Podcast: Is Police (CIT) Crises Training Needed?
A mentally ill man is standing in your yard yelling at the mailbox. What do you do? You call the police, right? Not so fast, according to today’s guest, mental health advocate Gabriel Nathan. There is a better way to do things. Gabriel believes that rather than training police officers to de-escalate people in mental health crises, the police shouldn’t be called at all in these situations.
Our host Gabe has a different take on things, as he is an advocate for training police officers in crisis intervention practices. Join us for an enlightening and nuanced conversation regarding the role of the police when it comes to mental health crises.
(Transcript Available Below)
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Guest Information for ‘Gabriel Nathan- CIT Training’ Podcast Episode
Gabriel Nathan is an , , , and a mental health and . He is Editor in Chief of , an online publication that features stories of mental health, empowerment, and change. Recently, OC87 Recovery Diaries produced a unique film series called “” that features candid and moving recovery stories from firefighters, EMS personnel, law enforcement, dispatchers, and a crisis intervention specialist instructor. These films are being used by first responder agencies across the U. S. and by the Royal Canadian Mounted Police.
Independent of his work at OC87 Recovery Diaries, Gabe raises mental health awareness, generates conversations around suicide and its prevention, and spreads a message of hope with his 1963 Volkswagen Beetle, Herbie the Love Bug replica that bears the number for the National Suicide Prevention Lifeline on its rear window. Gabriel lives in a suburb of Philadelphia with his wife, twins, a Basset hound named Tennessee, a long-haired German Shepherd named Sadie, and his Herbie. You can view Gabriel’s TEDx Talk on his approach to suicide awareness . Gabriel and Herbie teamed up to produce a documentary film about their suicide awareness mission; you can view the entire film and learn more information about Gabriel, Herbie, and suicide awareness . You can also follow Gabriel and Herbie on IG @lovebugtrumpshate.
About The Not Crazy Podcast Hosts
Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from Gabe Howard. To learn more, please visit his website, gabehoward.com.
Lisa is the producer of the Psych Central podcast, Not Crazy. She is the recipient of The National Alliance on Mental Illness’s “Above and Beyond” award, has worked extensively with the Ohio Peer Supporter Certification program, and is a workplace suicide prevention trainer. Lisa has battled depression her entire life and has worked alongside Gabe in mental health advocacy for over a decade. She lives in Columbus, Ohio, with her husband; enjoys international travel; and orders 12 pairs of shoes online, picks the best one, and sends the other 11 back.
Computer Generated Transcript for “Gabriel Nathan- CIT Training” Episode
Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.
Lisa: You’re listening to Not Crazy, a psych central podcast hosted by my ex-husband, who has bipolar disorder. Together, we created the mental health podcast for people who hate mental health podcasts.
Gabe Howard: Hey, everyone, my name is Gabe Howard, I am the host of the Not Crazy podcast and I am here with Lisa Kiner.
Lisa Kiner: Hey, everyone, and today’s quote is by John F. Kennedy, The rights of every man are diminished when the rights of one man are threatened.
Gabe Howard: It sort of reminds me of this idea that if it can happen to somebody else, it can happen to you, and if it can happen to you, it can happen to anybody. And I say this in mental health advocacy a lot. I was like, you realize if people with mental health conditions can’t get access to care, that means sick people can’t get access to care. So if you get sick, it is certainly possible that you might not be able to get access to care. But we always kind of dismiss that as it’s going to happen to other people.
Lisa Kiner: I think that’s just human nature. Everybody thinks that only good things are going to be coming to them and any bad things out there are going to be going to other people.
Gabe Howard: Well, and other people who deserve the bad things, right? Like we have this idea that every bad thing that happens to somebody else, it’s because they deserved it. They must they must have been doing something wrong.
Lisa Kiner: But I think that’s also self protective. The idea that the universe is random and bad things could happen to anybody at any time is scary. But if I think to myself, oh, no, that person brought that upon them, they did something that made the bad thing happen, that makes me feel better. I will not do that thing. Therefore, the bad thing will not happen to me. Therefore, me and mine are safe.
Gabe Howard: This, of course, all plays into a larger conversation that America is having with law enforcement and policing. We believe that police are 100% right in any police interaction. Whoever they are interacting with is 100% wrong. And in the mental health circles, this isn’t exactly believed in the same way because, you know, we have CIT, we have Crisis Intervention Training because we understand that when we’re in
crisis, people are going to call the police. If Gabe Howard is in crisis, somebody’s going to pick up the phone and call 911 and say, hey, there’s this giant guy acting erratically and we need help. And then the police are going to come, and we have decided that we’re OK with that. But we want to train police officers. And that’s where crisis intervention training came from. Full disclosure, that I believe in the CIT program so much, I teach it in central Ohio. I am proud of the work that I do. I am very pro, I am very, very, very pro training police officers on how to work with people with mental illness. Recently, I had the very good fortune to be involved in a virtual screening of a series put out by OC87 Recovery Diaries called Beneath the Vest: First Responder Mental Health. And it was talking about the suicide rates for first responders., talking about all kinds of things that I had never heard before. After it was all over, I was talking to Gabriel Nathan, who is the executive director of OC87 Recovery Diaries, and we were talking specifically about the crisis intervention training, of which I am a huge fan. And Gabriel said to me, well, I’m not a big fan of CIT. I think that CIT should go away. Lisa, you have known me for a long time. You can only imagine the words that were coming out of my mouth.
