A MENTAL HEALTH NEWSLETTER FOR LAW ENFORCEMENT PROFESSIONALS
 

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

In this issue . . .

By Lt. Dan Fitzgerald, who has been with the Brentwood Police Department for 23 years. He is co-chair of the Street Talk Advisory Committee.

This is the fourth in a series on stress in police work. 

In our continuing series of addressing stress in police work, this article looks at “line of duty” death and the stress it places on an officer and a department. 

Officer Jim Hurst was nearing the end of his watch when a call came out for a domestic disturbance.  Sgt. Matt Benson, a 19-year veteran of the department, and someone who had mentored Hurst for years, assisted Officer Hurst on the call. Both officers arrived at the same time and observed a heated exchange between a man and a woman. As the officers approached the couple, another man came through the front door of the residence and opened fire on the officers. Officer Hurst was able to draw his weapon and kill the shooter, but not before Sgt. Benson was struck fatally. 

Police officers are part of a very close family. When we lose a member of that family, it affects all of us. That loss hurts the deepest for members of the fallen officer’s agency. We all hope to complete our careers without having to deal with this tragedy, but the sobering fact is some of us will. Try and put yourself in the shoes of Officer Hurst. How will he and the members of his department handle this loss? 

Just like any other aspect of police work, preparing for your response to a line of duty death can help. Sometimes we feel we can handle any crisis because we are police officers, we have seen it all, and nothing bothers us. We put up a barrier against emotion and are expected to act stoically, because cops are tough and can handle it all. This mindset can lead to major problems when confronted with a situation such as a line of duty death, where a lot of emotions come into play. We need to prepare ourselves to handle the wave of feelings that come over us when we lose a member of our police family. 

Dr. Alexis Artwohl, a behavioral scientist who specializes in law enforcement, states it is important for police officers to have support mechanisms in place prior to being involved in a stress situation like a line of duty death. That support can come from peers, your agency’s chain of command, from significant others and from professional counseling. Most agencies provide counseling, some even mandate it, and Artwohl encourages officers to take full advantage of the help provided. 

Discussing how to handle the aftermath of a line of duty death with your fellow officers and how you might deal with the entirety of the event can help to prepare you for when it happens. Does your department have a set policy for the line of duty death of an officer?  If so, are you well informed on this policy?  If not, it is time you approach your supervisor about implementing a policy. Officers should not have to deal with the stress that the department has inadequately planned for the death of an officer. The hardship to the officer’s family should be considered when formulating this policy. A comprehensive policy should be in place for your department that addresses the needs of the officer’s family at home and family at work. 

One organization that has done some great work in this area is Concerns of Police Survivors. (www.nationalcops.org).  Their website offers sample policies for dealing with line of duty deaths. They are an excellent resource for assistance. 

I wonder if Officer Hurst ever thought of how he would deal with the loss of a fellow officer?  Was his department prepared for what would happen as a result of that disturbance call?   Officer Hurst and the members of his department will never be “back to normal” after that fateful day. Hopefully they were as prepared as they could be for what happened and that preparation made things less stressful.

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CIT Corner appears 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. 

The Missouri Foundation for Health (MFH) approved a grant to NAMI St. Louis to finance the CIT program in the Greater St. Louis Area. Part of the grant is evaluation of the program and CIT training. Sabrina Tyuse, Ph.D., an Assistant Professor at St. Louis University, is responsible for evaluating the program. She completed a one-year evaluation of the CIT program and results of her evaluation are used in this article. The one-year time period is from July 2005 thru June 2006. She has developed this information from reports I receive from police departments who participate in the CIT program and report the CIT incidents. 

• There were 1,259 reported CIT incidents; 55% involved male consumers and 45% female.
• 65% had a history of mental heath issues.
• Only 9% were compliant with prescribed medications
• 29.5% were under the influence of drugs or alcohol at the time of the intervention.
• 89% (850) were transported to a hospital emergency department or treatment facility.  633 incidents involved the CIT officer completing an affidavit for mental health evaluation.
• Law enforcement officers used some type of force with only 4% (52) of the persons involved in a mental health crisis and there was only one incident involving lethal force.
• There were only 9 reported injuries (bruises and scrapes) to police officers.
• 3% of the individuals in crisis received injuries after CIT involvement.

