I’m a New Orleans police officer trained to respond to calls from people with mental illness. Joining me is our department’s trainer. Ask us anything.

How many overturned vehicle calls does the NOPD respond to in an average week? Asking for a friend

Jonathan here: No one here knows. Sorry

Jonathan here: Not sure your question applies to this conversation.

New Orleanian here. Are there any plans for long-term mental health care facilities for some of our most vulnerable citizens? Obviously homelessness, drug use, and mental illness are strongly associated, but what resources are available in New Orleans for these people?

Also, is there a way to call the Crisis Intervention Team specifically? I will hardly ever call the police for any reason because I know that interactions between law enforcement and mentally ill people often ends in violence. NOPD does not generally inspire great confidence in our citizenry, either. I don't want to sic the police on someone experiencing a crisis and have them get tazed or worse. Do you have any input on this?

Cecile here: On your first question, our new mayor has a great understanding of the mental health needs in our community and I am confident in the near future we'll start seeing more services available. Just last month, the new city shelter (low-barrier) opened. People don't have to check-in and check-out; they can bring their pets. They can stay together as a couple. Odyssey House of New Orleans will also soon be opening a detox center, which is going to be a huge asset to our community. Both of these places give additional opportunities for officers to bring folks in lieu of the revolving door of emergency rooms and jails.

And for your second question, Metropolitan Human Services District manages our outpatient mental health community programs. It has a mobile crisis team, 24/7, which can be accessed by calling 504-826-2675.

This is Jonathan: It should be noted that if police are required, roughly 250 NOPD officers have received specialized CIT training and that training is designed to help them de-escalate these crisis calls and prevent violence from happening. I believe people can ask for a CIT officer and dispatchers have received training to help make sure a CIT officer gets dispatched.

Are the Saints going to the Super Bowl?

Jonathan here: Cecile is confident that they will go to the Super Bowl. Beth is also supremely confident. I'm a Chicago Bears fan, so football is over to me.

Sounds like the perfect time to become a Saints bandwagon fan!

Deal. I'm in. But I'm not buying any Saints stuff. Sorry

If we ever need police help for a situation involving a person with mental ihealth ssues, what can we tell the dispatcher that increases the chance that specialists like yourselves will respond?

Cecile here: Our operators and dispatchers receive an eight-hour CIT training. You can request a CIT officer is sent to a scene.

Thank you. If we're not in your area, and not sure what capabilities local law enforcement has, do you have any tips for helping inform authorities in a way that would trigger CIT -type response?

Cecile: The call is generated through communication with the 911 dispatcher. I always encourage families to give all available information to the operator/dispatcher so the call is dispatched as someone having a mental health crisis. This would include any diagnosis, medications taken/not taken, responses to previous law enforcement engagement, any weapons or threats involved, etc. Then, that information can be adequately passed to the responding officers.

What is a typical protocol for most officers who encounter mental illness in the field, particularly where weapons are concerned, and how does NOLA's protocol differ from this?

Cecile here: As a trainer in de-escalation, I always emphasis to our officers that policing and safety are the top priority.

Beth here: If we get the call and there is a weapon involved, securing the weapon and the person is priority number one. We have to assume there is a weapon if we're told as such. After that, then we can de-escalate.

Cecile: Once the scene is safe for officers and individuals, then we can work to verbally de-escalate the situation.

What happened to the officers that were simply re-assigned after ignoring hundreds rapes, including of small children? Were these officers perhaps suffering from mental illness? I know there was one female sex crimes detective who didn’t believe rape was a crime, as well as another who sent a toddler with an STD back home from the emergency room with her perpetrator.

https://www.nola.com/crime/index.ssf/2014/11/imagine_the_suffering_of_child.html

Each of the 13 had already been listed as an alleged abuse victim by the Police Department. But for the most part, the sex-crimes unit was apparently indifferent, so much so that a majority of its detectives were not even motivated enough to investigate reported sex crimes against children. These five detectives worked in a unit that exists to investigate sex crimes, but, given their dismissive attitude toward alleged victims, they seem to have operated as the most well-positioned friends a rapist could hope for.

