- Associated Press - Friday, May 13, 2016

KANSAS CITY, Mo. (AP) - As soon as the officers on the Kansas City porch announce themselves as the police, the man standing inside the door slams it shut.

Bam.

The officers in their black bulletproof vests - Ashley McCunniff and Aric Anderson - stand there a moment, exchanging a look.

Then, because they’re trained to set aside traditional “cop mode” demands for authority, these specialists in mental illness situations essentially shrug and head for the sidewalk. They figure on trying again later.

“Hey!” a voice shouts. The now-curious man has re-emerged on the porch behind them. “What’s this about?”

This: Police departments in Missouri and Kansas and much of the nation are training more officers to defuse potentially volatile situations of mental illness.

The Kansas City Star (http://bit.ly/1No9G3k ) reports that they’re doing it at a time of mounting pressure on communities and police to quell the threats of mental illness on public health and safety.

Even though too many encounters still end in tragedy, officers volunteering for CIT training - Crisis Intervention Team - are working to change that.

McCunniff and Anderson turn and look into the face of a man they know has recently called a police station with claims that a swallowed microchip and a mind-reading phone app are exposing his every thought, laying him bare to taunting voices.

“There are thousands and thousands and thousands - I’m talking thou-sands - of people listening to my mind daily,” he will soon tell them. Voices are urging him to do dangerous things.

The officers’ mission as the Kansas City department’s only full-time CIT officers is somewhat complicated. This is a pre-emptive call to try to get the man voluntarily engaged in mental health services and to gauge and ease any percolating threat to public safety.

No shouting. No pressure. No weapons raised to enforce commands.

McCunniff’s answer to the man’s question is simple:

“We just want to talk.”

The mental illness crises that officers face spill out of hiding places anywhere - midtown condos, suburban basements, college dormitories.

But isolated sufferers, living on their own, more often end up in harder, lower-rent places.

McCunniff wheels the black police SUV, with Anderson in the passenger seat, through narrow streets lined with worn cars. Although 30 percent of the Kansas City Police Department’s officers have received CIT training, McCunniff and Anderson make up the 19-month-old CIT unit that follows up on mental health crisis reports across the city.

In the back seat is a community mental health liaison, Truman Behavioral Health’s Erica Benson, with the case histories of the people they hope to visit.

The list includes people who prompted emergency calls for CIT officers in the past or who might need intervention to prevent a crisis.

One of their door knocks echoes in the empty stairwell of an apartment building with a pried and battered lock on its entry.

In another stop, they push through wood slats that conceal the porch of a home amid a littered yard of odd sculptures.

They kick at chain-link gates, seeing first if any dogs are lurking, before searching around the backs of houses.

Often they find no one home. But they’ll come back again.

They used to be the rarities on police forces - officers who had studied psychology in college and thought there were nuanced and gentler ways to confront distressed people in psychotic breaks, as frightening and potentially dangerous as they might be.

Benson supplements her full-time work as a community mental health liaison working odd hours as a crisis worker in Truman Medical Center’s “S-Pod,” where the medical staff tries to quell the distress of people placed on 96-hour holds with psychotic breaks.

They see how overwhelmed the system is, recycling people back into stressed homes or to the street because there aren’t enough beds to treat them.

Both sides of the state line have been freshly stressed, with Truman Medical Centers closing its behavioral health emergency room last September, and Osawatomie State Hospital in Kansas forced by regulators to lose many of its beds in the past year.

Many patrol officers, especially those new on the force, may not subscribe at first to the sometimes-counterintuitive approaches of CIT training, McCunniff says. They’ll say they’re “not mental health guys.”

But after a year or two on the street, you’ll see their names on the list for CIT training, she says. Some officers who were skeptical are now seeking out their advice.

Police work is changing.

For a lot of reasons, mental health advocates say, it has to.

Every first encounter has a “moment of truth,” Capt. Rance Quinn tells a lecture room filled with some 40 CIT trainees at the Kansas City, Kansas, Police Academy.

It’s that moment when an officer, in a stressful call, sees a troubled person in a state of psychosis.

