A MENTAL HEALTH NEWSLETTER FOR LAW ENFORCEMENT PROFESSIONALS
 

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

In this issue . . .

On June 8, 2005, the Mental Health Association of Greater St. Louis will host its 19^th Annual Police Recognition Luncheon. Officers who have been nominated for showing compassion, concern and understanding when dealing with persons with mental illness will receive the John J. McAtee Award. Charley Armey, (photo right) General Manager of the St. Louis Rams, will deliver the keynote address. 

Nominations are now being accepted.  Nominees must be commissioned officers associated with a police department, sheriff’s office, National Park Service, campus police department or a Missouri State Trooper assigned to or located in the City of St. Louis or the Counties of St. Louis, St. Charles, Lincoln, Warren, Jefferson or Franklin. 

The act cited must have involved someone with a mental illness.  The nominated officer must have gone above and beyond the call of duty in working with the person, providing outstanding compassion and service. 

The officer must be nominated by a supervisor within his/her department or by an employee of a mental health agency, emergency room staff or a social service agency. 

The act must have taken place between April 1, 2004 and March 31, 2005. 

If you know an officer who meets these criteria, use the nomination form in this newsletter to submit a nomination.  Click here for the nomination form and a luncheon reservation form.

We invite you to join us as we honor your fellow officers. 

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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 more police departments and officers receive CIT Training, the more comments we receive about the advantages of the training and program as a whole. Following are very good examples of CIT at work. 

Detective Donald Moore, Washington University Police Department, advises that the CIT Training “really paid off” when an incident occurred in his jurisdiction on September 4, 2004. Detective Moore was requested to respond to a call for a student who had consumed a large amount of medication and alcohol and was talking about suicide. When Moore arrived, he found the individual had left with a resident advisor who had a cell phone.  Detective Moore made contact with the person in crisis who was threatening suicide and who would not allow the student advisor to talk.  The consumer explained he knew the standard protocol used by police and countered several of Detective Moore’s techniques.  Moore continued in his efforts to get the consumer to tell him where he was, fearful for the consumer’s safety and the safety of the student advisor, even though the consumer kept disconnecting the phone.  The consumer explained his parents were psychologists and he had been “institutionalized” in the past and he preferred death to going back.  Detective Moore spoke to this person for over three hours and was finally able to find him and talk him into going to the hospital without any physical confrontation.  The consumer told Detective Moore he did not commit suicide because he reflected on their conversation.  Detective Moore said the tactical communications he learned from Louis (Geno) Dorough made the police involvement with this individual end in a positive way, with no injuries to any party involved. 

St. Louis County Police Public Safety Dispatcher Anthony Buss relates the following: “Emergency 9-1-1,” a phrase that those in this field have a way of becoming calloused to after saying it a few thousand times. I took a call in the summer of 2004, though, that reminded me what was behind that phrase.  The caller had a knife and needed help. 

I remember thinking as I heard him try to talk through crying that the emotion in his voice was real and that it was apparent this grown man had hit rock bottom.  The caller, Joe (changed for this article), was overtly upset about something that had pushed him to think about suicide. 

I immediately reverted to the class I attended at the St. Louis County & Municipal Police Academy, “Hostage Takers, Suicidal Callers, and Domestic Violence.”  In a moment’s time, the procedures explained by the department’s negotiator, trained in dealing with high-stress situations, including hostages and seemingly imminent loss of life, came back to me.  All at once I remembered the tactics I learned to ease situations like these. 

While one of my partners requested an ambulance and another dispatched police to Joe’s home, I settled in to talk with him about what was making him reconsider life. Just as I had been warned could happen, mentioning the cause of his stress upset Joe even more and he began screaming at me.  Employing tactic after tactic to find a way to build Joe’s trust, I convinced him to make a deal to move away from the knife. 

Joe then revealed to me that he had a history of suicide attempts and that he liked the people and facility at one area hospital more than others. Careful not to make any promises I didn’t know I could keep, I convinced Joe to pack a bag with personal effects to take with him so his stay at the hospital could be even better.  We talked about what things he should put in the bag including a change of clothes and a magazine, occupying the time until the first officers arrived on the scene. 

