PAWTUCKET — The frantic calls can be found almost daily in the police log: a husband “off his meds” and threatening to harm someone, a live-in girlfriend drunk and violently smashing furniture inside an apartment, a teenage son or daughter “out of control” and sounding suicidal.
As always, police officers respond with the intent—as they have been trained--to get the crisis situation under control as quickly as possible.
However, because there are so many variables and so much unpredictability surrounding a mental health crisis and the way that an individual police officer responds to it, there is a lot that can go wrong. The Pawtucket Police Department, like community police departments everywhere, has had its share of crisis responses that have gone awry — sometimes with tragic consequences.
Following a string of unfortunate and controversial incidents involving police officers' responses to mental health crises that occurred both in Pawtucket and in several other communities a few years back, the Pawtucket Police Department began a unique partnership with Gateway Healthcare Inc., Rhode Island's largest, non-profit behavioral healthcare organization. A program that began in 2009 in response to criticism and negative press about the Pawtucket Police Department's handling of some incidents involving emotionally disturbed individuals now stands as a successful model for other police departments.
The most recognizable faces of the Crisis Intervention Team program are Pawtucket Police Capt. Kevin Whalen and Gateway Healthcare Program Supervisor Christine Emond. The pair has responded to so many housecalls they are known on the street as “The Gateway girl and the bald guy.” Twice a week, a representative from the Pawtucket Police Crisis Intervention Team, along with a clinical consultant from Gateway, provide outreach to individuals and families who have been identified as emotionally disturbed or suicidal.
According to Whelan, the goal of this collaborative effort is to increase communication and familiarity with local individuals suffering from mental illness in the hope that this will reduce anxiety and show them that there are resources available and people in the community who are on their side.
Emond added that the intent is to be “proactive rather than reactive. There are lots of people who wouldn't have followed through with services if we hadn't gone by. It also lets people know that if they're in despair, there is a place to go,” she said.
Kyle Edward, director of emergency services and screening for Gateway Healthcare, said that back in the spring of 2009, then-Police Chief George L. Kelley III contacted the organization about providing specialized training for police officers in how to deal with the mentally ill. For many years, Gateway has been one of the area's key resources for mental health treatment, education and prevention services, and the Pawtucket Police Department was fully aware of its function. Yet, for the most part, the two organizations had always worked independently.
Edward noted that in the past, the police officers would typically respond to a mental health episode and then take the troubled person to a hospital emergency room, leaving once the admission was completed. “We would see an average of 11,000 people a year who were brought to the emergency room for a mental health evaluation,” said Brown. “And there was really no communication with the police department.”
With the formation of the Crisis Intervention Team, the pairing of police officers and mental health professionals has been found to be beneficial to all involved--from the person having the crisis who is given further assistance and reassurance, to the clinicians and police officers, who learn from each others' skills and training.
“Pairing someone in the mental health field with individuals involved in law enforcement and crisis issues is a huge benefit to individuals and families,” said Edward. “And this type of outreach is a good service for the city, as we try to limit the risk to both the client and the police officer.”
Besides Whelan and Emond, the Crisis Intervention Team includes Pawtucket Police Lt. Napolean Gonsalves, Det. Charles “Chip” Devine, Det. Linda Bachand-Doucet, Sgt. Mark Boisclair and Sgt. Alvaro Herrera, and Gateway clinicians Holly Batura, Allison Torti and Manny Matos.
Upon Kelley's request and by using a federal grant that had been obtained with the help of former Congressman Patrick Kennedy, Gateway provided training in mental health crisis and suicide intervention to the entire police department, from the dispatchers to the command staff. The funding also helped initiate the Crisis Intervention Team.
While the federal funding has since been cut, the current Police Chief, Paul King, has managed to keep the Crisis Intervention Team going with existing personnel and creative scheduling. He has made sure that some of the Crisis Team's police officers are assigned during the daytime and night time shifts to handle the bi-weekly follow-up visits without costing overtime.
“It's such an important program to the city that we found a way to keep it going even though the funding is cut,” King said. He noted that it puts more stress on the shifts, as the officers involved are responsible for doing the follow-up visits along with their regular work. Yet, the chief said it makes a big difference to ensuring the safety of the both the person having the crisis and the police officers who respond. He added that Mayor Donald Grebien is also “one hundred percent behind this program and in finding a way to continue it.”
King said he thinks the biggest benefit of the Crisis Intervention Team's follow-up is in establishing trust between the person who is emotionally unstable and the police department. “In many of these cases, we're going to deal with the same person repeatedly, so if we don't have trust the first time, it's likely going to be a fight. We have to physically restrain the person and haul them off to the hospital, and if they're fighting, sometimes the person can get hurt or sometimes the officer can get hurt,” he said. “This partnership has shown people that they can trust the police to help them, even when they are having an episode. Through the follow-up, they realize that these people are here to help, and they can feel safe. Even if they have to leave their home, they know they will be safe.”
King added that the program also serves to highlight the importance of how far-reaching the (federal) funding cuts are. He noted that the segment of the population that suffers from mental health issues is one that local police departments have to deal with—particularly during a tough economy.
Major Arthur Martins concurred about the benefits of the Crisis Intervention Team, saying, “The intent is for the police and the mental health experts to become familiar with the person suffering from the illness and his or her family and vice versa.” He added that the officers generally conduct the follow-up visits wearing plain clothes and arriving in unmarked vehicles. “We want our interactions to be relaxed and informal. The goal is to inform them that we are available to provide support and assistance when needed.”
“The objective is to provide aid before a situation develops into a crisis or self-destructive event,” Martins added. “The purpose is prevention and being pro-active instead of being merely a reactive organization.”
Additionally, whenever there is call to the police about a serious mental health emergency, such as one involving weapons or potential violence, an attempt is made to have a clinician from Gateway accompany the police officers who respond as part of a Crisis Negotiation Team. Oftentimes, said Edward, the clinician has proved helpful to the police officers by encouraging a more patient and individualized approach in calming someone who is violent and gaining control of the situation than perhaps the way the officers had traditionally been trained at the police academy.
Edward added, “We're not here to say police are doing things the wrong way. It's just providing a different mindset. Or, just taking more time. If no one is in immediate danger, maybe it could take an hour of talking instead of five minutes to take control.”
Edward said that the partnership also allows for more sharing of records and access to confidential information that can be vitally important in trying to deal with an emotionally unstable individual. “Taking control might not be the same thing in every situation,” she said.
Whelan said that while police officers all receive some level of training in suicide prevention and mental health crisis intervention, the police department was open to the idea of partnering with Gateway.
“It's been changing the philosophy of the entire police department,” Whelan said. “Things like approaching the person slowly, only one person talks at a time, do active listening. Take your time—not have three officers yelling at once. It seems to be working. There have been less incidents of violence and less arrests for disorderly conduct or assaults on police officers.”
Whelan noted that the Pawtucket Police Department typically handles about 1,600 calls a year that are for individuals who are emotionally disturbed or suicidal. Due to the downtown in the economy where people have less access to health insurance and/or money for medications and counseling, the number of calls has been up about 25 to 30 percent in the past year over previous years. Since January 1, 2011, the police department has received 378 such calls and is working with Gateway in following up on 178 cases.
Whelan, Edward and Emond said they have received nothing but positive feedback about the collaborative effort, both from those individuals who have been involved and the community as a whole. Whelan said the Pawtucket Police and Gateway Healthcare partnership is a model in the state, and that to his knowledge, the only other police department with a similar program is in Memphis, Tennessee. The program was also recently highlighted at the New England Crisis and Negotiation Association's annual meeting which was sponsored by the FBI.