With 'Reality Visors,' Officers Try New Tack To Face Mentally Ill

(September 26, 2006) -- The black visor wrapped around police officer Johnny Lopez's head made him look like a comic-strip character. As he peered at a computer screen, he felt his brain filling with murmurs and whispers calling him worthless and crazy. "They're after you," said one voice. Hallucinations flitted in and out of his line of sight.

Mr. Lopez and a group of 30 police officers from the Phoenix area were undergoing a simulated schizophrenic episode. It lasted just five minutes, but the officers were clearly relieved when it was over. One officer ripped off the headset broadcasting the voices. "This would drive me crazy," said Sgt. Barbara Alexander, "if I had to listen to it all the time."

The officers' taste of psychosis was supposed to give them new perspective on an increasingly common part of their work -- dealing with mentally ill people on the streets. The problem follows the shuttering of state-run mental-health facilities a generation ago. Prisons helped pick up the slack. The Justice Department estimates that about 330,000 of the nation's 2.2 million inmates are mentally ill. When released, they usually end up back in prison, in part because of a lack of outside treatment options.

Traditional police training runs counter to the tactics sometimes needed in encounters with sick people. Young recruits in police academies, for instance, are taught to take immediate command of unstable situations by shock and awe, issuing loud commands.

Mentally ill patients often react adversely to that. A Los Angeles study found that between 1994 and 1999, officers there shot 37 people during encounters with the mentally ill, killing 25.

Now, hundreds of police departments nationwide are trying to change their approach. In San Diego , officers are paired with mental-health professionals on some calls. In Arlington , Texas , all patrol officers and new recruits are given training that ranges from identifying symptoms to knowing what services are available. Some departments direct calls that appear to involve mentally ill people to officers with special training.

The training began here in 2001 and was patterned after a program created in Memphis , Tenn., following the fatal shooting there of a mental patient by local police. Five years later, about 1,000 officers have been trained, and now even 911 dispatchers and some detention officers are getting some instruction. The program here is one of the largest in the country.

Training for Phoenix police officers includes using sensory visors to experience symptoms of schizophrenia, tackling written tasks while listening to multiple voices, and taking part in symptom identification exercises.

In Mesa , officers learn to use softer, more conversational language less likely to agitate someone who is mentally ill. They also learn about psychiatric disorders and listen to firsthand accounts from mentally ill patients. A student at Arizona State University told the officers he had heard voices "every waking moment" for nearly 10 years. "It wasn't about the weather. They say your life's not worth living, kill yourself," said the student who asked not to be named. "The voices told me to kill a friend once. I told him. It made him nervous."

The student was quickly peppered with questions. "What words really piss you off?" asked Phoenix police Lt. Mark Hafkey, echoing the thoughts of other officers there.

"Nutcase," responded the college student. "I had an officer call me that." He added that while he was suffering a breakdown, trying to use physical force with him would only escalate a situation. Questions that make him focus his attention are best. " 'Have you eaten? Have you seen a case manager? Are you on medication?' Those questions bring me back to reality," he said.

Two of the officers instructing the classes, Nick Margiotta and David Beauchamp, went on patrol later that evening through Phoenix neighborhoods with a high concentration of homeless residents, some of them mentally ill. Both men do much of the outreach for the program. Over the next several hours, they patrolled areas and conducted home visits with a number of mentally ill residents to make sure that they were attending therapy sessions, getting medical care and taking their medication. They urged the homeless mentally ill to move to shelters and voluntarily accept help for their illnesses.

Because there is little bed space for the mentally ill outside prisons, the two officers see the stops as pre-emptive visits to head off potential crimes. They even drive some patients to doctors' visits.

Mental-health advocates like to see officers involved but worry that governments are shifting the responsibility for caring for mentally ill people to the criminal-justice system. Police officers are also wary of their new role.

"Doctors, lawyers and now mental health professionals -- they want us to be everything," says Chuck Canterbury, the national president of the Fraternal Order of Police, which represents more than 300,000 street level officers. He supports the training but cautions that the public "cannot expect or anticipate law enforcement will be mental health professionals." The training shouldn't change how police react when confronted with life-threatening situations, he added.

The first visit of the night was with a regular who frequents places near the airport, including a bank where he has parked five grocery carts of trash and trinkets. Wheelchair-bound because of a leg infection, he tried to outrun the patrol car when he spotted the officers, until Officer Beauchamp got out. The officer had tried several times to get the man into a shelter, but he refuses because he doesn't want to give up the grocery carts and one of his prized possessions, a 20-year-old stuffed animal.

Later, they ran across another of their former contacts, a schizophrenic pushing a grocery cart. He became agitated when he heard one of the officers describe him as homeless. He has in fact been homeless for 27 years and said, "I don't want to be off the street."

Phoenix police officer David Beauchamp urges a mentally ill homeless man to seek medical help and stay at a shelter.

Normally officers stay together in a show of force, but here Mr. Margiotta stayed several feet away, but within sight so the man wouldn't feel overwhelmed.

At another stop, the officers spotted an emaciated man sleeping on a grate behind an electrical-supply business. Mr. Margiotta hung back while his partner approached the man gingerly and talked to him softly. "Hey, we're not here to cause you any problems. We're just checking on you. You alright?" he asked.

Both officers noticed that the man had begun twitching and hitting his leg -- a sign, Mr. Beauchamp said, of mental illness and stress. "He's calibrating himself, doing that to keep himself on an even keel. We're making him uncomfortable."

His partner took a step back, giving the man more space and assessed his situation. Both realized the big toes on each of his feet were gone, probably the result of diabetes. It was difficult for him to walk. He carried no ID, but said his name was Smith. He said he was 30 but appeared to be in his fifties or sixties. Not once during the 20-minute encounter did he look at either officer, even as they reassured him repeatedly that he had done nothing wrong.

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Because the man wasn't suspected of a crime and didn't appear to be an immediate danger to himself or others, the police couldn't take him into custody or order him to get a psychological assessment. The man reluctantly agreed to cooperate with social service and mental health groups if the officers contacted the organizations.

By Gary Fields

Source: WJC

Last updated: 10/06

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