The CIT program has resulted in more than 600 officers trained in crisis intervention. Dr. Tyuse writes in her report, “Anecdotal reports suggest that CIT law enforcement officers have successfully integrated CIT methods with standard law enforcement officer training procedures, have been effective in intervening with individuals who have a mental illness during mental health crises and have successfully resolved situations on the scene or, when appropriate, have diverted individuals who have a mental illness in crisis to community-based mental health treatment facilities.” 

For more information on CIT, contact me at barmfield@stlouisco.com or call 314-628-5509. We are looking to expand the CIT program and I am available to assist.

St. Louis Police Department CIT Graduates - September, 2006

St. Louis County and Municipalities CIT Graduates - July, 2006

The Crisis Intervention Team (CIT) of Greater St. Louis continues to grow as new departments join the program and participating departments train additional officers. Courses were offered in July and September, with more than 90 officers participating. Congratulations to the newest CIT officers.

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By Lawrence Gibbs, a Long Term Specialist at the Missouri Department of Health and Senior Services. He has a master’s degree in Gerontology, and is a licensed nursing home administrator who has run several facilities in the St. Louis area.

Early Sunday morning, disheveled Joe Smith bangs on his neighbors’ doors in a high-rise complex, pleading for help, convinced someone is about to kill him. His behavior terrifies them and one calls the police. None knows Joe, 22, has schizophrenia and is in the midst of a psychotic breakdown because he stopped taking his medication. 

Hours later, elderly and widowed Marie May leaves her home on foot, determined to take tattered scarves and mittens to her children at the school on the corner, a school that was torn down years ago to make room for an auto shop. Once there, she asks to see her children, both of whom are middle-aged and live thousands of miles away. When the owner says no children are there, she becomes highly agitated, demanding to know what he’s done with them. She hits him repeatedly with surprising force. He calls the police, never realizing Mrs. Mayo suffers from Alzheimer’s disease. 

Increasingly, police are called to domestic scenes like these, expected to handle mental health crises involving schizophrenia, psychosis and dementia. These crises can turn hostile in a matter of seconds but can be defused with assistance from Missouri’s Department of Health and Senior Services (DHSS). The department is mandated by law to investigate cases of abuse, exploitation and self-neglect for seniors and disabled adults between the ages of 18 and 59. Our experienced social service workers encounter individuals with mental health disabilities daily and offer the following tips the next time you encounter a domestic situation like the ones outlined above. 

• Call the department’s Information and Referral line at 1-800-235-5503. We may be able to initiate a care plan to meet the needs of a Medicaid-eligible person suffering from a mental illness or Alzheimer’s disease. The care plan may involve placing a nurse’s aide in the home or apartment to clean, prepare meals, shop for groceries, and to help with medication, laundry and bathing. This assistance often allows a person to remain independent, minimizes domestic calls to the police and defuses dangerous situations before they erupt. In reference to the previous scenarios, an aide may be able to ensure Joe Smith takes his medication, preventing future psychotic breakdowns. Likewise, an aide may be able to help prevent situations such as Marie Mayo’s trek to the auto shop and combative behavior with the owner.
• Give the Information and Referral number (1-800-235-5503) to family members and friends who may be on the scene when you arrive. They are likely the at-risk individual’s caregivers and may be exhausted or at a breaking point. The department might be able to provide additional resources through Adult Protective Services (APS). APS helps seniors and disabled adults between 18 and 59 who are unable to manage their own affairs or protect themselves from harm. A department social worker makes regular visits to the at-risk individual and monitors the situation until the risk is under control and a degree of stability is achieved.
• Advise family members and friends at the scene that, in the future, they should call the department’s Elder Abuse and Neglect Hotline at 1-800-392-0210 if they suspect their loved one is in imminent danger.
• Learn to distinguish between the different types of mental conditions and illnesses.

·        Psychosis, which can be present in schizophrenia, bipolar illness (also called manic depression) and compulsive disorders, is characterized by hallucinations or delusions. The delusions, such as Joe Smith’s “someone is about to kill me” can be modified or controlled through medication.

·        Mental retardation and developmental disability is the inability to function at one’s chronological age. Many people with this disability are able to live independently in the community with social support centered on activities of daily living, e.g., shopping, cooking, bathing, housekeeping. The department often provides these supportive services.

