis City.

For Men	For Women and Children
Harbor Light                             314-652-3310	Karen House                            314-621-4052
New Life Evangelistic             314-421-3020	Missionaries of Charity           314-533-9070
Sunshine Mission                    314-231-8209	New Life Evangelistic              314-421-3020

New Life Evangelistic Center also has a shelter in St. Louis County                               314-890-0486

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This November, Missouri residents will be faced with a choice. Amendment 3 to the state’s constitution will redirect funding from General Revenue to the Missouri Department of Transportation. Presently, half of the sales tax paid on motor vehicles goes to the General Revenue fund and is used to support our schools, mental health, healthcare, drunk driving enforcement and other state services. 

Amendment 3 will redirect that money to the road bond fund. Over the next four years, more than a half billion dollars will be taken from critical state services and will be used to issue bonds to build new highways. We will not be repairing the ones that need it, just building new ones. Additionally, if this change is made, the Department of Revenue will no longer be able to administer the procedures related to drunk driving license suspensions. 

To make matters worse, the funding will be placed outside the appropriation process.  There will no longer be oversight by our elected Representatives and Senators. 

Children’s Tax Initiatives 

Jefferson County, St. Charles County and St. Louis City have initiatives on the ballot to establish a tax in each area to be spent on children’s services. We have seen the wearing down of state services, and local people with local control need to establish services in their own communities to protect our children from cuts now and in the future. 

Many times, schools need to refer children to outside services to maximize their potential in school. Often, they find these services do not exist or they are full. In other words, “come back later.”  Our children need help and assistance now…they cannot come back later.

Both of these ballot items have implications for law enforcement. Please take time to become educated on these important issues before you vote!

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By Kay Rittenhouse, Director of Volunteer Services at NAMI St. Louis.  For the past three years she has worked with staff and volunteers at MPC to establish this new outreach program.  Kay is a family member and has worked with police education during the past ten years.

Ordinary people doing ordinary things together can have extraordinary results. 

The NAMI Family Support Program at MPC (Metropolitan St. Louis Psychiatric Center) is a resource police officers can recommend to families they contact when someone has a mental illness. More than 15 volunteers work together to create this program where the families and friends of persons in this acute care hospital receive a friendly greeting and an invitation to hear about NAMI (National Alliance for the Mentally Ill) programs of family education and family support.  The volunteers work from a lobby desk at MPC during many visiting hours.  

(Names have been changed for this scenario.) Jo prepares the desk for her afternoon of work. She will change the water for the fresh flowers Grace brought yesterday. Nora has left some records of people who want to be added to the mail list. Four different volunteers have left messages from their work so Jo can learn what’s been happening since she was here last. She notes that two new volunteers are in training and that one student has completed her semester of internship. She reviews the end-of-month report and reads the new monthly letter that keeps everyone informed of the total project. She reviews new information and prepares to greet her first family. 

This simple program of one-on-one contact has reached more than 600 families during the past three years. One does not have to walk alone when a loved is diagnosed with a mental illness.  

Police officers during their ordinary work on an ordinary day can be part of an extraordinary process . . . getting someone who is ill access to treatment. During routine work you can do small things that make a tremendous difference. One woman told me of an officer who had to pick up her husband on Easter morning. He had bipolar disorder and had not taken his medication. Two young children were watching the scene. The officer knelt down and told them their dad was very sick and he would get him help.   

Taking just a moment to let family members know they can call NAMI St. Louis at 314-966-4670 or talk with a volunteer at the NAMI Lobby Desk at MPC can link them to the hope and support they need. Callers can also learn about other services at NAMI such as:

• HELPLine, for support, information and referral services
• A Library of books, pamphlets and flyers written for family members covering all aspects of mental illness
• Support Groups throughout the metro area for family members to share group wisdom and solve problems together
• Educational Programs of many kinds on all aspects of mental illness, treatment and other services necessary for recovery.

Working together, we can make all the difference!

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  By Rick Scott, Ph.D., the Unit Director of the Forensic Evaluation Program at St. Louis Psychiatric Rehabilitation Center.

On rare occasions, a person who has committed a crime is declared “not guilty by reason of insanity.” In Missouri, who decides whether or not a person is still dangerous and should be allowed access back into the community? 

When a person is found “not guilty by reason of insanity (NGRI), the court commits him or her to the Department of Mental Health (DMH). These “forensic clients” are placed at a level of security, e.g., maximum or minimum, appropriate to the NGRI crime and risk. Clients must work through the “forensic system” by making progress in treatment and demonstrating lower risk through their behavior over time. New dangerous behavior may mean transfer back a higher level of security. There is no maximum time of commitment like there is with a prison sentence. 

When clients are clinically ready, a “trial release” or “conditional release” may be sought. Trial and conditional releases include rules about when and where clients may go, what clients must and must not do, and how clients are supervised in the community. Trial release involves living in the facility and taking passes for up to 96 hours total. This is like John Hinckley’s (the would-be assassin of the late President Ronald Reagan) release several months ago. Conditional release is a release greater than 96 hours. With a partial conditional release, clients live in the hospital and go into the community for assigned activities and/or passes. Full conditional release includes discharge to an approved setting. Conditionally released clients continue to be supervised by caseworkers and a psychiatrist who monitor treatment, behavior and compliance with the rules of the release. Failure to comply with these rules leads to revocation of the release and return to a secure facility. Finally, there is unconditional release, which is complete release from the court commitment. These are granted rarely and only when the client proves that supervision by the court and DMH is no longer necessary to protect public safety. 

