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Mental Health 101 for first responders

The Humboldt Sun - 7/15/2017

Winnemucca Police Department Lieutenant Pam Coats and Humboldt County Sheriff's Office Captain Andy Rorex brought to Winnemucca a condensed version of special crisis intervention and de-escalation training for law enforcement and first responders. The trainers for the program were Bob Ridges from Lyon County and Dana Walburn from the State Department of Behavioral Health. Ridges heads a Mobile Outreach Safety Team (MOST) in Lyon County. MOST responds to assist law enforcement in responding to mental health crisis situations.

Walburn presented the main part of condensed Crisis Intervention Team (CIT) training for Humboldt County first responders in June. Walburn said how excited she was to see Humboldt County's law enforcement, first responders, dispatchers and jail staff personnel get training to help them better understand mental health issues and gain skills to de-escalate crisis calls.

Walburn said because first responders are on the front line, they're often able to intervene for someone before they go into the criminal justice system. "You are able to link them to services and keep them out of the emergency room or jail," Walburn said.

Walburn gave a short "mental health 101" presentation describing different mental illness conditions and common behaviors in those who suffer from those conditions. She also explained that sometimes individuals impaired by mind-altering substances can present as someone with a mental health condition. Past traumatic brain injury can also cause behavior consistent with a mental health condition, so can autism spectrum disorders, post-partum depression, Alzheimer's and many other conditions.

Walburn invited comments from those who attended the training.

Lieutenant Pam Coats explained that the CIT training she received in Carson City emphasized that law enforcement and first responders need to talk to the people they're trying to deal with. "You don't have to be aggressive, but you have to take control. If they're hearing voices, ask them what the voices are telling them. If they're telling them to hurt you or hurt themselves, tell them, ?I'm going to put you in handcuffs so you don't hurt yourself or me.'" She said the restraints can actually help calm them.

Coats said giving people in crisis options instead of orders and threats can help de-escalate. "All people want to be treated with dignity and respect. All people want to be asked instead of told to do something and want to know why they're being asked to do something. It allows them some feeling of control, gives them back some control.

Walburn agreed, adding, "Explain in very simple clear language and give time for them to hear and understand. A person in crisis will take longer to process what you're saying."

WPD Detective Matt Morgan said it's easy to overreact when going into a crisis situation but an adrenalin-fueled reaction is not always an advantage. "You can back up," Morgan said. "You don't always have to stand your ground."

Ridges agreed with Morgan's comment, and added, "Give them some space, instead of ?The law is here; I'm taking over.'"

While de-escalation techniques can often diffuse a crisis, nothing works in every case, Walburn emphasized. For instance, there are situations that require the individual be taken to the emergency room. "In an excited delirium state, an individual has a mind/body disconnect and doesn't respond to reasoning. Even using a taser on them won't help; they do not feel pain," Walburn explained.

Law enforcement personnel face dangerous situations every day where they have to assert their authority and an individual in mental health crisis does not react in predictable ways. "You go into scenes every day that most people would run from," Ridges said.

The training included two videos - one which showed a mental health crisis call that ended in a shooting and one which showed a different mental health crisis call where the officer was able to de-escalate the situation and keep both the person and himself safe.

"You do not have to diagnose," Walburn emphasized. "You assess the situation and then connect them with services."