Lisa Kiner: It seems like a pretty unreal statement.
Gabe Howard: And a conversation ensued, and I have no idea if I agree with Gabriel or not. On one hand, he makes some extraordinarily valid points that cannot be ignored. On the other hand, I remember what life was like in Columbus, Ohio, before the CIT program came along and of course, how much good it did. And I came to you, Lisa, and I said, Lisa, you’re never going to believe what this idiot Gabriel Nathan said to me. And this, of course, started a big debate between us.
Lisa Kiner: Yes, and from your version of what you and Gabriel talked about, I am really interested to hear what he has to say.
Gabe Howard: In addition to being the executive director of OC87 Recovery Diaries, Gabriel Nathan lives with depression. He’s a prominent mental health advocate who understands what it’s like. And on our show, we don’t want people with mental illness just to show up and tell their personal stories. We want to be more than that.
Lisa Kiner: And it’s not that we don’t think that the personal story has value, it absolutely does, but there’s plenty of sources out there for that. We want to have something different here at Not Crazy. On our show, we want to have people come on to discuss, argue, debate and talk about the world around us from the point of view of someone living with mental illness like us.
Gabe Howard: All right, Lisa, I think we’re ready to bring Gabriel on. Gabriel, welcome to the show.
Gabriel Nathan: Hi, and thanks for having me. It’s great to be here.
Gabe Howard: I love working with you because I think, now I’m not sure, but I think that our hobby is to disagree with each other because we love the debate so much. Is that true today? Like everything that you’re about to say, these are your genuine beliefs. You’re not playing devil’s advocate. We are having a real conversation. We’re not doing this thing where we each pick a side and pretend that we care. We care.
Gabriel Nathan: Yeah, these are my real views, I don’t play devil’s advocate because I really don’t have time to expostulate on some view that isn’t my own just for the sake of of arguing or being a guest on something. I really believe in speaking my own truth passionately. I don’t speak on behalf of any organization. These views are my own and I’m proud to share them with you.
Gabe Howard: Well, thank you again, Gabriel, and we’re super glad to have you. So let’s get right into it. You believe that that CIT, police officers, all of that, should have zero involvement in mental health. And if you were king of the world, you’d kick them out immediately. Can you explain that?
Gabriel Nathan: I think zero involvement is perhaps not quite accurate.
Gabe Howard: Ok.
Gabriel Nathan: So, for example, if someone is suicidal and they have a firearm, that’s a police emergency. Because, as they say, you don’t bring a knife to a gunfight. And we know that there are people who take their own lives via suicide by cop. People who will
point a firearm at a law enforcement officer who will fire, who will perhaps even shoot a police officer to provoke a response from other responding officers to kill them as well. So when firearms are involved, all bets are off. I just want to make that absolutely clear. First of all, before I really get into the weeds of the question, what I have found is whenever you are taking a position that is critical in any way of law enforcement or attempts to raise questions even about the way law enforcement agencies do anything, it is extremely important to establish your own bona fides. Because anybody who steps up to challenge law enforcement is immediately regarded with suspicion, paranoia, is dismissed as a quote, you know, libtard, troll, anti-cop antifa, whatever. I’m none of those things. I am someone who, for the last 20 years, has been an advocate for slain police officers and their families through editorials, commentaries in newspapers. I have attended over 10 police funerals in Philadelphia down to Maryland.
Gabriel Nathan: I have done a lot of advocacy work for law enforcement and also in regard to mental health of first responders. I produced a film series called Beneath the Vest: First Responder Mental Health for OC87 Recovery Diaries that features police officers, EMS personnel, dispatchers, fire service individuals talking about trauma and complex PTSD. I’m very well aware of the suicide rate for police officers. I am someone who knows law enforcement culture. I am someone who has a respect for police officers and what they do. However, just like when you criticize America, that doesn’t mean that you should leave it or that you don’t have any right to do that. I think that you need to know what you’re talking about. But I think we have every right to criticize institutions. I think we have every right to criticize this nation. And so I just want people to know that I am doing this from a place of love and concern and from a position of someone who believes ardently that there absolutely needs to be change and radical reimagining of law enforcement, not just related to mental health response but across the board. But, yes, I do believe that law enforcement should have very, very little place in mental health response.
Gabe Howard: Thank you, Gabriel, for establishing your bona fides, and I really appreciate that. The example that I always use is just because I think that my wife did something wrong doesn’t mean that I don’t love her. And just because my wife thinks that I can improve doesn’t mean that she doesn’t love me. And I think people really understand that in terms of our interpersonal relationships, friends, family, etc. But for some reason, when we extend it into the public space, it’s like, aha! You must be for or against me.
