Director of Crisis Intervention Training Speaks

From the Portland Mercury, February 5 2009

The director of the Portland Police Bureau’s Crisis Intervention Training (CIT) program, Liesbeth Gerritson, spoke out publicly for the first time last night about the program’s curriculum and its chances of success, at a talk sponsored by the National Alliance on Mental Illness (NAMI) at Emanuel Hospital.

Gerritson, who had earlier threatened to walk out if she was video-recorded at what had been billed as a public meeting, spoke for almost two hours to an audience predominantly comprised of people suffering with mental illness and their family members. Also present was Officer Betty Woodward, a Portland cop who has been a major advocate for CIT training. “She has stopped train wrecks from happening,” said Gerritson. “She’s talking to big dudes who want to go in in a different style, and stopped that from happening.”

CIT, which trains officers to diffuse confrontations with people in mental health crisis without necessarily resorting to force, started in Portland in 1995. It was voluntary until late 2006, when Mayor Tom Potter made the program mandatory for all uniform officers and sergeants in the wake of the death in custody of James Chasse, Jr, a man with schizophrenia. Gerritson completed the training for all uniformed officers last December—a total of 504 Portland officers and sergeants. The training was also extended to cover 70 Multnomah County Sheriff’s Deputies and 20 Gresham police officers.

It’s not yet clear whether expanding the program has actually worked. Indeed, news emerged last week that Officer Christopher Humphreys, one of the officers involved in the Chasse death, is now the potential subject of an excessive force lawsuit by a mentally ill woman whom he is alleged to have assaulted just days after going through CIT.

EXTRA – New Lawsuit Threatened Against Chasse Cop

Gerritson said the training has focused on teaching officers to identify potential signs and symptoms of mental health crisis in the field. “What are they actually seeing? How is a person acting? Ho do you deescalate the person verbally? How do you leave enough space so that you’re comfortable deescalating the person verbally?” asked Gerritson. “I think, and I hope, that that is something that we’ve gotten across to a good proportion of the officers. And not all of them got it. I can’t even tell you what percentage of them did. But a few of them did.”

Gerritson said the program is really trying to address stigma related to mental illness. “We’re trying to get at that idea of what are some of these ideas you have of people who are mentally ill?” On the other hand, Woodward said, the training doesn’t necessarily rule out the use of force by officers.

“We deal with behavior, but the very first thing is safety, and beyond safety is how I interact with everyone,” Woodward said. “Does that mean that I never use physical force? No.”

Woodward related a recent incident where she was called out by Project Respond—the county’s mental health outreach project—to do a check on a woman with mental illness who had been decompensating—showing worse signs and symptoms of mental illness—for the preceding two months.

“We went up, knocked on the door, and she answered the door with a knife drawn like this,” said Woodward—gesturing to show a knife held over her head, reminiscent of the shower scene from Psycho. “What we did was, we closed the door…we set up a plan where someone would open the door and I would Tase her. Tasers hurt more than anything you’ve ever felt in your entire life. But did I enjoy doing that? No. But in the end, the most important thing was to get her safe.”

“You know, the fact that physical force gets used is not as issue,” Woodward continued. “Is it used in excess on occasion? Probably, because we’re dealing with human beings. But I think we’re dealing with things that are a lot more complex than just knocking on the door and saying Hey, it’s time to go to the hospital.”

“I hope it’s a good step, but I can’t make a prediction,” said Gerritson, of the training. “You can train somebody to do something different, but my highest dream about the training was I want to change hearts and minds. I think what makes the difference is in here,” she said, gesturing to her chest. “What is your intention when you go out on that call?”

“I felt like the knowledge that we gave them would hopefully meant that there’d be less fear around these calls,” said Gerritson—Woodward estimated that 60% of emergency calls to Central Precinct, where she works, involve mental health crisis in some manner. Gerritson did not give a formal outline of the CIT curriculum, but handed out a sheet with elements of the curriculum listed on it, and discussed parts of the curriculum with the audience. The sheet read as follows:

    Curriculum Elements

    a. Major mental health (Axis I) disorders
    b. Mental health system in Multnomah County
    c. Process and criteria for putting “holds” on people
    d. De-escalation techniques for people in crisis
    e. Dual diagnosis
    f. Consumer presentation
    g. Officer videos
    h. Consumer videos
    i. Educational videos (“I’m Still Here”)
    j. Scenarios
    k. COPS videos
    l. Personality Disorders
    m. Exercises

Gerritson talked at length about the officer videos—of which five are currently offered as part of the training. “We thought, there are 1000 people in the bureau, what are the chances some have a family member with mental illness?” she said. “And a few brave souls came forward, because officers don’t like to be in the limelight.”

Gerritson said one video features an officer whose father was diagnosed with schizophrenia when the officer was six years old, and spent the rest of his life in institutions. The officer “was surprised at his own emotions,” said Gerritson. “It was really something. And you could hear a pin drop in some of those interviews.”

She also drew the following model for crisis escalation and deescalation, that showed a crisis victim’s curve in red, and an officer’s curve in green, a rough rendering of which is as follows:

 CRISIS CURVE: Both victim and officer are affected...

CRISIS CURVE: Both victim and officer are affected...

Gerritson said that at different points on the crisis curve, both officers and crisis victims will process information and act differently. For someone at the height of the curve, it’s almost impossible to respond to orders. “You’re talking to someone in that state, and they’re not responding. Why not?” Gerritson asked.

Gerritson also stressed the importance of body language in controlling crisis situations.
“You come in, and you’re not looking like, hey, I’m going to put an arm bar on you,” she said. “We’re just talking, here. If you come in with an aggressive stance, an aggressive stare, then they’re going to go up on that curve.”

Gerritson and Woodward also discussed Post Traumatic Stress Disorder among cops, and the difficulty in a partnership situation for an officer in showing weakness.

“There is this tension between officers that comes with the work that we do,” said Woodward. “We have to find ways to deal with that—the alcoholism rate among officers is much higher than the public at large. It’s a legal drug, so officers self medicate. And there’s been a remarkable change in the culture—there’s still a long ways to go but it’s gradually turning.”

“That tension is never going to go away, though,” Woodward continued. “But I think that this helps because it gives more guys permission to feel that it’s okay.”

The pair also addressed the shift in police work over the last 30 years, following the de-institutionalization of people with mental illness under President Reagan.

“Before CIT existed, the only training that did exist was police training,” said Woodward. “Now, police training and CIT are very different because police training is all about control and safety, about how to talk to someone with a command presence…and now we’re into this social service area.”

“Some of the roughest, toughest guys will come up to me and say how did you do that?” Woodward continued. “A lot of these things are things that these guys as human beings have never paid attention to I think that there is a drive to get from one place to another. I think it is going to take time, though, to turn people who are police officers into efficient social service providers.”

An audience member expressed concern that newly-trained CIT officers might be less effective at handling crisis calls than those with more experience at using the training.

“The logistics of it now are, there’s going to be a call and it’s going to be luck of the draw,” said Gerritson. “Whoever shows up, they’ll be CIT trained. But there is no ‘wait! I want the CIT person who, you know, sat in the front row!'”