Upon their arrival, a member of the Crisis Intervention Team (CIT) and an assisting officer spoke with Joe and were able to secure the scene without incident.  The paramedics arrived and he entered the ambulance voluntarily, departing immediately for the hospital. 

This call, lasting less than 15 minutes, was simultaneously the most emotionally draining and rewarding call I have taken in my time as a Public Safety Dispatcher.  I attribute this success largely to the training made available to me in dealing with situations like these.  Learning the functions of the CIT program and what types of action to take in crisis situations to help ensure the safety of everyone allowed me to be part of this peaceful outcome.

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After completing the 40-hour specialized training, 68 officers and one emergency department staff person graduated from the Crisis Intervention Team (CIT) course in March. There are now over 300 CIT officers in the metropolitan area. Congratulations to the recent graduates!

According to the National Institute of Mental Health, about 90% of people suffering from a mental illness will improve or recover if they get treatment. Today, there are a variety of treatments available, ranging from medications to various forms of therapy to help the person with mental illness live a normal, productive life. Because mental illnesses involve an imbalance in the way the brain metabolizes certain chemicals, medication is often the first step aimed at restoring balance in these chemicals, thus alleviating the symptoms of the illness. 

Psychiatric medications, like all other medicines, can produce unwanted side effects. Many of the milder side effects will lessen or disappear after the first few weeks of treatment. Side effects of anti-depressant, anti-anxiety and mood stabilizer medications vary, but common ones include: 

• Agitation
• Sexual problems
• Weight gain
• Liver toxicity
• Stomach cramps
• Sedation
• Headaches

Persons with schizophrenia will likely be prescribed antipsychotic medications. Fortunately, in the last 15 years, there has been much advancement in these medications. The older drugs, such as Haldol, Mellaril and Thorazine cause muscle rigidity, drooling or a shuffling gait. Newer medications (Risperdal, Seroquel, Abilify) are less likely to bring about these kinds of problems, but are not totally free of side effects. The severity of side effects, as well as the positive response to medication, varies from person to person. 

§         Bothersome side effects are actually one of the primary reasons people with mental illness stop taking their medications. Weight gain leading to diabetes, muscle stiffness, and “feeling drugged” are sometimes too much for the person to bear.  

§         Ironically, a positive response to the medication is another reason a person may stop treatment. Because the medication has taken away the “voices” or mood instability, allowing the person to function more normally, he or she no longer feels a need for it. Unfortunately, the psychosis and instability often return, sometimes leading to the need for hospitalization or legal involvement.  

§         There are times when the very nature of the person’s symptoms keeps him from being compliant with his treatment. Paranoid thinking may result in the person not trusting his doctor or loved ones who are encouraging him to take the medicine.  

§         Mania - the feeling of being “high” and invincible - may also keep a person from wanting treatment. 

§         Other reasons for noncompliance include the high cost of medicines, the stigma associated with being “ill”, and family or church members who tell the person he doesn’t need medication to feel better. 

As psychiatric medications become an increasingly important element in the treatment of mental illness, it is vital for the community to increase their understanding in this area. 

Learning about the complexity of mental illness and its treatment will hopefully lead to increased support of those working towards a healthier, more productive life.

When you encounter a citizen that appears to need mental health services, it's helpful to know if that person is under the care of a mental health professional or is taking medication for a psychiatric illness.  Knowing what kind of medicine the person is taking can help you identify the type of illness the person has.  We have prepared a list of the most common psychiatric medicines and what illnesses they are for.  This list has been designed so you can cut it out and keep it for a handy on-scene reference.  Click here for a printer friendly version that you can keep with you. (Requires Internet Explorer Web browser)

Click here for a directory listing mental health agencies you, or someone you encounter, might need to contact in crisis or to obtain a referral.

