Every couple of weeks, police in Americus, a small city in southwest Georgia, respond to trouble at the home of the same young man.

This story also appeared in Georgia Health News

The man goes through psychotic episodes, sometimes violent ones. He’s on the autism spectrum and has been diagnosed with a brain tumor.

The man got a lucky break after his latest incident, a physical attack on his father. The responding police officer was an old family friend, who engaged the man in conversation, managed to find a common interest – Marvel comics – and calmed him down.

“It was one of those moments when I knew my training worked,” says Officer Harry Brooks. “And it felt good. It felt right.”

Officer Harry Brooks

Brooks, 44, with an impressive stature, a spiky afro and a gentle voice, is one of five officers at the Americus Police Department who have received Crisis Intervention Teams (CIT) training. It’s a weeklong course that helps law enforcement officers build a skill set to interact safely and effectively with individuals with mental illnesses and other brain disorders.

Brooks was born and raised in Americus. He joined the police force 10 years ago, making him one of the more experienced officers on the current staff of 38. His recent encounter with the mentally distressed young man is not only a testament to his successful crisis intervention training but also proof that being a cop in a modest-sized community can sometimes be an advantage.

Over the past few years, police across the country have reported a sharp increase in 911 calls linked to mental health issues. The opioid crisis has disproportionately affected rural areas, and the Covid-19 pandemic has driven up the number of people affected by drug overdoses, suicide impulses and psychosis.

It’s mostly larger urban law enforcement agencies that have implemented significant crisis response programs, says Rob Davis, chief social scientist at the nonprofit National Police Foundation (NPF). He is the lead author of a January 2021 survey on how small agencies handle calls involving people in a mental health crisis.

Small and rural law enforcement agencies face the same challenges as the larger ones, but they generally don’t have the money, staff or professionals to respond effectively to mental health calls, Davis says.

Resources can be scarce

Most law enforcement agencies turn to CIT training and the so-called co-responder program to address the problems and often combine the two. According to the National Alliance on Mental Illness (NAMI), CIT training, started by the Memphis Police Department in 1988, is used in more than 2,700 agencies – of about 18,000 nationwide.

About 20 percent of all law enforcement officers in Georgia are CIT trained, according to Georgia’s Peace Officer Standards and Training Council (P.O.S.T.), which sets the training guidelines for the state. At the police department in LaGrange, 75 miles southwest of Atlanta, all officers have been CIT certified since 2007. But that department is an exception.

Criminal justice experts estimate that most metro Atlanta departments have about half of their personnel trained in CIT. One of these, the Brookhaven Police Department, is a leader in crisis intervention among Georgia law enforcement agencies, and the number of its officers trained in CIT runs between 60 and 70 percent, says Lieutenant Abrem Ayana, who coordinates the department’s mental health response.

Agencies such as Brookhaven’s have also implemented co-responder programs, pairing officers and mental health professionals in a coordinated approach. The idea is to make sure that individuals in crisis receive appropriate treatment, often instead of being incarcerated. Clinicians sometimes ride along with patrol officers. More often, they are deployed to the scene when needed.

CIT training and co-responder programs are “good models, as far as they go,” says Dr. Laurence Miller, a clinical, forensic and police psychologist based in Boca Raton, Fla. But he warns against applying a one-size-fits-all approach. He says it’s important to customize the response, lining it up with resources, training, as well as the size, location and philosophy of the agency.

Americus, in Sumter County

Mark Scott couldn’t agree more. “We are committed to getting our entire department through CIT training, every single officer,” says the Americus police chief, as he sits down in his office in the city’s downtown public safety building. A few patrol cars are parked out front, and a small fire station is in the back. It’s a quiet morning on a recent fall day, the sun casting long shadows.

“But it’s hard,” admits Scott, who’s tall and trim, with piercing bright eyes and a guarded smile.

