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Photo Courtesy of the San Antonio Convention & Visitors Bureau/Stephanie Colgan

First Annual
CIT International Conference
June 1-3, 2010
Marriott Rivercenter Hotel
San Antonio, Texas
http://www.youtube.com The Bexar County Story
Bexar County • Safety Net • Collaborative

The Center
Health Care
Welcome to San Antonio
It is my pleasure to welcome you
to the First Annual CIT International
Conference 2010! Welcome......................................... 1

Back in 2005 I had hoped that at CIT International Board of Directors..... 5

least 250 people would attend the first Social Media Links........................... 6
CIT National conference. I was quite
Program at a Glance........................ 7
surprised to see that over 700 showed
up and was excited. The next year the Speaker Bio’s................................... 8
conference moved to Orlando, FL and Tuesday summaries by time............ 10
attendance continued to grow. The
following year it was held where it all began, Memphis, TN with an Wednesday summaries by time ..... 24
attendance of over 1100! Thursday summaries by time . ........ 42
It became very clear that there was a need for a CIT conference Poster Presentations........................ 43
where people could exchange ideas, new friends could be made,

and old acquaintances rekindled. Not to mention the great
presentations that cover the entire gamut of CIT from those wanting
to know more about it, to those wanting to improve their current
program and everything and anything in-between. In 2008 Atlanta,
Georgia hosted this event and a great time was had by all.

This year San Antonio, Texas has stepped up to the plate and has
been working very hard to make this conference even better. There
are even more presentations, opportunities to network, and how can
you possibly beat being right on the Riverwalk in the spring! I would
Blogs............................................. 44
Reprints......................................... 45
Police 3x5 Crisis Intervention .
Quick Referral Cards...................... 49
Save the Date - Virginia Beach ...... 55
Hotel Map..................................... 56
Conference Committee................... 58
Conference Exhibitors..................... 58
like to thank the very hard working individuals who so graciously
Conference Sponsors...................... 59
volunteered to host this year’s convention.
Notes Pages.................................. 60
The Board of Directors of CIT International is all unpaid volunteers
who give freely of their time and expertise to make this relatively
new organization grow and meet your needs. After all, CIT – It’s
more than just training! It’s forming strong partnerships within the
community and together having a lasting PROGRAM!

On the CIT International Executive Committee are Sam Cochran &

Randy Dupont-Co-Chairs, Michele Saunders (Florida) Vice President,
Joe Mucenski (Arizona) 2nd Vice President, Victoria Huber-Cochran
(Virginia) Secretary, and Jim Dailey (Kentucky) Treasurer. General
Board members include Suzanne Andriukaitis, Jeff Murphy and Crisis Intervention Team
William Lange (Chicago), Ron Bruno (Utah), Brad Cobb (Tennessee),
Nora Lott-Haynes (Georgia), Donald Turnbaugh and Jeffrey Lefton
(Florida), Mark Munetz (Ohio); Nick Margiotta (Arizona); Thomas www.citinternational.org
Kirchberg (Tennessee); and Thomas Garrity (New Jersey).

Welcome to San Antonio, and I hope you have a great time!

Michael S. Woody
President – CIT International

First Annual
CIT International Conference 1
Greetings from the welcome from the City
Bexar County Sheriff’s of San Antonio Police
Office Department
On behalf of the Bexar It is a pleasure to welcome
County Sheriff’s Office, we you to San Antonio, Texas,
are proud and humbled to for the First Annual CIT
have been selected as the International Conference..
City to host the 2010 CIT We are honored and excited
International Conference. that you have chosen to
The City of San Antonio and attend this annual training
Bexar County have been conference.
leaders in this initiative and
we are anxious to showcase San Antonio is still known
our endeavors. All of the for its friendly small town
conference planners have atmosphere where the
Alamo and four other historic missions are located a

been working hard to ensure that your stay in
our fair city will be pleasant and enjoyable. The short distance from the beautiful downtown Riverwalk.
conference agenda guarantees that every attendee will But as the sixth largest city in the nation, it offers such
receive the latest information on crisis intervention; the amenities as theatres, museums, large shopping malls,
elite speakers selected for this event will share their Six Flags Fiesta Texas and Seaworld theme parks, and
knowledge and experience to support you in carrying many other major attractions.
out your mission.
I hope each of you has a rewarding, educational,
During your leisure time, please enjoy the sights in enjoyable experience in and out of the seminar. It is our
this beautiful and historical city, the attractions are pleasure to serve you during your stay.
many and varied which makes San Antonio the ideal
On behalf of all the members of the San Antonio Police
location for a vacation getaway. Event planners will
Department, “Bienvenidos!”
be available to answer any questions that you may
have, as well as give you directions and information Sincerely,
on places to see and visit.
William P. McManus
A special thanks to the men and women that work with Chief of Police
our special needs population on a daily basis; they
deserve special recognition. Have a great time during
the conference and thanks again for allowing us to be
your host. Deputies will be on hand throughout the
conference to assist you.


Amadeo Ortiz, Sheriff

Bexar County Sheriff’s Office

2 2010—San Antonio, Texas

Dear Conference Bienvenidos! Welcome
Attendees to San Antonio!
On behalf of our fellow The National Center is
members of the Board of thrilled to host the First
Trustees we wish to extend Annual CIT International
to each and everyone of you Conference in beautiful San
a warm welcome to the First Antonio. It is our privilege
Annual CIT International to assist in bringing together
Conference. such an incredible group of
innovators and dedicated
Your attendance professionals. Our hope is
demonstrates your passion that your experience here
and commitment to learning is uniquely productive and
and innovation. We enjoyable.
commend you for your service and contributions to
your community. Our passion and mission is to participate in the

promotion of public policy, leadership development,
The Center for Health Care Services Board of Trustees skills training and community education. With great
wishes to acknowledge the tremendously positive joy we note that this conference reflects a strong
outcomes which have resulted from Crisis Intervention commitment to community transformation and a direct
Teams all across the Country and in other nations of contribution from all of you.
the world.
I want to thank, the sponsors, exhibitors, and the
The advances in community policing continue to presenters for taking time out of your busy lives to
improve the quality-of-life for the many we serve. The participate in this landmark event!
first CIT conference in Ohio laid the groundwork for
the many contributions which would follow in the Participation in this conference is key for our involvement
subsequent CIT conferences in Florida, Tennessee and in helping persons with mental illness. These efforts are
Georgia. vital in establishing community initiatives to better serve
this diverse population.
As we add Texas to the conference site list, we still
believe Texas is its own country, so it is only fitting that A special thanks to the Conference Steering Committee
the first international CIT conference be hosted here (a in San Antonio which has brought fellow committed
little Texas humor). partners here at this conference to produce the
many opportunities for the development of models
It is our hope that you’ll take full advantage of the multiple establishing accessible community services based on
learning opportunities and of the many contributions best practices.
made by the over 130 presenters gathered here today.
Please let one of us from The National Center know
Enjoy the Conference, enjoy San Antonio, and enjoy if we can do anything to make your time at the
the Riverwalk! conference better.
Sincerely, Sincerely,
Margaret M. Vera Rudy Arredondo
Chairman Chairman of the Board of Directors
The Center For Health Care Services The National Center for Behavioral Health Solutions

First Annual CIT International Conference 3

Dear Participants,
Dear Participants

It is my pleasure to welcome you the the

First Annual CIT International Conference
here in San Antonio, just walking distance
from the cradle of Texas Liberty, the Alamo.
This year's conference has drawn
attendance from leading law enforcement,
mental health and advocacy organizations
from all over the Nation and now, the world.
Speakers representing industry, government
policy makers, as well as academic scholars
and researchers from the criminal justice,

mental health, substance abuse, and health
practitioners will present and discuss the latest topics in crisis
intervention training focusing on strategies, experiences and
techniques with regards to community policing, excellence in service
delivery and effective best practices.
This three day conference is an excellent opportunity for you to meet
with members from all over the world, share your approach with
Crisis Intervention Teams throughout the Nation and create an
opportunity for networking, collaboration, sharing of technical
information and the building of trust relationships internationally. As
always, we extend a warm welcome to all our colleagues in service
who share our interest in improving public safety and maximizing
compassionate care for persons we serve.

I am looking forward to meeting and hearing from you during what

promises to be a most stimulating and enjoyable event!
Enjoy San Antonio !!!
Leon Evans,
President and Chief Executive Officer
The Center for Health Care Services
Bexar County Mental Health and Substance Abuse Authority

4 2010—San Antonio, Texas

CIT International Statement of Purpose
CIT International is a non-profit membership organization whose primary purpose is to facilitate understanding, development
and implementation of Crisis Intervention Team CIT training programs throughout the U.S. and in other nations worldwide in
order to promote and support collaborative efforts to create and sustain more effective interactions among law enforcement,
mental health care providers, individuals with mental illness, their families and communities and reduce stigma of mental ill-
ness. CIT International works to accomplish this purpose by raising public and stakeholder awareness through education and
outreach, establishing and disseminating recommended standards for developing, implementing and sustaining crisis interven-
tion programs, providing assistance to communities interested in developing CIT programs, supporting research and evaluation
of CIT programs and partnering with CIT programs in various localities to hold annual National CIT Conferences.

CIT International
Board of Directors

FRONT ROW: Left to right: Michele Saunders (Florida) Vice President; Michael Woody (Ohio) President; Nora Lott-
Haynes (Georgia) Member; Donald Turnbaugh (Florida) Member

BACK ROW: Left to right: Ron Bruno (Utah) Member; Randy Dupont (Tennessee) Co-Chairman; Williams Lange
(Illinois) Member; Jeffrey Murphy (Illinois) Member; James Dailey (Kentucky) Treasurer; Joseph Mucenski (Arizona)
2nd Vice President; Sam Cochran (Tennessee) Co-Chairman; Vernan Keenan (Georgia) former Member.

First Annual CIT International Conference 5

Social Media Links
Connect Worldwide

All can be accessed via the Conference Website at

www.chcsbc.org/cit or directly at the listed site:

be sure to use #citinfo hashmark in every tweet



or just Google CIT International Conference 2010 Facebook



6 2010—San Antonio, Texas

Program at a Glance
Tuesday Wednesday Thursday
5/31/2010 6/1/2010 6/2/2010 6/3/2010

6:00 AM 6:00 AM 6:00 AM

Morning Walk Morning Walk Morning Walk

7:00 AM - 9:00 PM 7:00 AM - 9:00 PM 7:00 AM - 9:00 PM 7:00 AM - 9:00 PM

Central Operations Central Operations Central Operations Central Operations

1:00 PM - 4:30 PM 7:00 AM - 5:00 PM 7:00 AM - 5:00 PM 7:00 AM - 8:00 AM

Registrations Registrations Registrations Continental Breakfast

1:00 PM 7:00 AM - 8:00 AM 7:00 AM - 8:00 AM 8:30 AM - 10:00 AM

Early Registration Opens Continental Breakfast Continental Breakfast Closing Session

4:30 PM 8:30 AM - 10:00 AM 8:00 AM - 9:30 AM 10:00 AM

Registration Closes Opening Ceremony Workshop Session Adjournment

9:00 PM 10:00 AM 9:30 AM 10:30 AM - 12:00 PM

Central Operations Closed Break Break Tours: CC/Restoration

10:30 AM - 12:00 PM 10:00 AM - 11:30 PM 12:00 PM - 7:00 PM

Workshop Session Workshop Session MH First Aid Training
class pre-registration
12:00 PM - 1:30 PM 11:45 AM - 1:45 PM
Lunch Awards Luncheon

1:30 PM - 3:00 PM 2:00 PM -3:30 PM

Workshop Session Workshop Session Friday

3:00 PM - 3:30 PM 3:30 PM - 4:00 PM 8:00 AM - 3:00 PM

Break Break MH First Aid Training

3:30 PM - 5:00 PM 4:00 PM - 5:30 PM

Workshop Session Workshop Session

5:30 PM - 7:30 PM 6:00 PM - 7:30 PM

Networking Reception CIT International Board
Pete Earley Meeting
Grand Ballroom

First Annual CIT International Conference 7

Eric Holder
Eric Holder
U.S. Attorney General
U.S. Attorney General

Eric Himpton Holder, Jr. is the 82nd and current Attorney General of the United States and
the Himpton Holder,
African Jr. istothe
American 82nd
hold and current
a position, Attorney
serving underGeneral of Barack
president the United States and
the first African American to hold a position, serving under president Barack
Holder previously served as a judge of the Superior Court of the District of Columbia, Obama.
Holder States
United previously served
Attorney, as a judge
Deputy of the
Attorney Superior
General Court
of the of the
United District
States andofworked
at the
law firm of Covington & Burling in Washington, D.C. He was senior legal advisor toat
United States Attorney, Deputy Attorney General of the United States and worked the
law firm of Covington & Burling in Washington, D.C. He was senior legal
Senator Barack Obama during Obama’s presidential campaign and one of three members advisor to then
of Obama’s Barack Obama during
vice-presidential Obama’s
selection presidential campaign and one of three members
of Obama’s vice-presidential selection committee.

Steve Leifman
Steve Leifman

Special Advisor on Criminal Justice and Mental Health for the Supreme Court of Florida
Special Advisor on Criminal Justice and Mental Health for the Supreme Court of Florida
Since serving as Special Advisor, Judge Leifman has been responsible for chairing the
Since serving
Court’s Mental as Special
Health Advisor, Judge
Subcommittee Leifman
which hasa been
authored responsible for
ground-breaking chairing
report the
Court’s Mental
Transforming Health Mental
Florida’s Subcommittee which authored
Health System. a ground-breaking
In this report Judge Leifman report entitled,
Transforming Florida’s Mental Health System. In this report Judge Leifman recommends
the redesigning of services, systems and financial strategies by increasing access to com-
the redesigning
prehensive of services, systems
and cost-efficient community andbased
financial strategies by increasing access to com-
prehensive and cost-efficient community based services.
Judge Leifman also is responsible for creating the Eleventh Judicial Circuit Criminal Mental
Judge Project
Health Leifmanconsisting
also is responsible
of both preforand
creating the Eleventh
post-arrest diversionJudicial Circuit Criminal Mental
Health Project consisting of both pre and post-arrest diversion programs.

8 2010—San Antonio, Texas

Pete Earley

In a Washingtonian Magazine cover story entitled, Top Journalists: Washington's Media

In a Washingtonian
Elite, Pete Earley was Magazine
described cover story
as one of entitled,
a handfulTop Journalists:inWashington's
of journalists America who Media "have
the power to introduce new ideas and give them currency." A formerAmerica
Elite, Pete Earley was described as one of a handful of journalists in reporterwho "have
for The
the power to introduce new ideas and give them currency." A former reporter
Washington Post, he is the author of nine nonfiction books and three novels. His book, for The
CRAZY: Post, he
A Father's is theThrough
Search author of nine nonfiction
America's Mental books
Healthand three novels.
Madness, tells two His book, It
CRAZY: A his
describes Father's Search
attempts Through
to help America's
his college age Mental Health
son, Mike, Madness,
after he becomestells ill
two stories.
with It
describes his attempts to help his college age son, Mike, after he becomes
disorder and is arrested. It also describes a year that Earley spent at the Miami Dade ill with bipolar
County and is arrested.
where It also
he followed describes
persons witha mental
year that Earley spent
disorders, at the
who had Miami
been Dade
in jail, out
into the Jail where hetofollowed
community see what persons
sort of with mental
services theydisorders,
received.whoHis had
was in jail,
one of out
into the for
finalists community to see
the Pulitzer what
Prize sort of
in 2007 andservices they
has won received.
awards from His bookHealth
Mental was one of twoand
the for the
American Pulitzer Prize
Psychiatric in 2007 and has won awards from Mental Health America and
the American Psychiatric Association

Frederick J.Frese

Dr. Frederick J. Frese is a psychologist who served for fifteen years as Director of Psychol-
Dr. Frederick
ogy at WesternJ. Reserve
Frese is a psychologist
Psychiatric who served
Hospital, one offor fifteen
Ohio's yearspsychiatric
largest as Directorhospitals.
of Psychol-
is also Coordinator of the Summit County Ohio Recovery Project. Thirty-five years ago, He
ogy at Western Reserve Psychiatric Hospital, one of Ohio's largest psychiatric hospitals.
is alsoa Coordinator
while young Marine of Corps
the Summit
officer,County Ohio
Fred was Recoverywith
diagnosed Project. Thirty-five and
schizophrenia, years ago,
over the
next a young
years Marine
was in Corps
and outofficer, Fred hospitals,
of mental was diagnosed
often with schizophrenia,
on secure and over
wards. Despite his the
next ten
ability, heyears wasa in
earned and out
degree of mental hospitals,
in International Businessoften on securefrom
Management wards.
theDespite his dis-
ability, heSchool
Graduate earnedofa International
degree in International
Management Business Management
in Phoenix, as well asfrom the American
Masters and Doctoral
Graduate School of International Management
degrees in psychology from Ohio University. in Phoenix, as well as Masters and Doctoral
degrees in psychology from Ohio University.

