Is Police (CIT) Crises Coaching Wanted?

Our host Gabe sees it differently, as he is committed to training police officers in crisis intervention practices. Join us for an insightful and nuanced conversation about the role of the police in mental health crises.

(Transcript available below)

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Guest information for the podcast episode "Gabriel Nathan-CIT Training"

Gabriel Nathan is a author, editor, actorand a mental health and Suicide Awareness Lawyer. He is editor-in-chief of OC87 recovery diaries, an online publication that contains stories about mental health, empowerment, and change. Recently, OC87 Recovery Diaries produced a unique series of films entitled “Under the vest: Mental health first responders“Containing honest and moving recovery stories from firefighters, rescue workers, law enforcement, dispatchers, and a crisis intervention specialist instructor. These films are used by first responder agencies in the United States and by the Royal Canadian Mounted Police.

Regardless of his work at OC87 Recovery Diaries, Gabe raises mental health awareness, talks about suicide and its prevention, and spreads a message of hope with his 1963 Volkswagen Beetle, Herbie the Love Bug replica, which is numbered on the National Suicide Prevention Lifeline carries on the rear window. Gabriel lives in suburban Philadelphia with his wife, twins, a Basset Hound named Tennessee, a long-haired German Shepherd named Sadie, and his Herbie. You can view GabRielTEDx talk on his approach to suicide investigation Here. GaveRiel and Herbie have teamed up to produce a documentary about their suicide detection mission. You can watch the entire film and learn more information about GabRiel, Herbie, and suicidal awareness Here. You can follow Gab tooRiel and Herbie on IG @lovebugtrumpshate.

About the not crazy podcast hosts

Gabe Howard is an award-winning writer and public speaker living with bipolar disorder. He is the author of the popular book, Insanity is an asshole and other observations, available from Amazon; signed copies are also available directly from Gabe Howard. To learn more, please visit his website, gabehoward.com.

Lisa is the producer of the Psych Central podcast Not Crazy. She is the recipient of the National Alliance on Mental Illness' Above and Beyond award, has worked extensively with the Ohio Peer Supporter Certification program, and is a workplace suicide prevention trainer. Lisa has battled depression her entire life and has partnered with Gabe for over a decade to advocate mental health. She lives in Columbus, Ohio with her husband. enjoys international travel; and orders 12 pairs of shoes online, chooses the best and sends the other 11 back.

Computer generated transcript for "Gabriel Nathan – CIT Training” episode

publisher's Note:: Please note that this transcript was computer generated and therefore may contain inaccuracies and grammatical errors. Thank you.

Lisa: Y.You're listening to Not Crazy, a psychologically central podcast hosted by my ex-husband with bipolar disorder. Together we created the Mental Health Podcast for People Who Hate Mental Health Podcasts.

Gabe Howard: Hey everyone, my name is Gabe Howard, I'm the host of the Not Crazy Podcast, and I'm here with Lisa Kiner.

Lisa Kiner: Hey everyone, and today's quote is from John F. Kennedy. Every man's rights are restricted when a man's rights are threatened.

Gabe Howard: It kind of reminds me of this idea that if it can happen to someone else, it can happen to you, and if it can happen to you, it can happen to anyone. And I say this a lot in the mental health advocacy. I thought you realize that if people with mental illness do not have access to care, it means that sick people do not have access to care. So if you get sick, there's a very good chance you won't get access to care. But we always refuse because it will happen to other people.

Lisa Kiner: I think that's just human nature. Everyone believes that only good things will come to them and all bad things out there will come to other people.

Gabe Howard: Well, and other people who deserve the bad things, right? As if we got the idea that everything that happens to someone else is bad because they deserve it. You must have done something wrong.

Lisa Kiner: But I think that's self-protecting too. The idea that the universe is random and bad things could happen to anyone at any time is frightening. But when I think to myself, oh no, that person brought this to them, they did something that made the bad happen, which makes me feel better. I won't do that thing. That's why the bad won't happen to me. That's why I and mine are safe.

Gabe Howard: All of this, of course, plays into a larger conversation America has with law enforcement and police. We believe that the police are 100% right in every police interaction. Whoever they interact with is 100% wrong. And this is not exactly believed in mental health circles because, as you know, we have CIT and crisis intervention training because we understand that when we are at it

Crisis, people will call the police. When Gabe Howard is in a crisis, someone will pick up the phone and call 911 and say, Hey, there's this unpredictable giant and we need help. And then the police will come and we decided that we were okay with that. But we want to train police officers. And this is where the crisis intervention training came from. Full disclosure that I believe in the CIT program so much that I teach it in central Ohio. I am proud of my work. I'm very professional, I am very, very, very professional at training police officers on how to work with people with mental illness. I was recently fortunate enough to be able to participate in a virtual demonstration of a series of OC87 recovery diaries called Under the vest: Mental health first responders. And it was about first responder suicide rates, all sorts of things I'd never heard of before. After it was all over, I spoke to Gabriel Nathan, the manager of OC87 recovery diariesand we specifically talked about the crisis intervention training that I'm a huge fan of. And Gabriel said to me: Well, I'm not a big fan of CIT. I think CIT should go away. Lisa, you have known me for a long time. You can only imagine the words that came out of my mouth.