·        Alzheimer’s disease and dementia are degenerative diseases of the central nervous system characterized by premature mental deterioration. During the latter states of these diseases, an individual needs 24-hour protective oversight and total care. A person who has been providing total care to someone with Alzheimer’s may have overwhelming feelings of hopelessness and helplessness. As a result, s/he may abuse the individual, which could prompt a call to police. 

The department is eager to provide information and form lasting partnerships with police officers and law enforcement so Missouri’s most vulnerable citizens can live safely, with as much independence as possible, and achieve stability. 

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The following is excerpted from a letter written by a family expressing their appreciation to Officer Shannon Woolsey and other officers in the Town and Country Police Department.

“This is to commend Officer Woolsey and the team working with her for outstanding professionalism in responding to a call for help. 

On a recent evening, my wife, third son and I were at our church dealing with our second son who was very confused, trying to get into the church. The building was locked and while he was not trying to break in, he couldn’t understand why no one was letting him in. This was the latest in a series of events that day which made us realize he was losing his ability to think rationally. 

In the church parking lot, we tried to get him to come with us to get the help he needed. We called the police to intervene, asking them not to use lights or sirens. When Officer Woolsey arrived, she immediately understood our need for help and approached our son in a very gentle and non-threatening manner. One of the other officers kept his distance and seemed to purposely not impose into the situation. In my opinion, this approach helped keep the situation from escalating while Officer Woolsey built rapport with our son. With her very caring attitude, she persuaded him to get into her car so she could take him to a hospital. 

Officer Woolsey waited with us at the hospital until the staff began to work with our son. He was admitted to the mental health unit and released the following Monday. A few days later, Officer Woolsey called to check on his well-being. Fortunately, he is following the doctor’s orders and is doing very well. We were very impressed with the team of officers for their outstanding professionalism. 

This was a very complex and confusing situation. Officer Woolsey provided the best possible support. Although we do not live in Town and Country, much of our life seems to be lived there and we have developed a huge respect for your department. 

We know that officer Woolsey and her team were not performing this service for our thanks, but please pass it on to her and the others who responded to our call for help. It seems so simple, yet so profound to say that we called for help, help arrived, and it was wonderful help indeed.”  

Congratulations on a job well done!

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By Ilene Bloom-Ellis, MSW, LCSW. Ilene is the Director of Clinical Services at Women’s Support and Community Services.  Women’s Support provides crisis intervention, counseling, advocacy and education for women who have been victimized by intimate violence. The 24-hour crisis line for women is 314-531-2003.

The facts

• One of every three women will experience violence by an intimate partner sometime in her lifetime. The American Medical Association estimates that over 3 million women are victims of severe assaults by boyfriends and husbands each year. The FBI estimates that a woman is beaten every 15 seconds. 
• Intimate partner violence is primarily a crime against women. 85% of victims of intimate partner violence are women.
• Intimate partner homicides accounted for 33% of the murders of women and less than 4% of the murders of men. The FBI reports that more than four women are murdered by their husbands or boyfriends in this country every day. Pregnant and recently pregnant women are more likely to be victims of such homicide than to die of any other cause.
• Only about half of all domestic violence incidents are reported to the police. Domestic violence calls can be among the most dangerous calls a police officer can make. They can also be the most frustrating calls.

Things police officers should know

Domestic violence is not impulsive, but purposeful and instrumental. The batterer is not “out of control.”  Quite the contrary, the act of domestic violence is a means to retain control of a partner. Most batterers are very friendly and agreeable to friends, neighbors, co-workers and especially the police. Often, when a police officer is called to the scene of a domestic violence incident, the batterer appears calm and in control, while the victim appears out of control or “crazy.”  This can be very misleading, as a batterer can use this to pass blame for the violent incident onto his partner, the victim. Furthermore, when questioned by the police, many victims refuse to give police information on the assault or minimize the extent of the violence, which limits the officer’s ability to make an arrest. As a police officer, you ask WHY?? Why won’t she leave, why doesn’t she accept my help? 

