Empathy Lessons: Training Police To Understand People With Mental Illness

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In a training exercise, Somerville Police Officer Eli Kim, left, tries to book Somerville Officer Samir Messaoudi -- playing the role of a man with schizophrenia -- while Cambridge Police Officer Fred Cabral does the sound effects of voices in Messaoudi's head. (Cambridge Police Department)
In a training exercise, Somerville Police Officer Eli Kim, left, tries to book Somerville Officer Samir Messaoudi -- playing the role of a man with schizophrenia -- while Cambridge Police Officer Fred Cabral does the sound effects of voices in Messaoudi's head. (Cambridge Police Department)

Earlier this month, Somerville Police Officers Alan Monaco and Timothy Sullivan responded to a call about a fight between two young men. They found one of them, Mike, in an agitated state.

"He started flipping out — get your effing hands off me, don't touch me!" Monaco recalled. "He was up and down, he would be screaming and yelling one minute, nice and talking and smoking cigarettes the next. We talked about what the issue is; he said the other kid said something detrimental about his mother, and his mother’s sick, and he spit in his face."

Coincidentally, the two Somerville officers had just been in a training session on mental disorders — including Asperger’s, one of Mike’s diagnoses. So they knew people with Asperger's can be hyper-sensitive about being touched and insensitive about how close to get to other people. Like Mike, who got far too close to the officers when he talked to them, right up into their faces.

"Normally for a police officer, if you invade our space, we have a safety zone where we don’t want people close to us," Monaco said. "I would have pushed him away. I would have physically pushed him off me."

But the officers thought pushing Mike back with their hands — their natural reaction — would backfire.

"I think in this case Mike would have reacted adversely," Monaco said, "and he would have ended up in jail, where he didn't need to be."

"It also seemed to de-escalate Mike in a sense," Officer Sullivan said. "He got to vent and calm down and talk to us in I guess what would be a normal voice for Mike, and it worked. ... The class actually helped us a lot."

The class they took was part of 40 hours of training to create "Crisis Intervention Teams" that serve as a police department’s go-to group for mental health crises.

With a state Department of Mental Health grant of $168,000, the Massachusetts chapter of the National Alliance on Mental Illness is working to help bring that advanced training to more police departments around the state.

Crisis teams have been catching on around the country; earlier this month, the Connecticut Legislature passed a bill to ensure that all the state's police officers get such training. The need has been rising: Cuts in mental health services over recent years mean that police are called upon to deal with growing numbers of people with severe mental illness, who often end up in jail instead of treatment.

"What we know is that at least 10 percent of all calls to 911 involve people having a psychiatric crisis," said June Binney, director of the Criminal Justice Project at NAMI Mass., who oversees the training. "What we think anecdotally, from what we hear from police departments, is that number is really more in the range of 25-35 percent of all 911 calls related to people in a psychiatric crisis."

State government figures show Massachusetts spends relatively little on police training compared to other states, Binney noted. And when it comes to mental illness, a lack of police training can pose real risks, she said.

"The consequences at worst can be very dire," she said. "They could be people dying, they could be a person with a mental health problem who is fighting back and strong and may get hurt, and police officers are at a huge risk of getting injured in some of these encounters. So the skill set is really critical to keep the situation calm and keep the situation safe, first and foremost, and to avoid unnecessary arrests and get people the treatment they need."

The training isn’t just classroom lectures. It’s acting out explosive situations in a simulation room with a giant interactive screen. It’s role-playing and practicing "de-escalation" of fraught encounters, responding calmly even when faced with yelling and aggression.

In one exercise, Cambridge Police Sgt. Fred Cabral played the role of a suspect who has schizophrenia, and Somerville Police Officer Eli Kim played the voices inside his head, talking into his ear through a rolled up piece of paper. Cabral had to answer some simple questions while he was being booked: Name, height, Social Security number.

But as he tried, Kim's voice blared in his ear, reading from a script of typical auditory hallucinations: "How did you get to the police station? You must have done something wrong! I wonder what happened. You want to leave this place. You want to leave this place. You can't leave until he leaves. Stop! Stop talking to the police. We want to leave. We want to leave! Why are you wasting your time?"

It was challenging, Cabral said afterward.

"They’re very simple questions but it splits your focus, and it’s hard to concentrate on what you’re being asked," he said.

Kim — who played the auditory hallucinations — said the training could help police officers identify more with people who have mental illness. "As opposed to before, we had very little, or basic, knowledge about what caused them to act this way," he said.

Somerville Officer Samir Messaoudi, who played the booking officer, added, "It doesn't do any good to bring someone to the cell block if we could direct them to the hospital and staff and we could actually help them and get them the medication or the treatment they need, versus making the arrest."

David Fallon, Somerville’s deputy chief of police, says mental illness is not a problem "you can arrest your way out of." But the training is about more than that, he said, and it's important not just for Somerville but for "the policing profession as a whole."

"It's a very lofty goal, but you're trying to teach officers empathy for people with mental illness, and that's why I think that 'Hearing Voices' training was very important," he said. "Officers need to have empathy today — that's what society expects from officers and it's what they deserve, and it's what people need."

If someone is caught in a psychiatric crisis, Fallon said, "They're living in fear in our community. That’s important to us. We don't want anybody living in Somerville living in fear. So we’re taking this training to heart."

About a fifth of Somerville’s police officers went through this month’s training and several other towns have signed up for training this fall, for a total of about a dozen receiving training. A bill pending in the Massachusetts Legislature would boost the funding for police training by attaching a surcharge to car insurance; its fate remains unclear.

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Carey Goldberg Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth section.



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