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As one of San Diego’s newest police officers, David Ramirez said he didn’t know the signs of schizophrenia, depression or bipolar disorders. He knew their names, not the symptoms. He’s a police officer, not a doctor.
In the department’s academy, new officers get trained for a few hours about how to address people suffering from mental health problems. After all, they can be callers, victims, suspects or witnesses like anyone else.
After graduation, Ramirez started his patrol training in southern San Diego and realized, for the first time, how often police actually come in contact with these issues.
“We see it every day,” he said. “I haven’t dealt with that outside of being a police officer.”
At a time when San Diego’s crime rate is at a historic low, police say the number of incidents involving mental health issues is increasing. The city’s police chief has pointed to a decline in social services and called mental illness one of the city’s most growing public safety concerns. Some officers like Ramirez end up getting in-depth training to help them understand mental illness, but it’s uncommon.
The result, in some cases, is police officers being thrown into situations without the specialized training that advocates say could help them make better decisions. Some incidents, like suicide threats, develop so quickly that the average patrol officer can’t wait for crisis negotiators or licensed clinicians to assist.
Last year, San Diego Police received 4,812 calls for incidents involving suicide attempts or suicide threats, a 7 percent increase from the previous year. And 768 of those calls elevated to a point where police needed to intervene and document a serious threat to life, a 13 percent increase from the previous year.
These trends have caught the attention of police at a time when the rates of San Diego’s major crimes continue to sink well below normal levels. Violent crime decreased by 2 percent last year and property crime by 20 percent, police reported in January.
“The two areas that we’ve seen increase are aggravated assaults and mental health issues — suicides and people in deep emotional distress,” Police Chief William Lansdowne said about the city’s crime trends. “As the state cuts back and the county cuts back on those (mental health) issues, it’s the responsibility of local law enforcement to manage them.”
Lansdowne said police are coming in contact with mental illness more often as a result of government cuts in preventive programs. Gov. Schwarzenegger, for example, has proposed slicing the state’s health and human services budget by 16 percent during the next fiscal year.
San Diego County, bolstered by funding from the 2004 Mental Health Services Act, has increased funding levels over the last few years for its behavior health services, which includes drug treatment programs, mental health programs and the county’s mental health hospital. At the same time though, some officials like Lansdowne say these budget increases haven’t kept pace with rising demand.
Even though the county’s behavior health services budget has increased by 28 percent since 2008, people are now waiting longer for mental health outpatient care. More people are receiving care, but the county is doing it with fewer staff. As these services become stressed, police argue, more people end up in their temporary care.
As part of its mental health budget, the county funds a nonprofit called Psychiatric Emergency Response Team, or PERT, to improve training and provide licensed clinicians to assist police in the field. That assistance could mean anything from calming a crisis to interviewing a witness with schizophrenia.
Between July and November, the nonprofit’s staff assisted police on more than 5,200 incidents throughout the county. If that rate continues through 2010, it will be the nonprofit’s busiest year in existence, said Jim Fix, the executive director. When Fix adjusted the rate for staff increases, he found the number of calls increased by 20 percent in 2009.
“In a perfect world, we’d have more clinicians out there assisting law enforcement whenever possible,” Fix said. “(Police) go on far more calls than us that deal with this stuff.”
The department three years ago held crisis response training, which included some coursework on mental health issues, for every officer. The department also schedules four-hour refresher classes on mental health, which 157 officers attended last year. For more advanced training, officers can volunteer for a three-day course from PERT.
Last week, Ramirez, the rookie officer, graduated from PERT’s training course with about 50 other officers and dispatchers. He learned the symptoms of different mental illnesses and some tactics to approach them differently. He was taught to use less aggressive body language and more casual language, ask short questions and give people more time to respond when dealing with someone with mental illness.
“I’m just looking for something to make me a better police officer,” Ramirez said.
Ramirez and some of his colleagues at San Diego police attended training after petitioning their supervisors. With fewer officers working at the department than previous years, letting them take three days off for training puts more pressure on staffing levels. Around 400 officers have attended the PERT academy in recent years.
San Diego police leaders said they recognize mental illness may be a growing problem, but they haven’t committed to making major changes in department policy. When asked whether more mental health training would be made available or even made mandatory, Assistant Chief David Ramirez, who is not related to the rookie Ramirez, said officers are being encouraged to attend the PERT classes.
“I don’t know if we’re in a position to make it mandatory yet,” Ramirez said. “If we were going to do more mandatory training, we got to look at the impacts to scheduling.”
Although sometimes a critic of the department, Kevin Keenan, executive director of the American Civil Liberties Union in San Diego, said San Diego police are doing a better job with mental health issues than other cities around the country through crisis response training. He still wants police to get more mental health training, but acknowledges that some incidents might be unavoidable.
“There absolutely needs to be more mental health training … but that may not solve these difficult problems,” Keenan said. “It’s not a problem that law enforcement can pass off on anyone else unfortunately. They have to deal with it.”