Crisis Intervention Team Training aims to de-escalate dangerous situations

A man has stabbed himself multiple times. He's bleeding profusely. Police are called. They approach the man. The man charges at the officers with the knife. Police shoot the man, killing him.

That scenario might sound familiar if you've paid attention to regional crime headlines recently. The nightmarish confrontation played out in Poplar Bluff, Missouri, when officers shot and killed a knife-wielding man who they say was bleeding from self-inflicted stab wounds.

That description might also sound familiar if you lived in Memphis, Tennessee, in 1987.

That's when Joseph DeWayne Robinson, 27, stabbed himself many times. Memphis officers responded. Officers told him to drop his knife. Robinson stepped toward them, and they opened fire, killing the man.

That incident, more than 35 years ago, was the spark that ignited a new approach to how police respond to mental health crises. That incident, nearly identical to the one in Poplar Bluff, inspired what's called Crisis Intervention Team training, or CIT.

Mental health struggles

Decades after Robinson was shot to death in Memphis, the criminal justice system continues to grapple with mental health. While police departments face intense situations on the streets, Missouri's state government is struggling to provide the resources necessary for mental health services in the system, which can lead to delayed justice. In some cases, suspects wait longer in jail for a mental competency evaluation than the actual sentence they're facing.

A day after the knife-wielding man was killed by police in Poplar Bluff, the chief justice of the Missouri Supreme Court told the state's lawmakers that the court system was on the "front lines" of the "mental health crisis" in the United States. He asked lawmakers to support more efforts to provide mental health programs for those entering and exiting the criminal justice system.

At the street level, more police departments are adopting CIT, which is a specialized police curriculum aimed at de-escalating intense, emergency mental health episodes by using empathy and calmness. It's now being taught in jurisdictions all across the country, including Southeast Missouri.

The Three Rivers CIT council exists in the Poplar Bluff area. It serves 14 jurisdictions, including the Poplar Bluff Police Department. A lieutenant of the Poplar Bluff PD serves as the council co-chair.

Butler County Coroner Jim Akers told the Daily American Republic Monday that the deceased person was Michael R. Johnson, 30. His obituary stated he was a construction worker. The coroner said Johnson died from a gunshot wound. He said Johnson had no known history of mental illness and is presumed to have been on drugs at the time of the Feb. 7 shooting. Akers said drugs can reduce a person's pain threshold, and cause a person to act irrationally like Johnson did. A toxicology report is underway, according to the DAR.

An image posted as Johnson's Facebook profile in 2019 indicated Johnson was struggling with a drug addiction and trying to make amends.

Three officers were placed on administrative leave. One has returned to work since the incident, the DAR reported.

Poplar Bluff Police Chief Mike McClain told the Poplar Bluff newspaper that officers receive mandatory and extensive video and in-person de-escalation training for all department members. 

"We have use-of-force training annually. It's part of our CALEA (Commission on Accreditation for Law Enforcement Agencies) accreditation that not only our use-of-force policy be reviewed yearly by officers but that we also have use-of-force refreshers on an annual basis," he said.

While the shooting may be justified as a matter of self-defense by the officers, it's not yet clear whether they followed the CIT training.

The chairman of the Three Rivers CIT Council did not respond to questions about the shooting, or whether the CIT Council would be reviewing the police response. The Missouri State Highway Patrol, also a jurisdiction that participates in CIT, is investigating the incident. Akers, the coroner, told the DAR that the prosecutor will be kept informed.

Nationally, a large percentage of police-involved shooting deaths involve mentally ill people.

A study conducted by the Washington Post concluded about 25 percent of people killed by police had a mental illness. The Minneapolis Star Tribune studied police slayings in Minnesota, which concluded 45 percent of people killed by police in that state were having a mental health crisis.

The national CIT organization explains that historically, CIT began with the killing of Robinson in Memphis. In an essay on its website, the organization explains that before CIT, “officers were trained to use deadly force when they perceive their own or someone else’s life to be in grave danger. This incident was criticized because the perception on the call was the only life in danger was the man who wanted to kill himself. This occurred during a time of racial tension in Memphis, and the man was African-American while both officers were white. This incident was the catalyst for the creation of the Crisis Intervention Team (CIT) in Memphis.”

Training

According to the Three Rivers CIT website, selected/volunteer police officers and other first responders may take a five-day, 40-hour training program. The training includes experts in mental health and substance abuse. The education includes perspectives from family advocates and other experienced CIT officers. Several times a year, officers within the CIT Council meet to discuss tactical issues and discuss experiences and scenarios they have encountered, and participate in advanced training.

Generally, CIT calls don't result in arrests, at least not in Memphis, where CIT began, according to reporting by the Commercial Appeal. The newspaper reported in 2017 that only 3% of more than 18,000 CIT calls resulted in someone being taken to jail. In many cases, people were taken to a psychiatric emergency center.

Every county in Southeast Missouri is covered by a CIT Council.

"We, as a department, recognized several years ago that the normal police response to community members dealing with mental health issues was outdated," Cape Girardeau police chief Wes Blair said. "Interactions with these individuals do not fit the traditional mode of police-citizen interactions, and the 'way we've always done it' could sometimes make a situation worse as opposed to having a calming effect. As a result, we committed to making sure our officers were equipped with the necessary CIT training to assist those in crisis."

Blair said the department is launching a co-responder unit where social workers will respond with officers to certain calls. Training and orientation of that program is ongoing.

Blair shared two recent incidents that were resolved using CIT techniques. In one, Cpl. Johnny Spencer responded to a man who had previously been violent toward officers, but using CIT techniques, Spencer convinced the man to speak with a mental health professional at a hospital. In another example, patrolman Dylan Corvick transported a man having a mental crisis to the Community Counseling Center. The mental health professional at the facility determined the person was homicidal and needed a mental health evaluation. Without using force, Corvick was able to take the individual into custody and transport the man to two different hospitals to receive mental health care.