Gabriel Nathan: Yes, right.
Gabe Howard: This show is very much trying to establish more of a middle ground. Sometimes we succeed, sometimes we don’t. But we try to believe that we’re Not Crazy when we do it. The first question is CIT, people fought very, very hard to get CIT established in America. This is something that mental health advocates worked really, really hard for decades to bring CIT. So to listen to a prominent mental health advocate like yourself say, well, yeah, maybe we picked the wrong horse. Maybe we shouldn’t have backed that at all. Maybe we should have backed this instead. It sounds almost like you’re saying, hey, you just wasted 40 years bringing this here. It’s very nuanced, and I want you to tease that out because
Gabriel Nathan: Sure.
Gabe Howard: I suppose the real question, if not CIT, what?
Gabriel Nathan: Right. That’s a perfectly valid statement about what people would say and about what’s next. First of all, CIT, also known as quote, the Memphis model, was established in 1986. OK. There is a whole other model of crisis intervention that was begun more than 10 years before that at the psychiatric facility where I used to work. It’s called Montgomery County Emergency Service. It’s located in Norristown, Pennsylvania. Gabe, you know, while you were on the campus,
Gabe Howard: I do.
Gabriel Nathan: MCES created something called CIS. So it stands for Crisis Intervention Specialist training. And this was created in 1975 – 1976 to teach crisis intervention and deescalation to police officers. The philosophy behind this, as opposed to CIT, is train everybody in the department, train every single police officer in this stuff, in recognizing signs and symptoms of mental illness, in learning about what it feels like to issue commands to someone who may be experiencing auditory hallucinations, learning
about substance abuse, escalation of force, all that kind of stuff. Right? So this was already in play for ten years prior to the Memphis model. And the Memphis model said, let’s train specific officers in the department to respond to mental health emergencies. Working at MCES, as I did from 2010 to 2015, I was very immersed in the CIS culture and I gravitated much more to that because I think first, a component of CIT that’s inherently flawed is you’re only picking certain officers, right? Now, there are certain officers on duty all the time, but they may be tied up with other things. When a psychiatric emergency is happening, they may not always be available to respond. So you might be bipolar and manic and trying to rip out a traffic sign at 3:00 a.m. in an intersection in your town. Well, gee, the CIT officer, unfortunately, had to go to a domestic. So now you might be getting a sort of not very well trained, not empathic, not understanding officer to your situation. And he may be an action junkie. He may be someone who doesn’t have his emotions in check.
Gabe Howard: Or they may be somebody who is just not trained.
Gabriel Nathan: Exactly, exactly. And that may have a bad outcome. OK. Now there might be a bad outcome even with a trained officer. Also, being CIT trained is not a bulletproof vest, and it doesn’t mean that an encounter with a law enforcement officer is going to go hunky dory all the time. That’s important to recognize also. I have had police commanders say to me, to my face when I’ve questioned CIS, they’ve said, well, you know, we like CIT better because, quite frankly, not all of our officers would be good at that kind of thing. And I said, what is that kind of thing? Spending time to talk to someone as opposed to just taking them to the floor? Trying to de-escalate someone as opposed to escalating the situation? And of course, there’s no answer for that. And what I said is, if certain officers that you have, quote, wouldn’t be good at that kind of thing, they shouldn’t be police officers. And I really believe that. So that’s my problem CIT. You’re kind of cherry picking officers who you think would be good at that when really they all should be good at that, and lack of availability. But really, when you widen the scope and really look at the situation of law enforcement officers responding to mental health emergencies, psychiatric emergencies, you use the term de-escalation, right? While we’re teaching these police officers to de-escalate a situation that is potentially volatile. And what do we have? We have someone who’s not doing well. They may be off their medication, they may be psychotic, they may be paranoid. And we have a black and white radio car rolling up.
Gabriel Nathan: The door opens, the big boot steps out, they wear these big boots, you know, and the officer gets out and he’s got his bulletproof vest and he’s all jacked up, puffed up, looking twice as big as he actually is. He’s got the gun. He’s got the taser, he’s got the extra ammunition. He’s got the handcuffs. He’s got the retractable baton. He’s got the sunglasses with the mirrored finish, so you can’t even see his eyes. He’s got the buzz cut. I’m stereotyping. They don’t all look like that, but a lot of them do. That’s who we’re asking to, quote, deescalate a situation. And they’re showing up with the power of arrest to take your freedoms away from you, to lock you up. What is an individual who’s experiencing a psychiatric emergency most afraid of? They’re afraid of being restrained. They’re afraid of being contained. They’re afraid of having their freedoms taken away from them. And that’s who we bring to the scene. And so, I believe that crisis intervention training for law enforcement officers really puts them in an impossible situation where we’re saying you, just by your very presence, you are an escalation of force, but we want you to de-escalate the situation. It just on its face doesn’t make any sense to me.