Lisa Kiner: It seems like a pretty unreal statement.

Gabe Howard: And a conversation ensued, and I have no idea whether I agree with Gabriel or not. On the one hand, he makes some extremely valid points that cannot be ignored. On the other hand, I remember what life was like in Columbus, Ohio before the CIT program and, of course, how good it was. And I came to you, Lisa, and I said, Lisa, you will never believe what that idiot Gabriel Nathan said to me. And of course this sparked a great debate between us.

Lisa Kiner: Yes, and from your version of what you and Gabriel were talking about, I'm really interested to hear what he has to say.

Gabe Howard: In addition to his work as managing director of OC87 recovery diariesGabriel Nathan lives with depression. He's a prominent mental health attorney who understands what it's like. And on our show, we don't want people with mental illnesses to just show up and tell their personal stories. We want to be more than that.

Lisa Kiner: And it's not that we don't believe personal history has any value, it's absolute it does, but there are many sources for it. We want something different here at Not Crazy. On our show, we want people to come to discuss, argue, debate and speak about the world around us, from the point of view of someone who lives with a mental illness like us.

Gabe Howard: All right, Lisa, I think we're ready to bring Gabriel. Gabriel, welcome to the show.

Gabriel Nathan: Hello and thanks for having me It's nice to be here.

Gabe Howard: I love working with you because I think now I'm not sure, but I think our hobby is disagreement because we love the debate so much. Is that true today? Like anything else you will say, these are your real beliefs. You are not playing the devil's advocate. We're having a real conversation. We don't do this thing if we pick which side to go at a time and pretend that we care. We take care.

Gabriel Nathan: Yes, these are my real views, I'm not playing the devil's advocate because I really don't have time to get into a view that is not my own just to argue about something or be a guest. I really believe in speaking my own truth passionately. I am not speaking for an organization. These views are my own and I am proud to share them with you.

Gabe Howard: Thank you again Gabriel and we are very happy to have you. So let's get started right away. They believe that CIT, cops, none of this should have any mental health implication. And if you were the king of the world, you'd be kicking them out right away. Can you explain that?

Gabriel Nathan: I think zero participation might not be entirely true.

Gabe Howard: OK.

Gabriel Nathan: For example, if someone commits suicide and has a gun, it is a police emergency. Because, as they say, you don't bring a knife to a shootout. And we know that there are people who commit suicide by police officers. People who will

Point a gun at a police officer who will fire, who may even shoot a police officer to provoke a response from other responding officers to kill them as well. So if it is firearms all bets will be void. I just want to make that absolutely clear. Before I really get into the weeds of the question, I realized that whenever you take a position that is vital to law enforcement, or try to ask questions, even about how law enforcement is doing something. It is extremely important to have a good faith of your own. Because anyone who stands up against law enforcement is immediately viewed with suspicion, paranoia, it's dismissed as a quote, you know, Libtard, troll, anti-cop, antifa, whatever. I am none of these things. I am someone who has campaigned for killed police officers and their families through editorials and newspaper comments for the past 20 years. I have attended over 10 police burials in Philadelphia as far as Maryland.

Gabriel Nathan: I've done a lot of legal work on law enforcement and also on the mental health of first responders. I made a series of films called Under the vest: Mental health first responders to the OC87 recovery diaries This includes police officers, rescue workers, dispatchers, and firefighters talking about trauma and complex PTSD. I am very well aware of the suicide rate among police officers. I am someone who knows the culture of law enforcement. I am someone who has respect for cops and what they do. Just like when you criticize America, that doesn't mean you should leave it or that you have no right to do so. I think you need to know what you are talking about. But I think we have every right to criticize institutions. I think we have every right to criticize this nation. So, I just want people to know that I am doing this from a place of love and concern, and from a position that firmly believes that law enforcement needs to be changed and radically redefined, not just in context with the mental health response though across the board. But yes, I believe law enforcement should have very, very little place in the mental health response.

Gabe Howard: Thank you Gabriel for building your reputation, and I really appreciate that. The example I always use is just because I think my wife did something wrong doesn't mean I don't love her. And just because my wife believes I can improve doesn't mean she doesn't love me. And I think people really understand this in terms of our interpersonal relationships, friends, family, etc. But for If we expand it into public space, for some reason it is, aha! You have to be for or against me.

Gabriel Nathan: Yeah right.

Gabe Howard: This show tries very hard to strike a balance. Sometimes we succeed, sometimes we don't. But we try to believe that if we do, we are not crazy. The first question is CIT. People fought very, very hard to get CIT established in America. This is something that mental health advocates worked very, very hard for decades to bring CIT to life. To listen to a prominent mental health attorney like you, say, yes, maybe we picked the wrong horse. Maybe we shouldn't have supported that at all. Maybe we should have supported that instead. It almost sounds like you're saying, hey, you've just spent 40 years bringing this here. It's very nuanced and I want you to pull that out because

Gabriel Nathan: For sure.

