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N.H. police officers role-play crisis interventions

  • Sgt. Steve Mangone, left, and patrolman Kevin Jusza of the Manchester Police Department talk with Sheryl Putney, director of quality assurance at Riverbend Community Mental Health, during a break from crisis intervention training at the New Hampshire Public Risk Management Exchange.<br/><br/>(JOHN TULLY / Monitor Staff)

    Sgt. Steve Mangone, left, and patrolman Kevin Jusza of the Manchester Police Department talk with Sheryl Putney, director of quality assurance at Riverbend Community Mental Health, during a break from crisis intervention training at the New Hampshire Public Risk Management Exchange.

    (JOHN TULLY / Monitor Staff) Purchase photo reprints at PhotoExtra »

  • Stephen Burke, right, a Sgt. with the Rochester Police Department and an officer for 28 years, leads the crisis intervention training in Concord at the New Hampshire Public Risk Management Exchange.<br/><br/>(JOHN TULLY / Monitor Staff)

    Stephen Burke, right, a Sgt. with the Rochester Police Department and an officer for 28 years, leads the crisis intervention training in Concord at the New Hampshire Public Risk Management Exchange.

    (JOHN TULLY / Monitor Staff) Purchase photo reprints at PhotoExtra »

  • Sgt. Steve Mangone, left, and patrolman Kevin Jusza of the Manchester Police Department talk with Sheryl Putney, director of quality assurance at Riverbend Community Mental Health, during a break from crisis intervention training at the New Hampshire Public Risk Management Exchange.<br/><br/>(JOHN TULLY / Monitor Staff)
  • Stephen Burke, right, a Sgt. with the Rochester Police Department and an officer for 28 years, leads the crisis intervention training in Concord at the New Hampshire Public Risk Management Exchange.<br/><br/>(JOHN TULLY / Monitor Staff)

A woman calls poison control, wondering how many Advil she can take before it kills her. She’s asked whether she’s suicidal, then the line goes dead.

The police officers, clustered in a semi-circle hearing this scenario, know it’s just role-play. But these calls – from people in crisis, desperate or alone – happen on the job, too.

So they practice as if it’s real.

“Cheryl, did you eat some of those pills?” Concord Officer Eric Crane asks, in a soothing yet strong voice, after coaxing his way into the apartment.

“No one cares if I die or not,” the woman responds.

“I do.”

But she doesn’t believe him.

“I wouldn’t be here if I didn’t,” the officer says.

After Crane persuades the woman to hand him the pills, another officer tags in. Then another scenario is acted out, and then another.

The role-playing came toward the end of a 40-hour crisis intervention training held last week in Concord where 20 officers from across the state were taught techniques for dealing with mentally ill individuals in their communities.

The training covered each step for responding to a person in crisis, from diagnosing the person’s disabilities or disorders to de-escalating tension and providing community resources. The officers learned about medications and their side effects, substance abuse, post-traumatic stress disorder and the legal issues that surround intervening in moments of panic.

Concord police Chief John Duval had identified crisis intervention training among his top priorities after he was hired to head the department in 2011. Duval said crisis situations can include from a woman in hysterics because her neighbors called the cops, to potentially lethal situations where an individual is armed.

“Traditional law enforcement, we’re trained to, if there is a crime, to stop the crime,” Duval said. “But it gets more complicated when folks are experiencing a crisis. And I think we have a moral and ethical obligation to look at all the ways possible, that have proven to be successful, to give law enforcement the best chance
. . . to bring the people the help they need.”

Those dealing with mental illness are often isolated. As the scenarios continued Thursday, Sgt. Stephen Burke of the Rochester Police Department, who has taught crisis intervention training across New England, reminded the officers just how important their mere presence can be.

In one scenario, it was the person’s birthday. And a few of the officers thought to stop and acknowledge that by saying, “Happy Birthday.”

“With these people you may be the only contact they’ve had with the outside world in months. They’re isolated from their family because of their disease. They’re isolated from their relatives,” Burke said. “They don’t have friends because they don’t do well in interpersonal relationships. What’s very minor, two words to you, can change the whole direction of that interaction with somebody.”

But in the scenario in which Crane had told the woman who had taken the Advil that he cared about her, Burke told the group there are also possible pitfalls to that approach.

“You have to be prepared when you say you care just how . . . that can be twisted around and make things go south quickly,” Burke said. “I’m not saying don’t say it. Just be prepared for what the next question coming is. ‘Well I have no money, and I have no food. Are you going to buy me dinner for the next week?’ And you can always come back at that and say, ‘I can’t. But I can bring you to welfare and get you hooked up.’ ”

After Crane got the woman to hand over the Advil, he probed further, asking whether the bottle had been new. She said it was.

“Okay, it looks like it’s about half full. There’s 200 in here. Do you think you took a hundred?” he asked.

He sat down across from the woman, a step most of the officers took as well as they played out the scenario. One officer, though, chose to stand.

“In certain mental illnesses, if you stand up in that authoritative position projecting downward onto people, it’s considered a threat and they will respond to a threat,” Burke said as the group offered their critiques.

But that officer maintained that he didn’t feel comfortable sitting after entering someone’s home because once he was lunged at and didn’t have an opportunity to defend himself. Another officer suggested that if he wanted to stand he should put more distance between himself and the person in crisis so it wouldn’t feel like he was towering.

“You can accomplish that same thing by standing further away,” Burke agreed.

But like many skills the officers learned last week, there was a flip side they had to be aware of.

“If you have someone with a manipulative personality who is trying to get over on you, they’re going to take that increased distance as fear,” Burke added.

In Concord, about 800 of the 60,000 calls the department receives each year are connected to mental health issues, according to Duval. And really, he pointed out, those are just the ones where the officers are aware that mental health concerns are at play.

The real number may be two to three times that, Duval said.

A vast majority of those situations are handled successfully, he said. But in rare cases the crisis can’t be de-escalated.

In 2011, a Concord officer shot and killed a schizophrenic man while the police were attempting to take him to the state hospital. The police also fatally shot a mentally ill man in 2006. In both cases, the men were armed, and the state attorney general’s office determined the officers’ actions were justified.

“Those are the most extreme and tragic examples, you know. Law enforcement is (required) to protect life and protect property. And when lethal force is presented . . . there are these circumstances where people in crisis put others at risk of imminent death,” Duval said. “Law enforcement is forced to react, and that’s what they get paid and trained to do.”

The Concord Police Department sent seven people to the training; The rest of the officers came from Manchester, Rochester, Loudon, Merrimack and Boscawen. The financial burden of a 40-hour training is acute, Duval said, not just because of the missed shifts but because the person filling in at the station is likely earning overtime. But Duval said he wanted to see at least one Concord officer on each shift receive the training.

That isn’t possible in departments like Loudon, which had just one officer take part in the program. Chief Bob Fiske said that officer will likely be called to respond to crisis situations even if he isn’t on duty.

Despite the financial commitment, Duval said he plans to send more officers to similar training programs elsewhere in the state this year. And he hopes Concord will host another session in late 2013 or early 2014.

“Law enforcement deals with behaviors of people, and many of those behaviors manifest themselves in criminal type outcomes. And law enforcement officers are trained to react to that,” he said. “But having a deeper, broader understanding of what is presented to the officer, the hope is they’ll be able to de-escalate and manage the situation in different ways.”

(Tricia L. Nadolny can be reached at 369-3306 or tnadolny@cmonitor.com or on Twitter @tricia_nadolny.)

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