Lisa Kiner: Interesting, no, I would agree with you on that completely
Gabe Howard: The police force, or society has decided that the police respond to people with mental illness and we’ve got this one little program that people we had to advocate for.
Gabriel Nathan: Right, right.
Gabe Howard: Remember, police have been responding to people in a mental health crisis since before CIT.
Gabriel Nathan: Absolutely.
Gabe Howard: And we had to convince them that it was a good idea to train the responders. I just.
Gabriel Nathan: But that presupposes. That says, well, it’s not good that the police are responding to mental health emergencies, but if they’ve gotta, then at least train them. But they don’t gotta. That’s the flaw in the system,
Gabe Howard: Ok, gotcha, gotcha.
Gabriel Nathan: In my opinion, that’s what mental health advocates got wrong. They kind of just laid down and said, well, this is how it’s going to be. You know, the police are just going to do it, so we might as well train them. And that was the wrong supposition. This is incorrect. You know, if we can agree that people should not be showing up to a psychiatric hospital in the back of a patrol car with their hands cuffed behind their back, if we can all agree on that, and I think we can all agree on that, then we can all agree that the precipitating events that make that end result happen should also not be happening.
Gabe Howard: I just want to point out that I am involved in CIT. I’m a trainer for CIT, as I said at the top of the show. And I want you to know that what I tell people that CIT is not mandatory, they are confused.
Gabriel Nathan: Of course.
Gabe Howard: The belief of the general public is that CIT is mandatory for all officers.
Gabriel Nathan: Absolutely not. If they receive anything at the police academy level, it is very, very minimal and very, very terse. They don’t really address the trauma that police officers are going to experience. They don’t address the issue of police suicide, and they also don’t really address deescalating situations. It’s all about control. How do you control a suspect? How do you take control of a situation? How do you take command of a scene? The police academy curriculum is very, very full. And as we’ve seen with all of these discussions about reimagining law enforcement, we know in Germany it takes three years to become a police officer. In other places, it takes two years. My police academy curriculum, it was full time and it was nine months. All right. But nowhere in that nine months curriculum was there room for crisis intervention, de-escalation, signs and symptoms of mental illness, all that kind of stuff. That’s all taught later.
Gabe Howard: Right, and it’s voluntary in most places, and I think it’s important to point out that in many municipalities it takes longer to become a hairstylist than it does to become a police officer.
Gabriel Nathan: Correct. Right. Yes.
Lisa Kiner: You talked about the changing nature of police work, what’s up with that? How is police work changing and why?
Gabriel Nathan: Well, in the bad old days, it was like, come in, bust up whatever is going on, throw whoever it is who’s causing the most trouble in the back of the paddy wagon, maybe rap him over the head with the baton a couple of times and that’s it. And there were no cameras, no one saw anything. You know, it was, they call it the bad old days for a reason. Nobody used words like de-escalation and crisis intervention in the 60s, in the 70s. It’s let’s get in, let’s turn this guy up against the wall, and that’s it. Nowadays, we are expecting law enforcement officers to behave in different ways, to respond to very emotionally complex and dynamic situations and to resolve situations without their fists, without their baton, without their gun, without their taser. So expectations have risen and they need to rise to the challenge of that. And I don’t think these are unreasonable expectations, that you should be able to resolve a situation without violence. I think eight or nine times out of ten that is possible to do. Now, sure, you’re going to have bad actors who just want to hurt somebody and they need to be dealt with appropriately. And that’s fine. But I think there are times when there’s a situation occurring and a law enforcement officer is nearing the end of his shift and he just wants to get it over with and all right. That’s it. No, that’s not it.
Gabriel Nathan: You have all the time in the world to take care of this situation. And people have rights and people have a right to not be thrown on the ground face first simply because you have somewhere to be in an hour. Sorry, that’s not good enough. And we need to expect better of our police officers. Police officers are expected to be more social workers. And maybe that’s who we need to be attracting in terms of law enforcement, people who are articulate, people who understand family dynamics, people who take their time, people who don’t want to roll around on the floor with someone if they don’t have to. When I first applied to the psychiatric hospital, I applied to be an EMT to work on their psychiatric ambulance. And when I interviewed for the
position, I said to the ambulance director, I am not an action junkie. I am not a cowboy. I am not interested in busting down doors and rolling around on the floor with somebody. If I have to do it, I will do it. But I will do everything in my power to make sure that I don’t do that. And she said, well, most of the people we get applying for this job are cowboys, and that’s the problem. We need to stop kind of glorifying this profession and saying that this is what it’s all about. It’s all about takedowns and arrests. It ain’t all about that. It shouldn’t be all about that. And we need to be recruiting people who are not all about that.
Lisa Kiner: Well, Gabe had on The Psych Central Podcast a few months ago, a police officer, and the question was, why do the police respond to this at all? Why do we not send social workers? Why do we not send therapists? And his answer was because it is such a volatile and dynamic situation that you don’t know what will be required. His assumption was that violence will be required. And the thing he referenced specifically was, you know, something like half of all Americans own guns. So because this has such a large potential to escalate to a violent situation so quickly and we’re all wandering around with guns, that’s why we need police officers to respond. What would you say to that?