Recruiting and retention have been a national problem for years, and law enforcement agencies are stretched thin. The problems worsened after the killing of George Floyd in Minneapolis last year and the protests and increased public scrutiny that followed. Sending an officer away for a 40-hour, weeklong class in an already short-staffed department is a challenge, Scott says.

The co-responder model is an idea that Scott wishes he could implement. It is just not viable for a small police department because of a lack of funding and a shortage of mental health professionals in rural communities, he says. Georgia is 51st in terms of access to mental health care, according to a 2021 state ranking released by the non-profit Mental Health America.

Chief Mark Scott

Scott’s concern is echoed by many police chiefs and sheriffs around the country. Of the 380 small agencies participating in the NPF survey – 11 in Georgia – the majority said they would do more training and coordinated and innovative response if given bigger budgets and more staff.

“I would love for us to never have to respond to a non-criminal issue again,” says Scott, “but it’s not realistic. When you dial 911 at two in the morning or on the weekend, you’re probably not getting a psychologist.”

As first responders say, if it burns, it’s the fire department. If it bleeds, it’s EMS. “With anything else, you’re going to get a police officer,” Scott continues, wearily shrugging his shoulders. “It’s always been that way. We’ve always been the ones who are there when no one else is.”

Sumter County

Cops in Americus can call the Georgia Crisis and Access Line (GCAL) for advice or request a clinician to come to the scene. But it typically takes a mental health professional 90 minutes or longer to get there, says Lieutenant Tim Green, who oversees Americus’ uniform patrol division. Unless emotionally distressed people pose an acute danger to themselves or others and must be placed in protective custody, officers often take them to the local ER. They wait for them to get evaluated and, sometimes, take them to a psychiatric facility in Albany, Columbus or Macon, up to 70 miles away.

In any case, says Green, “it takes an officer off the street for several hours, and that’s a big problem for us.” The drain on officers’ time is one of the main concerns raised by small law enforcement agencies in the NPF’s report. Additionally, longer wait times tend to drive up the need for officers to use force, as the situation can quickly spiral out of control.

But smaller police departments also have distinct advantages that some agencies tap into as they’re developing creative solutions to make up for limited resources.

The main benefit is to “have a lot of good relationships,” says Chief Scott. He grew up in the area and has been at the helm of Americus PD for five and a half years.

Social dynamics in smaller communities can help mitigate or bypass bureaucratic hurdles and red tape when officers interact with the mentally ill. “Because everyone knows everyone else,” says Scott, “we often just pick up the phone and make a call” – to someone at Family and Children’s Services, the local homeless shelter or the hospital.

Through his Rotary Club, Scott is friends with Dr. Dale Lawson, the ER director at Phoebe Sumter Medical Center in Americus. When the police bring in mentally distressed people, “which is very often the case,” says Lawson, “we do not turn them away.”

In a small community, everyone’s in the same boat, adds Jana Dew, a licensed clinical social worker and the only mental health care provider at Phoebe Sumter. “There are no other hospitals in town,” she says. Often, there are no other facilities to turn to in a mental health emergency. “So, we have no choice but to closely work together, and we do.”

People who need help

Georgia is among several states with a severe worker shortage in its state-run psychiatric hospitals. That leads to people with mental health issues being stuck in emergency rooms or jails as they wait to get the treatment they need.

Green, the patrol supervisor at Americus PD, says it also helps when officers have grown up in the town they are policing – or have lived there for a long time. Green is originally from the San Diego area and later did a short stint in the military, but he’s been a cop in Americus for 29 years.

Not only do many officers know the person in mental distress, but they often know who it is that the distressed person trusts, he says.

Getting a family member, friend, neighbor, or pastor involved is sometimes better than waiting for a mental health provider, Green continues. “The family will say, ‘Joe a few blocks down could really help.’ And then we’ll get Joe and escort him to the scene.”

Lt. Tim Green

Working in a small agency, Green is also familiar with his officers’ diverse personalities. Some, he says, are just not wired to calm down an individual in mental distress.