Between 2011 and 2013, detectives Akron Davis, Merrell Merricks, Derrick Williams, Damita Williams and Vernon Haynes were assigned 1,290 sexual-assault or child-abuse calls, and 86 percent of the time they wrote no investigative report.

But the inspector general's report says one detective - identified by the Police Department as Davis - decided that a case involving a toddler brought to a hospital emergency room did not warrant criminal investigation. That child, described in Quatrevaux's report as "under 3 years old," was diagnosed with a sexually transmitted disease.

Jonathan: I'm sorry but I don't know the answer to the question.

Are these officers still on the force?

Jonathan again: It's a good question. I'm not sure. But I can do some research.

Looking back before your training, can you think of cases or calls that you can identify as mental illness that may have gone unrecognized?

Beth here: I'm lucky I came on when CIT training was implemented, so I didn't have the opportunity to see how things were handled prior. Veteran officers have told me they would go in and detain folks immediately.

Cecile here: I would say CIT training has a heavy emphasis on signs and symptoms, which has helped officers identify when an individual is having a mental health crisis.

This is Jonathan: Beth and Cecile have to take off. Thank you everyone for your questions. We appreciate it.

Craziest thing you’ve seen during Mardi Gras?

This is Beth: It's usually pretty calm because we are very good at stopping things before they become a problem.

How would you like to see the city approach the homeless encampments besides the ever so sweet "clearings" of the bridge underpasses, considering most of the people there are mentally ill and/or have addiction illnesses?

Cecile: The city just opened its first low-barrier shelter that is located in the old VA hospital. They currently have 100 beds available and my hope is that there will be expansion of this service. NOPD also hosts an awesome homeless assistance unit that helps respond to those living in the encampments -- getting them hooked to services, seeing what medical/mental issues might be and linking them to the community services currently available. Many people who live in these encampments, unfortunately, do not desire to live within walls for multiple reasons, and therefore, it presents a challenge in getting them adequate care. To be clear, mental illness does not define the person as a whole. Folks with a mental illness desire the same things we do: Intimacy, productivity, the desire to be part of a community. Those needs can often be met in these outdoor encampments.

Beth: I'd like to add, my hometown (Eugene, Oregon) has created tiny house communities specifically for that city's homeless population. A lot of those needs that Cecile just mentioned are met in those communities.

How do you support an officer's mental health and resilience after a critical incident?

Cecile here: I came back to the police department almost four years ago to be director of a newly formed Officer Assistance Program, which is an internal, confidential, free mental health service program for officers and/or families. A huge part of this program includes officer peer support and part of those responsibilities are to provide critical incident stress debriefings that occur typically within 72 hours of a critical incident.

Thanks for your hard work. Do you have specialized options for after you detain someone with mental illness? Obviously, you understand the need for training on the approach, but when you arrest someone what can you do with them? Our community still faces the problem of what to do with the mentally ill when taken into custody - even as our officers get better.

This is Beth: We have the opportunity to take them to the hospital instead of jail, even if the person has committed a crime -- depending on the crime. If the crime is a symptom of their mental illness, as in they're going through a crisis and maybe they lash out at someone close to them, more often their family want the person to get help. So we do have the ability to take them to the hospital.

Is it a safe assumption to you that somebody who is already in a bad situation has family that's safe? What methods are being put in place to assume that that is the case?

Cecile: Whenever there is a mental health crisis, there is the ultimate respect for unpredictable behavior at any given moment.

Beth: To add, as a police officer we're going to address the crisis first and then the safety of the family situation. So, we would never assume that the family is safe.

Cecile: To your last point, part of that is going to be the information given to us prior to arrival and observations from the scene.

What mental illness/type of mental illness do you deal with the most in the course of a year?

Cecile: Primarily, folks with untreated schizophrenia and bipolar disease. We also have a huge population of folks who use illegal drugs creating psychotic situations.