Gabe Howard: I suppose the real question, if not CIT, is what?

Gabriel Nathan: Correct. That's a perfectly valid statement about what people would say and what's next. First, in 1986, the CIT, also known as Citation, the Memphis Model, was founded. OK. There is an entirely different model of crisis intervention that started more than 10 years ago in the mental institution where I used to work. It's called the Montgomery County Emergency Service. It is located in Norristown, Pennsylvania. Gabe, do you know when you were on campus?

Gabe Howard: I do.

Gabriel Nathan: MCES created something called CIS. So it stands for Crisis Intervention Specialist Training. And this was created in 1975-1976 to teach police officers crisis intervention and de-escalation. The philosophy behind this, unlike CIT, is to train everyone in the department, to train every single police officer in this stuff, to recognize signs and symptoms of mental illness, and to learn what it feels like to give orders to someone experiencing auditory hallucinations

drug abuse, escalation of violence, all of those things. Correct? So that was in the game ten years before the Memphis model. And the Memphis Model is that we should train certain officers in the department to respond to mental emergencies. When I worked at MCES from 2010 to 2015 I was very immersed in the CIS culture and got a lot more interested in it because initially I think that one component of CIT that is inherently flawed is that you select only certain officials, right? Now there are certain officers on duty all the time, but they may be connected to other things. When a psychiatric emergency arises, they may not always be available to respond. So you could be bipolar and manic and try to rip out a traffic sign at an intersection in your city at 3:00 a.m. Well, my God, the CIT officer unfortunately had to see a domestic worker. Now you may find yourself getting some kind of not very well trained, not empathetic and not understanding officer for your situation. And he could be an action junkie. He can be someone who doesn't keep his emotions in check.

Gabe Howard: Or they can be someone who just isn't trained.

Gabriel Nathan: Exactly exactly. And that can have a bad result. OK. Now, even with a trained officer, you might get a bad result. Plus, being CIT-trained isn't a bulletproof vest, and that doesn't mean meeting a law enforcement officer will be a major challenge all the time. That is also important to realize. I had police commanders say to me when I questioned the CIS they said we like CIT better because honestly not all of our officers are good at this kind of thing. And I said what's that? Spending time talking to someone instead of just bringing them down? Are you trying to de-escalate someone instead of escalating the situation? And of course there is no answer to that. And what I said is that if certain officers you have quoted were not good at such things, they shouldn't be cops. And I really think so. So this is my CIT problem. They're kind of a cherry picker who you think is good at when everyone should really be good at it and lack of availability. But really, when you broaden the scope and look at the situation of law enforcement officers responding to mental or psychiatric emergencies, you are using the term de-escalation, right? While we're teaching these cops to de-escalate a potentially volatile situation. And what do we have? We have someone who is not doing well. They can be free from their drugs, they can be psychotic, they can be paranoid. And we have a black and white radio car rolls up.

Gabriel Nathan: The door opens, the big boot comes out, they wear those big boots, you know, and the officer gets out and he's got his bulletproof vest and he's jacked up, puffed up and looking twice as big as he actually is. He's got the gun. He's got the taser, he's got the extra ammo. He's got the handcuffs. He has the retractable baton. He's got the sunglasses with the mirrored finish so you can't even see his eyes. He's got the buzz cut. I am a stereotype. They don't all look like that, but many of them do. That is what we are asking to quote and de-escalate a situation. And they show up with the power of arrest, to take away your freedoms, to lock you up. What is the most afraid of a person experiencing a psychiatric emergency? They are afraid of being held back. They are afraid of being held back. They fear that their freedoms will be taken away from them. And that's what we bring to the scene. So I believe that law enforcement crisis intervention training really puts you in an impossible situation where we are telling you that just by your presence you are an escalation of violence, but we want you to de-escalate the situation. It doesn't make sense to me.

Lisa Kiner: Interesting, no, I totally agree with you

Gabe Howard: The police or society decided that the police would respond to people with mental illness, and we have this one little program that we had to campaign for.

Gabriel Nathan: Right right.

Gabe Howard: Remember that the police have responded to people in mental crisis since before the CIT.

Gabriel Nathan: Absolutely.

Gabe Howard: And we had to convince them that it was a good idea to train the emergency services. I have just.

Gabriel Nathan: But that assumes. That is, it is not a good thing that the police are Respond to mental emergencies, but at least train them if they have to. But you don't have to. That is the flaw in the system.

Gabe Howard: Ok, gotcha, gotcha.

Gabriel Nathan: In my opinion, mental health advocates were wrong. They just lay down and said, well, that's how it will be. You know, the police will just do it, so we can train them as well. And that was the wrong assumption. This is wrong. You know, if we can agree that people shouldn't come to a mental hospital on the back of a patrol car with their hands handcuffed on the back of a patrol car if we can all agree, and I think we can all agree Then we can all agree that the precipitating events that produce this end result should also not occur.

