When 28,000 Alabamians lost mental health care, police were expected to pick up the slack. Sgt. Blalock rose to the challenge.
Sgt. Shane Blalock began his policing career with the Hamilton Police Department and has spent the last 18 years with the Florence PD in Alabama. For the last six years, he’s been the coordinator of the community mental health officer program.
Mikayla Hellwich: Why did you join law enforcement?
Sgt. Shane Blalock: It’s always interested me. My father worked for the Birmingham police department and I have several relatives that used to be in law enforcement. It suited me and fit well, and after I got into it, I knew it was what I was made to do. In the last year, I’ve been looking all over for any available resources, anything where we can gain more knowledge, get more tactics, more training. Someone referred me to LEAP when I was looking at the Step-Up Initiative.
What made you interested in mental health issues, and why did you start working as a coordinator for your diversion program?
It started before I was in law enforcement. My mother actually taught special ed. my entire life. She is an educator, and I have relatives that have mental illnesses, so it’s kind of close to home. I have a gift of being able to communicate with people, even when people are very sick.
What does that look like in practice? If you get a call that someone’s in crisis, what would an officer do if they were doing the wrong thing? And what would an officer do if they’ve been trained correctly?
If everything goes the way it’s supposed to go, the officer — the first line responding officer — has had training and recognizes this person is in crisis and calls a community mental health officer. The community mental health officer responds, and they either get the person to go voluntarily for treatment, or in serious cases, we have to do an involuntary commitment and they end up going to the hospital and getting medical treatment. Hopefully this will get them well enough to realize what caused the problem and how to avoid getting back in this situation again. And we deal a lot with support networks. We talk to the family members, neighbors, the wives and husbands, mothers and fathers. We tell them the correct places to go and what help to ask for, and what they can do to help their loved one. You have to be aware of what resources are in your area and what to ask for, and when it’s appropriate and when it’s not.
So what does the process of de-escalation look like when you arrive to the scene of a crisis?
A lot of times if you’re involved, our criteria for commitment are signs of a mental illness. They’re an immediate danger to themselves or someone else and they have no pending charges. So most of the time the people are actively suicidal or homicidal. The de-escalation process sometimes is — you’re able to sit down and talk with them. Other times you go back and forth and back and forth for hours until you get to a place where they’re medicated and on the right path to getting well. The de-escalation process is different for every call you go on. Because people with the same illness can present differently depending on where they’re at in the stage of their illness or present crisis. Other factors include whether they’re self-medicating, how much stress they’ve been under, if they have a second diagnosis, other underlying issues, or their chemical makeup — we’re all different. So, everyone’s level of crisis is different, and it can change from minute to minute to minute. Even on the same person you’ve gone to 10 times — they can present totally different the tenth time you go.
When you’re able to divert folks out of the system, how do you decide who gets diverted out and who goes into the system?
It’s all on a case by case basis. Sometimes people who are mentally ill need to go to jail because they’ve committed a serious crime. Sometimes they need to get psychiatric treatment. I don’t believe that just because you were diagnosed with a mental illness, you get a get-out-of-jail-free card every time — that creates mayhem. There’s a difference between mental illness and behavioral issues and that goes back to our training.
When someone’s diverted out of the system and they get support services, what kind of services are available for them?
In my area, we have two facilities: Riverbend and IBH [Integrated Behavior Health]. Those are both community mental health centers that have doctors and nurses. They’re staffed with day treatment and programs. They take walk-ins, and they take appointments. I try to educate people who are mentally ill, who don’t have a health care provider, where they can go get services even without insurance or without a job. Every area is different. Birmingham has seven hospitals you can go to. Here, I only have one, but you have to look at the different resources in every area and know what they provide and when it is applicable to each situation.
If you could compare your community now to the way that your community was before you had this mental health response protocol, what have the results been?
