A MENTAL HEALTH NEWSLETTER FOR LAW ENFORCEMENT PROFESSIONALS
 

Mental Health America of Eastern Missouri A United Way Agency

In this issue . . .

by Erika Redmond, MA, and Kelly Ledbetter, BS.  Erika is a Crisis Intervention Counselor with Behavioral Health Response. She has a Master's Degree in Counseling and is currently working toward Licensure as a School Psychologist at University of Missouri-St. Louis. Erika has been directly involved in crisis response services in St. Louis and the surrounding area for over five years. She remains dedicated to assisting adults, children and adolescents with mental health needs.  Kelly is the Program Coordinator at Kids Under Twenty One (KUTO). She is a graduate student in Social Work at the University of Missouri-St. Louis. She received her undergraduate degree in Psychology from Missouri State University. Her interest in mental health began in high school, when she worked as a volunteer on the KUTO Teen Crisis HelpLine.

Erika Redmond

Since survival is a basic instinct, it can be difficult to understand why someone might have thoughts of suicide. It’s even more difficult to fathom a young person or teenager considering suicide. From a distance, it appears they have everything: youth, health, no bills, few responsibilities, and the future, with many years left to live. However, if one takes a closer look, pain - which can be absent in outward appearances - could be masking extreme turmoil. 

Childhood and adolescence can be extremely stressful times. With the pressures of school, peers and family, youth can find situations overwhelming and sometimes unbearable. Research indicates suicide is the third leading cause of death for youth ages 10 to 24. However, there is much we can do to assist children, teens and families in crisis. Understanding the reasons and situations that lead to suicide and identifying the warning signs can lead to early prevention and intervention of suicide attempts and ideation. 

Suicidal ideation can appear differently in youth as compared to adults. One might ask, “What is it that causes a teen to think about taking his or her own life?” It has been found that 99 percent of youth who kill themselves were suffering from a diagnosable mental illness; oftentimes, untreated. There are many factors that might prevent youth from seeking help. A few examples are: barriers in accessing treatment; stigma associated with mental health issues; feelings of not wanting to burden their parents/guardian. Suicidal youth can also experience an unbearable emotional pain, or “psyche ache,” thus viewing suicide as an end to their pain. This emotional pain could stem from stressful life events such as death of a loved one, moving to a new school, bullying, or a break up. Because of the lack of life experience, teens are often feeling these intense emotions for the first time. The pain and hurt is so strong that it feels unbearable and they are unsure if they will be able to survive it.  

The warning signs also look different in youth as compared to adults. One might observe a lack of energy and loss of interest that results in poor attendance or poor school performance, quitting sports or after-school activities, and isolation from peers, family and friends.  

Other warning signs include:

Ø     rebellious or reckless behavior such as getting into fights or using drugs or alcohol

Ø     feeling hopeless and worthless

Ø     feeling alone; feeling no one cares

Ø     increased anxiety

Ø     impulsive behavior

Ø     irritability 

Specific warning signs for suicidal behaviors could include:

Ø     giving away prized possessions

Ø     statements such as “I want to die,” “I hate my life,” “I can’t take it anymore,” “My parents would be better off without me,” and “I’m going to kill myself.” 

As an adult, it’s important not to minimize the youth’s experiences or how they are feeling. We know “life will go on,” but, because of the youth’s developmental stage and lack of life experience, these words often do not help. Adults must try to understand the youth’s perspective.  

Additionally, it is important to validate how a youth is feeling by listening and providing empathic feedback. This gives the child hope that things can get better and that they will feel better again.  

Early prevention and effective intervention strategies can assist youth in reducing stress and feelings of hopelessness. Here are five prevention and intervention strategies to assist youth in crisis.

• Educate yourself and actively look for risk factors and warning signs associated with children and teens in crisis.  Be on the lookout for the aforementioned warning signs. Eight out of ten youth who die by suicide had previously shown warning signs of their suicide intent. Become informed about the general signs of depression, hopelessness and possible suicidal ideation that the youth might experience. This information will act as a great tool when intervening. 

•  In assessing warning signs and risk factors, understand the need to Directly Ask the Teen If They Are Having Thoughts of Suicide. Asking about suicide will open the door for the youth to express any feelings of hopelessness they might have. This could be simply stated as, “Are you having thoughts of killing yourself?” Or, “Are you having thoughts of committing suicide?” Though this can appear uncomfortable and forward, it is a necessary step to keep the youth safe.  

• Listen and take them seriously.  It is not uncommon for youth to feel as if their concerns are being ignored. Thus, one should remain patient, lend an ear, and make the youth feel heard. One technique to use is "Active Silence," which will allow the youth time to explain their story, pain and any thoughts of suicide. Asking questions and restating their story to check for understanding alerts the youth they have been heard. It also validates their experience. Any threats or thoughts of suicide should be taken seriously. 

• Help youth identify coping strategies.  Asking questions like, “What have you done in the past when you have felt sad, angry, depressed etc?” or, “What are some things you like to do that take your mind off of things that are bothering you?” (e.g. reading, listening to music, journaling, drawing, talking to a friend, etc.).   Helping the youth realize he/she has tools to assist them when they are in crisis can help resolve the situation. 