Do you handle individuals psychotic from taking drugs the same as mental patients? As in, specifically do you have the option to take them to the hospital instead of jail?

Cecile: We defer to the hospital in most situations involving a person having a psychotic episode.

Beth: If someone is having a psychotic episode, they need medical care first.

What would you most like to tell us that no one asks about?

Beth: People don't ask about the mental health of police officers. It seems to be a taboo subject but is getting better.

In follow-up to that answer, how is the mental health of the officers? What mental health issues tend to arise due to the unique stresses of the job?

Cecile: This career is described as the most caustic career one could choose, and the reason for that is they receive stress from every possible angle -- i.e. job, organizational stress, stress from the public, stress from the media, stress from the criminal justice systems and stress in their private lives. So, combined, you can imagine the mental health issues that would arise for one who has chosen this as a career.

What aspect of your training do you find most helpful? And would any of it be valuable to non-LEO folks?

Edit: and thank you for this service and the AMA!

Beth: Regarding your second question, I would say absolutely! All of the de-escalation techniques would be good for anybody, especially if they know people who have mental illnesses. I use the techniques on almost every call I go on, regardless of whether the person has a mental illness. They work in many situations.

Cecile: This training has been valuable across the country, not only for LEOs but people in the medical and mental health professional communities.

Beth: When you go through the training, you learn empathy. People may be hearing voices or seeing things that aren't there. Having empathy gives you the opportunity to slow things down. You can tell someone you understand they might be seeing things or hearing things that aren't there, but you're not trying to tell them they're wrong. Instead, I say I understand what they're going through. I don't try to lessen someone's experience because they're going through this.

I really wish there was an emphasis on empathy regardless of the mental state of people LEOs interact with. Hell, even a traffic stop would go way smoother

Jonathan here: One thing I learned in speaking with the folks who offer Crisis Intervention Training to officers and deputies across Louisiana is that the training techniques -- empathy, patient, de-escalation tools -- are used regardless of whether someone has a mental illness.

Beth: More often than not, people just want you to listen to what they have to say, regardless of the outcome.

Another New Orleanian here. Thanks for all you do!

What happens when you have a frequent flyer who is released from inpatient care within days or hours time and time again?

Beth: It is really frustrating when that happens. When we encounter someone who is in crisis, and they need to go to the hospital for care, hospitals have to stabilize people. I often tell a person's loved one at the scene: Here's what will happen once they get to the hospital. I try to send them to the right places to get information about long-term care options. But at the end of the day, it's up to them to do that.

Cecile here: Unfortunately, this is a situation that happens all too often, with the reason being a lack of long-term inpatient beds and community based services and the linkage to those services. People are all-too-often discharged without a connection to those services, and we see "familiar faces," people living on the streets with unmet medical and mental health needs on a fairly regular basis.

This is Beth: Just to add to this, we see some people up to 40 times a year. It's a common misconception that when someone is "committed," they'll get long-term care. That's false.

What is New Orleans doing to make sure that incidents involving mental illness don't become long term problems and what data points is it using to do this? What efforts is it making to ensure resolution of the problem and what agencies medical or non medical do they partner with?

Cecile here: All calls involving someone having a mental health crisis result in a crisis intervention training incident form. That information we can then use to track the number of calls we're receiving and the familiar faces. With that information we can go back to our mental health community providers with the hopes they can intercede with the medical needs with the goal of stabilization and therefore decreasing the need for 911 intervention.

Beth: To add, that database is invaluable from a law enforcement perspective because we can search through it and get information on any symptoms, past experiences, what worked/didn't work -- all of which can help us better prepare prior to arrival.

Cecile: One more thing to note, one component of the CIT program is regular meetings with community mental health providers. This allows networking opportunities, how we can all do better to better serve the needs of people. All of this is in the hopes of decreasing 911 calls and getting people connected to long-term care. Some of the agencies: Metropolitan Human Services District, the coroner's office (which handles mental health commitments), National Alliance on Mental Illness (NAMI), Odyssey House and VERA Institute.