“If you could hear what they hear, if you could see what they see, if you could feel what they feel, would you treat them differently?” he says. “Every moment of truth counts.”

That’s all too evident in the numbers from a recent Star analysis of 47 fatal shootings by Kansas City Police Department officers since 2005. In at least 21 of the deaths, there were indications the person killed was mentally ill or depressed or may have been impaired by drugs or alcohol.

The age of video offers plenty of tragic episodes for the CIT class to retrace. Some are the police’s own recordings - dash cams, body cameras. Others come from security cameras aimed over alleyways, sidewalks and parking lots.

CIT training teaches officers that people in psychosis need space. They need time to vent. They need one calm voice talking to them. For people in mental crisis, shouted commands that seem crystal clear - like “Drop the knife!” - can be confusing or terrifying.

You have to get out of “cop mode,” Quinn says.

The room debates the different ways the officers seen in videos could have saved the young man in Dallas who was shot by police with only a screwdriver in his hand, or how an officer in Idaho who stepped alone into an apartment to confront a suicidal man with a knife could have kept from firing his fatal shots.

But drama caught by security cameras in Fullerton, California - showing a group of officers subduing and beating a belligerent and combative man with mental illness - drew a wide consensus as it finished with a picture of the man’s purpled, cut and swollen face in an emergency room.

One thing they all know, Quinn says, is that the days of handling cases that way are “done.”

The details are hard. Officers who come from academies trained to be loud and clear when they are identifying themselves and giving commands must learn when to dial down - while never compromising their safety.

It’s a weeklong basic course, a full 40 hours, learning the strategies and the resources available to them as they try to shepherd people who are ill and their families through a mental health system that is full of gaps and frustrations.

“Our system is broken,” CIT specialist Julie Solomon of Wyandot Inc. tells the officers. “We’re trying hard to fix it.” But a lot will depend, she says, on the officer who is standing before that person, who maybe can no longer stand the numbing side effects of so many medications, who doesn’t know who or what to listen to anymore.

“One thing I want you to come away with is compassion,” she says. “It’s all of our jobs.”

“The whole (expletive) city is reading my mind,” says the man on the porch. He’s hearing voices laughing at him. The two officers and Benson collect again at the gate to his small yard. “Stay off my property,” he snaps. “Stay there.”

“It doesn’t sound pleasant at all for you,” Benson says, keeping her distance. “It sounds stressful.”

“It is stressful,” he says. “I need FBI. I want them to hear the people who are talking to me. . I need help shutting down these people in my mind. (But) I can’t go to the FBI. Who can I trust?”

After some time, he allows Anderson to walk up along the neighbor’s side of the fence line until the officer is adjacent to the man on his porch - close enough to look at some of the writings the man has made regarding device ID numbers and other notes, and close enough to pass a card with a phone number.

Benson offers from the sidewalk to give him her phone number. He waves her away. He has picked her out to be a mental health worker.

This is not a mental health problem, he says forcefully. “I am not a mental health person,” he says. “I will be suing if this leads to a mental health place.”

One of Kansas City’s tragic confrontations exploded right in front of Jim Dougherty.

His 26-year-old son, suffering severe depression, was shot and killed in their Brookside home in November 2002 by officers responding to the family’s call for help.

His son had faced the officers with two knives. CIT training was new and scarce, piloted in a different police division in the city. Dougherty saw and heard the yelling and screaming, he said, and then the gunfire.

Dougherty learned about CIT through the National Alliance on Mental Illness in Kansas City and negotiated with the Police Department to increase its commitment to the training as part of a settlement in a lawsuit after his son’s death.

Times were different then, he said. It wasn’t well received by much of the law enforcement community.

“The culture was you stand by your own - it’s a dangerous line of work (with) a lot of complex issues,” Dougherty said. “To admit there was a problem appeared to break ranks.”

Nikk Thompson, now a retired Lee’s Summit police officer, carries his own regrets.

He remembers one year, 1999, when three calls he worked brought him in touch with three Vietnam veterans in emotional distress.