First Annual CIT International Conference 9

Tuesday Agenda

Tuesday Agenda
Tuesday 10:30 a.m. – 12:00 p.m. RM J Tuesday 10:30 a.m. – 12:00 p.m. RM K
Behavioral Health Indicators Project An Integrative Treatment Model for Mentally
Ill and Drug Abusing Offenders Re-entering
Presenters: Susan Stone, JD, MD, Executive Coordinator the Community
Mayor’s Mental Health Task Force Monitoring
Committee; James Van Norman, MD, Medical Director, Presenters: Chad Graff, Ph.D., LMFT, LPC, Sr. Director,
Austin-Travis County Integral Care; Abraham Minjarez, Southwest Institute for Addictive Diseases, Department of
LCSW, Criminal Justice Coordinator, Austin-Travis County Psychiatry, Texas Tech University Health Science Center;
Integral Care, Austin, Texas Rudy Arredondo, Ed.D., LPC, Board Chair National
Center for Behavioral Health Solutions; Greg Cruz,
In 2004, an African American woman with serious M.S., Sr. USPO, U.S. Probation and Pretrial Services,
mental illness was killed by a law enforcement officer Texas Northern District
in Austin, Texas. While the initial response was to
focus on law enforcement errors, the community took a This panel of experts will provide participants with an
broader look at the challenges faced by individuals with overview of an “integrated and collaborative” treatment
serious and persistent mental illness across a number model for adult Federal offenders at high risk for mental
of focus areas, including justice system involvement. illness and substance abuse re-entering the community.
The Mayor’s Mental Health Task Force Monitoring During the reality-based workshop, we will examine
Committee is a broad based collaborative that has the following topics: 1) service system philosophies
worked since May of 2005 to answer this question: and intervention goals; 2) barriers and resolutions to
“How will we know if we are making progress?” In effective integration; and 3) collaborations involving
response, we have arrived at a set of behavioral the criminal justice system and mental health/substance
health community indicators that have been nationally abuse systems to better serve the offenders and their
recognized. The next step in our work is how to use families.
these indicators to effectuate system change. This
presentation will outline our approach to decrease the
number of individuals with serious mental illness in our
county jail, using Results Based Accountability and the Tuesday 10:30 a.m. – 12:00 p.m. RM K
Bazelon Center for Mental Health Law Performance
Community Mental Health SAMHSA
Improvement Initiative.
– The National Perspective

Presenter: Neal Brown, MPA Chief, Community Support

Prgrams Branch SAMHSA-Center Mental Health Services

My presentation will trace care for individuals

with serious mental illnesses from institutions to the
community. It will include reflections on the movement
from deinstitutionalization to community mental health,
and on to community support, and then to managed
care. I will discuss the need for integration among
the mental health, substance abuse, primary care,
and justice systems. Information will also be provided
about SAMHSA programs focused on transforming
systems, integrating care, and diverting individuals with
serious behavioral health problems from the criminal
justice system into community care and rehabilitation

10 2010—San Antonio, Texas

Tuesday Agenda

programs. Finally, I will reflect on the report of the Tuesday 10:30 a.m. – 12:00 p.m. RM 1&2
National Leadership Forum on Behavioral Health/
Criminal Justice Services, “A Call to Action” and where CIT Leadership – Top Down for Success
we need to go from here.
Presenters: Major Sam Cochran, (ret.), MS, BS,
University of Memphis, Instructor, University of Memphis
CIT Center, Memphis, TN. Dr. Randolph Dupont,
Tuesday 10:30 a.m. – 12:00 p.m. RM L Ph.D. Professor, Clinical Psychologist and Chairman
of Department of Criminology and Criminal Justice
Psychological Effects on War Veterans and CIT Lead Instructor, The University of Memphis:
Memphis, TN., Chief Tom Garrity, MA, BA,. Camden
Presenter: Thomas von Hemert, BS-Business County Prosecutor’s Office: Camden, New Jersey,
Administration, CIT Coordinator, Thomas Jefferson Area Elaine Deck, Program Manager, BA, International
CIT Association of Chiefs of Police: Arlington, Virginia Ron

Honberg, JD, MA, NAMI Director of Policy and Legal
As the war in Iraq and Afghanistan continues, the
Affairs: Arlington, Virginia, Major Sam Cochran, MS,
measures of its psychological toll are coming in. A
BS, (retired). Department of Criminology and Criminal
medical study estimates that more than one in seven
Justice and CIT Instructor, The University of Memphis CIT
returning veterans are expected to suffer from major
Center, CIT Instructor: Memphis, TN.
depression, anxiety, or Post Traumatic Stress Disorder
(PTSD). For those who have survived the fighting, the The Crisis Intervention Team (CIT) program continues
battle is not over. For some, the return home can be to be an innovative national model of police-based
as painful as war itself. PBS FRONTLINE (60 minute crisis intervention and pre-jail diversion. Communities
video) tells the stories of soldiers who have come home of varying sizes have implemented CIT with positive
haunted by their experiences and asks whether the results. However, the implementation process can
government is doing enough to help. This workshop be time consuming. The panel will discuss factors
will demonstrate the horrific stigma of mental illness in leading to shortened implementation timeframes as
our society. Materials and information will be provided well as barriers that cause delays. One factor that is

to duplicate this class for your use for CIT Trainings. sometimes overlooked is the importance of effective

Communities suffering from a lack of effective leadership

Tuesday 10:30 a.m. – 12:00 p.m. RM M often fail to nurture partnerships and, are likely to
experience difficulty in realizing a successful program.
Training Ideas for Instructing CIT for
This panel discussion will provide a framework for
Dispatchers and Medics
engaging those in positions of leadership in order
Presenter: Sgt. Michael Yohe, BS, MA, Akron Police to implement and sustain a viable community CIT
Department program.

Although they play a crucial role in the success,

several CIT programs under develop the importance
of dispatchers and EMS providers. This presentation Tuesday 10:30 a.m. – 12:00 p.m. RM 3 & 4
will help develop stand alone instructional strategies
Crisis Intervention Teams for Youth- Training
for both safety communications centers and medics.
Law Enforcement to Respond to Youth with
Curriculum suggestions focus on improving connections
Mental Health Needs
with law enforcement’s safety, mission and culture. CIT
contacts many times begin with a call into dispatch Presenters: Kathleen Skowyra, BA, Director, Models for
centers and end with a hand-off or review from medical Change Mental Health Juvenile Justice Action Network;
staff and yet many times gaps exist that do not allow Don Kamin, Ph.D., Chief, Clinical and Forensic Services,
a smooth transition between different first responders. Monroe County Office of Mental Health; Sandra Sayre,
Numerous challenges exist in having the CIT work BA., Manager, Division of Criminal Justice, Colorado
hand-in-hand with support units and thus create a need Regional Community Policing Institute, New York, New
for substantial training and collaboration. York

The majority of specialized police mental health

training programs developed in this country focus on

First Annual CIT International Conference 11

Tuesday Agenda

training police to respond to adults. Recognizing this Tuesday 10:30 a.m. – 12:00 p.m. RM 8
gap, the Models for Change Mental Health Juvenile
Justice Action Network, working with support from the Using the Right Language when Enlisting
John D. and Catherine T. MacArthur Foundation and Help from Law Enforcement
in conjunction with the Colorado Regional Community
Presenter: Jeanie Paradise, LPC, Center for Health Care
Policing Institute, developed Crisis Intervention Teams
Services, San Antonio, Texas
for Youth (CIT-Y), a youth-focused supplemental training
for CIT trained officers that provides critical information This session is designed to help facilitate the mental
on adolescent development, mental health disorders health professionals interaction with police. Come
and response techniques appropriate for youth. and see role plays and practice for yourself how using
This workshop will provide an overview of the key the right language can better your outcomes with law
components of the CIT-Youth curriculum and highlight enforcement. Through the art of negotiation, put the
the experiences of one Action Network state to use focus back on the consumer and having the consumer’s
the training curriculum to expand their existing CIT needs met rather than allowing professional egos take
program. over. It’s all out in the open now, no holding back!
Presenters will also share information on how to access
the training curriculum, as well as discuss developing
efforts to expand the training curriculum into a 24 hour Tuesday 10:30 a.m. – 12:00 p.m. RM 8
San Antonio CIT

Presenter: Sgt. Romana Lopez, B.A., San Antonio Police

Tuesday 10:30 a.m. – 12:00 p.m. RM 7 Department, CIT Coordinator

Integration of Crisis Care Services Learn about CIT San Antonio style including curriculum,
class structure, how to choose guest instructors and the
Presenter: Debra S. Dillon, MA, RN-BC, Deputy importance of evaluating each class for improvement.
Director, Transitional Services, Memphis, Tennessee We’ll discuss keeping your CIT class involved and
invested in the learning process for the full 40 hours
Adult crisis services in Memphis and Shelby County
with special attention to active role play. The session
Tennessee underwent a complete redesign and
will also cover pitfalls to look out for and how to avoid
integration in 2009. The reorganized system provides
missed opportunities to learn about mental illness. You
a full continuum of integrated crisis services consisting
will receive our curriculum itinerary, a copy of our
of a Crisis Assessment Center (walk-in and mobile
resource cards and other helpful hints!
crisis services), Police Diversion Unit (social detox
services), Crisis Respite, Crisis Stabilization Unit, and
Peer Support all housed at a single location. The
program offers services to assess, stabilize and direct Tuesday 10:30 a.m. – 12:00 p.m. RM 11
individuals to the most appropriate and least restrictive
level of care; provides a single point of entry for law Cognitive Behavioral Therapy for Psychosis:
enforcement officers to access mental health and Basic Tenets and Skills for Interacting with
substance abuse services for individuals; improves Individuals Experiencing Psychotic Symptoms
access to the full continuum of care; and decreases
fragmentation and duplication of services. Following Presenters: Dawn I. Velligan, Ph.D., Professor/Director,
integration and redesign, the number of individuals Division of Schizophrenia and Related Disorders,
served doubled and the diversion rate increased from Department of Psychiatry, University of Texas Health
10%-15% previously to 59%-60% currently. Feedback Science Center, San Antonio; Meredith L. Draper,
from consumers, referral systems, families, advocacy Ph.D., Postdoctoral Fellow/Licensed Psychologist,
groups and funding agencies has been overwhelmingly Department of Psychiatry, University of Texas Health
positive. Science Center, San Antonio, Texas

A recent report from the Council of State Governments

Justice Center indicated that individuals diagnosed
with a serious mental illness (SMI) were three to six
times more likely to be incarcerated in local jails than
members of the general population. SMI includes the

12 2010—San Antonio, Texas

Tuesday Agenda

diagnoses of bipolar disorder, treatment refractory Tuesday 10:30 a.m. – 12:00 p.m. RM 13 & 14
depression and schizophrenia. Schizophrenia is a
complex disorder that includes an array of symptoms It All Begins at the Jail
such as; cognitive deficits, negative symptoms and
Presenters: Denise Curiel, Criminal Justice Liaison,
psychosis (hallucinations and delusions). Cognitive
Adult Services/CPSA; Diana Carino, Criminal Justice
Behavioral Therapy for Psychosis (CBTp) focuses on
Assistant, CPSA, Tucson, Arizona
helping individuals to develop alternative explanations
for the symptoms of their illness and to reduce the impact The Community Partnership of Southern Arizona (CPSA)
of these symptoms on their behavior. This workshop has developed a comprehensive model of care that
provides an overview of schizophrenia and psychotic starts at the time of arrest and moves though the justice
symptoms, and will focus on basic skills informed by system and ends with the member developing a plan
CBTp, that may be employed by members of law for recovery.
enforcement or community groups when interacting
with individuals experiencing psychotic symptoms. Community Partnership of Southern Arizona (CPSA) is

the first responder for its members who are arrested
and detained in the Pima County Adult Detention
Center. CPSA’s role at Pima County Detention Center
Tuesday 10:30 a.m. – 12:00 p.m. RM 12 is to ensure coordination of care is being provided to
our members. The process starts by getting release
Mobile Crisis Intervention: The Toronto
of information so that collaboration efforts can begin
between the member, jail staff, jail medical staff,
Presenters: David Gotlib, M.D., FRCPC, Medical treatment providers, peer support, law enforcement and
Director of the Emergency Psychiatry Team, Community the courts.
Mental Health Services and Mobile Crisis Intervention,
This model offers a number of points of engagement for
St. Joseph’s Health Centre, Toronto, Ontario, Canada.
members, supports community safety efforts, reduces
Michael Zawerbny, Police Constable, Toronto Police
the numbers of days a member is in custody, expedites
Service. Conny Stefan, RN, Mobile Crisis Intervention
case processing, reduce recidivism and relieves jail
overcrowding. This model will also show what Mental
The presentation will discuss the operation of a Mobile Health Diversion programs have to offer our members
Crisis Intervention Team within a large Canadian urban with a co-occurring disorders and family members.
environment. The team is comprised of dedicated
police officers, psychiatric nurses and is supported
and managed by a base hospital with a psychiatric
Tuesday 10:30 a.m. – 12:00 p.m. RM 13 & 14
medical director who oversees and directs patient
care. The perspectives of all three team members A Diversionary Program for People with
will be presented and discussed as it relates to their Psychiatric Disabilities
experiences in the field. Topics of discussion will
include team operation and function, experiences Presenter: Brian Coco, BS, Chief Probation Officer,
in developing a collaborative model, internal and Judicial/Adult Probation
external challenges faced by police, the influence of
the Canadian health care system on the functioning of The presentation will provide an overview of the
the MCIT, attempts to use new computer technologies, specialized supervision initiatives within Court Support
practical strategies for dealing with challenging clients Service’s Adult Probation Department in CT with a
whose needs extend across many service systems, and special focus on the development and implementation
what works, what doesn’t. of a diversionary program specifically geared for
clients with psychiatric disabilities.