Gabriel Nathan: Well, what I would say to that is I think it’s very interesting that the police officer’s answer was about guns. It wasn’t about, quote, crazy people. We have a major problem in this country with firearms. And I think it’s really interesting, too, because so many police officers are avid gun collectors. They’re all into the NRA. They’re all about the Second Amendment, and yet they’re afraid about responding to houses of people with guns.
Lisa Kiner: I didn’t think about that one.
Gabriel Nathan: Ok, so that’s a bunch of bullshit, in my opinion. I am so, so sick of having arguments with people about firearms, particularly with law enforcement officers. So they want to be all Second Amendment and guns, guns, guns. But all of a sudden, well, we need to respond to mental health calls because there are so many guns in this country. Well, yeah, there are, and that’s a huge problem. And yes, half of all suicides occur with a firearm. Two thirds of all gun deaths are suicides. You’re more likely to kill yourself than you are to be killed with a firearm.
Gabriel Nathan: So let’s just put that out there right now. It also presupposes that people with mental illness are dangerous. And we know statistically that that is not true. However, people with serious and persistent mental illness who are off their medication and who may be using street narcotics and who may be increasingly paranoid, yeah, they can be dangerous, that’s for sure. And I have certainly seen that in the hospital. But what I will also tell you is my sister in law is a social worker for the VA. The VA has no compunction about sending my unarmed sister in law who weighs one hundred and twenty pounds. Sorry Tova, I just revealed your weight. But unarmed, they give her self-defense training, crisis intervention training and using your your hands to defend yourself. Now, they always go out in teams, of course, they don’t send her alone. But they will send two unarmed females to deal with veterans who have traumatic brain injuries, a lot of whom are using drugs and alcohol, to apartments alone. Oh, but a police officer with a bulletproof vest and a gun and extra ammo and a shotgun in his car and all the rest of it needs to go to a psychiatric emergency call. I’m sorry, I don’t think so.
Gabe Howard: Well, it’s the same thing with children. I have often thought of that as well. If I call Children’s Services right now on my neighbor, they send a social worker.
Gabriel Nathan: Right.
Gabe Howard: Now, I know that different states are different, but in my state, in Ohio, if there is a welfare check for children, they send a single social worker to talk to people about their children.
Gabriel Nathan: Mm-hmm.
Gabe Howard: They’re investigating whether or not these people are child abusers.
Gabriel Nathan: Right.
Gabe Howard: And that can be done by somebody with absolutely no protection, no weapon, no anything.
Gabriel Nathan: And there may very well be a gun in that house.
Lisa Kiner: That’s a good point.
Gabriel Nathan: Right.
Gabe Howard: And, of course, you’re messing with people’s children.
Lisa Kiner: We’ll be right back after these messages.
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Lisa Kiner: And we’re back with Gabriel Nathan talking about police response to people with mental illness.
Gabe Howard: I know we’ve kind of skirted around the issue of how we should get police officers away from responding to us. But I don’t know that you’ve provided an actual answer of if not them, then who?
Gabriel Nathan: Right.
Gabe Howard: When Gabe Howard is having a mental health crisis, I need, like, I personally want somebody to save me. We can all agree with that.
Gabriel Nathan: Absolutely.
Gabe Howard: So who’s coming?
Gabriel Nathan: Ok, first of all, not every situation needs a call to anybody. I think we’re also presupposing that police officers dealing with mental health cases are only called when there is, quote, an emergency. A lot of calls to police involving mental health issues are nuisance issues.
Lisa Kiner: I didn’t consider that.
Gabriel Nathan: Perfect example. There’s someone who lives in my community who is seriously and persistently mentally ill. He yells and screams a lot. He curses a lot. He knocks on the window at people and gives them the finger. OK, stuff like that. People call the cops on him. That’s not a psychiatric emergency. That is not a case of life or death. That’s someone who doesn’t like their neighbor. And so the police show up and there could be a violent, bad outcome for no reason whatsoever. That person is not endangering themselves. That person is not endangering anybody else. It is not against the law to be mentally ill. However, we’ve created a situation where people just pick up the phone and call the police willy nilly because they’re scared of crazy people. I mean, let’s just put it out there, right. That’s very unfortunate. And so we certainly don’t need the police responding to situations like that. You know, that is a situation that can be just dealt with in the community. There is a lot of different areas to explore between nothing and either inpatient hospitalization or an arrest. That’s what we need to to be aware of I think. Now, when we talk about, quote, defunding the police, that’s different than abolishing the police or disbanding the police. A lot of money that goes into buying weapons and car porn could be used to fund mobile crisis units. Mobile crisis units are comprised of mental health workers who are not armed. They do not respond in emergency looking vehicles. They wear civilian clothes. They are very trained in crisis intervention and de-escalation. So, maybe assessing is someone not engaging in proper self care? Are they possibly a danger to themselves or others? Do they need a higher level of care? If you do not have a mobile crisis unit in your county, you better start advocating for one now. And a lot of them work in conjunction with law enforcement. I do
believe at a potentially dangerous scene, law enforcement could be there to establish scene safety and then back off. Leave entirely. OK, are there guns here? We do a search. Is this person violent? Pat the person down. OK, we’re out of here. And then let the mobile crisis team handle it. So, we don’t have to remove them one hundred percent from the equation, but just decrease our dependance on them. There are also very, very, very, very few psychiatric ambulance squads in the country. And by very few, I mean basically one, which operates out of Montgomery County Emergency Services, the hospital I used to work at.