“Every department has their aggressive, alpha-type guys,” he says with a grin – the type who can handle danger but who would do more harm than good trying to de-escalate a situation. “They just have the attitude: ‘Let’s go lock them up.’ ”

Others, like Officer Brooks, are naturals in building a rapport with people, he adds. Green says it’s invaluable to have an officer who combines deep community ties, genuine interpersonal skills, and solid training in crisis intervention.

Brooks knows just about everyone in town, Green continues. “And he knows how they click. That’s a huge asset for us.” At times, community members in mental distress even request Brooks, Green says.

On this morning, Brooks returns to the station after a court appearance. His black shoes are shined, and he wears his Class A uniform with a tie and a small round metal pin indicating he completed CIT training. “I’m proud of my pin,” he says, smiling.

Many officers dread mental health calls — especially those involving a person with a weapon — because they are unpredictable and can explode in a split second. Brooks, however, takes every chance to put his training into practice. “When we get a call from an emotionally distressed person, I want to go,” he says. “When we get someone who threatens suicide, I want to go.”

It’s a job he likes and seems to be quite good at. Recently, Americus police responded to a call that involved a man holding a knife to his own throat and threatening to kill himself and his family. Green watched Brooks de-escalate the situation by talking to the man in a low tone and keeping eye contact.

“He was not giving commands. He was not belittling him. He was just talking to a human being who’s having some issues,” Green says. He even let the man continue to hold the knife where it was, giving him the feeling of being in control of his decisions even if they were suicidal. Very slowly, the knife came down from the man’s throat, Brooks’ supervisor remembers.

For a cop, crisis intervention training “is just as valuable as a patrol car, a badge and a gun,” says Brooks. He adds, “every situation needs a proper tool.” With the growing number of mentally distressed people, this tool is becoming more important for police to have, he says

Dispatchers are another tool that cops rely on for mental health calls. “They are a lifeline for us,” says Green. The more information officers receive, the better equipped they are to know what they’re walking into.

Rob Davis, with the NPF, says the survey shows that many small police departments find it important to also train dispatchers in crisis intervention “so they can better recognize a call from a person in a mental health emergency.”

Often, computer-aided dispatch, or CAD systems, guide dispatchers through a set of scripted questions. In rural areas, many dispatchers recognize frequent callers and can piece together a mental health history.

The Georgia Association of Chiefs of Police (GACP) is currently reviewing basic police training. The plan is to make some suggestions to the state’s Peace Officer Standards and Training Council, says Scott, who is a GACP board member

He would like to see the 40-hour CIT course incorporated into police academy training, even though that would cause recruits to take a little longer to graduate, he continues. If it can’t be done at the academy, he wants young officers CIT trained after they graduate, while they’re going through so-called field training alongside experienced officers, and before they start patrolling on their own.

If nothing else, Scott pushes every officer in his department to take an eight-hour Mental Health First Aid class, which can be done virtually, or at the local hospital. The need to respond to mental health calls “isn’t going away any time soon,” he says.

Laurence Miller, the police psychologist in Florida, suggests standardizing verbal de-escalation training – with elements of CIT – as part of the curriculum at police academies nationwide. It would be basic instruction, like learning to use the radio or how to apply a tourniquet. Officers shouldn’t feel that dealing with mentally distressed citizens requires a highly specialized skill set, he says. “We need to demystify these interactions.”

Back at the Americus Police Department, Officer Brooks says a professional – and empathetic – response to a mental health call can also boost the public perception of police in the community.

“So that the next time people see us patrolling the streets, they think of us as a positive influence,” he says, “not just for our mental health response, but on every level of policing.”

Katja Ridderbusch is an Atlanta-based journalist who reports for news organizations in the U.S. and her native Germany. Her stories have appeared in Kaiser Health News, U.S. News & World Report, USA Today and several NPR affiliates.

Katja Ridderbusch is an Atlanta-based journalist who reports for news organizations in the U.S. and her native Germany. Her stories have appeared in Kaiser Health News, U.S. News & World Report, USA...