Minds in Crisis

Police repeatedly interacted with her, either coming to her house when she called, or when multiple neighbors called to say she was outside screaming. They drove her home twice from the police station, only to have her walk back downtown to call again.

Hours later, she was finally arrested on a charge of disorderly conduct after mental health counselors reported she was at their office and “ramped up.”

Hers is an extreme case, but represents the increasing demand on police resources from the mentally ill.

The Dalles Police Officer Chris Simonds said he’s seen an uptick in calls involving the mentally ill over the last five years. The Dalles Police Chief Patrick Ashmore said he’s seen an increase just since taking his job three years ago.

Five years ago, Simonds went on such calls about once a month. Now it’s a few times a week.

“It’s just very surreal how much this has increased, and this is, in a way, not the new definition of police work, but it is the new significant component of what police work is,” Simonds said.

Simonds said that about three years ago, Steve Bradley, a counselor with Mid-Columbia Center for Living, made “a very conscientious effort” to reach out to police, becoming the first CFL employee to go on ride-alongs.

Bradley also spearheaded an effort to get officers Crisis Intervention Training (CIT). Simonds said the 40-hour training was the most impactful of his 14-year police career, and changed his entire outlook on how he polices and how he handles calls generated by the mentally ill.

He said the training, attended by over half of city officers so far, is “absolutely necessary because this situation isn’t going to go away anytime soon.” He believes drug use and homelessness, which has skyrocketed, feed into mental illness. Other factors are judicial rulings allowing the mentally ill the right to refuse treatment and lack of space in treatment facilities.

Given all those factors, “This is the only result that could’ve happened,” he said of the increase in call load.

Ashmore said the closer working relationship with the Center For Living has meant that “we know a lot more about what they can and can’t do, and vice versa.”

The two entities talk regularly about difficult cases, he said.

Regarding the woman who took up so much time, Ashmore said, “What I’m worried about, if we have six people like that, I’m not going to have the resources.”

Ashmore said the impetus behind getting crisis response training for police officers is to “slow down and try to find a remedy to the problem vs. showing up at the house again six times.”

Sgt. Doug Kramer was one of four officers who had a combined nine contacts with the woman as she slid into crisis. He contacted her four times, including giving her a ride home from the police station.

“We were lucky that night because we didn’t have other calls pending,” Kramer said.

The woman told dispatchers and police a variety of things, from fearing she would wake up without hands to saying she couldn’t find the stab hole in her head to saying she was the president and owned Sprint.

Kramer said officers reached the point that night that if one more neighbor called—three had already—they were going to arrest her. But no one else called during their shift.

A contact with a mentally ill person can take anywhere from a couple minutes to an entire day, if they have to stay with them at the hospital as they await transfer to a facility, Kramer said.

Kramer recently took the crisis intervention training and said it was good, but “it feels like a lot of the responsibility is still being pushed back on the police, unfortunately.”

But he appreciates having crisis counselors to respond to calls with the police, since “obviously, a uniform can trigger people.”

The woman’s situation that night, and into the next morning, had both counselors and law enforcement asking each other for help. The last call involving the woman was from counselors asking that the woman be removed from their office. Dispatchers “asked if there is someone there that can talk to [the woman] as a client.” The caller stated “she will work on it. Still [requests] officer respond.”

The situations where a crisis counselor responds work out the best, Kramer said. “And, of course, these never happen at a convenient time. It’s either super early in the morning or late, late at night.”

He said, some officers “have the ability to be more calm with the situation and get a better resolution,” but it all depends on the situation. “We all go there and try to be empathetic and be of assistance, but we’re all under the timeline too.”

Simonds said the police culture of “go to the call, handle the call, clear the call” starts in police academy. It’s not pressure from police brass, but an expectation officers have among themselves.

It’s an unwritten code that an officer in another area should not have to take calls from your own area because you are taking too long on a call, Simonds said. “The common line was, ‘Are you making a career out of this call?’”