I believe a lot of people who were not getting the treatment that they needed are getting out of the legal system and they’re getting into treatment. They’re learning how to take care of themselves and not fall back into the legal system — how to break that cycle. The hard part is the homeless community that has high numbers of mentally ill people. There aren’t a lot of resources to help them. I can get them medicated, but I can’t keep them medicated. I don’t have support networks [for continuing care]. I can’t help them get an ID to get a job to get a place to live. I’m looking for more help with this every day.
But all in all, I think use-of-force through the different agencies that I’ve trained has gone down when dealing specifically with mentally ill people. I think the number of calls has gone up, because Alabama psychiatric services closed in 2015. Their funding was cut in 2015, and 28,000 mentally ill people lost their healthcare provider. I’m still dealing with that backlash. That’s a lot of people they closed the doors on. Funding has been cut for mental health services, and you really have to constantly be looking for something new, begging for more help, and pushing your legislators to help you put laws into practice that benefit everyone. It’s a continuous work in progress.
Has your department struggled with any part of implementing the mental health diversion program, or has it been pretty smooth?
There are always challenges. My department is very supportive of this unit. I have a very forward-thinking chief. He recognizes there is a problem and that you can’t just turn your head. We train probably more than any agency in northwest Alabama. We have multiple kinds of mental health training and de-escalation training. There are a lot of barriers to overcome because you’re dealing with probate judges, you’re dealing with lawyers, you’re dealing with hospitals and doctors and outpatient services. You have a bunch of different people that, if you’re not all on the same page, it turns into a disaster. It’s actually taken many years to make the [diversion] process as smooth as it is.
How long has it taken?
The eight years that I’ve been leading the unit is all I can give you a quantitative measurement of. We have to get the person medically cleared to the emergency room before they can go on to the behavioral health part of the program. When I started, the wait time in between was around six hours. It is now down to under three, because all the different agencies and departments are working together so that mentally ill people get the treatment they need as quick as possible. And it doesn’t take away resources from the police on the street. It doesn’t take away from agencies with two or three officers. Every minute is valuable to everybody.
What can other departments across the country learn about your program’s successes and failures? What do you think that they should know?
I would start with this: Every patrol officer needs more training to deal with and recognize mentally ill people in crisis — and how to distinguish between people who are abusing drugs or people who may have a dual diagnosis. The more educated law enforcement is, the better our reaction is. And in any facet of our job, the more knowledge we have, the more training we have, the better prepared we are to respond and the better the outcome will be for everyone.
I didn’t mention earlier, but aside from being coordinator of the mental health officers, I also teach responding to the mentally ill from a patrolman’s perspective. I’ve taught this class for the last three years to over 1000 officers. Every agency said the training has given them more tools. This training also goes beyond what the state requires officers to have every year.
What does the training cover?
I usually do it in four-hour blocks. We cover how to recognize people with mental illness. I describe the different mental illnesses and how they present and how to identify from verbal clues, behavioral clues, and environmental clues. I teach them about the most common medications. If someone’s not able to communicate, maybe you can see their prescription bottles. Sometimes we can tell what their diagnosis is just by looking at their prescription bottles. I tell officers how to help the person find the treatment they need, what the different options are, the alternative solutions, and how to use resource networks. We also cover how to deal with people who don’t fall under the umbrella, people with untreatable mental illnesses. For example, for people with Alzheimer’s or dementia, we connect them with the right services specific to their unique needs. I can’t commit someone with Alzheimer’s or dementia as they are untreatable mental illnesses. So, we tell their support networks how to get guardianship when that person is in crisis. Guardians can get them to the doctor and keep them in treatment. You have to be able to tell the mentally ill person’s support networks what to do to protect their family members when they’re in crisis.
Historically, how has law enforcement approached mental health? What’s worked and what hasn’t?
Mental health has not been as much in the forefront as it has in the last five to ten years. Officers weren’t trained in how to recognize mental illness and how to help people with mental illness. We’re basically sent through the academy and given a programmed response for every situation. Those programmed responses don’t always work for people who are in mental health crisis. So, we looked further for other ways to train officers to recognize when somebody is in crisis and how to step outside the box that we’ve been in.