First Annual CIT International Conference 13

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Tuesday 10:30 a.m. – 12:00 p.m. RM 15 address this barrier and maximize limited resources,
the Eleventh Judicial Criminal Mental Health Project
CIT Program Calls for Assistance: Two Year (CMHP) in Miami-Dade County developed an
Outcomes innovative plan to improve the ability to transition
individuals from the criminal justice system to the
Presenter: Sabrina W. Tyuse, Ph.D., Associate
community. Toward this goal, all participants in the
Professor, School of Social Work, Saint Louis University
program who are eligible to apply for Social Security
The St. Louis County Police Department, in cooperation entitlements are provided with assistance utilizing a
with the National Alliance for the Mentally Ill (NAMI) in best practice model referred to as SOAR (SSI/SSDI,
St. Louis, Missouri, and several mental health treatment Outreach, Access and Recovery).
agencies, developed a crisis intervention team (CIT)
training program the goal being incarceration reduction
among the mentally ill. A critical assessment is
TUESDAY 1:30 p.m. – 3:00 p.m. RM J
necessary to determine the effectiveness of CIT program
interventions; this presentation will address CIT calls for Outpatient Commitment Law: The Missing
assistance during the first two years of the Program. The Piece for Crisis Intervention
presentation will provide information on the number
and types of CIT calls, who was diverted for evaluation Presenter: Daniel Garza, MD
and why, and which individuals were hospitalized for
mental health treatment. Inpatient psychiatry’s “revolving door” often has as
its welcome mat a crisis intervention referral. Crisis
teams are often the first witnesses to the unraveling of
outpatient treatment adherence. Mentally ill individuals
Tuesday 10:30 a.m. – 12:00 p.m. RM 16 with dangerous symptoms often make headlines
throughout the country and shine an unflattering light
Cross-System Collaboration Promotes Access on regional mental health systems. This increases
to Health Care in Miami-Dade County, referrals to crisis teams as providers reflexively make
Florida more referrals.
Presenters: Cindy A. Schwartz, MS, MBA, Project As state after state incorporates outpatient commitment
Director, Eleventh Judicial Criminal Mental Health Project; legislation, crisis teams should familiarize themselves
Alejandro Aristizabal, MBA, Felony Jail Diversion Team with these reforms. Assisted Outpatient Treatment
Leader, Eleventh Judicial Criminal Mental Health Project; Program is an ideal example of such an adjustment
Florida to the New York State mental health system that has
helped thousands of mentally ill clients enhance their
To improve access to medical and psychiatric care,
compliance, and lower negative consequences while
the Eleventh Judicial Criminal Mental Health Project
living in the community, now 10 years after its inception.
(CMHP) of Miami-Dade County, Florida developed
Crisis teams are key stakeholders in promoting such
a collaboration with the Public Health Trust/ Jackson
changes in their communities and ensuring they are
Health System (PHT/JHS) to assist individuals with
properly designed and correctly implemented.
mental illnesses and co-occurring substance use
disorders to transition from the criminal justice system
to the community. The collaboration has ensured that
program participants have immediate admission to Tuesday 1:30 p.m. – 3:00 p.m. RM K
treatment, medication, support services and housing
upon release from jail. The Road to the Houston Police Department’s
Crisis Intervention Response Team (CIRT)
Stakeholders in the criminal justice and behavioral
health communities consistently identify lack of access Presenters: Rebecca Skillern, MA, LPC-S, Police
to public entitlement benefits such as Supplemental Officer/Investigator, Mental Health Unit, Houston Police
Security Income (SSI), Social Security Disability Department; Eric Chimney, Senior Police Officer,
Insurance (SSDI), and Medicaid as among the Houston Police Department; Mike Erickson, MA,
most significant and persistent barriers to successful Clinician/Licensed Mental Health Practitioner, Mental
community re-integration and recovery for individuals Health Mental Retardation Authority, Houston, Texas
who experience serious mental illnesses and
co-occurring substance use disorders. In order to The Houston Police Department’s Mental Health Unit,
along with the Mental Health Mental Retardation

14 2010—San Antonio, Texas

Tuesday Agenda

Authority (MHMRA), has developed a program, the include recommendations for training police officers,
Crisis Intervention Response Team (CIRT), that pairs psychiatric emergency room and emergency room staff
a uniformed police officer with a Licensed Mental on how to recognize and treat this condition.
Health Professional for responding to more serious calls
involving citizens in mental health crises. This model of
policing allows for a collaborative approach to dealing
with citizens in mental health crises. Tuesday 1:30 p.m. – 3:00 p.m. RM M
Advanced CIT Class Focusing on Children and
Adolescent Mental Health Issues
Tuesday 1:30 p.m. – 3:00 p.m. RM K
Presenters: Sgt. Michael R. Peterson (Ret), MA LAMFT.
Premise Histories, Mental Health Referrals Jane Marie Sulzle, RN, CNS, MS, Clinical Nurse
and a Working Relationship between CIT Specialist at PrairieCare; Sgt. Steve Wickelgren, MA,

and the Mental Health Department MFT, Minneapolis Police Department

Presenters: Priscilla Rayon, Police Officer, Houston After listening to the requests of our CIT officers who
Police Department, Mental Health Unit; Evelyn Locklin, work closely with children and adolescents with mental
MCOT Supervisor, HMRA; Houston, Texas health issues, the MN CIT Officers Association in
collaboration with PrairieCare, a provider of health
This workshop will discuss the importance of Premise care services to children, adolescents and their families,
Histories and Referrals to the Harris County Mental have developed an advanced CIT course. This 3 day
Health Department, Mobile Crisis Outreach Team. class is for SRO’s, juvenile corrections staff, and any
Premise History is used to flag a location and (or) other CIT officer who wants to expand their knowledge
person to advise officers of previous activity at the and expertise in CIT. The expanded curriculum will
location or with the person. MCOT Referrals are from include a closer look at how mental illness looks very
the Houston Police Department to the Outreach Team different in children as in adults. Officers will gain a
to give them information of a consumer in possible greater understanding of parental perspectives, and
need of services. The workshop will also discuss how how family systems and environmental forces can affect
having a working relationship between the Houston a child’s behavior. This will be a dynamic learning
Police Department and the Harris County Mental experience featuring actors with specifically designed
Health Department, has helped both agencies better scenarios that reflect the unique emotional situations
serve the community. that often arise when working with youth.

Tuesday 1:30 p.m. – 3:00 p.m. RM L Tuesday 1:30 p.m. – 3:00 p.m. RM 1 & 2
Excited Delirium: What is it? U.S. Department of Veterans Affairs
Engagement with CIT
Presenters: Erik Lindgren, BA, Police Training Officer,
Riverside Police Department; Corey Braxton, LVN, CIT Presenters: Ira R. Katz, MD, PhD, Deputy Chief Patient
Trainer, Riverside County Regional Medical Center – Care Services for Mental Health, U.S. Department of
Department of Psychiatry; Deborah Johnson, LCSW, Veterans Affairs; Thomas M. Kirchberg, PhD, ABPP,
Assistant Hospital Administrator Chief Psychologist, VA Medical Center Memphis, U.S.
Department of Veterans Affairs; Trent Pettis, Course
Excited delirium is a controversial term currently used Manager, VA Law Enforcement Training Center, U.S.
by law enforcement to explain unexpected in-custody Department of Veterans Affairs
police deaths where the person may be agitated,
exhibiting bizarre behavior with increased physical There have been a number of recent media articles
strength and other medical-psychiatric emergency indicating that veterans returning from deployment in
presentations. This course will provide the student with Iraq and Afghanistan are at risk for contact with the
a basic understanding of the term excited delirium, criminal justice system. In response to the intersection of
presentation of the kind of person that may be mental health issues, substance abuse issues, veterans’
exhibiting excited delirium and interventions to prevent services and the criminal justice system, the United States
possibility of death or serious harm. Use of tasers Department of Veterans Affairs has recently launched
will also be incorporated. The course will also the Veterans Justice Outreach Initiative, which includes

First Annual CIT International Conference 15

Tuesday Agenda

an education effort for law enforcement professionals from a video that was put together by a statewide CIT
focusing on mental health issues among veterans. This committee. Details will be provided on the statewide
workshop will have four components including an committee approach and the achievements- Guidelines
overview of veterans’ mental health and criminal justice to promote quality, Lessons learned, Web site (state
issues, examples of VA and CIT team partnerships, and local examples), sample data sheets, MOUs,
and a national plan to train VA police officers in CIT and fidelity scale. NC has a unique relationship with
concepts. At the end of the workshop, attendees will community colleges as partners – we’ll review the
have a deeper understanding of services available for statute that makes it possible to receive reimbursement
veterans and opportunities for partnership between CIT that sustains the program. We will also cover the new
and VA medical centers. audiences we are reaching – school resource officers,
jail staff, dispatchers, airport security. Finally, we
will mention other improvements stemming directly
from CIT: prison rules reform, statute requiring
Tuesday 1:30 p.m. – 3:00 p.m. RM 3 & 4 communication on arrests between the jail and the
public local management entities.
Keys to the Successful Implementation of a
CIT program

Presenter: Frank Webb, Senior Police Officer, Houston

Tuesday 1:30 p.m. – 3:00 p.m. RM 7
Police Department
CIT Training for Corrections
Key #1: Marketing: For many law enforcement officers,
as soon as the words crisis intervention training are Presenters: Bruce Handler, MH Consultants, Inc., Jeffry
mentioned they automatically think warm and fuzzy Murphy, President of MH Consultants, Inc.; Carl Alaimo,
social work. The program needs to be marketed PsyD, Director of Advance Psych training, Cook County
correctly. Key #2: Level of collaboration. It is important Department of Corrections, Cook County, Illinois
to collaborate with local mental health agencies to
develop and implement the program and to help teach Crisis Intervention Team training (CIT) is widely accepted
the classes. This process should be driven by law as an effective model for law enforcement agencies
enforcement, however. Key #3: Involve the community throughout the country. Correctional institutions, on
in “selling” the program. Unfortunately, many chiefs the other hand, have very different circumstances.
and sheriffs listen to members of the community more Detainees do not leave their behavior and needs at the
than personnel in their agencies. Key #4: Getting the jail door after being arrested. Correction officers need
right person/people to coordinate the program and to similar education and skills to deal with crisis to insure
teach the classes. Key #5: The importance of data. The safety and security within the jail setting. Modified CIT
collection of data is necessary in order to implement training can accomplish those goals.
and run a successful program. Before program and
after program data is optimal.

Tuesday 1:30 p.m. – 3:00 p.m. RM 8

Tuesday 1:30 – 3:00p.m. RM 3 & 4 Detecting Malingering on the Street

CIT the North Carolina Experience Presenter: Felicia Byars, Master’s in Forensic
Psychology, Police Officer, Menlo Park Police
Presenters: Jamie Sales, CIT Coordinator, Mental Health Department; Menlo, California
Partners; Deby Dihoff, Executive Director, NAMI, NC;
Sgt. Bob Cardwell, Moore Co. Sheriff’s Office; Bonnie Have you ever wondered if the person is claiming
Currie, CIT coordinator, Pitt Coordinator; and LaShay to be suicidal for attention or if they really mean it?
Avery, CIT Coordinator, Piedmont Behavioral health. How do you know the mentally ill person stole that
beer because the “voice of God” told them to? What
This session will give a history of how the state verbal or visual cues could you look for? What do
of North Carolina began to improve its outcomes you do next? The purpose of this workshop is to
in diverting people from jail through the goal of develop the skills of the law enforcement responder
statewide implementation of CIT. Much of the effort to detect malingering during initial contacts “on the
was prompted by a UNC CH jail study that highlighted street.” The attendees will be introduced to some
the need for diversion and jail improvements. Various basic principles and skills in determining malingering,
media will be used to tell our story, including clips then broken up into groups to practice the interview

16 2010—San Antonio, Texas

Tuesday Agenda

techniques introduced to them. While practicing, they ingredient to establishing community alternatives or
will have an opportunity to critique themselves and “divert to where” solutions. (133). This workshop will
determine best practice solutions. also address how CIT must be an integral part of a
larger behavioral healthcare diversion system. It will
include state examples of leadership and legislation
and other unique national initiatives. Mr. Engelhardt
Tuesday 1:30 p.m. – 3:00 p.m. RM 11 will provide a step by step planning process, including
key community stakeholders, values, services that are
Persuading Policy Makers: Effective CIT
critical ingredients to designing and implementing
Program Evaluation
acute care systems.
Presenters: Maria Felix-Ortiz, PhD, Professor, Incarnate
Word University, San Antonio, Megan Brodie, University
of the Incarnate Word, San Antonio
Tuesday 1:30 p.m. – 3:00 p.m. RM 12

How can you convince local and state policy makers
Providing Health Care for the Acute Mentally
and stakeholders to support your CIT program? In this
Ill: A Community Response
presentation, the benefits and challenges of collecting
various types of data from the CIT training program, Presenter: David Hnatow, MD, FAAEM, FACEP,
and from the community are discussed, and some basic Emergency Medicine Physician with the Greater San
models for data collection and program evaluation are Antonio Emergency Physicians group, Chair, Community
provided. The benefits of and how you can involve the Medical Director’s Roundtable.
community in setting goals for your CIT program will
be discussed and related to program evaluation, and A group called the Community Medical Directors
educating legislators/policy makers about CIT using Roundtable developed out of initial discussions regarding
old and new technologies. Finally, issues related to emergency detention orders, crisis intervention training,
selecting a program evaluator will be presented. and jail diversion. Recent collaborative efforts by
the major stakeholders (mental health advocates,
emergency department administrators, public health
officials, and law enforcement) in the San Antonio health
Tuesday 1:30 p.m. – 3:00 p.m. RM 11 care community have resulted in improved coordination
of acute psychiatric services. These community leaders
“Divert To Where?” - Cross-Systems
along with the Center for Health Care Services
(CHCS) and University Health System, the two largest
Presenter: Mark Engelhart, MS, MSW, ACSW, faculty providers of mental health services in the Greater
member at the University of South Florida, Department San Antonio area, lead to the development of the
of Mental Health, Law and Policy, and Associate Crisis Care Center. A 24 hour a day comprehensive
Director of Florida’s Criminal Justice, Mental Health and acute mental health clinic located at University Health
Substance Abuse Technical Assistance Center. Clinic Downtown. This type of collaboration remains
one of the few available means for addressing the
This workshop will address a formula for developing deteriorating mental health system.
a range of recovery-oriented crisis and acute care
alternatives in states and communities. It will address
the essential principles; community challenges; public-
private partnerships; concrete goals and objectives,
problem solving approaches and service array that is
necessary to develop alternatives to jail, unnecessary
hospitalizations and support the efforts of CIT Teams.
CIT is not a single service. Integrated community
planning efforts, such as legislative changes, program
expansion and development, subpopulations like
co-occurring disorders and homeless interventions and
emerging consumer best practices will be discussed.
Practical cross-systems planning examples and
collaborations from several states will be featured.
Leadership: from top down and bottom up is a key

First Annual CIT International Conference 17

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Tuesday 1:30 p.m. – 3:00 p.m. RM 13 & 14 profit and faith-based agencies, Haven for Hope seeks
to transform the lives of the homeless by addressing
Buddy Up for Success – The Power of Public/ the root causes of homelessness through education, job
Private Partnerships training and behavioral health services. While most
“shelters” feed, clothe and shelter the homeless, Haven
Presenters: Sgt. Shannon Wichtendahl, Virginia Beach
for Hope and its Partners will provide critical social
Police Department, Mary Witwer, LCSW Virginia
services to help the homeless become self-sufficient
Beach Dept. of Human Services, Emergency Services
individuals on a long-term basis.
Supervisor, PO Steven G. Shunk, VBPD, Jada M. Lee,
Emergency Communications Supervisor, Lt. John Gandy,
VBPD, PO Andrea Bryk, VBPD, Capt. William T. Dean,
VBPD, Debi Evans, Virginia Beach Psychiatric Center, Tuesday 1:30 p.m. – 3:00 p.m. RM 15
Director of Development
CIT Officers and the Psychiatric Evaluation:
In this presentation, VB CIT Police Officers, Human Community Collaboration in a Crisis
Services clinicians, 9-1-1 Supervisor and a VB Psychiatric
Center representative will discuss how we resolved the Presenter: Emily Ribnik, Bachelors in Psychology,
issues of different cultures, use of terminology, and Masters in Counseling, CIT Coordinator & Emergency
myths about each other to a point where communication Mental Health Therapist, Coleman Professional Services
and partnership became a reality for Virginia Beach
Crisis Intervention Team. As a result of this Private/ CIT officers on street patrol play an integral and
Public partnership Virginia Beach Human Rights immeasurable role in emergency psychiatric evaluations
Commission formally recognized CIT Core Faculty for individuals in psychological crisis. Emergency
and CIT Leadership Committee as recipients of the mental health professionals rely on the officer’s for
prestigious Human Rights Commission Award on March acute and concise information so that they can best
18, 2010. Virginia Beach Crisis Intervention Team’s prepare and approach the individual for his/her
story of success represents the collaboration from a evaluation. This presentation pulls back the curtain
multi disciplinary group including the VB Department of of the psychiatric evaluation, and will give officers an
Human Services clinicians, VB Police Department CIT inside view of what mental health professionals due to
Officers, VB Sheriff’s Office deputies, 9-1-1 Dispatchers, assess someone in crisis. Officers will also learn about
Virginia Beach Psychiatric Center, and many state and different options that mental health professions have,
local advocates. Virginia Beach Psychiatric Center is a and what restrictions that exist with the assessment.
private-for-profit free standing psychiatric hospital that Officers will learn how to provide concise and effective
partnered with the City of Virginia Beach by offering reports to mental health professionals and enhance their
ample space in their facility for the transfer of custody observations of “mental health evidence.” Officers will
for evaluations of people with serious mental illnesses additionally understand what a psychiatric evaluation
who are in crisis. This not only prevents inappropriate is, and their important role in this assessment.
incarcerations for misdemeanors, but allows CIT Officers
an opportunity to return to street duty. The result is a
partnership that is unique and serves the needs of
Tuesday 1:30 p.m. – 3:00 p.m. RM 16
several systems.
Recovery Is Possible

Presenter: Gail Tapp, full time staff Advocate Specialist,

Tuesday 1:30 p.m. – 3:00 p.m. RM 13 & 14 County of Los Angeles
Haven for Hope Homeless Campus and As a presenter with my own story coming from years
Diversion Initiatives of incarceration, prison, I talk about the feelings, the
hopelessness I owned for years caught up in a frayed
Presenters: Art Vela, Chief of Life Safety/Security,
system along with stigma and a misdiagnoses. A
Haven for Hope, Dr. Ann Meyers, Director of
supreme court judge ruled that I would never be fit to
Transformation Services
live in society again back in 1979. Today I am a leader
Haven for Hope is a $100 million dollar, 1,000 bed in the workforce a speaker for consumer rights and an
facility aimed at transforming the lives of homeless example, ‘Recovery Is Possible!’
men, women and children in the San Antonio/Bexar
County area. Partnering with 78 governmental, non-

18 2010—San Antonio, Texas

Tuesday Agenda

Tuesday 1:30 p.m. – 3:00 p.m. RM 16 a clinician and will not attempt to offer a diagnosis
for you, but will share ideas and possible insight to
The Need for CIT as viewed by Persons with maintaining your own wellness. Her extensive work in
Mental Illness the field has enhanced officer safety. She is a trainer at
the Indiana Law Enforcement Academy, has trained for
Presenters: John Elizondo, BA, English, Community
the Indiana and Kentucky Departments of Correction,
Relations Specialist, Research & Development; Paul
has consulted on numerous projects and has provided
Eisenhauer, BA, Supervisor, San Antonio State Hospital.
training for local law enforcement agencies and jails.
As people who have been on the opposite side of She has also developed curriculum for those who work
the law during crises, Paul and I will discuss our with people with mental illness in Parole, Probation,
experiences and views when a person with mental Community Corrections, Work Release and others.
illness intersects with law enforcement both before and
after the establishment of Crisis Intervention Teams.