But the crisis training changed his thinking. Now, he’s learned to slow down on a call involving the mentally ill, listen to them and talk with them until a crisis counselor arrives. The mobile crisis counseling that makes this approach possible is a service CFL began providing in 2014.

Now, after Crisis Intervention Training, Simonds is comfortable taking 30 minutes on a call if need be as he awaits a counselor.

“We’ve always tried to defuse the situation, but now we invest more time, and we have better skills,” Simonds said.

Simonds has gone on calls with the mentally ill woman who made the slew of calls earlier. He’s used his new de-escalation skills to get her from an agitated to a calm state, “but I’ve never brought her back to any sense of reality whatsoever.”

The crisis intervention training included wearing headphones and listening to a recording of voices so they could experience what it’s like to have the auditory delusion of “hearing voices,” Simonds said.

The crisis intervention training teaches officers to acknowledge that a mentally ill person is hearing voices. “It would be ridiculous for me to say they’re not hearing voices. They are.”

But while officers are trained to acknowledge the delusion, they are also trained not to feed into it.

So Simonds might also say to a person, “No there’s nobody there, but I understand you believe there is.”

He said, “You’re grasping the concept of what it might be like to be them and it’s very real to them. That has to be part of the encounter, that you are empathetic.”

If he talks softly, the other person has to quiet down to hear what he’s saying. He can also use distraction. Maybe he’ll say, “What kind of plant is that? Did you grow that?”

Thanks to the de-escalation methods he’s learned, Simonds said about 90 percent of the time he can get a mentally ill person calm by the time crisis counselors arrive.

“The training has completely changed the success rate, from changing the crisis situation to a calm situation, without reverting to an arrest,” he said.

The previous mindset was that making an arrest solved the problem. But “that doesn’t solve the problem, that solves the incident,” Simonds said.

In a situation, for example, where a person pees on a bush in public, “in old tactics, [you’d say] ‘Hey, you need to stop it and move on.’ And because they’re in crisis and not listening to you,” the situation escalates to an arrest.

Now, he said, the officer’s perspective is, ‘Why are you in a state where you’re peeing on a bush and not realizing it’s not ok?’”

The other common scenario is the person screaming at 2 a.m. Back in the old days, Simonds would check if they’re irrational and not listening to his instructions. If they weren’t, his response was, “Heck with it, I’ll just take them to jail for the noise ordinance.”

But the crime of disorderly conduct isn’t as all-encompassing as it seems, he said. First, someone needs to actually complain and say they’re being bothered by someone.

To be a crime, disorderly conduct has to be overtly alarming and put the public in fear, he said. “It is not as default an arrest as you think.” He added, “There’s no law that says you can’t yell.”

The woman who kept police so busy in early May was yelling in her neighborhood a few times, but none of the neighbors wanted her arrested.

Another surprising law, for what it doesn’t cover, is indecent exposure. “You can walk downtown naked all day. It’s not against the law,” Simonds said. Only if the unclothed person is overtly trying to arouse themselves or others is it indecent exposure.

The criteria for putting someone into mental health treatment against their will is if they present a danger to themselves or others. It’s a very difficult standard to meet, Ashmore said.

It’s not a question of how they have behaved previously, but at that moment in time, Ashmore said. He said about 90 percent of the time, CFL counselors can’t do anything, unless the person voluntarily seeks help.

“The impacts to us are huge,” Ashmore said. He said the department handles three to four calls a day involving the mentally ill. “We’re out on a suicide subject right now,” he told a reporter recently. “We’ve had two officers out chasing this subject around for the last hour and a half. And that’s our entire shift.”

He said the department’s records system isn’t very modern so it’s hard to pull data, but he is working on compiling it to get a clearer picture of how the department is being affected.

He said the “unusual” is happening “more often.” He said, “the issues are evolving, and we have to evolve with those issues to address them. It’s not locally; it’s at a state level.”