Hi everyone! This is Jonathan. We're going to get started. Thanks for joining us

What made you decide to go into this field?

Is there any situation where you would have done something differently?

Is there a common misconception about police officers that you wish the public was clear about?

Beth here: I decided to go into this field because my brother has a history of mental illness and has been incarcerated. After doing CIT for three years or so, you learn very quickly on a scene whether or not the de-escalation is going to work or not. In the early months after the training, recognizing whether it was going to work was not a honed skill for me. Like anything, the more experience, the better you get. And regarding your last question, a common misconception -- especially around this topic -- is that all we want to do is handcuff somebody, throw them in the back of the car and drag them to the hospital or jail. I want the public to know that by and large, police officers choose this profession to help people and make their communities a better place.

How does this work and how do police officers know if it's going to work or not and what is being done to avoid situations where non CIT trained officers escalate things? What data points are being used to achieve this? How can New Orleans ensure their ability not to discriminate when racism is such a big issue among law enforcement as highlighted and demonstrated by Black Lives Matter? Lastly, is anything being done to screen people already in jail for need of mental health resources? And what is being done to ensure they are not treated as second class citizens? Is this being treated as the human rights crisis it is and how do you protect people like your brother from having a criminal record? What is being done to decriminalize poverty?

Beth: I can speak to a few of these questions. Training and responding to these scenes teaches you when it's going to work because you learn how to recognize symptoms of these illnesses. There are certain symptoms that when manifested, I know that verbal de-escalation is not going to work. If a non-CIT trained officer is on scene and begins to escalate things, CIT officers have the ability to take over. Also, if a CIT-trained officer is not building a rapport with the subject, another officer can step in if he or she is having a better response.

Cecile: One thing to note, Orleans Parish jail has started incorporating CIT into their training.

Favorite restaurant in New Orleans?

This is Jonathan: Both Beth and Cecile are in agreement here -- Horns at Dauphine and Touro. Great breakfast!

Thank you for your hard work, sir/ma'am.

​

Are you trained for specific cases of specific illnesses, or is there just a standard protocol that can generally apply to every situation?

Beth: During the training, we do go through different illnesses and associated symptoms. So, knowing those symptoms gives us a roadmap for de-escalation techniques that can be a bit more tailored to a specific diagnosis.

Very relieving! Thanks Beth. You are all doing NOLA proud.

^{also who dat}

Beth: Aw shucks! Thanks

Hi there and thank you for all of the hard work you do! What seems to be the most common trigger for people having mental illness episodes and how can people of the city help prevent situations that cause extreme mental distress in order to lessen the calls per day?

Cecile: Self-medication, often with illegal drugs and alcohol, is a huge issue. Lack of community based mental health resources -- i.e. housing, case management, psychiatrists, inpatient care -- all contribute to situations in which the police are going to have to be involved.

This is Beth: A lot of the people we encounter are familiar faces, because they have one family member -- if that -- who is a caregiver. And that person often cannot meet the medical needs of their loved one.

It sounds like a lack of family seems to be a major issue. What is the city doing to address the lack of resources that contribute to this problem and to ensure their safeguard? What is it doing to strengthen the community so these incidents don't happen in the first place?

Cecile: Being the caregiver of someone with chronic mental illness presents an exhausting scenario. Families are also left with very limited resources to help them meeting the needs of their loved ones. Therefore, quite often, we do see folks who go from family member to family member, with the end result being homelessness and medically unattended. It is a very sad situation for all involved.

Cecile again: I find that we lack the advocacy, sometimes, from all members of our community, in demanding a response to those who suffer from mental illness. We as a community of people need to push the systems to respond. It truly does take a village.

Who Dat! What's your favorite King Cake (not including Dong Phuong or Randazzo)?

Beth: Norma's!!! Guava and cream cheese is fantastic

Cecile: Bywater Bakery has a great one!

Jonathan: My wife is a pastry chef and she made one a couple days ago that was strawberry and cream cheese and jalapeno powder.