Gabe Howard: I just want to point out that I am involved in CIT. I'm a trainer for CIT as I said on the show above. And I want you to know that what I am telling people that CIT is not mandatory, they are confused.

Gabriel Nathan: Naturally.

Gabe Howard: The general public believe that the CIT is mandatory for all civil servants.

Gabriel Nathan: Absolutely not. If they get something at the police academy level, it is very, very minimal and very, very scarce. You don't really address the trauma that police officers will experience. They don't deal with police suicide, nor do they really deal with de-escalating situations. It's all about control. How do you control a suspect? How do you take control of a situation? How do you command a scene? The Police College curriculum is very, very busy. And as we have seen in all these discussions about the redesign of the law enforcement system, we know that it takes three years to become a police officer in Germany. In other places it takes two years. My curriculum for the Police Academy was full-time, and it was nine months. Well. But nowhere in that nine month curriculum was there room for crisis intervention, de-escalation, signs and symptoms of mental illness, all of those things. This is all taught later.

Gabe Howard: Right, and it's voluntary in most places, and I think it's important to point out In many communities it takes longer to become a hairdresser than a police officer.

Gabriel Nathan: Correct. Correct. Yes.

Lisa Kiner: You talked about the change in policing. What's wrong with it? How is police work changing and why?

Gabriel Nathan: Well, in the bad old days, it was like walking in, wrecking everything, whoever it is who is causing most of the problems in the back of the touring car maybe hit him over the head a few times with the baton from Times and that's it. And there were no cameras, nobody saw anything. You know it was, they call it the bad old days for a reason. In the 60s and 70s nobody used words like de-escalation and crisis intervention. Let's get in, let's put this guy against the wall and that's it. Nowadays we expect law enforcement officers to behave differently, react to very emotionally complex and dynamic situations and to release situations without their fists, without their baton, without their gun, without their taser. So expectations have risen and they have to face the challenge. And I don't think these are unreasonable expectations that you should be able to resolve a situation without violence. I think eight or nine out of ten is possible. Now you're sure to have bad actors who just want to hurt someone and who need to be handled appropriately. And that's fine. But I think there are times when a situation arises and a law enforcement officer is near the end of his shift and he just wants to get it over with and be all right. That's it. No it is not.

Gabriel Nathan: You have all the time in the world to take care of this situation. And people have rights and people have the right not to be thrown on the ground first just because you have to be somewhere in an hour. Sorry, this is not good enough. And we have to expect better from our police officers. Police officers are expected to be more social workers. And maybe that's what we need to attract when it comes to law enforcement, people who are articulate, people who understand family dynamics, people who take their time, people who don't want to roll around on the floor with anyone when they do don't do it. does not have to. When I first applied to the mental hospital, I applied to be a paramedic to work on their psychiatric ambulance. And when I interviewed for them

Position, I said to the ambulance director, I'm not an action junkie. I am not a cowboy. I'm not interested in tearing down doors and rolling around on the floor with someone. If i have to do it i will do it. But I'll do everything in my power to make sure I don't. And she said most of the people we apply for this job are cowboys, and that's the problem. We have to stop glorifying this profession and saying that's what it's about. It's all about shutdowns and arrests. That's not what it is about. It shouldn't be all about that. And we have to recruit people who are not just about that.

Lisa Kiner: Well, Gabe was on The Psych Central Podcast a cop a few months ago, and the question was, why are the cops responding in the first place? Why don't we send social workers? Why don't we send therapists? And his answer was because it is such a volatile and dynamic situation that you don't know what is going to be required. His assumption was that violence would be required. And what he was specifically referring to was, you know, about half of all Americans who own guns. Since this has such great potential to escalate into a violent situation so quickly and we all wander around with guns, we need cops to respond. What would you say

Gabriel Nathan: Well, I would say I find it very interesting that the policeman's answer was about guns. It wasn't about crazy people. We have a big problem with firearms in this country. And I think it's really interesting because so many police officers are avid gun collectors. They are all in the NRA. They only care about the second change and yet they are afraid to react to people's houses with guns.

Lisa Kiner: I did not think about that.

Gabriel Nathan: Ok, that's a bunch of shit in my opinion. I'm so tired of arguing about firearms with people, especially law enforcement officers. So they all want to be Second Amendment and guns, guns, guns. But suddenly we have to respond to mental health calls because there are so many guns in this country. Yes, there is, and that is a big problem. And yes, half of all suicides involve a gun. Two thirds of all gun deaths are suicides. You are more likely to kill yourself than to be killed with a gun.

