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Crisis training educates officers in mental health
Locals organize first CIT training in Green County
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Chrisanna Manders, an associate director with the National Alliance of Mental Illness of Wisconsin, leads a class about what it’s like to have schizophrenia at the Government Services Building June 19. Police officers attending the class were given earphones and went through a simulation activity. - photo by Marissa Weiher

MONROE — Last week in front of his peers, Sgt. Larry Harkey of the Monticello Police Department talked about how a mental health crisis he encountered on the job affected him personally.

He was called out to help a woman in a barn with a rope around her neck.

“She was going to jump,” he said. He unarmed himself, then “walked up and talked her down.”

The experience left him shaken, even though he had helped save her life.

“For four days after, I sat and stared at a wall,” he said.

Harkey was one of 28 police officers from across the state who gathered in Monroe last week for a mental health and crisis de-escalation training at the Green County Government Services Building.

In the fields that we’re in, we can be a contributing factor to their resiliency.
Amber Van Fossen

Dozens of mental health, social services and law enforcement professionals shared their expertise and resources over the course of the 40-hour training, designed to educate police on how to respond to people in crisis due to a mental illness and how to approach vulnerable populations like veterans, adolescents, dementia patients and the elderly.

The training also included a session on secondary trauma, the “burnout” or numbness caused by routine exposure to other people’s trauma, led by Capt. Jerry Dahlen of the Monroe Police Department and Bridget Mouchon-Humphrey, program director of the Behavioral Health Partnership of the Southwestern Wisconsin Community Action Program.

This is the session that prompted Harkey to tell his story about staring at a wall for four days. Nobody checked in with him during that time, he said, because the common attitude toward police who encounter trauma is “it’s part of the job.”

Dahlen described his own experiences of secondary trauma on the job, starting when he was a 19-year-old deputy on the night shift and got sent out on a domestic abuse call involving a Vietnam War vet having a flashback to combat.

Over the years, he said he’s watched colleagues drink and smoke themselves to their deaths, or slowly tune out and turn numb until they were “down to a puddle.”

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Monroe Police Chief Fred Kelley participates in a simulation activity about having schizophrenia during mental health training at the Government Services Building June 18. - photo by Marissa Weiher

Talking about it helps, he said: “It’s a good, calming feeling to kind of off-load.”

Mouchon-Humphrey asked the officers what they do to prevent burnout.

“Las Vegas,” one said, to chuckles around the room.

Mouchon-Humphrey said she dislikes the term “self-care” because it sounds selfish. She prefers “vicarious resilience” to describe the healing process from secondary trauma.

“There are certain professions, and law enforcement is one of them, where you see people at their worst. But you also notice how people get better,” she said.

This prompted an officer from Lafayette County to tell a story about a meth addict he encountered on the job. He was called out to check her welfare and found her “secluded in her room, laying in her own vomit.” He estimated she weighed about 80 pounds. He told her she wasn’t going to make it if she kept shooting up meth.

Some months later, he happened to bump into her. He barely recognized her. She told him she’d checked herself into rehab and was trying to get her boyfriend clean, too. She thanked him for the wake-up call.

There are certain professions, and law enforcement is one of them, where you see people at their worst. But you also notice how people get better.
Bridget Mouchon-Humphrey

He was stunned by her transformation.

“I told her, ‘You just made my month. Not my day, my month,” he said. “I thanked her.”

From Memphis to Monroe

Last week’s training in Monroe is the first of its kind locally and the result of decades of collaboration from the national level to local partnerships.

The Crisis Intervention Team training program started over 30 years ago in Memphis, Tennessee, in the aftermath of a tragedy. 

In 1987, a Memphis police officer fatally shot a man with a history of mental illness and substance abuse who was cutting himself with a butcher knife.

The program has since grown to more than 2,700 training sites across the U.S. It arrived in Wisconsin in 2004 and is now administered statewide by the National Alliance on Mental Illness, a nonprofit advocacy group.

Frank Mixdorf, director of NAMI Green County, was instrumental to bringing CIT trainings to Wisconsin in 2004. Then the board president of NAMI Fox Valley, he was approached by an Appleton police officer. 

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Monticello Police Chief Szvon Conway works on an exercise about schizophrenia and hearing voices. - photo by Marissa Weiher

The officer “told his personal story about being involved in an incident that went very badly and he vowed to see that interactions with individuals with mental illnesses would be handled better,” Mixdorf recalled. The officer was looking for an organization to sponsor the training, and NAMI “quickly agreed.” 

Mixdorf describes the CIT training as “a community-based initiative to improve interaction between police and individuals who have mental illnesses and are experiencing a crisis.”