Fear is the primary reason a woman doesn’t leave or accept help. Many women do not believe that the police can actually help and are fearful of retaliation from their abusers. Statistics show that a woman is at a 65% to 75% greater risk of being killed when she takes definite steps to end the abusive relationship.  Other reasons for staying in the relationship include a love for her partner, a hope that he will change, lack of economic resources (including income and housing), isolation from family and friends, and therefore the lack of an effective support network, and fear of either losing her children or an unwillingness to deprive them of their father. Despite their fear and limitations, women do often leave their batterers many times before they are safe enough and have established enough resources to make the final break. 

How officers can help

First, talk to the victim alone. This gives an officer an opportunity to get information on the situation without the abuser punishing her afterwards for talking. This also provides an opportunity to assess what resources the victim has available to her. Then, an officer can give her additional resources such as information on shelters, orders of protection and counseling agencies. Do not be surprised if she does not accept literature from you during your visit—knowing that you have resources available to give her may be reason for her to contact you at a later time. Safety planning is crucial for women who decide to get help or leave. So, be patient, be understanding, and have resources available to offer the victim in case she is willing and ready to accept the help.

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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, 2006

• Stress on the Street
• 20th Annual McAtee Award Winners
• Street Talk Survey: Tell Us What You Think
• At Your Service: Survivors of Suicide Response Team 
• CIT Corner: CIT at Work
• Street Tips: Self-Mutilation - "Cutting"
• Open Mind: Teen Self-Mutilation
• Street Talk Archives
• Mental Health Directory

April, 2006

• Family Effects of Police Work
• 20th Annual McAtee Award Nominations
• Street Talk Survey: Tell Us What You Think
• Open Mind: Stress Management
• CIT Corner/March 2006 CIT Graduates
• Street Talk Archives
• Street Tips: Eating Disorders
• Mental Health Directory

January, 2006

• The Stress of Shift Work
• At Your Service: NAMI St. Louis
• Street Talk Survey: Tell Us What You Think
• Open Mind: Stress Management
• CIT Corner
• Street Talk Archives
• Street Tips: Guardianship and Conservatorship
• Mental Health Directory

October, 2005

• A Police Officer's Guide to Mental Retardation vs. Mental Illness
• At Your Service: Productive Living Board
• NPSF Survey: We Need Your Help
• Open Mind: St. Louis Mental Health Resources
• CIT Corner
• Street Talk Archives
• Street Tips: Recognizing BiPolar Disorder
• Mental Health Directory
• Current Issues: Mental Health Court

July, 2005

• Police Recognition Awards
• At Your Service: Life Crisis Services
• Officer of the Year: Lori Bethmann
• Do You Know?  Effects of Stress
• CIT Corner
• Open Mind: Inheriting Schizophrenia
• Street Report: Police Suicide
• Street Talk Archives
• Street Tips: Mental Health Glossary
• Mental Health Directory
• Current Issues: Effects of PTSD

April, 2005

• Police Recognition Award Luncheon
• Current Issues: Police Could Bear Brunt of Budget Cuts!
• CIT Corner: CIT at Work - Case Examples
• At Your Service: National Council on Alcoholism and Drug Abuse
• Law In Action: March, 2005 CIT Graduates
• Open Mind: St. Louis Resources
• Street Tips: Medication Non-compliance
• Street Talk Archives
• Tip Sheet: Common Psychiatric Medicines
• Mental Health Directory

January, 2005

• Post-Holiday Blues
• At Your Service: CenterPointe Hospital
• Law In Action: Nov. 2004 CIT Graduating Class
• Q&A: Not Guilty by Reason of Insanity
• CIT Corner: CIT Training Pays off on the Street
• Street Report: Cops Have Feelings, Too
• CIT Appreciation Dinner
• Open Mind: St. Louis Resources
• Street Tips: Keys to Tactical Communication
• Street Talk Archives
• Current Issues: State Budget Affects Mental Health Services
• Mental Health Directory

October, 2004

• Living with Killing
• Current Issues: Important Ballot Issues
• Law In Action: July 2004 CIT Graduating Class
• CIT Corner: Update on CIT
• Street Tips:Encountering the Homeless
• At Your Service: Family Support Program
• Street Report: The Brotherhood
• Q&A: Not Guilty by Reason of Insanity
• Open Mind: Supporting a Friend with Mental Illness
• Street Talk Archives
• Mental Health Directory

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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