Gabriel Nathan: Now let's just publish that. It also assumes that people with mental illness are dangerous. And we know statistically that this is not true. People with severe and persistent mental illness, who no longer take medication and may use narcotics on the street and are increasingly paranoid, can be dangerous, that's for sure. And I saw that in the hospital. But I'll also tell you that my sister-in-law is a VA social worker. The VA has no trouble sending my unarmed sister-in-law, who weighs 120 pounds. Sorry Tova, I just revealed your weight. But unarmed, they give their self-defense training, crisis intervention training, and use your hands to defend you. Now they always go out in teams, of course they don't send them alone. But they will send two unarmed women alone to homes to deal with veterans with traumatic brain injuries, many of whom use drugs and alcohol. Oh but a cop with a bulletproof vest and a gun and extra ammo and a shotgun in his car and everything else has to go to a psychiatric 911. I'm sorry I don't think so.

Gabe Howard: It's the same with children. I've often thought of that too. Now when I call my neighbors childcare, they'll send a social worker.

Gabriel Nathan: Correct.

Gabe Howard: Now I know different states are different, but in my state of Ohio they send a single social worker to talk to people about their children when there is a child welfare check.

Gabriel Nathan: Mm-hmm.

Gabe Howard: They investigate whether these people are child abuse or not.

Gabriel Nathan: Correct.

Gabe Howard: And that can be done by someone who has absolutely no protection, no weapon, nothing.

Gabriel Nathan: Und vielleicht gibt es in diesem Haus eine Waffe.

Lisa Kiner: Das ist ein guter Punkt.

Gabriel Nathan: Correct.

Gabe Howard: Und natürlich spielen Sie mit den Kindern der Leute.

Lisa Kiner: Nach diesen Nachrichten sind wir gleich wieder da.

Ansager: Möchten Sie von Experten auf diesem Gebiet etwas über Psychologie und psychische Gesundheit lernen? Hören Sie sich den Psych Central Podcast an, der von Gabe Howard moderiert wird. visit PsychCentral.com/Show oder abonnieren Sie den Psych Central Podcast auf Ihrem Lieblings-Podcast-Player.

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Lisa Kiner: Und wir sind zurück mit Gabriel Nathan, der über die Reaktion der Polizei auf Menschen mit psychischen Erkrankungen spricht.

Gabe Howard: Ich weiß, wir haben die Frage, wie wir Polizisten davon abhalten sollen, auf uns zu reagieren, irgendwie umgangen. Aber ich weiß nicht, dass Sie eine tatsächliche Antwort gegeben haben, wenn nicht sie, wer dann?

Gabriel Nathan: Correct.

Gabe Howard: Wenn Gabe Howard eine psychische Krise hat, muss ich persönlich, dass mich jemand rettet. Dem können wir alle zustimmen.

Gabriel Nathan: Absolutely.

Gabe Howard: Also, wer kommt?

Gabriel Nathan: Ok, zuallererst braucht nicht jede Situation einen Anruf bei irgendjemandem. Ich denke, wir setzen auch voraus, dass Polizisten, die sich mit Fällen psychischer Gesundheit befassen, nur dann angerufen werden, wenn ein Notfall vorliegt. Viele Anrufe bei der Polizei im Zusammenhang mit psychischen Problemen sind störend.

Lisa Kiner: Das habe ich nicht berücksichtigt.

Gabriel Nathan: Perfektes Beispiel. In meiner Gemeinde lebt jemand, der schwer und dauerhaft psychisch krank ist. Er schreit und schreit viel. Er flucht viel. Er klopft an die Fenster und gibt ihnen den Finger. OK, solche Sachen. Die Leute rufen die Polizei an. Das ist kein psychiatrischer Notfall. Das ist kein Fall von Leben oder Tod. Das ist jemand, der seinen Nachbarn nicht mag. Und so taucht die Polizei auf und es könnte ohne Grund zu einem gewalttätigen, schlechten Ergebnis kommen. Diese Person gefährdet sich nicht. Diese Person gefährdet niemanden. Es ist nicht gesetzeswidrig, psychisch krank zu sein. Wir haben jedoch eine Situation geschaffen, in der die Leute einfach abheben und die Polizei wohl oder übel anrufen, weil sie Angst vor verrückten Menschen haben. Ich meine, lass es uns einfach da rausbringen, richtig. Das ist sehr unglücklich. Wir brauchen also auf keinen Fall die Polizei, um auf solche Situationen zu reagieren. Sie wissen, das ist eine Situation, die nur in der Community behandelt werden kann. Es gibt viele verschiedene Bereiche zu erkunden, zwischen nichts und entweder stationärem Krankenhausaufenthalt oder Verhaftung. Das ist es, worauf wir achten müssen, denke ich. Now, when we talk about, quote, defunding the police, that’s different than abolishing the police or disbanding the police. A lot of money that goes into buying weapons and car porn could be used to fund mobile crisis units. Mobile crisis units are comprised of mental health workers who are not armed. They do not respond in emergency looking vehicles. They wear civilian clothes. They are very trained in crisis intervention and de-escalation. So, maybe assessing is someone not engaging in proper self care? Are they possibly a danger to themselves or others? Do they need a higher level of care? If you do not have a mobile crisis unit in your county, you better start advocating for one now. And a lot of them work in conjunction with law enforcement. I do

believe at a potentially dangerous scene, law enforcement could be there to establish scene safety and then back off. Leave entirely. OK, are there guns here? We do a search. Is this person violent? Pat the person down. OK, we’re out of here. And then let the mobile crisis team handle it. So, we don’t have to remove them one hundred percent from the equation, but just decrease our dependance on them. There are also very, very, very, very few psychiatric ambulance squads in the country. And by very few, I mean basically one, which operates out of Montgomery County Emergency Services, the hospital I used to work at.