The department hosts monthly team meetings and officers regularly attend refresher trainings and conferences.

Cape Girardeau County Sheriff Ruth Ann Dickerson said CIT helps her deputies and officers to recognize signs of mental health emergencies both in the course of responding to calls in the community and in the jail.

One of the first local jurisdictions to adopt CIT training was the Perry County Sheriff's Office, in 2014. As of September 2022, there are 34 local CIT Councils covering 108 of 114 counties and the City of St. Louis.

Over the same time period that more police units have adopted de-escalation techniques, mental illness has become a bigger issue throughout the United States, affecting as many as 20% of adults. Mental health touches every stage of the criminal justice continuum, from the time officers arrive and continues as cases move through the courts and as offenders enter and then exit prison.

Judicial perspective

The chief justice of the Missouri Supreme Court on Feb. 8 told the Missouri General Assembly that the state's courts need help dealing with the growing "mental health crisis" in this country.

Chief Justice Paul C. Wilson urged Missouri lawmakers to expedite the expansion of mental health and drug-abuse programs for offenders in the criminal justice system.

"Too often, we are confronted with individuals manifesting mental health conditions so profound they are not even competent to stand trial," Wilson said. "Police have to arrest them and prosecutors charge them — both to protect those defendants and the rest of us — but we can't proceed with their case. Medication, case management and treatment can often restore competency, but delays in getting defendants into traditional in-patient facilities leaves them — and our courts — stuck in limbo, unable to move forward or back."

Data provided by the Missouri Supreme Court shows that 610 cases were suspended pending a mental evaluation since 2020. During that same time span, only 375 exams were filed.

Cape Girardeau County Prosecuting Attorney Mark Welker said while police departments have taken big strides in dealing with mental health issues, the courts are lagging behind in the way of resources.

"With the expansion of the new Cape Girardeau County jail, one of the main concerns was the housing of inmates receiving mental health services," Welker said. "This was due to a rise in criminal defendants that are awaiting an evaluation to be completed by the State Department of Mental Health."

Welker said the court may order a mental examination under state law, directing the defendant to appear for an evaluation to be completed by the State Department of Mental Health.

The court sets a 60-day deadline for the completion of the exam, but the state has a backlog.

"The State Department is taking six to nine months to have these examinations completed," Welker said. "While awaiting the examination, the defendant is being housed in our local county jail."

Effectively, in some cases, the penalty for awaiting a mental health exam can be longer than the imposed sentence itself.

Welker said he believes the state government needs to increase funding for mental health in the court system.

"Mental Illness does impact law enforcement daily," Sheriff Dickerson said. "There are limited resources, leaving us constantly searching for resources, or hours traveling across the state for court-order commitments due to the lack of programs. Many times, those with mental illness end up with criminal charges in our local jails and in our court system. Putting them in local jails does not address the underlying issues and an exorbitant amount of time is spent searching for assistance. Once they are released from the local jails, they have nowhere to go or no assistance, they return to the community, repeat the cycle, and return to the local jails."

Pilot program

Dickerson said the sheriff's office is part of a pilot program that funds a mental health coordinator working daily at the jail.

"As valuable as this coordinator is to my staff and the inmates, without more resources, we are all still dealing with the cycle," Dickerson said.

Mental illness affects more than just the local jails across the state. It affects the entire prison system in a major way.

A unit manager at the Southeast Correctional Center in Charleston, Missouri, told the Southeast Missourian in 2016 that he estimated 80% or more of the 1,600 inmates in the prison were suffering from some type of mental illness. Missouri's Department of Corrections provides mental health services at all its institutions. The DOC provides mental health screenings and testing to determine appropriate care. The state also funds specialized programming for offenders with severe mental illnesses at two facilities, one in Farmington, and another in Chillicothe. Offenders requiring maximum security are treated by a Secure Social Rehabilitation Unit in Jefferson City.

Managing medications and care for inmates is a big responsibility. Plus, mixing so many people with mental illness issues into a contained environment creates a combustible situation.

Once offenders are released on parole, mental health and drug abuse services can be unaffordable or unavailable. Missouri is working on changing that dynamic.

Wilson, the supreme court justice, asked lawmakers to follow through with recommendations by the Department of Corrections and the Department of Mental Health that would bring "competency restoration services to the defendants where they are."

The recommendation is part of the Missouri Justice Reinvestment Initiative (MJRI), passed in 2018, following a rise in violent crime from 2010 to 2016, according to a website explaining the MJRI. Gov. Mike Parson created an executive oversight committee to implement the legislative changes. The committee identified six policy areas. One of those areas launched a partnership with the Missouri Department of Mental Health to establish a substance-use treatment system for people in the criminal justice system. The committee understood that the Department of Corrections needed more community-based mental health services, noting the system's best and primary substance-use treatment programming was located inside state prisons at what's called Institutional Treatment Centers. The initiative would also provide comprehensive services for individuals on supervision or those at high risk for revocation.

Early data returns on MJRI pilot programs — adopted in several communities throughout the state including Butler County in Southeast Missouri — look promising, according to a 2022 study conducted by the U.S. Department of Justice. Small sample-size data and the larger mental health complications caused by the pandemic limited the ability to draw definitive conclusions regarding community-based mental health services, but the impression conveyed by the study's authors was that mental health interventions adopted by the MJRI are limiting recidivism. The program involves assessment systems developed in Ohio to evaluate offenders and target interventions.

In his speech, Wilson said the mental health crisis is creating problems for judges in their daily lives as well. He said judges are seeing more threats of violence to them and their families.