To obtain any type of release, the treatment team applies to the Forensic Review Committee, composed of senior clinicians at the client’s facility. If the committee approves, DMH leadership in Jefferson City review the request. If they approve, the release is sent to courts in those jurisdictions involved in the NGRI commitment and in the release plan. Prosecutors and victims have 30 days to object to the proposed release. For trial release, if there is no objection, the release is approved. For conditional release, if there is no objection, a judge will sign an order for release. In any case, if there is an objection from a prosecutor, a hearing is held and the decision to release the client is made by the judge after the hearing testimony.

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By Officer Kendra Miller, Maryland Heights Police.  Officer Miller has been with the Maryland Heights Police Department for three years and has spent several years as a reserve with the Florissant Department. She also works part-time as a nurse at Christian Northwest and for the St. Louis Medical Examiner’s office.

Earlier this summer, on July 15, during an arrest attempt, I was attacked and basically mauled by a suspect’s dog. Following the incident, I was asked to write about how the police brotherhood “came to my rescue.” This, I said, would be easy. 

The following is an excerpt from an open letter to the Maryland Heights Police Department I wrote after getting out of the hospital. 

“. . .Now to the thank you part.  To everyone who worked that day and was there when I needed them, I thank you. There is nothing sweeter than to hear a hundred screaming sirens coming your way when you yell HELP”.

And there is no sweeter sound than that. While I was standing there with my arm bleeding and gun filling with blood, I knew it would be only a matter of seconds and the place would be “swarming with cops.” I knew I would be safe. There is no other life situation I’m aware of that can bring a hundred strangers who will drive 100 miles an hour and get into a gun battle to save someone they never met. This brotherhood, this camaraderie we have is second to none. Through this, I and every other Police Officer, has the strength, the backing to do this job every day. 

After the initial incident is over and the suspect has gone to jail, this brotherhood does not end. While in the hospital following surgery, there was a steady stream of Police Officers coming to see me, calling, sending cards and flowers. This in itself was amazing. My hospital room looked like a funeral parlor exploded and I loved it. This continued even after I returned home. Not a day went by I did not hear from one or more of my fellow officers. 

All of these wonderful things showed me what the police brotherhood is about. Knowing your fellow officers are going to be there for you 100%, no matter what, is what has given me the strength to put in 110% at rehab…no matter how badly it hurts. I want to get back to work. I want to be able to return the favor.

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Open Mind is a column produced by the Mental Health Association, which appears weekly in many Suburban Journals.  Click here for the reprint above and access to the entire Open Mind Archive on this website.

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We have archived past issues of Street Talk on this website.  All back issues also include a Mental Health Directory and a link to a relevant Open Mind column.

July, 2004

• 2004 John J. McAtee Award Winners
• Q&A: Schizophrenia - What Officers need to Know
• In the Limelight: Officer Emily Mancuso
• ASIST Training
• Law In Action: March 2004 CIT Graduating Class
• Open Mind: Schizophrenia and the Brain
• Street Tips: Dealing with Mentally Ill or Suicidal People
• Tips from NAMI: Responding to a Mental Health Crisis
• Mental Health Directory

April, 2004

• 2004 John J. McAtee Award
• State Budget Cuts Affect Law Enforcement
• St. Patrick Center Programs
• Homeless People are Not All the Same
• Mental Health Directory
• Say YES to Homeless Youth
• Youth In Need Provides Services to Young People
• Roll Call
• P.O.S.T Approved Training
• Open Mind: Homelessness

January, 2004

• CIT: Safety, Understanding, and Service
• Street Tips: When Someone is "Acting Strangely."
• CIT: Training Makes it Happen
• Law in Action: Jail Diversion Program
• Do You Know? Obesity
• Q&A: Criteria for Involuntary Commitment
• At Your Service: Hawthorn Children's Psychiatric Hospital

October 2002

July 2002

April 2002

Following is a dated index of previous articles that have appeared in Street Talk.  To get a copy of any article or a previous issue, please call LaDonna Haley at 314-773-1399.

"It Worked for Me" (Officer Gorman)

Holiday blues vs. Seasonal Affective Disorder (SAD)

What should I know about Bipolar Disorder?

"When it finally hit home – part 1" (FBI agent Burt Jensen)

Public policy, mental health, your work

Liability issues for officers and departments

In the Limelight: Hazelwood PD

At Your Service: St. Patrick Center

I’d like you to know (helpful hints)

Dealing with frequent callers

"When it finally hit home – part 2" (FBI agent Burt Jensen)

Officer and Department of the year awards

At Your Service: Provident Counseling

Q&A: All about EAP’s

Know your mental health options

What does confidentiality really mean?

Rethinking our strategies (John Bozarth)

Anger management

Helping peers in distress

In the Limelight: Ballwin and Hazelwood PD’s

January 2002

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