Gabriel Nathan: These are fully trained and certified emergency medical technicians who run on fully equipped basic life support ambulances. They can respond to all manner of physical emergencies, but they also respond to psychiatric emergencies. They execute psychiatric commitment warrants. They show up in an ambulance. They have polo shirts and khakis. They don’t have the badges and all that stuff. If you need to go to the hospital, you’ll go on a stretcher in an ambulance. Not handcuffed in the back of a police car. That’s how it should be in America. So we’ve got psychiatric ambulance squads, we’ve got mobile crisis. We have social workers embedded in law enforcement. We have the possibility of reimagining the kind of people we’re recruiting to do this job. There are lots of different ideas out there. London, for example, in the Metropolitan Police Department, the average constable that you see on duty does not carry a firearm. Now, in every municipality, there are armed response units that can be in a situation in a matter of minutes if they need to be. But maybe we need unarmed police officers in certain areas. It’s less threatening. And I know people will freak out at me about that, but, golly, it works in other places.
Lisa Kiner: So one of the things you said earlier was that part of the problem is that people are perceiving people with mental illness as scary. And when there’s something scary, you call the police. So do you think that part of this doesn’t actually have anything to do with the police? It’s more about how society views mental illness and the average person’s reaction to the mentally ill?
Gabriel Nathan: One hundred percent. It is the same thing as, unfortunately, a lot of Caucasian people’s gut reaction when they see a six foot two black man in their neighborhood. Oh, black people are scary. Oh, he looked in my window. What is that?
Oh, my God. OK, that’s learned subconscious racism. And we as white people need to recognize that we feel hinky, we feel uncomfortable and scared when we see a black person in our neighborhood. You know, you better do some really serious soul searching and try to figure out why that is. It’s the same thing with someone who has mental illness. You know, they’re in their garden and they’re talking to themselves and they’re yelling at your dog or whatever. Oh, that’s scary. I better pick up the phone and call the police. No. You better give that person some space and give yourself some time to reflect on why is that scary to you? And maybe sit with that feeling of discomfort. Where does that come from? What does that mean? Is that person really a threat to you? Is that person really a threat to your neighborhood and your existence? Someone said to me about that specific person that I mentioned, well, it’s a crime because he’s disturbing the peace and that’s a crime. And I really wanted to say to her, oh, so when you stub your toe in your garage and go, oh, f-word, should I call the police? You just disturbed the peace. When your dog is barking too loud? No, so we don’t do that right. But if someone’s yelling argh, government over me and I have a microchip in my tooth and, we’re calling the police. And we just hide behind that because we’re scared and we want the police to make it all better. And I’m sorry those days are over. Or if they’re not over, they should be over. We need to do better because people with mental illness are not going away. Gone are the days when we’re locking them away in institutions for years at a time. And we need to reckon with the fact that they’re in our community. And we need to do better.
Gabe Howard: Gabriel, thank you. It’s been an incredible discussion and enlightening discussion, and you mentioned OC87 Recovery Diaries, which I think is incredible. So I’d like you to tell the listeners what that is first and foremost.
Gabriel Nathan: Sure. So I’m the editor in chief of OC87 Recovery Diaries. It’s a nonprofit mental health publication. We tell stories of mental health empowerment and change in two ways. First person mental health recovery essays. We publish a brand new personal essay every single week, and we also produce short subject, professionally made documentary films all about people living with mental health challenges. You can see all of our mental health films and read all of our mental health essays at OC87RecoveryDiaries.org. And if you want to follow me, really the only place to do that is on Instagram. I’m at Lovebug Trumps Hate and I would love to, I’d love to be your friend.
Gabe Howard: Lovebug Trumps Hate is about Gabriel driving around in his Herbie replica, his lovebug replica. The pictures are incredible. The suicide prevention that you do is incredible. But also on the OC87 Recovery Diarieswebsite is where you can find Beneath the Vest. That entire series is on their completely free, correct?
Gabriel Nathan: Yeah.
Gabe Howard: Please watch it, it’s incredible. And you interviewed first responders. It’s not Gabriel talking. It’s actual first responders.
Gabriel Nathan: No, I’m not in it at all. So, it’s police officers, a dispatcher, firefighters, EMS personnel and my friend Michelle Monzo, who is the crisis intervention specialist trainer at MCES. All of the videos are free to watch.
