This article first appeared in the St. Louis Beacon, June 1, 2011 - Members of the Jefferson County Sheriff's Department faced a tension-filled standoff a year ago with a High Ridge man who was armed and threatening to kill himself. One of the officers, Lt. Kevin Carle, is credited with defusing what law enforcement officials say could easily have turned into a deadly encounter.
Speaking in a calm, reassuring voice during the standoff, Carle told the man, who had locked himself inside his home, that the officers and the man's daughter were at the scene to offer help. Eventually, Carle convinced him to put down the gun, a black and gold six-shooter, and come to the front porch to "at least give your daughter a hug because she loves you very much."
The man said he wanted to do that. But Carle saw an earlier chance to get him out of the house and away from the gun when the man leaned from behind a screen door for a quick peek at a waiting ambulance parked up the street. Carle quickly grabbed the man, and pulled him away from the door. Other officers moved in, and the man was taken to St. Anthony's Medical Center for care.
Carle is convinced the police presence made a difference, saying the man "told me that he had been laying in the bathtub with the gun contemplating shooting himself just prior to our arrival."
Recently, Mental Health America of Eastern Missouri honored Carle and 25 other area law enforcement officers for making a difference by showing compassion and patience in dealing with a mentally ill person in a crisis.
Not all the encounters involve victims trying to kill themselves. Last fall, St. Charles police began getting dozens of calls from a man who complained that people were hiding under his mobile home, or tampering with his car, or trying to poison him.
"Officers would respond, but what they were checking for what didn't exist," said Sgt. Ron Bextermueller, who heads investigative services for the St. Charles Police Department.
The man's circumstances had fallen under the radar until the calls were tracked by Officer Britt Duncan, who also won a police award.
Based on interaction with the Missouri Department of Health and Senior Services and other sources, Duncan eventually learned that the man was a veteran and suffered from schizophrenia. The state agency was aware of his condition but had no idea that the man had been the subject of 57 incidents involving St. Charles police. Working with the state health agency, the Veterans Administration and the Crider Health Center in St. Charles County, Duncan made it possible for the man to get help for his illness.
Invisible Victims
This year marked the 25th anniversary of the MHA's McAtee Recognition Awards luncheon. Bryan Evans, director of MHA's suicide prevention programs, praised the police work over the years and says many of the victims who were helped tended to be invisible because they were unemployed and uninsured.
He said they end up "trying to navigate a mental health system that is fragmented, limited in scope and difficult to access. Additional barriers include lack of factual information about mental illness, misperceptions about treatment, and stigma."
Through the crisis intervention team (CIT) training, thousands of area law enforcement officers have received 48 hours of guidance in dealing with mental health situations. The National Alliance for the Mentally Ill (NAMI) St. Louis set up the local CIT program two years ago as a way to help officers assess situations to determine whether a person is facing a mental health or substance abuse crisis, says Richard Stevenson, who manages NAMI's involvement with the CIT program. "If they determine there's a probable mental health or substance abuse, the officers are trained to transport the individual to the nearest hospital and transfer custody to hospital personnel."
City, County Hospitals Lend A Hand
Officers used to take the mentally ill to an emergency inpatient unit at the Metropolitan St. Louis Psychiatric Center on Delmar, west of Union. After the Missouri Department of Mental Health eliminated those beds, the St. Louis Regional Health Commission took the lead in bringing hospitals into the picture. That's why many hospitals in St. Louis and St. Louis County accept and stabilize mentally ill individuals picked up by police.
Accommodating these individuals is a big job, says Sgt. Barry Armfield, the St. Louis area CIT coordinator. He says that even as city and county hospitals "are picking up the slack," there is an ongoing effort to persuade the state to reopen the psychiatric center's emergency room.
"It's being worked on, but it's definitely not a done deal yet," Armfield said.
The number of police encounters with mentally ill individuals has been steady over the years, says Sabrina W. Tyuse, a St. Louis University social work professor who evaluates the CIT program.
She says area police get about 1,400 calls a year involving a person experiencing a mental health crisis, and that about 60 percent of them involve suicide. Of that number, she says, 75 percent of the targets of the calls had the means available -- a knife, a firearm or a rope for hanging -- to take their lives. Or each had a "detailed plan, for example, to jump from a local bridge or step onto a busy highway or roadway to carry out a suicide attempt," she said.
Tyuse and others say the CIT data paint an accurate picture of area police encounters with the mentally ill, but Armfield adds that the numbers of encounters might be higher, because some police don't always report incidents as encounters with suspects who appear to be mentally ill.
Sheriff Glenn Boyer says the program has given his deputies a better understanding of mental-health issues.
"Officer Carle was very professional in that incident," Boyer said. "He didn't excite the situation in any way. He saw an opportunity to use a minimal amount of force to protect the individual. We're trained to deal with suicidal subjects. It's not extensive training, but Officer Carle was able to take that training and use his experience to make it work."
Before CIT, he said, "The officers were demanding that the individual put the weapon down and were aggressive in their stance. In hindsight, we realize that this actually incited the individual we were trying to help and caused the situation to escalate. The training helps you remain calm and calm the individual."
The old approach, Boyer says, amounted to more guesswork "where you did the best you could. Sometimes it worked, sometimes it didn't." In the old days, he says individuals "probably in fact were" killed during standoffs with police.
Mental Health America of Eastern Missouri honored 26 officers
St. Louis Police Dept: Officers Franklin Derby, Nicholas Dibble, Paula Brant, Joseph Niemira, Mona Lisa Moore-Dandridge and Matthias D. Blake; and Detectives Patricia Nijkamp and Richard Noble
St. Louis Sheriff Dept: Deputy Sheriff John Rice
St. Louis County Police Dept: Officers Kevin Minor, Leonard Sanders, Amy Willenbrock and Scott Ruder
Jefferson County Sheriff Dept: Deputies Jason Clardy and Donald Feltman; Cpl. Eric Burgard, Det. Scott Poe, and Lt. Kevin Carle
Warrenton Police Dept: Officers Robert Bowen and Chris Nolte
Shrewsbury Police Dept: Officer Tomey Foltz
Hazelwood Police Dept: Officer Jason T. Perkins
Creve Coeur Police Dept: Officer Richard Wiginton
O'Fallon Police Dept: Officer Jennifer Rohr
Creve Coeur Police Dept: Officer Donald Szydlowski
St. Charles Police Dept: Officer Britt Duncan
Funding for the Beacon's health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization that aims to improve the health of the people in the communities it serves.
