By Laura Usher, NAMI CIT Program Manager
When Virginia’s first crisis intervention team (CIT) program got started in the New River Valley area in 2001, Victoria Cochran knew that, to be successful, their long term goal had to be more than police training. She envisioned development of the full Memphis Model for CIT – a program that brings behavioral health, consumer, and law enforcement partners to change the way communities handle mental health crisis response. Law enforcement training is a key component, but equally important is improving access to services. In Virginia, over the past dozen years, this has included the development of mental health crisis assessment centers – treatment centers in the community where people in crisis can get immediate help and officers can get back to their regular patrol duties quickly.
Without good treatment, people in crisis often wind up in jail. The CIT program set out to change that by training police officers to recognize mental illness, calm people down in a crisis and get them to treatment, not jail. In the process of training officers, “we presented this program to include the assessment site option as an additional carrot to get people involved,” says Cochran. For police accustomed to spending hours waiting in hospital emergency rooms with people in crisis, the possibility of an easier process was appealing.
For the New River Valley program, there weren’t resources to set up a crisis assessment center right away. However, the relationships fostered by the program made it easier for police to bring a person to the hospital for treatment and create a system for video conferencing with local magistrates to speed up the process for an emergency evaluation.
Cochran led development of the New River Valley program and now oversees the Office of Behavioral Health and Criminal Justice at the Virginia Department of Behavioral Health and Developmental Services (DBHDS). She explains that a crisis receiving center permits people to have a mental health assessment in a setting that is much less traumatizing than a jail or hospital emergency room. “Crisis receiving centers, even if set inside a hospital are calmer and less stigmatizing. The quicker they can be disengaged from law enforcement, the better for the individual.”
In a crisis center, the staff is specially trained to assess the person’s needs and connect them to other services and supports. Many people don’t need to be hospitalized at all. If they do, a crisis center offers a calm and supportive environment to wait for a psychiatric hospital bed to open up.
At the Arlington County Crisis Intervention Center, “calming rooms” offer comfortable couches, quiet and relative privacy. The crisis center serves people who walk in on their own or with the help of family and it provides a separate entrance for police bringing in a person in crisis. Julie Coldren, the CIT coordinator in Arlington, says that without the crisis center, CIT officers would have few options to get people services. “We encourage officers to bring in people with mental illness in lieu of arrest whenever possible. We know that individuals with mental illness decompensate quickly in a jail setting,” says Leslie Weisman, Client Services Entry Bureau Chief at the Arlington Community Services Board.
The New River Valley CIT program’s insistence that crisis assessment was key to the success of CIT eventually paid off. Now, they, along with the Arlington Crisis Center, represent just two of the 13 crisis assessment sites in Virginia paired with CIT programs. These sites use funding specifically allocated for this purpose by the Virginia General Assembly and managed by DBHDS.
Cochran explains that it was not a straight path to opening the crisis centers. Nationally, state governments have been cutting mental health services for years and Virginia was not immune. In 2007, the state’s Commission on Mental Health Law Reform was considering ways to improve the state’s mental health system when the mass shooting at Virginia Tech tragically highlighted gaps in the system.
Recalling that day, Cochran says she was in CIT training when the calls came for assistance at the university. “First, all the [police] trainers left; then all the mental health providers who were training – they left to respond to the crisis.”
After the shooting, the legislature and the governor acted quickly on the Commission’s recommendations and created a statewide office for criminal justice/mental health collaboration, currently housed at DBHDS. Legislation quickly followed to support the development of CIT programs across the state and fund crisis centers in jurisdictions with CIT programs.
It’s about getting the criminal justice system and the mental system working together more effectively, says Cochran. “I spent nearly 20 years as a public defender, watching law enforcement do their best but not have the tools they needed. I watched the criminal justice and behavioral health systems often unable to find ways to talk to each other and work together to resolve issues.” CIT is so transformative because it brings those players together and bridges that communication gap.
The crisis center is a natural outgrowth of this collaboration because it serves everyone’s needs and it makes smart financial sense. Cochran say, “You’re investing a lot of money into training for law enforcement. Without an assessment site, it’s more like they are walking into a blind alley with nowhere to go. With the assessment site, law enforcement can see where they are going and everyone can get there more safely.”
In Arlington the path to services is clear. Residents in crisis can see a psychiatrist or psychiatric nurse practitioner, get referrals to the county mental health system and access an array of services. According to Coldren, “If there was no crisis center, the individual and their family would not have easy access to these services.”
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