Law enforcement undergoes crisis intervention training

In many places, people in crisis are served by law enforcement officers who arrive armed only with what they learned about mental health and substance use in their basic law enforcement training. However, officers at the Asheville Police Department and Buncombe County Sheriff’s Office have additional special training for working with these situations.

According to APD spokesperson Samantha Booth, about 95% of APD officers have undergone a weeklong crisis intervention training provided by Vaya Health. CIT is a program designed to improve safety for emergency responders such as law enforcement and firefighters, telecommunicators and people who are in crisis.

CIT gives instruction on behavioral health “in a more interesting way than all officers are given in basic law enforcement training,” which touches on depression, anxiety, schizophrenia and bipolar disorder, says Capt. Joe Silberman. That training teaches “these are some [disorders], this is what they look like — and that’s it,” he says.

CIT instructs about mental health crises through “an utterly different lens,” Silberman continues. “They try to give you an understanding of the experience of having [the mental health issue], not what it looks like.”

Vaya, a public managed care organization, provides CIT for APD and the Buncombe County Sheriff’s Office, explains Leslie Lawson, Vaya community training specialist.

Around 70% of BCSO sworn personnel have completed CIT, according to spokesperson Aaron Sarver. BCSO also recently implemented a co-responder unit in which a licensed mental health counselor responds, along with a trauma-informed sergeant, to certain acute calls. Co-responders are part of an emerging model nationwide.

A jail diversion program

The 40-hour CIT prepares first responders to interact with someone in crisis. A significant component of the training is making first responders aware of the community’s resources that exist for people with substance use or behavioral health challenges. Lawson calls CIT a jail diversion program. “We’re trying to find different resources so [people in crisis] do not have to go to jail,” she says.

APD’s policy requires officers to have CIT in order to carry a Taser, says interim Chief Mike Lamb. The department began training officers in the CIT program in 2007. Participants are required to have at least six months’ experience in their agencies before undergoing CIT, for which they can earn continuing education credits, says Lawson.

Vaya offers CIT three times a year — in March, August and December — at A-B Tech Woodfin. In addition to law enforcement agencies, the organization offers CIT to telecommunicators working with 911 dispatch, the detention center, local universities, school resource officers, magistrates and Asheville Regional Airport employees, among other groups.

Vaya’s program is certified through the nationwide nonprofit CIT International, and Lawson is the local certified CIT coordinator. The N.C. Department of Health and Human Services covers the training costs, says Patty Wilson, Vaya vice president for learning and development. Lamb says officers are paid while attending CIT training.

‘An effective memory’

CIT brings guest speakers who discuss the varied experiences law enforcement may encounter during policing. Officers have the opportunity to ask whatever questions they might have about substance use or behavioral health. “You get to ask them really personal questions,” Silberman says. “It is an utterly interesting perspective that you get.”

Class speakers can include behavioral health professionals from Mountain Area Health Education Center, RHA Health Services, Mission Hospital Copestone or Caiyalynn Burrell Child Crisis Center. They can also include the loved ones of people with mental illness and people who are in recovery.

A pharmacist from Vaya or MAHEC will discuss psychopharmacology and talk about some of the medications officers may encounter in individuals, Lawson says. And a magistrate or an attorney will speak to the legal aspects of involuntary commitments, or IVCs, for inpatient treatment. (IVCs require a legal process that must be approved by a district judge.)

Lawson says an important part of CIT is the role-play component, where a person enacts a crisis that law enforcement may encounter. Officers “have to de-escalate that individual, instead of having to put hands on that person,” she explains.

BCSO received a grant that allows its officers to learn about psychiatric conditions through a virtual reality component. The officer wears a VR headset during CIT that simulates conditions like schizophrenia. “You can experience things that somebody who’s struggling with delusions [experiences], like hearing voices, seeing things,” explains Lamb. “Because that helps us to provide a more empathetic response whenever we’re encountering these situations.”

Silberman, who tried the VR simulation at the last CIT, calls it “an effective memory.” He explains, “You remember the difficulty [you had] communicating coherently … and you could tell whether you’re being dismissed.”

Participants in CIT are also taken outside the classroom to visit various providers of behavioral health and substance use support. Lamb says officers may visit RHA Health Services’ Behavioral Health Urgent Care, which can assess individuals without an appointment and refer them to substance use detox services, a hospital or other treatment, and Julian F. Keith Alcohol and Drug Abuse Treatment Center, which provides treatment for substance abuse and mental health disorders, as well as detoxification.

Reducing use of force

APD officers also participate in a use-of-force training called Integrating Communications and Tactics, or ICAT. All officers have been required to participate in ICAT training since 2017, says APD spokesperson Booth.

Law enforcement is “limited in what we can do with somebody who’s using a firearm,” Lamb says. But if an individual is armed with “a stick, a knife or some other weapon other than a firearm,” law enforcement has more discretion about the response, he explains. The officer could employ specialized communication skills to reduce the need to use force.

ICAT is offered through the Police Executive Research Forum, a nationwide organization of police executives that has provided other services previously to the City of Asheville.

ICAT training addresses topics like critical decision-making and threat assessment; identifying mental illness or intellectual and developmental disabilities; verbal and nonverbal communication; teamwork; and speaking up if a colleague is about to make a mistake. According to a 2020 study of the Louisville Metro Police Department, officers with ICAT training had a 28% reduction in the use of force, a 26% reduction in citizen injuries and a 36% reduction in officer injuries.

“What we’ve learned is it’s important to have time and distance and resources to help de-escalate that person,” Lamb says of ICAT training.

Suicide by cop

ICAT training includes a module about suicide-by-cop incidents — “those in which a person attempts to die by suicide by forcing an officer to use lethal force,” according to the Police Executive Research Forum. A person with suicidal ideation may see interacting with law enforcement as a way to facilitate death, Lamb explains.

Suicide-by-cop training addresses how to recognize these circumstances and how to appropriately respond. The most important aspect of the training, says Lamb, is for the officer to understand that depending on how they approach and talk to an individual, they could actually “give somebody the idea of committing suicide by cop. And that’s something that we want to avoid.”

Lamb cites an example of “not using shaming statements” while interacting with a vulnerable individual. Officers are also trained that a more aggressive approach like shouting “Drop the knife! Drop the knife!” may not result in the best outcome. Instead, officers are trained to use “I” statements, Lamb says, such as “I feel scared because you have that knife in your hand. Why do you have that knife in your hand?”

Public trainings

Currently, CIT and ICAT are only offered to people working in certain fields. However, Lawson notes that Vaya does offer several trainings for members of the general public who want to learn about behavioral health and de-escalating crises.

One training covers mental health first aid. Another training is on general de-escalation tactics. Vaya also offers two trainings about suicide risk: a two-hour program called Question, Persuade, Refer and a two-day program called Applied Suicide Intervention Skills Training, or ASIST. Additionally, Vaya can tailor specific trainings by request, such as if a community or school experiences a series of deaths by suicide.