He knew nothing of CIT training, but he was a Vietnam vet himself and thought he could talk them through it and motivate them to carry out the counseling opportunities he delivered them to.

“All three of them completed suicide,” Thompson said. “We weren’t doing the right thing. We didn’t know where to take them. As an officer, you were at the mercy of your own experience.”

He learned in 2000 about training developed in Memphis, Tennessee, - prompted by a tragic shooting - that would become the model of the CIT programming today.

Thompson brought the idea to Lee’s Summit. A meeting with Guyla Stidmon, the Kansas City director of the National Alliance on Mental Illness, led to a regional effort to enlist more law enforcement agencies.

By 2007, the tide had turned broadly in favor of CIT. That year, the Kansas City Police Department, at Thompson’s urging, invited Dougherty to begin addressing police trainees.

“It’s been an amazing process to be part of something,” Dougherty said. “A lot of mental health awareness is building in the community.

“I think the world of this program.”

Families interviewed by The Star - some with adult children with mental illness who have been dealing with the system for decades - say they have noticed the CIT effect.

Many of them know to ask for CIT officers when calling for help. Familiar officers often become their partners in trying to navigate exhausting circumstances.

Sometimes CIT officers will be the only friends of isolated people with illness, Thompson said.

Some Lee’s Summit officers who cared to the end for a woman in poor physical health served as the woman’s pallbearers.

There is no research that measures whether CIT efforts are preventing jailings, hospitalizations or violence, but close observers say the effects are clear.

CIT advocates say departments need enough trained officers on duty and nearby to respond to mental health crises. The goal is to have more than 20 percent of a department’s force with CIT training.

The Kansas City Police Department has pushed well above 30 percent, CIT unit Sgt. Sean Hess said.

Officers in the field are more observant, he said, and records show that the number of incident reports making mental health referrals to Hess’ three-person special CIT unit has tripled to more than 2,400 a year since 2010.

As more officers in Jackson County police departments receive Crisis Intervention Team training for dealing with people with mental illness, the number of CIT reports has doubled.

“We could have 10 officers and we’d still be overwhelmed,” he said.

The Kansas City, Kansas, Police Department reports that more than half of its force is now CIT trained.

Johnson County police departments have reached at least 20 percent, with higher numbers in the larger cities, said Capt. Wade Borchers of the Lenexa Police Department, which has passed 40 percent.

Lenexa has kept records that show the number of mental health calls that require transport to a hospital or crisis center has fallen by nearly one-fourth since 2012 - a sign that the increased number of CIT officers has helped get more people into mental health services before there is a crisis.

And yet, he says, CIT officers still spend agonizing hours speaking into their cellphones in hospital emergency rooms, trying to find available psychiatric beds for volatile patients who want none of it.

The probate court where Jackson County deputy probate commissioner Mark Styles Jr. presides over civil commitment hearings still witnesses the cycle, Styles said, where patients committed for treatment are released early by crowded hospitals.

County jails, National Alliance on Mental Illness of Kansas executive director Rick Cagan said, are still “the largest mental health facilities.”

And when mental health services let people slip, he said, the crises that come will be back in the hands of law enforcement.

No way will the man on the porch agree to go for help today. Not surprising for a first visit, the CIT team says. They need to offer him a valid reason for them to return. They want to lay groundwork to nudge him later.

“I’ve got a guy I work with in the FBI,” Anderson says. “I’m going to talk to him about this app” that the man had mentioned earlier.

He doesn’t dismiss the man’s delusion, nor does he fuel it. (And yes, he says later, he will run the conversation by his contact.)

“What’s a good day to come back?” Anderson says.

“Oh,” the man says, a twitch in his voice, “you’re going to try and lock me up.”

No, Anderson says. They just want to help, to talk some more. This is also the truth, but it’s a hard sell.

“You want to lock me up.”

They leave him with pleasantries, their phone numbers, a promise to help however they can, knowing they will return - the beginning of another relationship pitched in the unknown.

___

Information from: The Kansas City Star, http://www.kcstar.com

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