Tuesday 3:30 p.m. – 5:00 p.m. RM L
A Train-the-Trainer Workshop for Teaching
Tuesday 3:30 p.m. – 5:00 p.m. RM J
Military Culture, Mental Health and Law
Presenter: Don Kamin, Ph.D., Chief, Clinical & Forensic
Services, Monroe County Office of Mental Health,
Presenter: Deloria Ramos Wilson, Ph.D. Clinical Rochester, New York.
Research Psychologist, Warrior Resiliency Program-
Designed as a ‘train-the-trainer’ workshop, this session
Training Division
will help participants gain the knowledge and skills
With sustained operations around the world, military necessary to enhance their current teaching. It will
service members of the Active Duty, Guard and Reserve provide ways to demonstrate the importance of using
Components are being asked to do more for longer empathy, explain the benefits of empathy, and articulate
periods of time. The majority of service members a 3-step process of how to use empathy during crisis
and families are resilient, but even the most resilient intervention. Specific examples of structured role-plays
individuals may have difficulty adjusting to life once they will be provided and demonstrated for trainers to
return, which can also pose challenges for the family incorporate into their own trainings. In addition, a semi-
and community. Understanding the unique stressors of structured spontaneous exercise (known as the “Random
service members and their families is essential when Roving Role-Play”) will be used. The “Connect, then
considering responding to crisis situations or working Direct” approach – which emphasizes the importance
with veterans within your agency. This workshop of establishing rapport prior to directing those in crisis,
will discuss military culture and how it is similar and is the cornerstone of this interactive training.
different from mental health and law enforcement,
describe unique stressors of military members and
families including combat stress and PTSD, and finally
Tuesday 3:30 p.m. – 5:00 p.m. RM M
review some collaborative efforts between departments
and agencies to help build an understanding to better Police Surviving Catastrophic Events
meet the needs of the military community.
Presenter: Roberto L. Jimenez MD. FAPA, Clinical
Professor of Psychiatry, University of Texas Health
Science Center at San Antonio
Tuesday 3:30 p.m. – 5:00 p.m. RM K
Today the number of catastrophic events police officers
If I am the Last Resort, Where do I Turn for have to face seems to be growing on a daily basis.
Support? This workshop will define and review the impact of
catastrophic events, exploring potential complications
Presenter: Kellie Meyer, M.A., Criminal Justice Director
and consequences resulting from post traumatic stress
& Development Director, NAMI Indiana
syndrome. This workshop will present an overview
While there is no exact formula for those who work in of psychiatric disorders as they relate to today’s
the human being business to find support for themselves, officer and especially the impact on their spouses,
there are some techniques that are helpful. Kellie is not children and families. The workshop will explore the

First Annual CIT International Conference 19

Tuesday Agenda

interrelationship of survival, mental illness, physical and Tuesday 3:30 p.m. – 5:00 p.m. RM 3
psychic trauma. Cues in everyday routines which may
trigger disproportionate reactions will be explored. From Triage to Treatment: Innovative Crisis
Lastly, treatment approaches and helpful suggestions Care
will be offered in helping our officer’s address potentially
Presenters: David Cozadd, M.Ed., Director of Mental
increasing levels of catastrophic events.
Health Operations for Burke Center; Thomas Kerss,
Sheriff, Nacogdoches County, Texas, Current President
of the Sheriff’s Association of Texas; Anne Bondesen,
Tuesday 3:30 p.m. – 5:00 p.m. RM 1 & 2 Director, Rural East Texas Health Network

Medical Conditions Masquerading as Communities are often challenged to address mental

Psychiatric Illness or Accompanying a health crisis situations. In an environment of limited
Psychiatric Crisis mental health resources, general hospitals and law
enforcement are often the predominant defacto mental
Presenter: Rosario Rodriguez, MD, University of Texas health crisis response system. Twelve counties in
Health Science Center, San Antonio, Texas rural Texas came together to address this very issue.
The result is a mental health triage and treatment
This lecture will review a variety of medical conditions intervention center that draws upon technology, as
that may present with behavioral changes.   Also, well as ongoing stakeholder collaboration to meet both
certain medical conditions are more prevalent in consumer and community needs.
people with chronic mental illness.   These conditions
may complicate the community evaluation of these
patients by law enforcement or mental health
professionals.   Unfortunately, many communities have Tuesday 3:30 p.m. – 5:00 p.m. RM 7
separate facilities for the emergent evaluation of
patients with psychiatric symptoms.   Simple protocols Proving Success in CIT: Developing Evidence-
to aid in guiding the determination of whether patients Based Programs
require medical evaluation in addition to psychiatric
Presenters: Larry E. Thompson, Ed.D., Coordinator,
evaluation will be discussed.  
Law Enforcement Initiative, Department of Mental Health
Law & Policy, Louis de la Parte Florida, Mental Health
Institute; Sgt. J. Thomas Acker, M.S., Pinellas County
Tuesday 3:30 p.m. – 5:00 p.m. RM 1 & 2 Sheriff’s Office

Forensic Court Services Unit Crisis Intervention Teams (CIT) has existed in numerous
communities and continues to grow throughout the
Presenter: Mike Alkek, MS, Clinical Administrator II, U.S. Yet the professional literature is absent of data to
Center for Health Care Services Forensic Court Services support the success of this highly touted best practice.
Unit. From the inception, programs have suggested that the
training and implementation of the Memphis model
The Forensic Court Services Unit provides services 1st responder system will achieve several objectives
for clients ordered for treatment by various criminal including: 1) reduction of injury for officers and
courts in Bexar County. At the current time we consumers, 2) fewer arrests, 3) improved relations
have four programs: The Bexar County Outpatient between law enforcement and the mental health
Competency Restoration Program, the Forensic community.
Outpatient Commitment Program (NGRI Program),
the Bexar County Drug Court Program, and the Bexar Pinellas County Sheriff’s Office has sought to use
County Mental Health Court Program. existing data systems including their Computer Aided
Dispatch and report system as sources of evaluative
data. This agency was able to develop a data
collection system that minimizes additional effort or
paperwork on the part of the reporting officers. Many
agencies utilize tracking forms that are in addition to
other required reports and require additional time and
effort on the part of CIT officers. These tracking forms
are also have limited value in that they are completed

20 2010—San Antonio, Texas

Tuesday Agenda

solely by CIT officers, giving no basis of comparison to Tuesday 3:30 p.m. – 5:00 p.m. RM 8
non-CIT officer activity.
Georgia CIT – Partners in Transformation
Data from this veteran CIT program (10 + years) of
operation will be presented to demonstrate the process Presenters: Pat Strode, BA - Political Science, GA CIT
of gleaming valuable quantitative data and applying Program Administrator, NAMI Georgia; Nora Haynes,
qualitative measures showing positive results of CIT. Master of Education, Policy Committee Chair, NAMI
Georgia Board of Directors; Sheriff William Massee,
Handouts and PowerPoint displays will provide the Baldwin County Sheriff’s Office.
audience with an evaluation tool which other police
agencies can implement. This workshop will showcase how Georgia CIT officers
and their collaborative partners have become agents
for transforming Georgia’s mental health system. The
Georgia CIT Program has been a leader in forming

Tuesday 3:30 p.m. – 5:00 p.m. RM 7 community partnerships since its inception in 2004.
It has demonstrated how non-traditional partners
Heartland CIT: Toward Comprehensive can work together toward solutions to Georgia’s
Evaluation behavioral health dilemma, inspiring trained CIT
officers to advocate for improved local and statewide
Presenters: Shinobu Watanabe-Galloway, Ph.D.,
community based services. CIT officers have been called
Assistant Professor, Interim Chair, Department of
upon to address state legislators and the Governor’s
Epidemiology, College of Public Health at University of
Commission on Mental Health. Their testimonies
Nebraska Medical Center; Stephen Spelic, Operational
have influenced recommendations for increased CIT
Director, Alegent Health
funding. From their respective positions, workshop
Practical approach to comprehensive evaluation of CIT: presenters will explain the influence GA CIT officers
Heartland CIT Council Experience and the GA CIT Program have had in persuading the
Georgia Sheriff’s Association, Georgia Association
Due to limited resources, expertise and time, development of Chief of Police, probate, magistrate and superior
and implementation of comprehensive evaluation of court judges to spearhead an initiative to change GA
Crisis Intervention Team (CIT) is often very difficult. statutes that allow for the continued criminalization and
Without objective data that capture the inputs from marginalizing of citizens with mental illness, while
multiple stakeholders (e.g., law enforcement, criminal tying the hands of law enforcement officers trained to
justice, behavioral health providers, consumers), it is assist them in treatment and recovery.
not possible to understand the true effectiveness and
impact of the CIT program. Evaluation is necessary in
order to improve the curriculum and instruction as well
as to understand the training gaps. In this presentation, Tuesday 3:30 p.m. – 5:00 p.m. RM 8
the experience of Heartland CIT program is shared to
Speaking the Language of Community
illustrate how the evaluation activities have evolved
Involvement – Getting the Word out that
and become more comprehensive over the years. The
the Politics of CIT are in Everybody’s Best
workshop participants will learn how the Heartland CIT
Council uses local resources and expertise to conduct
curriculum evaluation and to expand the evaluation Presenters: Dennis Bosley, President NAMITopeka. Ken
plan to include collection of inputs from multiple Kerle.
stakeholders. Practical examples for inexpensive data
collection will be also discussed. The ethos of the CIT program is treating everyone
as if they matter. It is a grassroots political program
taking roots in the Topeka Police Department and
reverberating throughout the entire community. Every
CIT practitioner must know that his/her actions strongly
affect the quality of life throughout the entire community.

First Annual CIT International Conference 21

Tuesday Agenda

Tuesday 3:30 p.m. – 5:00 p.m. RM 11 units beyond patrol, but will also provide curriculum
and course outline samples. “Out of the box” thinking
CIT and Crisis Negotiations Teams: A and creative teaching methods/styles to capture your
Natural Alliance student’s attention will also be discussed.
Presenters: Michael McMains, Ph.D., San Antonio,
Texas; Lt. Mark C. Lowthwer, Weber County Sheriff’s
Office Tuesday 3:30 p.m. – 5:00 p.m. RM 12
Both CIT Officers and Crisis Negotiators share the Civil versus Criminal Commitment Process
goal of making the community, consumers and officers
safer while managing emotionally disturbed and Presenters: Honorable Oscar Kazen, Bexar County’s
mentally ill consumers. Sometimes their responsibilities Associate Probate Judge for Probate Courts One and
overlap. This presentation will explore the shared Two.
concern of CIT officers and Crisis Negotiators. It will
present a systematic comparison of the similarities and The workshop will review the basic processes involved
differences in training and experience between the within both Civil and Criminal commitments including
units, highlighting the unique strengths of both. It will special considerations which can expedite judicial
explore the boundaries between the two units. It will proceeding and address overall needs for both
present observations on the change in attitudes and consumers and stakeholder agencies. Participants will
operations in Crisis Negotiations since the siege at also be given an introduction to criteria and process for
Waco, Texas and outline the limits of those changes civil involuntary commitment programs which provide
when dealing with the mentally ill consumer. Data for judicial interventions with persons suffering from
on CNTs views of the CIT program will be presented mental illness.
and the support each unit can provide the other will
be explored. Finally, there will be suggestions for the
establishment of a working alliance that will move both
Tuesday 3:30 p.m. – 5:00 p.m. RM 13
units to better services, less violence and more safety.
Customer Service, CIT and Policing

Presenter: Jeff Futo, Patrol Officer and CIT Coordinator,

Tuesday 3:30 p.m. – 5:00 p.m. RM 11 Kent State University Police Services, Department of
Public Safety.
CIT Out of Uniform: Tailor-Made Training for
Specialized Units In an era in which police services are in greater
demand than ever, police professionals must reflect
Presenters: Habsi W. Kaba, MS, MFT, Miami-Dade CIT
on the terminology they use to label the services their
Coordinator, Eleventh Judicial Circuit Criminal Mental
agencies provide, such as “law enforcement” and
Health Project. Patricia A. Perez Nogues, Field Training
“crime fighting.” Law enforcement is only one of many
Unit Officer, Miami-Dade Police Department.
services that police provide. Characterizing policing
Miami-Dade County is home to the largest percentage as merely “law enforcement” misrepresents the true
of people living with serious mental illnesses of nature of policing. Service and order maintenance
any urban community in the U.S. and represents functions account for the majority of time the average
210,000 individuals, 9.1 % of the general population. officer spends in the field. Regardless of the specific
The Eleventh Judicial Circuit Criminal Mental Health function a police officer is carrying out, customer
Project has trained nearly 3000 police & corrections service should be the focus of the police services your
officers within 36 agencies in Miami-Dade County and agency provides to the community. This workshop
is internationally recognized as a leading learning explores the concept of customer services as it relates to
institution. policing and discusses the ways in which CIT programs
represent an example of customer service in action.
Miami-Dade CMHP now offers training exclusively
designed for Police and FBI Hostage/Crisis Negotiators,
Dispatchers, Recruits, Law Enforcement Clergy and
Victims Advocates amongst others. This workshop
will not only focus on progressive concepts/strategies
in developing specialized to advanced courses for

22 2010—San Antonio, Texas

Tuesday Agenda

Tuesday 3:30 p.m. – 5:00 p.m. RM 13 Tuesday 3:30 p.m. – 5:00 p.m. RM 16
Compassion Fatigue: Self-Care for Crisis Cultivating Children’s CIT - Grassroots to
Intervention Professionals Systems Implementation

Presenter: Isaac Martinez, Ph.D., Director of Resource Presenters: Keri Fitzpatrick, MS, Client Services
Development, Center for Health Care Services Consultant, Northpoint Institute for Public Management;
Terri Mabrito, MA, CCIT Coordinator, The Center for
Compassion fatigue is a concept which relates to the Health Care Services
cognitive schema of the provider or CIT professional.
Research on this concept evolved in the field of This session explores the many paths toward planting,
traumatology and is related to secondary traumatic cultivating and sustaining Children’s CIT programs.
stress. Crisis Intervention Professionals are consistently The unique lay of the land of the presenters’ respective
exposed to trauma and are at risk for development communities will provide for an in-depth exploration

of secondary traumatic stress. This presentation will of lessons learned and creative, practical problem
address the relationship between trauma exposure, solving approaches following the concept of growth:
burnout, compassion fatigue and the necessity of self- seeding, weeding and feeding. The presenters will
care for Crisis Intervention Professionals. guide attendees through topics and discussion using a
grounding central theme, “meet them where they’re at”
as it applies within a strength-based approach at the
grassroots level and at a systems level. Children’s CIT
Tuesday 3:30 p.m. – 5:00 p.m. RM 15 “gardening” tools, tips and techniques will be plentiful!
Exploring Statewide Implementation of CIT

Presenters: Melissa Reuland, MS, Research Consultant, Tuesday 5:30- 7:30 pm Grand Ballroom
CSG Justice Center; Mark Munetz, M.D., Chair of
Psychiatry, College of Medicine; Detective Ron Bruno, Tuesday Network Reception Pete Earley
Salt Lake City Police Department.
The main ballroom will be open to all to attend
Specialized Policing Responses (SPR) designed and meet with other officers, mental health workers,
to improve public safety and linkage of people advocates and consumers from across the world who
with mental illnesses to treatment initially spread to will be attending the conference. This will be a great
new communities by word of mouth or in response opportunity to network and learn of individual stories
to a tragedy. To encourage systematic program and accomplishments from others in their respective
implementation and resource pooling, several state- communities. (Light appetizers and cash bar available)
level organizations have developed mechanisms to
foster programs statewide. Statewide coordination of
SPRs is practical given that the mental health system
is state based and that state law authorizes police
powers for emergency mental health evaluations. The
Bureau of Justice Assistance funded the Council of
State Governments Justice Center to provide guidance
to states seeking to support the design, implementation
and sustainability of effective responses to people
with mental illnesses. This presentation will define a
“Statewide Implementation Model” and present data
collected from three states on how these models are
structured to achieve the dual objectives of program
proliferation and fidelity to essential program elements.