Gabriel Nathan: These are fully trained and certified emergency medical technicians who run on fully equipped basic life support ambulances. They can respond to all manner of physical emergencies, but they also respond to psychiatric emergencies. They execute psychiatric commitment warrants. They show up in an ambulance. They have polo shirts and khakis. They don’t have the badges and all that stuff. If you need to go to the hospital, you’ll go on a stretcher in an ambulance. Not handcuffed in the back of a police car. That’s how it should be in America. So we’ve got psychiatric ambulance squads, we’ve got mobile crisis. We have social workers embedded in law enforcement. We have the possibility of reimagining the kind of people we’re recruiting to do this job. There are lots of different ideas out there. London, for example, in the Metropolitan Police Department, the average constable that you see on duty does not carry a firearm. Now, in every municipality, there are armed response units that can be in a situation in a matter of minutes if they need to be. But maybe we need unarmed police officers in certain areas. It’s less threatening. And I know people will freak out at me about that, but, golly, it works in other places.

Lisa Kiner: So one of the things you said earlier was that part of the problem is that people are perceiving people with mental illness as scary. And when there’s something scary, you call the police. So do you think that part of this doesn’t actually have anything to do with the police? It’s more about how society views mental illness and the average person’s reaction to the mentally ill?

Gabriel Nathan: One hundred percent. It is the same thing as, unfortunately, a lot of Caucasian people’s gut reaction when they see a six foot two black man in their neighborhood. Oh, black people are scary. Oh, he looked in my window. What is that?

Oh, my God. OK, that’s learned subconscious racism. And we as white people need to recognize that we feel hinky, we feel uncomfortable and scared when we see a black person in our neighborhood. You know, you better do some really serious soul searching and try to figure out why that is. It’s the same thing with someone who has mental illness. You know, they’re in their garden and they’re talking to themselves and they’re yelling at your dog or whatever. Oh, that’s scary. I better pick up the phone and call the police. No. You better give that person some space and give yourself some time to reflect on why is that scary to you? And maybe sit with that feeling of discomfort. Where does that come from? What does that mean? Is that person really a threat to you? Is that person really a threat to your neighborhood and your existence? Someone said to me about that specific person that I mentioned, well, it’s a crime because he’s disturbing the peace and that’s a crime. And I really wanted to say to her, oh, so when you stub your toe in your garage and go, oh, f-word, should I call the police? You just disturbed the peace. When your dog is barking too loud? No, so we don’t do that right. But if someone’s yelling argh, government over me and I have a microchip in my tooth and, we’re calling the police. And we just hide behind that because we’re scared and we want the police to make it all better. And I’m sorry those days are over. Or if they’re not over, they should be over. We need to do better because people with mental illness are not going away. Gone are the days when we’re locking them away in institutions for years at a time. And we need to reckon with the fact that they’re in our community. And we need to do better.

Gabe Howard: Gabriel, thank you. It’s been an incredible discussion and enlightening discussion, and you mentioned OC87 Recovery Diaries, which I think is incredible. So I’d like you to tell the listeners what that is first and foremost.

Gabriel Nathan: Sure. So I’m the editor in chief of OC87 Recovery Diaries. It’s a nonprofit mental health publication. We tell stories of mental health empowerment and change in two ways. First person mental health recovery essays. We publish a brand new personal essay every single week, and we also produce short subject, professionally made documentary films all about people living with mental health challenges. You can see all of our mental health films and read all of our mental health essays at OC87RecoveryDiaries.org. And if you want to follow me, really the only place to do that is on Instagram. I’m at Lovebug Trumps Hate and I would love to, I’d love to be your friend.

Gabe Howard: Lovebug Trumps Hate is about Gabriel driving around in his Herbie replica, his lovebug replica. The pictures are incredible. The suicide prevention that you do is incredible. But also on the OC87 Recovery Diarieswebsite is where you can find Beneath the Vest. That entire series is on their completely free, correct?

Gabriel Nathan: Yeah.

Gabe Howard: Please watch it, it’s incredible. And you interviewed first responders. It’s not Gabriel talking. It’s actual first responders.

Gabriel Nathan: No, I’m not in it at all. So, it’s police officers, a dispatcher, firefighters, EMS personnel and my friend Michelle Monzo, who is the crisis intervention specialist trainer at MCES. All of the videos are free to watch.