•  Explore social support.  It is important to help youth identify individuals that can act as support during the crisis and when the crisis is resolved. This could include a close friend or a family member.  Together, with the youth, try contacting the support person(s) to get their agreement to act as a support. This offers a greater level of reassurance for the youth and hope for support in the future.  

6)      Provide additional support information.  Provide the youth with the numbers to toll-free crisis lines:

Ø     Behavioral Health Response (BHR) provides 24/7 service at 314-469-6644 and 1-800-811-4760.

Ø     Kids Under Twenty One (KUTO) provides a youth-staffed crisis line on Sunday thru Thursday from 4:00p.m. to 10:00p.m. and Friday/Saturday from 4:00p.m. to Midnight at 1-888-644-5886 (KUTO).

Ø     Life Crisis Services provides 24/7 service at 314-647-4357 (HELP).  

Being aware of the warning signs and implementing prevention and intervention strategies to a youth in crisis will not only provide the youth with a level of needed support…it can also make the difference in saving a youth’s life.

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On May 26, Mental Health America of Eastern Missouri honored 34 police officers from the metropolitan area by presenting them with the John J. McAtee Police Recognition Award. Nominated by either a departmental supervisor or a mental health agency, the officers were recognized for exemplary compassion, concern and understanding when dealing with a person in psychiatric crisis.  

Chief Dan Isom

Colonel Daniel Isom, Chief, St. Louis Metropolitan Police Department, delivered the keynote address. Steve McAtee, son of John McAtee, conveyed his personal appreciation for officers who make a positive impact with individuals and families who are dealing with an immediate mental health crisis. McAtee joined Chief Isom in presenting the award to each officer. Judge David L. Dowd, Missouri 22nd Judicial Circuit, chaired the event and recounted each officer’s actions as awards were presented.  Chief Isom’s keynote address provided an historical context for the four eras of the modern policing profession. While describing the progresses of each era, he stated, “there is no better example of this progress and high level of professionalism within the ranks of local law enforcement than the recognition of the special needs of citizens suffering from mental illness or a psychotic episode.”

Steve McAtee

In praising the actions of the awardees, he emphasized, “these officers had constructive outcomes for individuals experiencing suicidal behavior, bipolar illness, psychosis, depression, delusions, schizophrenia and post-traumatic stress disorder. They have shown courage, bravery, patience, understanding and compassion that pays tribute to themselves and the history of law enforcement.”  Pictured right are Chief Isom, award recipient Officer Aaron Vinson, and Steve McAtee.

The award is presented annually and is named for the late John J. McAtee (pictured left),  an attorney and judge whose practice and community service exemplified his understanding of persons with mental illness. 

We encourage police departments and mental health agencies to make note throughout the year of officers’ interventions that meet criteria for the 2011 nomination process. For nomination criteria, contact LaDonna at Mental Health America (314-773-1399 or mhagstl@aol.com). 

The event, hosted by Mental Health America of Eastern Missouri, has been honoring officers since 1987.

Mental Health America is pleased to announce and recognize the following awardees:

Officer Carrie Gentile Webster Groves  Deputy Justin Cosma Jefferson County Sheriff’s Office  Sgt. Dale Johnson Officer Matthew Eldridge Officer Jason Rappold Officer Chris Gilyon Officer Lucas Donaldson Officer Aaron Vinson Officer Danielle Durham Sgt. Donna Ostendorf Officer Brad Mueller Officer Tyler Crews Officer Jeremy Hake Officer Clayton Fair St. Louis County

Officer Danial Kenner Sgt. Douglas McGarry Officer Brendan Gilbert Hazelwood  Officer Rick DeWitt O’Fallon  Corporal Mike Devine Shrewsbury  Officer Nicholas Harbaugh Officer Kyle Mack Officer Silas Ellis, Sr. Officer Joseph Corson Officer William Hoffman Officer Matthew Miller Officer Richard Newcomb Officer Travis Vuichard Officer Timothy Bockskopf Officer Jamon Neal Officer Michael Weldon St. Louis Metropolitan Police

Officer Cedric Brooks Officer Michael Rumping Moline Acres  Officer Alex Garcia Sullivan  Detective Douglas Ziegemeier St. Peters 2010 McAtee Award Winners

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At Your Service: Tax Boards Fund Local Resources       

As state budgets shrink and charitable funding lags during the current economic downturn, it’s becoming more and more difficult for those who interact with persons in crisis to find appropriate – and available – services for the people they serve. 

While this has been and will continue to be a challenge, voters across the metropolitan area recognized the need to approve new funding measures to allocate financial support for mental health services. The passage of ballot initiatives to create Mental Health Boards has helped generate funding at a most crucial time. This article briefly overviews the newest funding stream of this type and identifies the other mental health boards throughout the metropolitan area. 