First Annual CIT International Conference 23

Wednesday Agenda

Wednesday Agenda
Wednesday 8:00 a.m. – 9:30 a.m. RM J Wednesday 8:00 a.m. – 9:30 a.m. RM K
CIT “If It’s Worth Doing, It’s Worth Doing Does your CIT program deserve the Gold
Well” Seal of approval? Come take the test

Presenters: Michael Woody, B.A., President - CIT Presenters: Michelle Saunders, LCSW; Larry Thompson,
International; Mark Munetz, M.D., Psychiatry, Ed.D, Coordinator of Academic Programs
Northeastern Ohio Universities College of Medicine and
Pharmacy The Florida CIT Coalition has developed a self-
assessment process for communities to determine their
Ohio has been fine tuning their statewide CIT efforts level of implementation for the Memphis Model Crisis
for over 10 years and has learned a lot. From its Intervention Teams and have a means to develop
beginnings in the Akron, Ohio Police Department it standards for their CIT program. Core values of training
has spread through over 72 of Ohio’s 88 counties and and the first responder system are used as the basis for
continues to evolve as times and circumstances change. determining fidelity with the model. This workshop will
Ohio tries to stick to a 40-hour course with a classroom present the instrumentation, the development process
filled with volunteer officers and other interested and the current results of over 50 communities who
“civilians.” However, since parts of Ohio are very rural have participated.
in nature an alternative CIT Program is also offered.
This course is true to the Core Elements of CIT but is
able to accomplish the learning task in less than 40
hours due to smaller class size and limited availability Wednesday 8:00 a.m. – 9:30 a.m. RM L
of site visits. Ohio recently produced a video titled
Portrait of a Police Suicide
“Ohio’s CIT Initiative” which, though only 14 minutes
in length, explains and shows just how far the state has Presenter: Amy Lyons, B.S.O.E., Lyons Investigations
come through their grass roots efforts and partnerships and Consulting, L.L.C.
with law enforcement, mental health organizations,
and advocates of persons with a mental illness. Of As CIT officers, we are used to dealing with suicidal
particular interest to the audience are the strides Ohio people. What happens when the suicidal person is
has made in its training of police dispatchers who are a cop? More police officers die by suicide than in
the first law enforcement contact a family or consumer the line of duty every year. The biological family and
usually has when calling for help when there is a crisis. the law enforcement family of the deceased, struggle
The video also shows the workings of Ohio’s State CIT with how to pick up the pieces. In this workshop,
Coordinators Group made up of over 70 coordinators participants will be presented with an intimate glimpse
that meet twice yearly to keep everyone on that same into the life and suicide death of a 19 year veteran
page and exchange ideas. police officer. Participants will receive information
about the risk factors that police officers face, and will
Ohio truly is a model for other states to look at. We be provided with information about intervention and
believe that a job worth doing is worth doing well! prevention programs in an effort to reduce the number
of police suicides in the future.

24 2010—San Antonio, Texas

Wednesday Agenda

Wednesday 8:00 a.m. – 9:30 a.m. RM M unique panel will share the experience and expertise
of federal probation supervisors, a clinical director
Trauma Recognition and Coordination: Early of a mental health court program, and a mental
Intervention with Youth health/criminal justice advocate in order to show how
collaboration and partnerships can enhance the court
Presenters: Keith Warner, M.S., Sharon Lipford,
programs serving consumers.
Executive Director, Harford County Mental Health; Victor
Welzant, PsyD, CIT Program Psychologist, Harford
County CIT; Shawn Dundon, MA, Director, Mobile
Crisis Program, Sheppard Pratt Health System-Harford Wednesday 8:00 a.m. – 9:30 a.m. RM 3 & 4
Behind the Scenes of Self-Selection into
The Harford County Sheriff’s Office, Harford County CIT Training of Police Officers: The Role of
Crisis Program and partner agencies established a Family and Personal History, Trait, Empathy,
multi-systemic approach to provide early detection, and Psychological Mindedness
improved screening and better response for youth

experiencing trauma. The Trauma Recognition and Presenters: Michael T. Compton, M.D., M.P.H.,
Coordination (TRAC) program uses CIT officers and Assistant Professor, Emory University School of Medicine,
Mobile Crisis Program as the first contact to identify Psychiatry and Behavioral Sciences; Beth Broussard,
children with risk factors related to family violence, M.P.H., C.H.E.S., Emory University School of Medicine,
mental health/substance abuse issues and trauma. Psychiatry and Behavioral Sciences; Janet R. Oliva,
The purpose of the presentation is to describe clinical Ph.D., Georgia Bureau of Investigation (Retired)
indicators of trauma, the TRAC model, and innovative
responses to child & adolescents experiencing crisis. Widely accepted as an important feature of CIT is the
self-selection of officers into training (i.e., volunteering
rather than being assigned.) It has also been proposed
that a “self-selection bias” occurs, meaning certain

Wednesday 8:00 a.m. – 9:30 a.m. RM 1 & 2 characteristics of some officers predispose them to want
to be trained and to being ideal for CIT. In this workshop,
Specialized Court Programs for Mental past research on characteristics of self-selecting officers
Health and Substance Treatment Consumers: will be presented and results will be presented related
How Court Programs Work and How They to demographic characteristics, family history of mental
Can Work for You illnesses, and previous exposure to mental illnesses.
Secondly, given a lack of research in this area, new
Presenters: Bonnie Sultan, M.A., Criminal Justice/
results of recent research will be presented. This
Mental Health Consultant, Founding Coordinator for
research will provide the first empirical examination of
NAMI National CIT Technical Assistance Center; Dr.
some of the behind –the-scenes characteristics involved
Charles Amrhein, Psy D, Clinical Director, Bronx Mental
in self-selection into training among pre-CIT officers
Health Court; Christopher Wodzinski, MA, Senior U.S.
and non-CIT officers. Characteristics examined include
Probation & Parole Officer
empathy and psychological mindedness. Lastly, the
People with mental illness and substance abuse issues benefits and disadvantages of self-selection into CIT
many times are not diverted before arrest and continue as opposed to wider-scale or universal training will be
into the justice system. Exposure to correctional debated.
facilities can not only be dangerous for this group,
but significantly worsen their symptoms both while
inside prison and upon reentry. This population
Wednesday 8:00 a.m. – 9:30 a.m. RM 7
with co-occurring disorders poses extensive policy
challenges at all levels of government, especially at Arresting Stigma and Preconceived Notions
the level of court case processing. To address this
issue, our nation’s courts are developing new initiatives Presenter: Sylvia Luna, M.A.(Counseling), LCDC,
and programs in order to assist these individuals in Ministry Assistant Coordinator, Faith based Mental
obtaining needed services while safely living in their Health Initiative/NAMI
home community. Navigating through court systems
and learning how to utilize the programs and services Consequences of attitudes and behaviors stemming
in which clients are referred can be overwhelming for from stigma within law enforcement, mental health and
consumers, family members, and advocates alike. This advocacy systems create barriers to providing and

First Annual CIT International Conference 25

Wednesday Agenda

receiving competent and effective services. Society’s partner of CIT in Wisconsin, and this session will
views and interpretations have been distorted through provide all of the information needed to replicate it in
strongly held social beliefs and continue to reinforce other communities, ultimately expanding the Circle of
inaccuracies about mental illness. Reducing stigma Care that begins with CIT.
and discrimination requires community and individual
responses. This interactive workshop is designed
to raise the participants’ awareness of prevalent
stigmatizing behaviors, attitudes, and practices within Wednesday 8:00 a.m. – 9:30 a.m. RM 11
law enforcement and mental health agencies.
Calming a Psychotic Person in Crisis

Presenter: Milt Greek, M.A. – Sociology, Project

Leader, Office of Information Technology, Ohio
Wednesday 8:00 a.m. – 9:30 a.m. RM 7
Psychological Assessment and Psychological
The material for this talk is drawn from case studies with
Robustness: An Exploration of How Police
psychotic and recovering schizophrenics. It focuses on
Officers Cope with Impact of Trauma
concrete examples and specific guidelines to help those
Presenter: Sajida Naz, Ph.D. student, University of responding to a crisis with a schizophrenic work with
Huddersfield, UK, Lecturer at Fatima Jinnah Women the person to calm them and end the crisis successfully.
University, Pakistan The purpose of this talk is to help attendees:

The study is concerned with traumatic events that police 1. Understand that seamless, often symbolic
personnel encounter during their work. Exposure hallucinations build a delusional framework around
to negative experiences such as death can trigger the rational core of a psychotic person.
high stress levels leading to various personal and
2. Be able to apply basic and advance techniques
professional difficulties. Analyzing perception of
for calming schizophrenics in crisis and safely
negative experiences and identification of emotional
resolving the crisis.
triggers attached to it may be helpful for psychological
assessment of police /security officers. 3. Following a question and answer period to hone
the attendees understanding of this material,
attendees will hear how a series of hallucinations
can tell a symbolic story, helping them to have a
Wednesday 8:00 a.m. – 9:30 a.m. RM 8
deeper understanding of the inner experiences of
Completing the Circle of Care Wisconsin a person in psychosis.

Presenters: Sgt. John Wallschlaeger, B.S., Appleton

Police Department; Karen J. Aspenson, MSW, Executive
Director, NAMI Fox Valley, Appleton, Wisconsin Wednesday 8:00 a.m. – 9:30 a.m. RM 12

The issues faced by people living with a diagnosis CIT Driven Partnerships with the Faith Based
of mental illness are many and complex. The issues Community to Address Homelessness and
service providers face when confronted with a person Substance Abuse
diagnosed with mental illness who is in crisis are just
Presenters: Alexis Zoss, LCSW, Division Director, City of
as complex, especially if it is not a part of the training
Virginia Beach, Dept of Human Services, Mental Health
and education background of the provider. Developed
Substance Abuse Services Division, CIT Project Director,
from NAMI Fox Valley’s successful CIT law enforcement
Carolyn H. Wood, Mental Health Substance Abuse
training initiative, the Crisis Intervention Partner (CIP)
Division Consultant and NAMI Representative; Carolyn
education workshop addresses this need. This 16-hour
H. Wood, Mental Health Substance Abuse Division
workshop is targeted to meet the needs of personnel
Consultant and NAMI Representative
working within corrections, residential, vocational,
medical, and first-responder settings. CIP combines Join us to learn about the role the faith community can
lecture by experts in their field with discussion and have in your community to support the development
experiential learning opportunities. The life stories of and work of CIT and the people it serves. The
people living with mental illness (consumers) and their humanity of the Crisis Intervention Team program in
family members are also presented. CIP is a valued Virginia Beach was the impetus for the establishment

26 2010—San Antonio, Texas

Wednesday Agenda

of the Faith-Based committee of the Virginia Beach community. There are several important land marks
CIT Coalition. This was the idea of an Episcopal that attract summer tourists, i.e., Grandfather Mountain
rector who attended the inaugural Virginia Beach CIT and Mount Mitchell. There are several ski resorts that
Coalition meeting in August 2008. CIT is a mindset attract the winter tourists. Two of these are Sugar
and is about collaboration between public safety, Mountain and Beach Mountain. Law enforcement and
mental health, and community non-profit partners to mobile crisis respond to a variety of calls involving
enhance the program. In addition to collaboration, mental health issues. These three agencies are the
the Faith Based committee works to educate faith overseer of mental health services in their perspective
leaders and congregations about how they can assist areas.
individuals who are living with mental illness and /or
substance abuse. This workshop will include review of
a resource directory created to assist clergy to more
effectively identify resources for individuals. Wednesday 8:00 a.m. – 9:30 a.m. RM 15
Post-Intervention Follow–up with consumers
and Families–Reducing CIT Recidivism
Wednesday 8:00 a.m. – 9:30 a.m. RM 12
Presenters: Barry Armfield, Coordinator, St. Louis
Community Collaboration: A Case Study Area CIT Program, St. Louis County (Missouri) Police
Department; Richard D. Stevenson, BA, Director of
Presenter: Jill Marcum, J.D., Magistrate, Vanderburgh Special Projects/ CIT Coordinator, NAMI St. Louis;
Superior Court Wendy Dudek, MS, CIT Family Outreach Specialist,
NAMI St. Louis
Community collaboration will make your CIT program
stronger and provide more benefit to your community. Crisis interventions are often the result of less-than-
Learn who to bring to the table, how to identify the successful inter-relationships among law enforcement
issues of your community, how to resolve some of agencies, individuals in their communities with untreated

those issues, and how collaboration will help with the severe mental illness, emergency medicine, courts, and
solutions. The CIT of Vanderburgh County, Indiana the mental health treatment system. CIT will be most
has been running a successful program for almost successful when all those disparate groups work well
two years. We will share with you how we achieved together to deliver effective inpatient and community-
our success. More importantly, we will share with based psychiatric care following a successful CIT
you the problems we overcame through community intervention. Unfortunately, various obstacles still
collaboration to make our program a success. impede good treatment. This presentation will review
those obstacles and outline an array of activities
offered by the collaborative, multi-jurisdictional St. Louis
Area CIT Program that improve access to mental health
Wednesday 8:00 a.m. – 9:30 a.m. RM 13 & 14 services for individuals served by CIT.
How CIT Works in a Small Rural County

Presenters: Sheriff Kevin Frye, B.S., Applied Science in

Wednesday 8:00 a.m. – 9:30 a.m. RM 15
Criminal Justice, Avery County NC; Ann V. Robinson,
B.S., Psychology, Emergency Services Coordinator Collaboration with your Local Law
Smoky Mountain Center Mental Health, CIT Coordinator Enforcement
The information presented will discuss the reasons why Presenters: Kym Bolado, President/CEO of Advanced
Avery County Sheriff’s Office, New River Mental Health Childhood Learning, President, NAMI-San Antonio;
(the mental health provider) and Smoky Mountain Ernest Stevens, CIT Mental Health Unit, San Antonio
Center came together to provide mental health services Police Department
resulting in fewer involuntary commitments, fewer
arrests and providing a monetary savings for the NAMI San Antonio’s collaboration with the San
county. CIT is the program that has provided training Antonio Police Department paved the way for the
and collaboration to achieve these goals. Avery institution of the department’s first Mental Health Unit.
County North Carolina is a small rural county that has Hear why NAMI was involved and the importance of
two different populations. The year round residents community liaison between your local law enforcement
are mostly farmers, factory workers and a retirement agency and the community.