Gabe Howard: Yeah, OC87 Recovery Diariesis a nonprofit, they survive by donations, please, if you see value in what they do, support them because they are worth it.

Gabriel Nathan: Danke dir.

Gabe Howard: OK. Gabriel, thank you so much for being here. To our listeners, hang on, as soon as we get rid of Gabriel, we’re going to talk behind his back.

Lisa Kiner: Well, again, it’s not behind his back because he can listen to it later.

Gabe Howard: That is very true,

Lisa Kiner: You keep forgetting that part.

Gabe Howard: Gabriel, thank you. Thank you once again.

Lisa Kiner: Oh, thank you so much.

Gabriel Nathan: It’s a privilege. Thank you for having me on.

Gabe Howard: Lisa, were there any aha moments for you?

Lisa Kiner: Yes, actually. The point that Gabriel raised was that the police do not need to respond to these situations at all, that this is not a police matter. It honestly had not occurred to me that, yes, our default thing to do in America when there’s a problem is to call the police. It’s my default thought. And it doesn’t necessarily have to be a problem that it makes sense to call the police about. It doesn’t have to be a school shooting or a hostage situation. That is just what we all do reflexively. If there’s a problem, we call the police. And it hadn’t occurred to me that there are other options.

Gabe Howard: The exact example that Gabriel used was somebody being loud while walking down the street, not showing any form of aggression or violence or breaking things, but just making people feel uncomfortable. People are picking up the phone and saying, well, I’m scared because my neighbor is loud in their own yard.

Lisa Kiner: This person is exhibiting clear symptoms of mental illness. And therefore something needs to be done, therefore, we as a society must do something to make that stop. And the thing that we think will make that stop is to call the police. But in reality, no, that’s probably not going to work and could turn out very poorly. Why do we think the police are the people to call to make that stop? And why do we need to make it stop at all? Why can’t we just tolerate this? Why can’t we just allow this to go on?

Gabe Howard: Genau. That was kind of an aha moment for me, too. In teaching CIT, one of the things that police officers say all the time is you have to remember that it’s not illegal to be mentally ill and you call the police when something illegal has happened. Somebody’s being loud in their own yard, even if it is symptomatic, that is not illegal. Calling the police when no crime has been committed, it’s clearly escalating the situation that unfortunately, it often works out poorly for the person who is symptomatic. Not only do they not get help, but now the police are there. And just by showing up, there’s an escalation.

Lisa Kiner: I really hadn’t thought about, why is that the default, reflexive thing that you do? In this situation to call the police? Why is that?

Gabe Howard: I don’t know.

Lisa Kiner: Why do we as Americans do that? And, yeah, I don’t know either.

Gabe Howard: And that’s obviously on the general society, that’s not on police officers at all. This is just another example of where they get thrust in the middle of something that they are unprepared for, untrained for and not the best situation.

Lisa Kiner: Correct.

Gabe Howard: Lending credence, of course, to Gabriel Nathan’s point that police officers should be out of this entirely.

Lisa Kiner: Well, it’s just very interesting. Why do we decide that police are the ones who need to resolve every situation? That every difficult or uncomfortable situation, we should get the police to fix it? Why are they the designated fixer of such problems? And it had not occurred to me that there are other options.

Gabe Howard: Einverstanden. That we’re sending law enforcement for a medical issue. I don’t agree with that at all, but I still think that it’s just very pie in the sky and optimistic and almost sunshine and rainbows to think that police officers will stop responding to mental health crises. It doesn’t sound logical to me.

Lisa Kiner: Well, I think you’re right about that, in part because police officers won’t be able to stop responding because the public will still call the police for these things. I think the argument that Gabriel is making is that it doesn’t have to be that way. The question will be what happens in the meantime while we’re working towards this goal? I don’t think he’s advocating getting rid of CIT.

Gabe Howard: Oh, yeah, I don’t think that either.

Lisa Kiner: He’s not saying that we should not train police officers to de-escalate or that we should not train police officers to handle people with mental illness. He’s saying that

we need to move towards this different vision, this different way of doing things. But obviously this type of training will always be valuable. Part of it is de-escalation. Isn’t that good for every crisis? Isn’t that good for every high energy, intense situation? How could that not be a good thing? Why wouldn’t you want to resolve a situation in a way other than with violence?

Gabe Howard: The use of force is problematic, especially when you consider the use of force on sick people. I’m obviously seeing the world very much through the eyes of somebody living with bipolar disorder. I was in crisis. I think about how close I came to having the police called on me. And I’m so very lucky that the people who were surrounding me were able to deescalate, control and, of course, didn’t feel threatened. You and I have talked about this before, Lisa. I don’t know why you didn’t call the police on me when I thought there were demons under my bed, I.

Lisa Kiner: Because I didn’t feel threatened.

Gabe Howard: I don’t understand why you didn’t feel threatened, but let’s put that on the back burner for a moment. You, of course, had a history with me.

Lisa Kiner: Yeah, you were not a stranger.