By Jim House, Executive Director, Mental Health Association of Greater St. Louis. Citizens of our community could face a mental health crisis! Governor Blunt recommended a budget that cut $40 million from community mental health services throughout the state.

·        Over 48,000 seriously ill children and adults will lose services and vitally needed medications.  (Over 17,000 in St. Louis)

·        9,200 children and adults with mental retardation will lose partial services. (Over 3,200 in St. Louis)

·        Over 11,000 adults will lose substance abuse treatment services.  (Over 3,900 in St. Louis)

·        People who have been functioning well with medication and community support services will become completely disabled. People with severe conditions and at risk of harm to themselves and others will not receive treatment.

·        Hospitalizations, homelessness and incarceration of people with mental illness will increase. These conditions result in an increased need for expensive hospital beds, prison beds, foster care referrals and homeless shelter beds for people with disabilities.  

·        Families will not have help for their loved ones who are struggling with addiction, psychiatric illness or developmental disabilities.

·        People will suffer and die needlessly.

Make no mistake! You, the peace officer on the beat, will become the first line responders to these crises. And guess what? It will be nearly impossible to get people into treatment unless they have Medicaid, and even then it will not be easy. People will end up in jails because there is nowhere else for them to go. Your job will only become more difficult if these cuts are made.

Fortunately, the Missouri House of Representatives has lessened this problem by eliminating many of the cuts. However, as of this writing, the State Senate has not yet acted on the mental health budget. Until the budget is passed by both chambers and signed by the Governor, mental health services are still at risk!

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We’re here to help you help others. 

The past decade has been an era of gradual regression for those seeking help with alcohol and other drug issues. Despite the widespread proliferation of treatment resources in the 1970s and 1980s, we have lost well over half of the local services that were available in the late 1980s. 

How could this happen? Essentially, two factors are responsible: managed care and conservativism. Each has done damage. Managed care decided that treatment had become too expensive, thus chipped away at inpatient lengths of stay with a vengeance until inpatient care in the private sector had disappeared, altogether. This created a major cost-shift and overburdening of our public sector treatment services. And now, an increasingly conservative state government is asking why it should be expected to shoulder the cost of providing these types of services, saying that addiction issues are about “personal responsibility,” that it should be left to the faith community, etc. Never mind that not treating addiction costs us far more than treating it; that if treatment is not available, associated costs will increase in the areas of healthcare, crime, corrections, accidents, AIDS, business productivity, social welfare, family disruption and youth-related problems. This is where ideology and pragmatism collide. Where this thinking will ultimately take us is anyone’s guess. All that can be said for sure at this time is that it has become more difficult for both adults and adolescents to get help when they need it, and it’s truly a shame.  That’s the bad news.

Here’s the good news. The National Council on Alcoholism and Drug Abuse (NCADA) – St. Louis Area, celebrating our 40^th anniversary providing services in the St. Louis region, is still here and still helping. Yes, treatment has been greatly reduced, much of it now provided through various types of outpatient services, and many of the programs have disappeared, but some help does remain. There are several publicly-funded treatment programs and there is self-help, such as Alcoholics Anonymous and Narcotics Anonymous. Self-help is still an option and sometimes people need assistance in figuring out what fits their situation and how to get started. That’s where we can help. The NCADA Helpline (314 962-3456) is available Monday – Friday, 9:00 to 5:00. Anyone seeking information or assistance for themselves or others can call and speak with a counselor.  

Law enforcement has a unique role to play in helping folks help themselves. You are often that first line contact with people whose addictions are very obviously interfering with their lives. Bad people? Not necessarily. Sometimes, just sick people whose behavior and attitudes are a result of their addictions. Meet those same people in recovery and you might not recognize them. How to get them into recovery is where it gets difficult. Sometimes a comment, a nudge or a firm recommendation to get help from a law enforcement officer will make THE difference in willingness for the alcoholic or addict to take action. Hard as it may be sometimes, try to see the person behind the addiction and see if you can help them help themselves. NCADA can help you help them.    

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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.

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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