National Alliance Of Mental Illness Pushes For De-Escalation Tactics After Three In-Custody Deaths

In a span of four months there have been three in custody deaths reported by local law enforcement agencies. In each case there are some common threads. The suspicion of a mental health crisis and each person was restrained. Several organizations have been pushing for law enforcement agencies to use more de-escalation tactics when dealing with vulnerable populations. NAMI is one of those organizations the CEO of NAMI San Diego Catharina Cario spoke with PBS Jade Heineman about recent deaths and training with law enforcement. Catherine thanks so much for being here I really appreciate it. What are some of the de-escalation tactics Nami would like to see used more often. There are several that are actually pretty much what we call ten commandments of de-escalation. One has being respect respecting personal space. I think all of us can understand that even if we're not in a heightened state of anxiety or maybe having a psychotic episode if you're right in somebody's personal space that is really anxiety producing and it may cause some aggression as well trying not to provoke the person who may be having a mental health crisis at that time again. These are times when obviously a person is not fully functioning and cognitively available to be able to make sound choices and when there's aggressive behavior threatening stances it can really provoke the situation. Right. And so this year alone we've seen the in custody deaths of Earl McNeil phyto Vitale and Jason Allen. Do you think law enforcement is progressing with how they interact with those who are having mental health crisis as they did. You know that's a real tough one. I think we've come a long way and I think we have much further to go in the way of educating our officers on how to deal with somebody who is having a mental health crisis versus somebody who's exhibiting criminal behavior and I think that's where we have to make the designation. So we really have to treat somebody who may be having a substance substance abuse problem or be in a heightened state of a mental health condition. As a patient first and not as a criminal we've unfortunately done a very poor job in our country of criminalizing mental illness versus seeing it as a true health condition such as diabetes or high blood pressure. So I think we we've we've come a long way but we still have a long way to go. What was your thought when you heard about these three cases and in such a short period of time. It's heartbreaking. It's absolutely heartbreaking. I'm going to go back to my earlier statement of the criminalization of those who are mentally ill and we have to change the lens in which we look at people who are living with a mental health condition. And we just know there needs to be reform whether it's the policy level or continuing to advocate and educate all those who are you know our front line folks on the ground and working with those who are mentally ill and coming in contact with those who are having an escalated process going on. But it's heartbreaking. Now in all of these three recent cases there was a common thread in that they were all restrained whether in a rap or being pinned down to the ground where do you all stand on restraints. We do not believe in the use of physical restraints. You know they're coming from a healthcare background and working in an emergency room which I've had in the past. There may be that half a percent of a time where may be appropriate but we truly believe that we should be restraint free and the Hospital Association of San Diego and Imperial Counties started collecting data on the Cirie strains after there were some incidents that are occurred at hospitals where the deaths weren't unfortunately had happened after the use of restraints and there are now most hostile. Now how has zero policy for use of restraints and it's been going great. And we're really happy with our hospital partners. So out in a field in law enforcement again I think there needs to be more education and training. You know I do understand that the Rafferty's strength is now one of the newest restraints for what they're considering a safer restraint versus traditionally hog tying somebody where their face down and accessory if you are a larger human being or are you know have some substances on board or even in a heightened psychotic episode where you could really experience a heart attack or just can't breathe. I think most of us can identify with even if we've just been held too tightly sometimes that it's very claustrophobic feeling and your heart rate is going to go up your breathing is going to go up and your gonna start to hype that are late as well. And you mentioned that that person should be treated as a patient first if they appear to be having a psychiatric issue. I know that both paramedics and in the hospitals they use chemical restraints when someone comes in and they are agitated. Are those safe. The jury's still out on those. So traditionally in cars they've used haloperidol for severely agitated patients. Most recently there's been some research on the use of ketamine. Ketamine is has been out for many many many years is typically used as a sedative or pre analgesic prior to surgery. And some hospitals are starting to do some basic research on the use of ketamine. Is there anything that both the community and law enforcement can do to build understanding with people who may be having a mental health issue. You know one of the biggest challenges we still have is stigma against mental illness. So we think you think even the word stigma is stigmatizing so we like to say Let's have open and honest discussion about mental health and mental illness responses resources sticks are showing one and four of us experience a mental health concern in any given year. That's pretty much anybody you know and everyone but there is still such a barrier and shame and talking about having a mounting health condition that really just need to get over. We need to be able to recognize that we all experience points in our lives or we may be depressed or anxious. You know even aside from having a diagnosis of a medical medical or mental health condition we just have to keep that dialogue open and knowing that it affects all of us. And I guess as mentioned before it's just like having a brain disorder it's just like having congestive heart failure or cancer even something that can be treated and you can live successfully in recovery with a mental illness. Catherine thanks so much for joining us. You're welcome. Glad to be here.