Gabe Howard: Yeah, OC87 Recovery Diariesis a nonprofit, they survive by donations, please, if you see value in what they do, support them because they are worth it.
Gabriel Nathan: Thank you.
Gabe Howard: Ok. Gabriel, thank you so much for being here. To our listeners, hang on, as soon as we get rid of Gabriel, we’re going to talk behind his back.
Lisa Kiner: Well, again, it’s not behind his back because he can listen to it later.
Gabe Howard: That is very true,
Lisa Kiner: You keep forgetting that part.
Gabe Howard: Gabriel, thank you. Thank you once again.
Lisa Kiner: Oh, thank you so much.
Gabriel Nathan: It’s a privilege. Thank you for having me on.
Gabe Howard: Lisa, were there any aha moments for you?
Lisa Kiner: Yes, actually. The point that Gabriel raised was that the police do not need to respond to these situations at all, that this is not a police matter. It honestly had not occurred to me that, yes, our default thing to do in America when there’s a problem is to call the police. It’s my default thought. And it doesn’t necessarily have to be a problem that it makes sense to call the police about. It doesn’t have to be a school shooting or a hostage situation. That is just what we all do reflexively. If there’s a problem, we call the police. And it hadn’t occurred to me that there are other options.
Gabe Howard: The exact example that Gabriel used was somebody being loud while walking down the street, not showing any form of aggression or violence or breaking things, but just making people feel uncomfortable. People are picking up the phone and saying, well, I’m scared because my neighbor is loud in their own yard.
Lisa Kiner: This person is exhibiting clear symptoms of mental illness. And therefore something needs to be done, therefore, we as a society must do something to make that stop. And the thing that we think will make that stop is to call the police. But in reality, no, that’s probably not going to work and could turn out very poorly. Why do we think the police are the people to call to make that stop? And why do we need to make it stop at all? Why can’t we just tolerate this? Why can’t we just allow this to go on?
Gabe Howard: I agree. That was kind of an aha moment for me, too. In teaching CIT, one of the things that police officers say all the time is you have to remember that it’s not illegal to be mentally ill and you call the police when something illegal has happened. Somebody’s being loud in their own yard, even if it is symptomatic, that is not illegal. Calling the police when no crime has been committed, it’s clearly escalating the situation that unfortunately, it often works out poorly for the person who is symptomatic. Not only do they not get help, but now the police are there. And just by showing up, there’s an escalation.
Lisa Kiner: I really hadn’t thought about, why is that the default, reflexive thing that you do? In this situation to call the police? Why is that?
Gabe Howard: I don’t know.
Lisa Kiner: Why do we as Americans do that? And, yeah, I don’t know either.
Gabe Howard: And that’s obviously on the general society, that’s not on police officers at all. This is just another example of where they get thrust in the middle of something that they are unprepared for, untrained for and not the best situation.
Lisa Kiner: Right.
Gabe Howard: Lending credence, of course, to Gabriel Nathan’s point that police officers should be out of this entirely.
Lisa Kiner: Well, it’s just very interesting. Why do we decide that police are the ones who need to resolve every situation? That every difficult or uncomfortable situation, we should get the police to fix it? Why are they the designated fixer of such problems? And it had not occurred to me that there are other options.
Gabe Howard: Agreed. That we’re sending law enforcement for a medical issue. I don’t agree with that at all, but I still think that it’s just very pie in the sky and optimistic and almost sunshine and rainbows to think that police officers will stop responding to mental health crises. It doesn’t sound logical to me.
Lisa Kiner: Well, I think you’re right about that, in part because police officers won’t be able to stop responding because the public will still call the police for these things. I think the argument that Gabriel is making is that it doesn’t have to be that way. The question will be what happens in the meantime while we’re working towards this goal? I don’t think he’s advocating getting rid of CIT.
Gabe Howard: Oh, yeah, I don’t think that either.
Lisa Kiner: He’s not saying that we should not train police officers to de-escalate or that we should not train police officers to handle people with mental illness. He’s saying that
we need to move towards this different vision, this different way of doing things. But obviously this type of training will always be valuable. Part of it is de-escalation. Isn’t that good for every crisis? Isn’t that good for every high energy, intense situation? How could that not be a good thing? Why wouldn’t you want to resolve a situation in a way other than with violence?
Gabe Howard: The use of force is problematic, especially when you consider the use of force on sick people. I’m obviously seeing the world very much through the eyes of somebody living with bipolar disorder. I was in crisis. I think about how close I came to having the police called on me. And I’m so very lucky that the people who were surrounding me were able to deescalate, control and, of course, didn’t feel threatened. You and I have talked about this before, Lisa. I don’t know why you didn’t call the police on me when I thought there were demons under my bed, I.
Lisa Kiner: Because I didn’t feel threatened.
Gabe Howard: I don’t understand why you didn’t feel threatened, but let’s put that on the back burner for a moment. You, of course, had a history with me.
Lisa Kiner: Yeah, you were not a stranger.
Gabe Howard: Imagine if I had thought the demons were under the cash register at Wal-Mart?
