Monday, March 25, 2024

Student wants Mental Health Crisis Training for First Responders

  I believe that first responders should undergo mental health crisis training. I believe this because there are so many circumstances in which this training could be crucial. Police officers in particular are faced with situations such as potential suicide attempts and/or people who could be having mental health episodes. They need someone who is going to be understanding and well trained on how to handle such situations. If first responders are not well-educated on how to handle persons who are experiencing suicidal or psychotic episodes, the resulting interactions could be traumatic for all parties involved. 

Unfortunately, people struggle with mental health on a daily basis. Sometimes, even those with proper training cannot prevent a suicide attempt. So, those who are going to be responding first should definitely have adequate training to mitigate the chances of violence or suicide from being higher in an encounter with a distraught or disoriented person in crisis. It is almost impossible for there not to be trauma and guilt associated with every suicide committed. If every first responder is well educated on how to respond well, they can at least have the comfort of knowing that they did everything in their power to prevent it. 

It would be a protection for everyone involved, and since it is a training that has already been established, it would not be hard to implement it in the police and first responder’s training. I also think that police officers and first responders need to be frequently checked up on especially after traumatic events happen to make sure they are mentally stable. They do not have to maintain a tough exterior. Time taken off and therapy should be a given after experiencing severe situations, especially one as severe as a successful suicide. 

Most police departments, sheriff departments, and fire departments in Illinois have serious training requirements, and have all their staff engage in on-going training to keep up their skills and build their expertise. Suggesting that professionals in these occupations have a certain number of hours of theory and simulation practice to enhance their ability in handling people who are suicidal or suffering a mental health crisis makes sense. That training would not be too difficult to implement, in the sense that this sort of training could be incorporated into existing training programs.  After the two deaths in 2022 where emergency medical technicians essentially killed persons they were supposed to help (Leonardo Guerrero killed in Chicago on August 31st and Earl Moore Jr. killed in Springfield on December 18th) I looked into the training that EMS workers must have, and I read the minutes and agendas of the advisory board that advises the Department of Public Health on certification of EMS staff and ambulance services in Illinois (there is an administrative code for emergency services and it dictates the level and scope of training for EMT and EMS system professionals). I had my students join me in sending letters to the members of the Emergency Medical Services Advisory Council urging them to mandate training that would help EMS workers avoid the sort of burn-out and demoralization where they would become abusive against people in mental health crisis or intoxicated people.  I spoke with people who worked as first responders, including Kainan Rinaberger (president of Springfield Firefighter Local 37) about the issue. 

Leo Guerrero and Earl Moore Jr. both had problems with mental illness and substance addiction. Police and EMT workers who encountered them did not treat them as they should have done. I can think of other examples. Greg Small, Jr. (of Chatham, Illinois) was suffering a mental break-down related to schizophrenia, and he had a knife in his hand, so his mom called for help, but officer Adam Hahn saw that Greg had a knife and would not drop the knife when ordered to do so, so when Greg approached Hahn, Hahn shot him several times. The Sangamon County State's Attorney Dan Wright charged Greg Small, Jr. with aggravated assault for approaching Officer Hahn with a knife in his hand, but Greg was found not guilty by reason of insanity. The fact that Officer Hahn hadn't received specialized training in dealing with a person in a psychotic crisis holding a weapon led to Greg Small suffering four gunshot wounds and Officer Hahn becoming a public example of incompetence. Dan Wright said he had to bring charges so that the courts could order Greg to get mental health treatment he needs.  

Generally, what I gather is that first responders are, as you suggest, traumatized through their work.  I’m told firefighters tend to encounter two or three dead persons each month, and I suppose the EMT workers and police would see a similar number.  Any encounter with a victim of an accidental death, a suicide, or homicide, or even just a natural death can be traumatic, but imagine encountering such situations on nearly a weekly basis!  And a significant number (although a small minority of all cases) of persons who need emergency medical or police protection will be hostile, abusive, or even violent against their rescuers and helpers. It can wear down people.  In Springfield, the police and firefighters are well-trained, and I think that some of them would accept referrals to professional counseling as a way to help them cope with the stresses of their jobs. As for the EMT staff in the private ambulance services, that is often a transitional job for young people who aren’t old enough to become firefighters or police, and the pay is very low, the training requires dedication, and the job can be dangerous and stressful.  

It seems to me that law enforcement professionals facing the anti-police bias widespread in the community (and sometimes well-founded on experiences with unprofessional or brutal/corrupt police) and dealing with regular exposure to traumatic situations and people engaged in anti-social or threatening behaviors could easily turn some fraction of the workforce into an us-versus-them mentality where suspicion and contempt would inform their interactions with the public.  Not only do police, firefighters, and EMT professionals need help dealing with the traumas and stresses of their job, they need idealistic rituals or processes to help them commit themselves to their missions. They need help feeling the support that comes from actually committing to service to others, and respect for human rights. 

Without help and training, first responders may easily dehumanize difficult patients and members of the public (e.g., persons freaking out and having a suicidal attempt, or just generally disrupting the community as they suffer from severe intoxication or a florid psychotic episode). What do we do with people who wander around in a busy area during a community event screaming and shouting threats and obscenities and generally making a nuisance of themselves as they act in a disorganized fashion?  The impulse to treat such people harshly, locking them up and removing them from the community, may appeal, but harsh treatment can exacerbate the problem. You can see how mental health professionals help the angry and violent man (Todd) threatening the doctor in the documentary "Bedlam" (you'll watch it later this semester). 

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