St. Louis County - St. Louis County Children’s Service Fund

In November 2008, St. Louis County voters passed a “one-quarter cent” sales tax to create a community children’s service fund. After a thorough review of proposals submitted by applicants, the fund will allocate its revenue to entities that will provide mental health and substance abuse services for children and youth ages 19 and under in St. Louis County. Also known as “Keeping Kids First,” this funding stream plans to invest up to $35 million for mental health services in its first funding cycle (August 1, 2010 through December 31, 2011). As defined by Missouri State Statutes RSMO 67.1775 and 210.861, the following types of services will be funded:

·        Temporary Shelter Services

·        Transitional Living Services

·        Services to Unwed and Teenage Parents

·        Respite Care Services

·        Crisis Intervention Services

·        School-Based Prevention Services

·        Home and Community-Based Intervention Services

·        Individual, Group, and Family Counseling Services

·        Outpatient Substance Abuse Treatment

·        Outpatient Psychiatric Services

For more information, go to www.KeepingKidsFirst.org.   

Other local funding boards

Mental Health Tax Boards in surrounding areas provide funding for similar programs. While none of these boards provide treatment or make referrals, visiting the websites will provide information about funded services in your geographic area.  

Ø     City of St. Louis:  St. Louis Mental Health Board – www.stlmhb.com

Ø     Franklin County:  Franklin County Children and Families Community Resource Board – www.franklincountykids.org

Ø     Jefferson County: Community Mental Health Fund Board – all services contracted with Comtrea, Inc., the Community Mental Health Center for Jefferson County – www.comtrea.org

Ø     Lincoln County:  Lincoln County Resource Board – www.lincolncountykids.org

Ø     St. Charles County:  Community & Children’s Resource Board – www.stcharlescountykids.org

Ø     Warren County:  A needs assessment has been completed and a board has been established, but the measure has not yet been put before voters.

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By Mark Utterback, President and CEO of Mental Health America of Eastern Missouri, an education, services and advocacy organization.

This Current Issues column is the second in a series focusing on transitions and changes in services within the state-funded mental health system. The series will provide updates and information that may impact your strategy when helping a person in psychiatric crisis find treatment services.  

The Missouri Department of Mental Health (DMH) is making some significant changes to the Metropolitan Psychiatric Center (MPC). The MPC emergency department will close July 15. Sometime after July 1 and before the end of September, DMH will close one of two acute care wards, reducing the number of beds at MPC from 50 to 25. (The second ward will close in the spring.)  The exact dates are still fluid as DMH looks for private hospitals to provide services previously performed by MPC. 

These changes are, in large part, being driven by the state’s financial crisis.  

Clearly the time frame to make these changes is unrealistically short. A Short-term Crisis Management Team has been formed to make recommendations to DMH regarding the emergency department and acute care closures. This team includes representation from the law enforcement community, as well as hospitals and community mental health organizations. One of the team’ goals is to create procedures and protocols between law enforcement, courts and community hospitals.   

More information will come as the dates for the closures are set and the Short-term Crisis Team makes its recommendations to DMH. 

Current Issues will provide updates as the process moves forward. Look for another article in the October edition of Street Talk.

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By Sgt. Barry Armfeld, St. Louis County Police.  Sgt. Armfield has been a St. Louis County officer for 37 years, with assignment in all patrol divisions, including Tactical Operations. He currently serves as the CIT Police Liaison Coordinator for the St. Louis County CIT Program. CIT Corner appears regularly in Street Talk.

Members of Area Crisis Intervention Councils nation-wide are aware CIT training in mental health crisis response by the police helps minimize incidents of violence and promotes the safety of consumers and officers. A new study analyzing officer attitudes about the use of force adds to the growing body of evidence that confirms these observations. 

The study by Compton, Neubert, Broussard, McGriff, Morgan and Olivia, published in the November issue of Schizophrenia Bulletin, compared the responses of law enforcement officers with CIT training to those without CIT training. The officers were presented with a series of written scenarios of encounters with individuals experiencing a psychiatric crisis. Officers could choose between a range of eight encounters from “My physical presence and authority as a police officer is enough to handle the situation” to “I would use my police baton to physically engage the suspect.”  The officers also completed a self-report on profile characteristics such as age and experience. 

The study found significant conclusions about how officers viewed the use of force and when they choose to deploy. First, officers with CIT training were less likely to use force to engage persons living with a mental illness. Secondly, CIT-trained officers believed that non-physical responses were more effective and physical responses less effective when responding to a person with a mental illness than did non-CIT trained officers. These findings suggest that verbal de-escalation training is effective in providing officers with the tools they need to safely resolve situations without resorting to force. 

The study’s authors point out that CIT trainees for the most part (about 75 % of participants) took the CIT training by choice. CIT officers indicated they had significantly more contact or experience with mental illness or mental health professionals in their families than those who did not take the training, so this may also contribute to their different treatment of people who live with a mental illness. 

Favoring verbal over physical de-escalation can lead to fewer injuries to law enforcement and individuals who live with a mental illness alike, saving law enforcement time and money, while preserving the good will of the community.   

This article is reprinted from a NAMI Newsletter by contributor Benjamin Summers.

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