First Annual CIT International Conference 27

Wednesday Agenda

Wednesday 8:00 a.m. – 9:30 a.m. RM 16 & In-Custody Death Specialist, a Certified Litigation
Specialist, a Contract Instructor for Texas Municipal
CIT Expansion in Virginia League and Texas Municipal Police Association.
Presenters: Patrick Halpern, MPIA, Executive Director,
Mental Health Association of the New River Valley;
Victoria Cochran, J.D., Behavioral Health/Criminal Wednesday 10:00 a.m. – 11:30 a.m. RM K
Justice Services, Coordinator, Virginia Department of
Behavioral Health and Developmental Services; Joseph Mental Health First Aid
Yost, M.S., Jail Diversion Coordinator, Mental Health
Association of the New River Valley Presenters: Bryan V. Gibb, Director of Public Education,
The National Council for Community Behavioral
This presentation will focus on the statewide expansion of Healthcare, Washington, DC; Ms. Carole L. Bernardo,
crisis intervention team programs in the Commonwealth Training Coordinator, LifeWatch Employee Assistance
of Virginia. CIT was originally developed in Virginia Program, Providence, RI; Lieutenant Joseph C. Coffey,
in 2004 with the advent of the New River Valley CIT Warwick, Rhode Island Police Department; Chief
Program (NRVCIT), the first rural, multi-jurisdictional Anthony J. Silva, Director, Rhode Island Municipal Police
program in the nation. In 2006 and 2007, the Academy, Providence, RI
Virginia General Assembly awarded funding to the
NRVCIT to lead the Commonwealth’s initial statewide This workshop/panel will present on Mental Health
expansion efforts, which led to the development of First Aid (MHFA) - a training and certification program
other successful programs in the Commonwealth, that introduces participants to risk factors and warning
including the Thomas Jefferson Area CIT program signs of mental health and substance abuse problems,
(TJACIT) and the Hampton-Newport News CIT program builds understanding of their impact, and overviews
(HNNCIT). The presentation will discuss subsequent common treatments. Participants gain skills, resources
legislation that codifies CIT in Virginia, the progress of and knowledge to help an individual in psychiatric
the Virginia CIT Coalition, the development of minimal crisis connect with professional care.
standards for CIT programs, and the utilization of the
three marquee programs for the provision of training,
consultation and mentoring of CIT programs under
Wednesday 10:00 a.m. – 11:30 a.m. RM L
development in Virginia.
The Restoration Center – Center for Health
Care Services
Wednesday 10:00 a.m. – 11:30 a.m. RM J Presenters: Kathryn Jones, LCSW, LCDC, Substance
Abuse Director, Center for Health Care Services;
Excited Delirium – Taser
Melanie Lane, LMSW, LCDC, AAC, Director of
Presenter: Jerry Staton, Associate’s Degree from Austin Operations, The Restoration Center, Center for Health
Community College; Austin Police Department, Master Care Services, San Antonio, Texas
TASER® Instructor
The Restoration Center is an innovative facility that has
Jerry retired in 2000 to start his own training business been in operation since April of 2008. The program
after 25 years of law enforcement experience with the has at its core the goal of reducing the pressure on
Austin Police Department. Jerry spent a good portion both the Bexar County jail and court systems; as well as
of those 25 years in the tactical arena where he relieving the pressure on community emergency rooms
received extensive training in firearms, combative skills through the diversion of the chronic homeless serial
and police tactics. As the owner of Affordable Realistic inebriants, substance abusers, and injured prisoners to
Tactical Training (ARTT) he has passed on much of that their location for services.
training to thousands of officers, improving their tactical
skills and increasing their odds of winning a physical

Staton has been recognized as a TASER® and Use of

Force expert. He has testified and consulted about the
use of TASERs, Use of Force, and Police Training. He is
a Senior Master TASER® Instructor, an Excited Delirium

28 2010—San Antonio, Texas

Wednesday Agenda

Wednesday 10:00 a.m. – 11:30 a.m. RM L Wednesday 10:00 a.m. – 11:30 a.m. RM 1 & 2
Suicide and Law Enforcement – Taking Care No Good Deed…Improving Mental Health
of Your Own Mental Response to Law Enforcement

Presenters: Michael Alicea MS, MFT, MSW, Ed. D. Presenter: Dan Abreu, MS, CRC, LMHC
(Candidate), Law Enforcement Officer//Therapist,
Counseling Network; Habsi W. Kaba, MS, MFT, Following several recent adverse incidents involving
Miami-Dade County CIT Coordinator, Eleventh Judicial law enforcement and individuals with mental illness,
Circuit Criminal Mental Health Project New York State and New York City convened a panel
to develop recommendations to improve services and
The objective of this panel presentation is to identify promote safety. Among the many recommendations
the risk factors that are often associated with the contained in the June 2008 report issued by the New
subject of suicide in the law enforcement community York State/New York City Mental Health- Criminal
and its explicit impact on society and the family unit. Justice Panel was that the State should sponsor a
Variables that have an expressed causal effect on the Mental Health-Law Enforcement Summit to “enhance
law enforcement agent and its attributed secondary relationships between law enforcement and the mental
casual effects. health community statewide.”

Suicide in general is one of the most prevalent and This session will describe the outcomes that resulted
burdensome issues of distress, and a contentious issue from participation in the Summit and the post Summit
within the law enforcement community that impinges a technical assistance in area such as:
substantial limitations on the well-being and functioning
of society and the family. • Cross system planning

A model that considers an intervention alternative • Cross system communication and information
which is solution-oriented and identifies critical factors sharing

in the prevention of suicide will be introduced.
• Cross system training
This model is prescription for developing a constructive
• Development or revision of P&P to improve crisis
and effective dialogue within the mental health and
response to LE emergency
the law enforcement community that will facilitate a
partnership invaluable in recognizing and responding • Peer participation in MH/LE initiatives.
to the “at-risk” law enforcement officer.

Wednesday 10:00 a.m. – 11:30 a.m. RM 1 & 2

Wednesday 10:00 a.m. – 11:30 a.m. RM M
Criminal Justice’s Collaborative Paradigm
Mental Needs for Returning Veterans Shift: A Sequential Intercept Model
Presenter: Emma Mata-Galan, PsyD., Clinical Presenters: Sgt. Darek Ardoin, B.S., Psychology, CIT
Psychologist, Program Director, PTSD Clinical Team Coordinator Calcasieu Parish Sheriff’s Office, Lt. David
Anders, FBI National Academy, CIT Coordinator,
The purpose of this workshop will be to become familiar
Lake Charles Police Dept.; Mickey Shannon, M.Ed,
with the mental health needs of returning veterans, the
Chairperson of CIT/Crisis Task Force, Executive Director
services available at the South Texas Veterans Health
of Samaritan Counciling Center
Care System, and to become familiar with the evidence
based therapies for the treatment of chronic Post Criminal justice systems are better understanding
Traumatic Stress Disorder. the difference between a person having a mental
illness crisis and a person committing a criminal act.
Calcasieu Parish in Southwest Louisiana has recognized
the trends and moved to create a paradigm shift in
criminal justice along with developing collaborative
partnerships that are critical to successful best practices
in law enforcement’s response. The collaborative has
developed a sequential intercept model defining a
continuum of care from least restrictive environment to

First Annual CIT International Conference 29

Wednesday Agenda

most restrictive environment responses to consumers in of emergency receiving facilities with “no refusal”
crisis. Cooperation of media in educating the entire and “minimal turnaround time” policies that serve
community has increased awareness and reduced the as a single point of entry, and (3) problems with
stigma of mental illness. transportation to and from mental health facilities. For
each of these barriers, examples are given, potential
solutions are considered, and research opportunities
are suggested.
Wednesday 10:00 a.m. – 11:30 a.m. RM 3 & 4
Domestic Violence
Wednesday 10:00 a.m. – 11:30 a.m. RM 7
Presenter: Jared A. Detter, PsyD, Clinical Psychologist,
San Antonio Police Department Beyond the 40 hours: An In-Depth Look
at the Influence of CIT on Behavioral
Domestic violence is a widespread societal issue that
Health System Development and Program
has become more and more the purview of police
departments and mental health professionals. Recent
research has shed light on the most at-risk populations, Presenters: James R. Stringham MC, Community
risk factors for domestic violence, cycles of domestic Counseling, VP of Operations Magellan Health Services
violence, causes and warning signs of domestic of Arizona; Nick Margiotta, Masters of Education, CIT
violence, and the effects of violence on victims and Coordinator, City of Phoenix Police Department
children who witness domestic violence. In addition,
common misconceptions have been unearthed, as well In Maricopa County, Magellan of Arizona and the
as a better understanding of offender recidivism and Phoenix Police Department have partnered around
better community options for victims. These topics will CIT and have expanded well beyond just 40-hours of
be discussed, and an actual case of domestic violence training. In a region with the largest behavioral health
will be presented to highlight the devastation that this contract in the nation, which serves more than 80,000
form of violence can cause. enrolled individuals and handles more than 20,000
crisis-line calls a month, the partnership has allowed
both parties to move to the next level. In 2007,
Magellan implemented a community governance board,
Wednesday 10:00 a.m. – 11:30 a.m. RM 7 which gave law-enforcement a direct voice in shaping
the system. This voice directly affected behavioral
System and Policy Level Barriers to Full
health system design. Magellan has implemented a
Implementation of the Crisis Intervention
“no-wrong-door” philosophy and achieved tangible
Team (CIT) Model
outcomes the average street-cop can appreciate;
Presenters: Michael T. Compton, M.D., M.P.H., Emory including reducing wait-times from over an hour to
University School of Medicine, Psychiatry and Behavioral fewer than seven minutes at our psychiatric “drop-off”
Sciences; Beth Broussard, M.P.H., C.H.E.S., Emory center and immediately responding to more than 3,000
University School of Medicine, Psychiatry and Behavioral police requests for community mobile teams annually.
Services; Amy C. Watson, Ph.D, Jane Addams College Even more amazing, Magellan collaborated with CIT
of School Work to guide clinical practice – developing an innovative
crisis safety net to break the cycle for those entering
It is widely recognized that the CIT model of partnership the crisis system and launched a Suicide Prevention
between law enforcement and mental health is “more Steering Committee.
than just training.” That is, the published Core Elements
of CIT include a number of features extending beyond
the widely replicated 40-hour training curriculum.
Many of these features involve operational elements
that enable officers to facilitate mental health referral.
However, unlike the training aspect, which many
departments have successfully implemented; a number
of systems-level and policy-level barriers commonly
make full implementation difficult in many communities.
In this workshop, three such barriers are discussed:
(1) aspects related to dispatch training, (2) availability

30 2010—San Antonio, Texas

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Wednesday 10:00 a.m. – 11:30 a.m. RM 8 the program and to inform school districts in the
county about CCIT and the importance of community
Applying CCIT Skills in a School Setting collaboration. Lessons learned and practical tips will
be presented.
Presenters: Ralph A. Garcia, Police Officer, San Antonio
Independent School District Police; Jessica Sepulveda,
Police Officer, San Antonio Independent School District
Police Wednesday 10:00 a.m. – 11:30 a.m. RM 11
Since implementing Children’s Crisis Intervention Lee’s Story
Team training in 2007, San Antonio ISD Police
have responded to numerous calls for assistance Presenters: Herbert Cotner, BA Criminal Justice, Senior
involving students in crisis. We have learned that often, Corporal, Dallas Police Department/NAMI Dallas;
these students slipped through the system, labeled Sherry Cusumano, MS, Executive Director of Community
as problematic children. As a result their behavior is Education and Clinical Dev., Green Oaks Hospital/
criminalized and the very real need of the student is NAMI Dallas; Janie Metzinger, MS, Director of Public
unresolved. Policy Mental Health America

Affecting the response to a crisis on campus are the The Dallas CIT Group will present a short film, directed
normal activities of the school day. School personnel and produced by the Dallas Police Department that
and their respective responsibilities are also factors. portrays a real-life crisis episode of a consumer with
This session is designed to reflect upon actual crises severe mental illness. The film, which depicts an
within the school setting and the application of CCIT event from the viewpoint of the consumer, the family,
techniques. and law enforcement, was coordinated through
NAMI Dallas, NAMI Collin County, MHA Dallas and
We will discuss successes and obstacles we have the Dallas Police Department. The author portrays
experienced and offer insight to address these situations. himself, and NAMI parents portray his parents in

the film. Dallas Police officers portray themselves in
Ultimately, our collective goal should be that which is
the movie, which was filmed in the home of a NAMI
in the best interest of the child. By properly employing
Dallas board member.
tools of CCIT, we can better serve those who are
unable to help themselves. The film is used as a starting point for a discussion
about the roles of law enforcement, the family, and the
consumer in a psychiatric crisis. Panelists will present
from each viewpoint and allow time for questions.
Wednesday 10:00 a.m. – 11:30 a.m. RM 8
Children’s Crisis Intervention Training – for
School Based Officers
Wednesday 10:00 a.m. – 11:30 a.m. RM 12
Presenters: Terri Mabrito, CCIT Coordinator, Center for
Development of the SAPD CIT Unit
Health Care Services, Stan Slate, Sergeant, San Antonio
Independent School District Police Department Presenters: Ernest Stevens, CIT Mental Health Unit,
San Antonio Police Department; William Kasberg, CIT
This presentation will explore the unique development
Mental Health, San Antonio Police Department
and implementation of the Bexar County Children’s
Crisis Intervention Training (CCIT). CCIT involves 40 It all began with local stakeholder collaboration
hours of intensive training for officers and a 3 day which even now continues to play a major part in
training for school administrators, including simulations the day to day operations of the San Antonio Police
in which trainees are confronted with realistic student Department’s Mental Health Detail. Officers assigned
mental health and behavioral crisis situations on a to the Detail team up with a CHCS assessor to make
school campus, acted out by youth and young adult “house calls” in order to make the best determination
volunteers. Children’s Crisis Intervention Training of a consumer’s well-being. The Detail’s first priority
(CCIT) is the result of the joint efforts of a group of is to patrol in order that patrol officers have more
community service providers. Trainers include officer time for more emergent calls. The collaboration with
instructors and over a dozen children’s mental health CHCS, the Mental Health Authority, extends to CIT
professionals from the partner agencies. CCIT works training which consists of training police cadets, 911
closely with law enforcement agencies to promote dispatchers and clerks, local police agencies, school

First Annual CIT International Conference 31

Wednesday Agenda

administrators and school district police officers, services, and county officials. This workshop will
and EMS and Fire personnel. Find out how you can address the important roles county commissioners play
develop a CIT Unit in your police department. in the support and implementation of CIT and linkages
to social services, as well as how to gain county
commissioner support for your diversion efforts.