The goal is increased safety, for both police and the community, and diverting people with mental health issues away from the criminal justice system and toward services.

According to NAMI, nearly 15% of men and 30% of women booked into jails have a serious mental health condition.

Mixdorf said research has shown an 80% reduction in injuries after officers went through the CIT training.

A leader with CIT International told a Memphis newspaper in 2017 that the training is considered “a best practice, but we aren’t evidence-based yet,” although the organization is working on it. He said one challenge to testing the training’s effectiveness is that any truly scientific experiment would require a control group, and in the real world that could lead to someone getting hurt or dying.

It was a very frustrating experience because ... when you start seeing symptoms appear, you don’t necessarily know what is going on.
Frank Mixdorf, director of NAMI Green County

Mixdorf got involved with NAMI after a family member was diagnosed with a mental illness.

“It was a very frustrating experience because ... when you start seeing symptoms appear, you don’t necessarily know what is going on” or who to turn to for help, he said. He and his wife found answers in a class offered by NAMI.

“It turned me into an advocate,” Mixdorf said.

Mixdorf spearheaded the effort to bring the CIT training to Green County, a process that took several years but started becoming reality last fall with the help of Monroe Chief of Police Fred Kelley and Green County Human Services Mental Health Supervisor Rob Miles. Also assisting in the planning process were Trevor Long, deputy chief at the Brodhead Police Department, and Dahlen.

The CIT training is always free to participants, and NAMI Green County even offered stipends to law enforcement agencies to cover the cost of filling shifts for the week officers were gone at the training, according to Mixdorf.

Kelley said two of his officers participated in last week’s training, alongside officers from Belleville, Brodhead, Darlington, Milwaukee, Monticello, Door County, Green County and Lafayette County. The training also had one non-officer participant from Vernon County Human Services.

“Our goal would be to have everyone complete it,” he said.

‘Listen more than you talk’

The CIT training “is about developing better interpersonal skills,” Mixdorf said.

Learning empathy skills was a common theme during the Monroe training. In one session, participants wore headphones to simulate the experience of hearing voices. On the last day, they were led in role-playing scenarios.

A U.S. Veteran Affairs team taught a session on responding to suicidal veterans, citing a statistic that 20 vets take their own lives each day and the majority are not involved in treatment.

Commands to stay calm often backfire in the midst of crisis, said Andrea Bailey, a clinical social worker and suicide prevention coordinator for the Veterans Affairs Hospital in Madison.

Instead of issuing orders like “You are going to have to calm down or I can’t help you,” she recommended asking permission, for example, “Would it be helpful if I gave you a moment to breathe and we didn’t talk?”

“Listen more than you talk,” Bailey told the assembled officers.

In a session on interacting with elderly people, Maria Johnson livened up a lecture-heavy morning by leading the class in a Family Feud-style game to test everyone’s knowledge. Johnson is an Adult Protective Services worker with Green County’s Aging & Disability Resource Center.

“What must you do differently when interviewing an older adult?” she quizzed.

“Turn down the thermostat,” someone joked.

But soon, others piped up with the correct answers: speak slowly, talk with eye contact at eye level, check for comprehension.

To the surprise of many participants, death is not one of the top fears of older adults. The top fear is being put in a nursing home.

“So are they going to be honest with you about whether they need help?” Johnson said. “No.”

She said that 60% of Adult Protective Services calls are for self-neglect. “Now, self-neglect is not illegal,” she added, but it can be challenging to get someone who is neglecting themselves to understand the risk.

“It’s all about sales” and figuring out how to convince a person in need to get help, she said.

Amber Van Fossen and Stacey Weber-Beck, therapists at Orion Family Services in Madison, got some pushback during their presentation on trauma-informed care.

The therapeutic model of trauma-informed care acknowledges and seeks to understand a person’s life experiences as a way to improve engagement. For law enforcement, it’s a tactic for de-escalating or gathering information.

Van Fossen and Weber-Beck recommended using the Adverse Childhood Experience Questionnaire, which assesses risk on a scale of 1 to 10 with questions about childhood experiences like divorce, physical abuse and having a parent in prison. Research shows the higher a person’s ACE score, the more likely they are to smoke, be an alcoholic, use IV drugs or attempt suicide.

Several officers at the training expressed concern that some people who profess past traumas are entitled, use trauma as an excuse or have an “inability to cope” with normal stress.

Van Fossen countered that trauma is subjective and that acknowledging trauma doesn’t relieve anyone of accountability.

“Trauma is not identified by us, it’s identified by them. ... We don’t get to decide that for them,” she said. “These aren’t excuses.”

“In the fields that we’re in,” she told the officers, “we can be a contributing factor to their resiliency.”