Gabe Howard: Imagine if I had thought the demons were under the cash register at Wal-Mart?

Lisa Kiner: Correct.

Gabe Howard: You know, I’m a large guy, I’m six foot three, 250 pounds, broad shouldered, and I’m screaming that there are demons in the cash register to a 19 year old who’s working the evening shift at the local supermarket. That would seem very threatening. And I’m sure that the police would be called. And I just don’t like the idea that the first thing that they would do upon seeing this loud, screaming, mentally ill man is tase me or tackle me or worse. I don’t know that the person picking up the phone and calling would say, hello, 911 operator, I believe that we have a mentally ill man here. I think that they would say that we have a violent asshole threatening a teenage girl. And how would they know to send the mental health team?

Lisa Kiner: Well, that’s why we’re hoping that all police officers would have this training, and it’s kind of like a triage type thing, right? You don’t have a surgeon standing at the gate of the emergency room. You have a trained person, usually a nurse, who can assess whether or not to immediately send you to the surgeon or tell you to go wait for your turn. The idea being that all police officers would have this ability to kind of triage the situation to say to themselves, huh, that’s mental illness, and then call the appropriate response. That once they figure out what’s going on, they can turn this over to someone else, someone with either more or different qualifications.

Gabe Howard: I like that, I like that a lot. I do feel the need to be extraordinarily thankful to all of the police officers who have gone through CIT since in many municipalities, it is not mandatory.

Lisa Kiner: Including here in Columbus.

Gabe Howard: Yeah, including here in my state. Which means the police officers who have done it have volunteered. They have decided that there is value in learning how to help people with mental health issues in a way other than what they’ve already learned. I sincerely am so grateful for police officers who have taken that extra step because they don’t have to.

Lisa Kiner: But it’s not entirely altruistic. They also see the utility in it. It’s not just about people wanting to be nice to people with mental illness. It’s also about wanting to be safe themselves, not wanting these situations to get out of control, about not wanting bad things to happen. This isn’t just a benefit to people living with mental illness. This is a benefit to everyone, including police officers.

Gabe Howard: I have mad respect for the police officers who realize that. Who realize that they can learn more and help their community in a better way. Somebody with mental illness who is in a mental health crisis is most likely going to be seen by a police officer before anybody else. That training is not required, even though it is understood that people with a mental health crisis will be seen by a police officer before anybody

else. That’s really the only take away that you need to understand. Richtig?

Lisa Kiner: There’s a lot of weird stuff that happens in society that makes no sense.

Gabe Howard: Yeah, yeah, if Gabe gets sick, they’re sending the police. Are they going to train the police? Nee.

Lisa Kiner: Maybe.

Gabe Howard: If the police officer sees the utility in it and has the introspection, the understanding and the time to sign up for CIT training all by themselves, the bottom line is I hope that any law enforcement, first responder or politician listening to this will understand that mental health training is vital, period. We learned so much from Gabriel Nathan that we decided to do another show with him over on The Psych Central Podcast. And you can find that show on your favorite podcast player, just search for The Psych Central Podcast. Or you can go to PsychCentral.com/Show, and it will be there on Thursday. And Gabriel talks about the suicide rate among law enforcement. Forget about protecting people like me with mental health issues and bipolar disorder. Forget about all of that. The suicide rate among first responders.

Lisa Kiner: It’s quite shocking that more police officers will die by suicide this year than will be killed in the line of duty. A lot more

Gabe Howard: Yeah, by a lot,

Lisa Kiner: Almost three times.

Gabe Howard: It made us do an entire another episode on an entire other podcast hosted by me, so please go to PsychCentral.com/Show or look for The Psych Central Podcast on your favorite podcast player. And listen to more from Gabriel Nathan, the executive director of OC87 and one of the people behind Beneath the Vest: First Responder Mental Health. Lisa, are you ready to get out of here?

Lisa Kiner: I think we’re good to go. Thanks again to Gabriel Nathan for being here with

us.

Gabe Howard: All right, everybody, here’s what we need you to do. Please subscribe to Not Crazy on your favorite podcast player. Rank us, review us, use your words and type in why you like the show. This really helps us a lot. Share us on social media and also tell people why to listen. We love doing this show for you and you can help us out greatly just by doing those simple things.

Lisa Kiner: And we’ll see you next Tuesday.

Announcer: You’ve been listening to the Not Crazy Podcast from Psych Central. For free mental health resources and online support groups, visit PsychCentral.com. Not Crazy’s official website is PsychCentral.com/NotCrazy. To work with Gabe, go to gabehoward.com. Want to see Gabe and me in person? Not Crazy travels well. Have us record an episode live at your next event. E-mail (Email protected) for details.

Gabe: Hey Not Crazy Fans! We are so cool our outtakes have sponsors! We want to give a shout out to Southern Cross University. Learn about mental health risk factors in older people at https://online.scu.edu.au/blog/risk-factors-mental-illness-older-people/. Check them both out and tell them Not Crazy sent you!

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