Wednesday 10:00 a.m. – 11:30 a.m. RM 12

Deputy Mobile Outreach Team Wednesday 10:00 a.m. – 11:30 a.m. RM 15
Presenters: Yvonne Vann, Sergeant, Bexar County CIT Response with Cultural Consideration
Sheriff’s Office, Deputy Ross Garza, Bexar County
Sheriff and Deputy Toni Stanfield-Mims, Bexar County Presenter: Patti Kresley, Master of Arts - Counseling
Sheriff. Psychology, a retired police, adjunct professor at Argosy
University-Twin Cities, Forensic Psychology Masters
This presentation will familiarize people with The Bexar Program, CIT instructor
County Sheriff’s Mental Health Unit. This presentation
will include: The History, Mission Statement, Goals, CIT Officers are often are required to respond to a
Duties and Responsibilities, Initiatives, and what DMOT mental health emergencies with time and resource
consists of. constraints. Often, officers are responding to people
with mental health emergencies who are from culturally
The Deputy Mobile Outreach Team (DMOT). This diverse populations. The cultural context is often not
team—consisting of a mental health professional and recognized or neglected despite the influence it has on
a law enforcement officer trained in working with the outcome. CIT officers can benefit from increased
persons with mental illness—responds to calls from knowledge of cultural traditions and experiences that
the community for assistance with persons with mental can impact the course of the response. Cultural training
illness or mental retardation. The team is available to which specifically addresses behaviors and customs
respond to calls and is able to make on-site mental combined with community collaboration will improve
health assessments, consultations, and referrals. The the response of the CIT Officer.
actions of the DMOT often minimize the need for on-site

Wednesday 10:00 a.m. - 11:30 a.m. RM 16

Wednesday 10:00 a.m. – 11:30 a.m. RM 13 & 14 The Houston Response to Elder Abuse,
Neglect and Exploitation
Community Collaboration: A Successful
Partnership between Law Enforcement, Presenters: Barbara Reiley, PhD., Research Manager,
Mental Health, and County Officials Geriatrics Division, University of Texas Medical School
at Houston. James Booker, Regional Director, Adult
Presenters: Kathleen Guerra; Panel featuring Protective Services, Region VI, Department of Family
representatives from the National Association of and Protective Services. Lynne Parsons, Assistant DA, &
Counties, a CIT officer, mental health, and a county Candice Twyman, Better Business Bureau, JD&LMSW-
commissioner. For all contact regarding this application, AP, Assistant District Attorney & Executive Director, Better
please contact Kati Guerra at kguerra@naco.org Business Bureau Education Foundation, Harris County
District Attorney’s Office and Houston Better Business
Community collaboration and coordination is vital for
successful diversion from jail for persons with behavioral
health issues. Law enforcement, behavioral health Houston, Texas is the 4th largest city in the nation. This
entities, social services, and county officials can come workshop is intended to describe the collaborations
together to collaboratively create successful diversion formed between three different but intertwined teams
programming. County officials are responsible for to stem the tide of elder mistreatment in Harris
balancing fiscal responsibility, public safety, and County, and to share our insights with others. A
doing what is “right”. Come to this workshop to collaboration between Texas Department of Family
learn about a county program that has succeeded in and Protective Services (APS), and the medical school
implementing CIT and connecting people to social led to the TEAM Institute formed in 1995 to address
services. Learn how this county program succeeds elder mistreatment whereby clients are referred by
through the collaboration of law enforcement, social

32 2010—San Antonio, Texas

Wednesday Agenda

APS to a team of medical providers for comprehensive an obligation to explore and provide appropriate
geriatric assessment and intervention of chronic and intervention and follow up support for these veterans
acute health problems. Later, the Harris County Elder and their families. CIT has many answers and the
Abuse Fatality Review Team (EFFORT) was formed programs developed for people with mental illness in
to investigate suspicious elder and disabled death the general population also are valid for veterans and
cases. This team, comprised of law enforcement, the their families. This workshop will explore how to bring
medical school, the district attorney’s office, the medical CIT and veterans programs together and how to form
examiner’s office and others are charged with making community collaborations of support and follow up. If
recommendations to the Harris County Commissioners you are already involved with CIT or just starting to
Office. The Financial Abuse Specialists Team is led by build a program, come talk to some people who have
the Better Business Bureau and consists of Medicaid made it happen.
investigators, elder attorneys, banking institutions,
health professionals, and others. These groups do not
work in silos and a significant overlap in membership
enables a uniformed and coordinated approach to Wednesday 2:00 p.m. – 3:30 p.m. RM L
elder mistreatment as these groups also educate the
Integration of Safety & Defensive Tactics into
public, health professionals and the community at
Advanced CIT
large, including the CIT.
Presenter: Sgt. Michael Yohe, BS, MA, Akron Police
Wednesday 2:00 p.m. - 3:30 p.m. RM J Although perhaps overly simplified, one of the main
purposes of CIT is to improve community and officer
Suicide by Cop
safety. While this seems obvious, some in CIT imply
Presenters: Yvonne Vann, Sergeant, Bexar County that it is not our job to teach “safety”, that our officers
Sheriff’s Office, Deputy Ross Garza, Bexar County already know theses skills and will know when to “switch

Sheriff, Deputy Toni Stanfield-Mims, Bexar County Sheriff, hats” between safety and CIT. It is the purpose of this
and Deputy Rafael Williams, Bexar County Sheriff workshop to address and develop concepts that would
allow CIT to integrate safety, defensive tactics and less
This presentation will help officers and individuals lethal weapons systems into what is typically taught as
understand the characteristics, warning signs, the stand-alone de-escalation skills. While we must prioritize
indicators for either a peaceful or deadly resolution, the the training time, segregating safety from CIT can lead
impact of suicide by cop, as well as personal situations to the perception that they are two separate techniques.
that officers encounter in a suicide by cop situation. If our purpose is safety, then we must teach officers how
and when to switch hats if you must use that analogy…
or better yet wear both hats at the same time.

Wednesday 2:00 p.m. – 3:30 p.m. RM K

CIT and Veterans: Support and Community Wednesday 2:00 p.m. – 3:30 p.m. RM L
Increasing Safety Means Decreasing Violence
Presenters: Sally Miller, MHA, Chair NAMI Veterans Through Positive Behavior Supports
Council; Thomas Kirchberg, Ph.D., Chief, Psychology
Section, VA Medical Center; and Ron Bruno, Detective, Presenters: Terrance P. Stanton, Training Officer, Bexar
Salt Lake City Police Department County Juvenile Probation Departmen; Sally Phipps,
Registar, Mandt System, Inc.
Veterans are not only military people, but are citizens
of the communities they live in. Whether they are still Abstract: The Bexar County Juvenile Detention Center
on active duty, in the National Guard or Reserves, or has incorporated training in The Mandt System®
veterans separated from service, they have earned our into their overall approach to increase the safety of
respect and support. Mental illness or re-adjustment correctional officers and juveniles. The unique blend of
issues, called the hidden wounds of war, cause a a relationally based Positive Behavior Support training
variety of service and recovery needs which may land program and a restorative justice model has resulted in
them in the criminal justice system. As public agencies a significant decrease in rates of physical aggression
and community mental health advocates, we have and injuries to officers and juveniles.

First Annual CIT International Conference 33

Wednesday Agenda

Wednesday 2:00 p.m. – 3:30 p.m. RM M This class will provide a unique way to review the
common topic of medications used to treat mental
Emotional CPR for De-escalating Emotional illness. The presentation will incorporate a review of
Crisis common medications while incorporating interviews
from consumers, family members and doctors. The
Presenters: Daniel Fisher, MD, Executive Director,
interviews will focus on the side effects, financial burden
National Empowerment Center; Lauren Spiro, MA,
and other issues related to the use of medications to treat
Director, National coalition Mental Health Consumer/
mental illness. All of this will be used in an effort to help
survivor Organizations
persons better understand why the issue of medication
The purpose of this workshop is to teach the skills and compliance is so difficult for some consumers. This
attitudes that enable non-mental health workers to class will help agencies think of unique ways to teach
assist people through emotional distress. This process about issues related to mental illness while also helping
enables people to assist each other in a way similar students to understand medication related issues.
to how physical CPR enables the non professionals to
assist persons in a cardiac crisis. The participant will
learn how people often emotionally disconnect and feel
Wednesday 2:00 p.m. – 3:30 p.m. RM 7
powerless during emotional distress. The participant
will learn how to connect with compassion and concern MHMCT: An Example of a Co-Response
in order to communicate. This will enable the person in Model of Mental Health and Policing
distress to feel empowered to experience their passion
and purpose so they can begin planning to revitalize Presenters: Mary Pyche, MSW, Health Service
their life in the community through re-establishing Manager, Mental Health Mobile Crisis Team; Angela
relationships, routines and rhythms with important Balcom, Constable Halifax Regional Police; Susan Hare,
people in their life. BScOT, Program Leader Crisis Support Portfolio

The Mental Health Mobile Crisis Team (MHMCT)

established in 2006 is a co-response model of a
Wednesday 2:00 p.m. – 3:30 p.m. RM 1 & 2 joint police/mental health team based in a mental
health system. It offers a collaborative and consistent
CIT for Telecommunications and Cadets intervention response to individuals across the age
spectrum experiencing a mental health crisis in the
Presenters: Emile Clede, Communications Training
community. Plain clothes police officers are designated
Coordinator-San Antonio Police Department; Lauri
to respond to calls triaged by the crisis team in an
Berkman, MS LPC, Team Leader-Crisis Care Center;
unmarked police car partnered with a mental health
Melissa Graham, PhD San Antonio Police Department;
clinician. This presentation will highlight the development,
Officer Justin Stepanik and Officer Sean Preyor-Johnson,
implementation, and lessons learned, as well as, the
San Antonio Police Department.
results of a research project studying this program.
Much CIT training and education has been developed
for police officers and other emergency responders.
However, very little training has been developed for
Wednesday 2:00 p.m. – 3:30 p.m. RM 8
the public safety communicators who are not only
the primary source of information for the responding Helping the Helper: Peer Support
officers, but are often the first available to calm the
situation to which the officers are responding. This Presenter: Sgt. Troy Anderson, CT State Police; Louise
presentation describes the solution to this problem, as Pyers, MS Executive Director
well as the development of a CIT curriculum for the
cadets at the San Antonio Police Department. Sergeant Troy Anderson is the State Coordinator for
the Connecticut State Police STOPS Program (State
Troopers Offering Peer Support). In 2005, following
several tragic events in the State Police, he authored
Wednesday 2:00 p.m. – 3:30 p.m. RM 3 & 4 a letter detailing the inherent benefits of an evidence-
based peer support network within his agency. As a
Just Take Your Meds result, the CT General Assembly codified Public Act
(PA) 06-188 authorizing the formation of a pilot peer
Presenter: Corey Nooner, Sergeant, Oklahoma City
support program for the Connecticut State Police.
Police Department

34 2010—San Antonio, Texas

Wednesday Agenda

To date, the program has assisted 881 personnel Wednesday 2:00 p.m. – 3:30 p.m. RM 12
during times of personal and professional stress, and
developed off-shoot programs to address Military CIT in Idaho: Turn Around Time in the
Support, Family Support, and CISM. This presentation Emergency Department
describes the development of the STOPS Program.
Presenters: Kim Jardine-Dickerson, MSN, RN, MSN,
A basic training curriculum will be shared with the
BC, CADC, Clinical Assistant Professor Idaho State
participants. A discussion of obstacles faced while
University, School of Nursing; Pete Snyder, MS,
implementing such a program will be described to
Administrator, Behavioral Health Center, Eastrn Idaho
give participants a realistic portrait of the challenges of
Regional Medical Cente; Captain Sam Hulse, BS,
instituting such a program.
Captain Bonneville County Sherriff Office, Bonneville
County Sheriff Office

It is problematic for law enforcement transporting and

Wednesday 2:00 p.m. – 3:30 p.m. RM 11
waiting with the mentally ill patients in crisis for hours
911 High Utilizer Committee in the emergency department (ED). There is a desire
for medical clearance taking less time. When mentally
Presenters: Karen Hogan; Judge Polly Jackson-Spencer, ill patients in crisis are transported by law enforcement
Bexar County Probate Court to the (ED) there is a medically safe, ethical and
professional assessment, treatment and discharge is
Bexar County began a program to identify frequent possible with shorter time taken. A regional medical
911 callers who overuse the system who do not center in rural Idaho has implemented such a program.
have true police, fire or health emergencies. Some Triage as well as discharge planning originated from
high utilizers have been found to be incapacitated a community partnership aim for shorter time in the ED
persons and have had guardians appointed who have and discharge transportation to hospitalization, crisis
changed the living arrangements for the individual, housing or back into the living environment for these
who now no longer overuse the system. The program is patients. Utilization of CIT Officers, ED personnel and

collaborative of Police and Fire Department of the City community case management has become an effective
of San Antonio, the local Adult Protective Services staff, solution in one region of Southeastern Idaho
the local Mental Health agency and the local mental
retardation authority who share information and work
on creative solutions to reduce the over users calls to
the 911 system in Bexar County, Texas. Wednesday 2:00 p.m. – 3:30 p.m. RM 12
Peer Crisis Respite: Recovery Based Crisis
Wednesday 2:00 p.m. – 3:30 p.m. RM 11
Presenters: Janet Paleo, ED Prosumers International; Anna
Chronic Consumer Stabilization Initiative: A H. Gray M.Ed, Co-Owner PRO International
Systems Approach
Consumer-run Peer Crisis Respite is an emerging
Presenters: Kim Kornmayer, LCSW Assistant Deputy model that empowers consumers to develop their own
CPEP; Miles Lee, MS, Director of Mental Health Unit; crisis plan and provides a placement that bypasses
Ann McLeod, MS, Clinical Team Leader; Sgt. Patrick the traditional intervention process. Specially trained
Plourde, BS, Houston Police Department. Peer Crisis Navigators work with consumers likely to
use crisis services and develop a plan that is mutually
The Chronic Consumer Stabilization Initiative (CCSI) is negotiated for crisis intervention. This is a recovery
collaboration between the Houston Police Department, based model in which the individual determines the
the MMHRA of Harris County and the City of Houston services needed and provided during a crisis.
Health and Human Services Department. This program
was designed to identify, engage and provide services
to those diagnosed with a mental illness, which have
had frequent encounters with the police. The main goal
of this program is diversion from repetitive encounters
with police, reduce excessive calls for service, and
provide clients with opportunities to lead a more stable
life. This pilot program success will be discussed.

First Annual CIT International Conference 35

Wednesday Agenda

Wednesday 2:00 p.m. – 3:30 p.m. RM 13 & 14 Wednesday 2:00 p.m. – 3:30 p.m. RM 15
The Brain Injury Epidemic and Its Impact on Building Collaboration In: What’s Our
Law Enforcement Problem?

Presenter: Elizabeth Bilderback, MA, Program Presenters: Mark Anderson, MA, Executive Director,
Coordinator, Health South Rehab Institute of San Antonio Barbara Schneider Foundation; Charles Jensen, MA,
consumer Advocate and Board member, Barbara
Brain injuries are a major cause of disability in our Schneider Foundation; Renee Jenson, MA, Community
society, and have received recent media attention Collaboration Coordinator, Barbara Schneider
due to our returning soldiers with brain injuries. This Foundation
presentation reviews causes of brain injury and how
such injuries impact behavior. Scenarios taken from 13 minute DVD, “What’s Our Problem?” will be
real life events will be utilized to clarify how such a followed by panel presentation with the following
health problem can cause behavioral problems that participants:
might result in a confrontation with a police officer.
Cognitive, physical, and psychosocial/behavioral 1. Charles Jensen, Board Member from the Barbara
problems following brain injury will be discussed. Schneider Foundation will discuss his experience
Problems officers may face in the field will be discussed. talking to law enforcement as a consumer with 89
Suggestions regarding how to best approach and arrests, (7 felonies, 12 years of homelessness with
interact with someone with a brain injury will be the last 7 years in recovery).
2. Renee Jenson, Community Collaborator, Barbara
Schneider Foundation: discusses her experience
facilitating community collaboration with local and
Wednesday 2:00 p.m. – 3:30 p.m. RM 15 state government, law enforcement, mental health
providers, consumers and advocates; keeping
An Innovative Community Collaboration to consumer perspective and involvement always at
Enhance the Continuum of Care the table.