Lisa Kiner: Right.
Gabe Howard: You know, I’m a large guy, I’m six foot three, 250 pounds, broad shouldered, and I’m screaming that there are demons in the cash register to a 19 year old who’s working the evening shift at the local supermarket. That would seem very threatening. And I’m sure that the police would be called. And I just don’t like the idea that the first thing that they would do upon seeing this loud, screaming, mentally ill man is tase me or tackle me or worse. I don’t know that the person picking up the phone and calling would say, hello, 911 operator, I believe that we have a mentally ill man here. I think that they would say that we have a violent asshole threatening a teenage girl. And how would they know to send the mental health team?
Lisa Kiner: Well, that’s why we’re hoping that all police officers would have this training, and it’s kind of like a triage type thing, right? You don’t have a surgeon standing at the gate of the emergency room. You have a trained person, usually a nurse, who can assess whether or not to immediately send you to the surgeon or tell you to go wait for your turn. The idea being that all police officers would have this ability to kind of triage the situation to say to themselves, huh, that’s mental illness, and then call the appropriate response. That once they figure out what’s going on, they can turn this over to someone else, someone with either more or different qualifications.
Gabe Howard: I like that, I like that a lot. I do feel the need to be extraordinarily thankful to all of the police officers who have gone through CIT since in many municipalities, it is not mandatory.
Lisa Kiner: Including here in Columbus.
Gabe Howard: Yeah, including here in my state. Which means the police officers who have done it have volunteered. They have decided that there is value in learning how to help people with mental health issues in a way other than what they’ve already learned. I sincerely am so grateful for police officers who have taken that extra step because they don’t have to.
Lisa Kiner: But it’s not entirely altruistic. They also see the utility in it. It’s not just about people wanting to be nice to people with mental illness. It’s also about wanting to be safe themselves, not wanting these situations to get out of control, about not wanting bad things to happen. This isn’t just a benefit to people living with mental illness. This is a benefit to everyone, including police officers.
Gabe Howard: I have mad respect for the police officers who realize that. Who realize that they can learn more and help their community in a better way. Somebody with mental illness who is in a mental health crisis is most likely going to be seen by a police officer before anybody else. That training is not required, even though it is understood that people with a mental health crisis will be seen by a police officer before anybody
else. That’s really the only take away that you need to understand. Right?
Lisa Kiner: There’s a lot of weird stuff that happens in society that makes no sense.
Gabe Howard: Yeah, yeah, if Gabe gets sick, they’re sending the police. Are they going to train the police? Nope.
Lisa Kiner: Well, maybe.
Gabe Howard: If the police officer sees the utility in it and has the introspection, the understanding and the time to sign up for CIT training all by themselves, the bottom line is I hope that any law enforcement, first responder or politician listening to this will understand that mental health training is vital, period. We learned so much from Gabriel Nathan that we decided to do another show with him over on The Psych Central Podcast. And you can find that show on your favorite podcast player, just search for The Psych Central Podcast. Or you can go to PsychCentral.com/Show, and it will be there on Thursday. And Gabriel talks about the suicide rate among law enforcement. Forget about protecting people like me with mental health issues and bipolar disorder. Forget about all of that. The suicide rate among first responders.
Lisa Kiner: It’s quite shocking that more police officers will die by suicide this year than will be killed in the line of duty. A lot more
Gabe Howard: Yeah, by a lot,
Lisa Kiner: Almost three times.
Gabe Howard: It made us do an entire another episode on an entire other podcast hosted by me, so please go to PsychCentral.com/Show or look for The Psych Central Podcast on your favorite podcast player. And listen to more from Gabriel Nathan, the executive director of OC87 and one of the people behind Beneath the Vest: First Responder Mental Health. Lisa, are you ready to get out of here?
Lisa Kiner: I think we’re good to go. Thanks again to Gabriel Nathan for being here with
Gabe Howard: All right, everybody, here’s what we need you to do. Please subscribe to Not Crazy on your favorite podcast player. Rank us, review us, use your words and type in why you like the show. This really helps us a lot. Share us on social media and also tell people why to listen. We love doing this show for you and you can help us out greatly just by doing those simple things.
Lisa Kiner: And we’ll see you next Tuesday.
Announcer: You’ve been listening to the Not Crazy Podcast from Psych Central. For free mental health resources and online support groups, visit PsychCentral.com. Not Crazy’s official website is PsychCentral.com/NotCrazy. To work with Gabe, go to gabehoward.com. Want to see Gabe and me in person? Not Crazy travels well. Have us record an episode live at your next event. E-mail [email protected] for details.
Gabe: Hey Not Crazy Fans! We are so cool our outtakes have sponsors! We want to give a shout out to Southern Cross University. Learn about mental health risk factors in older people at https://online.scu.edu.au/blog/risk-factors-mental-illness-older-people/. Check them both out and tell them Not Crazy sent you!
The post Podcast: Is Police (CIT) Crises Training Needed? first appeared on World of Psychology.