Presenters: Cecil Tebo, LCSW, Crisis Transportation 3. Mark Anderson, Executive Director, Barbara
Services Program Administrator, NOPD; Lisa Romback, Schneider Foundation: discusses growing the
MA, Program Director, NAMI New Orleans Memphis model CIT in the Upper Midwest by
building the Mental Health Crisis Response Institute:
The New Orleans Police Department has operated training the whole community with specialized
the Crisis Transportation Service (CTS) for the past trainings for each profession; using trainings as a
28 years. It is the only program of its kind staffed door opener and platform for collaboration building;
by auxiliary civilian volunteers and supervised by a creating comprehensive CIT programs with inter
police Sergeant and a mental health professional. and intra agency collaboration; collaborating with
Following Hurricane Katrina in 2006, calls for service diverse community based initiatives and including
increased dramatically, so the program extended its them in CIT.
community collaboration to the NAMI New Orleans
Assertive Community Outreach (ACO) Program which
is funded by the human services district. Details of this
program will be discussed. Wednesday 2:00 p.m. – 3:30 p.m. RM 16
Rural Maine CIT: The Case for

Presenters: Richard Brown M.ED., CEO Charlotte White

Center; Elizabeth Carolin, MSW, Clinical Coordinator
Charlotte White Center

In rural Maine collaboration is key to success. For

over six years the Piscataquis Regional CIT program
has engaged all public safety stakeholders in creating
a wide net of informed CIT practitioners. A regional
Community Corrections Advisory Committee also

36 2010—San Antonio, Texas

Wednesday Agenda

oversees the delivery of an effective CIT model. Wednesday 4:00 p.m. – 5:30 p.m. RM J
By involving Emergency Medical Services, Dispatch,
County Patrol, Corrections, local Law Enforcement, Addressing the needs of Veterans in
ER staff, Chaplains, Fish and Wildlife Officers, and Crisis
Crisis workers we demonstrate how collaborative CIT
Presenter: Juanita Buck, MS, MHT, Kern County Mental
training acts as a “force multiplier” and improves
the de-escalation techniques skill set for many key
stakeholders in the crisis response network. We present As we see more war veterans coming home, the need
a brief film examining the impact of multi-disciplinary is greater to be aware of the special problems that
training within these various sectors and a video the community faces regarding these heroes. It is not
discussion of a successful CIT engagement in a rural enough to understand mental health and the course
police department. We return with our popular “Rural of mental illness with veterans. Theirs is a unique
CIT Grant Starter’s Kit” which provides an overview of situation, with a unique language and culture. As first
how to apply and start up a rural CIT training. responders, law enforcement is often the first line of
defense when a VET is in crisis. There are strategies
to be learned from past experiences, and much to
understand with this special population. This lecture
Wednesday 2:00 p.m. – 3:30 p.m. RM 16
will address the special needs of this population, with
Reaching Beyond CIT Westchester’s Police dignity, respect and honor as they deserve.
Mental Health Outreach and Coordination

Presenters: Mark Giuliano, LMSW Program Director

Community Support, Westchester County Department Wednesday 4:00 p.m. – 5:30 p.m. RM K
of Community Mental Health; Sgt. Brian Mc Cormack,
Stalking: When are you really in danger?
Yonkers Police Department, 4th Precinct
Presenter: John Price, Ph.D., Psychologist, San Antonio

Westchester County in New York uses a model
Police Department
that expands on the traditional Crisis Intervention
Team. Both the City of White Plains Department of Stalking is an old problem but a new crime, despite
Public Safety and the Yonkers Police Department have evidence that stalking often has a devastating impact on
embraced a model of intervention that includes CIT victims; the first stalking law was not enacted in 1990.
trained officers as well as clinical support and case A study by the National Institute of Justice and Center
work follow-up. The Department of Community Mental for disease Control and Prevention found the lifetime
Health provides a mental health clinician to these risk for stalking victimization is 8% for women and 2%
Police Departments to co-respond and provide follow for men. Twenty five percent of stalking victims are
up on those calls involving people in emotional crisis. assaulted and 2% are killed. The length of pursuit by
Using this model we have been able to increase officer stalkers is measured in months or years and most victims
safety, the safety of the person in crisis, decrease suffer major disruptions in their lives. Mental disorders
repeated calls for services and offer people hope are evident in the majority of stalkers and substance
in working towards their recovery. For people that abuse is frequently seen in this group. Stalkers are
come in repeated contact with law enforcement, we older than most criminals but frequently have a history
offer intensive outreach through Care Coordination, a of prior criminal behavior. This presentation will discuss
program with a person centered approach to recovery. scope of the problem, characteristics of stalkers and the
This presentation will provide an overview of these differences in stalkers who pursue public figures vs.
interventions and their outcomes. acquaintances. A typology of stalkers and the mental
health issue common among stalkers will be discussed.
Strategies for identification and management of stalkers
will be presented.

First Annual CIT International Conference 37

Wednesday Agenda

Wednesday 4:00 p.m. – 5:30 p.m. RM L Wednesday 4:00 p.m. – 5:30 p.m. RM 1 & 2
The Wilco Way…Collaborative Emergency Acute Episode of Illness Is a Family Crisis
Mental Health Response
Presenter: Yolanda Ortega, BA, Management of Human
Presenter: Annie Burwell, LBSW, Director, Williamson Resources, Newspaper Journalist
County Mobile Outreach
Role of the Family
This session will use three actual psychiatric emergency
incidents to demonstrate the operation of our award Former journalist and NAMI member Yolanda Ortega
winning Mobile Outreach Team (MOT). Each case has been an advocate for consumers and families since
will highlight different aspects of our collaborative the mid-1980s, first in Michigan and now in Bexar
approach – joint CIT and MOT response, field County. Her mental health network includes family
assessments, expediting psychiatric admissions, the members, consumers and mental health and community
use of technology, telemedicine, working with EMS and service professionals. Because of her involvement
911 dispatchers, facilitating respite care, and follow- with NAMI and her leadership with the Faith-based
up services. This multi-media presentation will include Mental Health Initiative, she has received many calls
911 tapes and a demonstration of the department’s from families in crisis before and after police has
web-based patient database. Administrative concerns been called. Her presentation will focus on including
such as flex funding, logistics, data collection, and the family in jail diversion efforts. She believes family
multi-jurisdictional and interdepartmental collaboration support is crucial in preventing homelessness, suicides,
will also be discussed. Over the past four years, substance abuse and the repeated incarceration of
the Williamson County Mobile Outreach Team and consumers.
Williamson County Sheriff’s Office Crisis Intervention
Team have saved our county government over four
million dollars by diverting mentally ill persons from jail
Wednesday 4:00 p.m. – 5:30 p.m. RM 1 & 2
and hospital emergency rooms to clinically appropriate
services. Learn how your department can achieve the The Contributions of Family Members &
same in this practical case driven session. Consumers to the Teach

Presenters: Suzanne Andriukaitis, MA, LCSW; Michael

& Marcia Schumacher
Wednesday 4:00 p.m. – 5:30 p.m. RM M
CIT training is designed to inform and influence law
Will Hearing Voices that Are Distressing: enforcement officers in their encounters with persons
A Simulated Training Experience living with mental illness. Stigma reduction research has
demonstrated conclusively that face to face encounters
Presenters: Daniel Fisher, MD, Executive Director,
are the most powerful tool to reduce stigma. Family
National Empowerment Center; Lauren Spiro, MA,
members and consumers sharing their personal stories
Director, National Coalition Mental Health Consumer/
bring home the message that persons with mental
Survivor Organizations; Ron Bruno, Detective, SLCPD,
illness are not to blame for these illnesses. Shifting
CIT Training Director
officer’s perceptions to viewing individuals as being ill,
This workshop is an introduction to a program used by changes encounters and outcomes. Personal accounts
the State of Utah Police Department CIT Program as of symptoms during episodes of illness and current
a special law enforcement adaptation of a program in-person functionality enhances officer’s motivation
developed by the National Empowerment Center. In to assist in bringing about recovery. Family members
this program, the participants will hear a talk about and consumers find presenting at CIT trainings a very
hearing voices program, and will also experience satisfying experience.
some of the simulations of what it is like to hear
voices. The presenters will demonstrate how this voice
simulation can be effective in CIT training programs.
This workshop teaches the officers how difficult it is
for people hearing voices to communicate in the usual
manner with officers. The training also gives tips to
officers about new and improved ways to communicate
with persons who are hearing voices.

38 2010—San Antonio, Texas

Wednesday Agenda

Wednesday 4:00 p.m. – 5:30 p.m. RM 3 & 4 convinced him his parents were the enemy, that their
death could prevent World War. The young man took
Building New Partnerships for Youth: those tragic steps to “prevent the war”. Thankfully, most
Implementing CIT Programs for School people with mental illness are not violent, but when it
Resources Officers occurs, police are first to respond. This documentary,
used in St. Louis Area CIT training courses, provides
Presenters: Ron Honberg, J.D., Director of Policy and
insight into events leading to and subsequent to that
Legal Affairs; Major Ginny Higgins, Special Services
tragedy. It highlights the benefits that can result for
Bureau Chief, St. Martin Parish Sheriff’s Office; Lt. David
even the most profoundly ill individuals when he or she
Anders, Lake Charles Police Department
receives the benefit of strong support from a loving and
The workshop will introduce participants to CIT for Youth, understanding family, plus aggressive psychiatric care. 
an evolving and emerging program that is growing
nationally with a major focus on training school resource
officers. CIT for Youth brings together law enforcement
Wednesday 4:00 p.m. – 5:30 p.m. RM 8
personnel, mental health and other social service
providers, consumers and family advocates, school Updates in Police Emergency Commitment
personnel and juvenile justice leaders to effectively and Connecticut’s Response
address youth in psychiatric crisis. NAMI will share
results from a focus group with School Resources Presenter: Marshall Segar, Deputy Chief, City of New
Officers (SROs) from southwest Louisiana who received London, CT
CIT for Youth training and will be joined by law
enforcement personnel from that region who will talk My presentation is on the recent updates and events
about the development and implementation of CIT for in the law of emergency committal.  Currently in the
Youth in Louisiana, lessons learned and feedback they state of Conneticut we have a U.S. District Court
have received from SROs. case which  has passed summary judgment on an
emergency committal case.  To summarize, the plaintiff

is challenging our commitment statutes and claiming that
she was seized in violation of the Fourth Amendment. 
Wednesday 4:00 p.m. – 5:30 p.m. RM 3 & 4 She has conceded that she needed psychiatric help, but
challenges the police officers reasons and articulation
School Resource Offenders and CIT of the seizure.  The court has decided to  let the case
go to trial.
Presenter: Scott Davis, CIT Coordinator,Montgomery
County Department of Police

This workshop stresses the importance of having CIT

Wednesday 4:00 p.m. – 5:30 p.m. RM 11
trained School Resource. SRO’s are often the first line
of defense against school violence and can serve as an Emergency Mental Health Services
important preventive resource to the school incident/
crisis management team. This lector will focus on training Presenter: Wayne Unger, Police Officer, Mobile Crisis
considerations, threat assessment, cooperative between Response Team, Victoria, BC, Canada
school and police administration.
IMCRT is a crisis response team, not to be confused
with the first response of patrol officers or with a
service providing ongoing follow-up. The goal of the
Wednesday 4:00 p.m. – 5:30 p.m. RM 7 team is to collectively triage calls for service, involve
the most appropriate staff based on discipline, gender,
Family Perspective on Mental Health Tragedy sub-specialty, etc., provide consultation and where
– A Video Documentary necessary direct intervention to resolve the crisis in
the least intrusive manner possible while maintaining
Presenters: Richard Stevenson, B.A., Director of Special
safety. The team may provide very short-term follow-
Projects, NAMI St. Louis; Sgt. Barry Armfield, CIT
up as a bridging mechanism to other services that can
Coordinator, St. Louis Area, St. Louis County Police
provide longer-term and more intensive support.

In 1994, the son of a typical middle-class suburban

family was fighting paranoid schizophrenia. Voices

First Annual CIT International Conference 39

Wednesday Agenda

Wednesday 4:00 p.m. – 5:30 p.m. RM 12 Wednesday 4:00 p.m. – 5:30 p.m. RM 15
Got Consumers? How to maximize Accessing Entitlements Using SOAR (SSI/SSDI,
consumer contributions in CIT training Outreach, Access and Recovery)

Presenter: Mark Creekmore, Ph.D.,Lecturer,University of Presenter: Cindy Schwartz, MS, MBA, Project Director,
Michigan Eleventh Judicial Criminal Mental Health Project

Our experience has been that consumer participation Stakeholders in the criminal justice and behavioral
in CIT training has been productive and important to health communities consistently identify lack of access
the consumers, the trainers and the trained (i.e. police to public entitlement benefits such as Supplemental
officers). We will relate our experience and provide Security Income (SSI), Social Security Disability Insurance
data from police officers, trainers and consumers about (SSDI), and Medicaid as among the most significant
their perceptions of consumer participation in training. and persistent barriers to successful community
Is our experience similar to other CIT programs? re-integration and recovery for individuals who
We will provide new information from five diverse experience serious mental illnesses and co-occurring
police agencies with regular CIT training programs to substance use disorders. In order to address this
answer these questions: 1. In what ways do consumers barrier and maximize limited resources, the Eleventh
participate in CIT training? 2. Do different modes Judicial Criminal Mental Health Project (CMHP) in
(models) exist for consumer participation? 3. How Miami-Dade County developed an innovative plan to
is consumer participation organized and sustained? improve the ability to transition individuals from the
4. How do officers receive and assess consumer criminal justice system to the community. Toward this
participation? 5. How important do trainers assess goal, all participants in the program who are eligible to
consumer participation in CIT training programs? We apply for Social Security entitlements are provided with
will make recommendations that might be applied to assistance utilizing a best practice model referred to
all training programs about the benefits, difficulties and as SOAR (SSI/SSDI, Outreach, Access and Recovery).
practical feasibility of consumer participation in CIT
training programs.

Wednesday 4:00 p.m. – 5:30 p.m. RM 15

Wednesday 4:00 p.m. – 5:30 p.m. RM 13 & 14 HIPAA Laws

Applied Crisis Intervention & De-escalation – Presenter: Frank Webb, Police Office Houston Police
Safety Plans and Resources Department

Presenter: Oren Skurnik, Lead Instructor, Applied CID HIPAA Laws. Are you confused about the HIPAA
laws? Are you frustrated with HIPAA confidentiality
The Safety Plan and Resources course gives the restrictions that interfere with your job as a CIT officer?
student an understanding of an effective tool that can Have the HIPAA laws ever been explained to you?
be utilized in any work environment & how to create Do you know what information you can and cannot
it. A Safety Plan is a step by step plan that guides a obtain or divulge regarding individuals with mental
person’s actions, statements and decisions in order to illness? If you would like answers to these questions,
help them to respond to a crisis situation. This will help this presentation is for you. The HIPAA laws will be
in trying to insure a safe outcome for everyone involved explained once and for all!
using applied training and skills. This will also provide
an opportunity to learn from the incident to adapt and
update the plan to the needs of the individual entity/
office/organization. This course provides instruction
in a concept created by the founders of Applied CID
utilizing their substantial years of experience in Law
Enforcement as well as their personal prior experiences
in running and managing retail businesses.

40 2010—San Antonio, Texas

Wednesday Agenda

Wednesday 4:00 p.m. – 5:30 p.m. RM 16 Wednesday 6:30-7:30 p.m. Grand Ballroom
Steps to Successful Community Collaboration CIT International Board Meeting

Presenters: Artie Williams, LCSW, MSSW, Director Q & A Night

of Mental Health Intensive Services, MHMR of Tarrant
County; Sonja Gaines, BA, Chief of Mental Health
Services, MHMR of Tarrant County

Community collaboration is the hallmark of successful

program development and sustainability. Strong
partnerships provide opportunities to know what
resources are available in the community but also
assist with identifying service gaps. This workshop
will provide the participants with concrete and concise
steps to building and maintaining a strong and active
community stakeholder base. Topics will include but
are not limited to: “How to identify stakeholders”,
“How to gain buy-in from the community”, “Sustaining
meaningful collaborations,” and when the partnership
goes south. The presentation will include a video
which shows how a successful collaboration worked
to fill crisis services gaps in Tarrant County, Texas
and how continued support and input have shaped
these services to provide the exact services that the
community needs.

Wednesday 4:00 p.m. – 5:30 p.m. RM 16
Knocking on Doors, Peeping Through

Presenter: Denise Curiel, Criminal Justice Liaison, Adult


Do you want to establish a better relationship with the

Courts, Law Enforcement, or Jail? Having trouble getting
buy-in, or even getting people to come to the table?
No matter how advanced any community’s mental
health and criminal justice collaboration is, there will
always be organizations that are slow to get involved
due to the fact that they see little advantage to their
agency. This session will address various techniques
and strategies one can use to get partners to the table,
including potential cost savings, liability abatement,
and positive community image. This presentation will
assist conference attendees with techniques needed to
get criminal justice, law enforcement, and treatment
providers to work together to create a viable crisis
intervention training. The presentation will demonstrate
a win-win outcome for all involved.

First Annual CIT International Conference 41

Thursday Agenda

Thursday Agenda
Thursday 8:30-10:00 a.m. Grand Ballroom
Closing Session

Thursday 12:00-7:00 p.m. Rm 17 & 18

Mental Health First Aid Course (Part 1)

Brian Gibb-National Behavioral Health Council

Class pre-registration required.

Class also on:

Friday 8:00 a.m.-3:00 p.m. Rm 17 & 18

Mental Health First Aid Course (Part 2)

Brian Gibb-National Behavioral Health Council

Class pre-registration required.

42 2010—San Antonio, Texas

Poster Presentations

Kym Bolado
National Alliance on Mental Illness

Beth Broussard
Implementing a Crisis Intervention Team (CIT) Force in a Large International Airport Setting

Michael Compton
Use of Force Preferences and Perceived Effectiveness of Actions among Crisis Intervention Team
(CIT) Police Officers and Non-CIT Officers in an Escalating Psychiatric Crisis Involving a Subject with

Brian Garrett
Hearing Voices that are Disturbing - A Simulation Experience

Oren SkurniK
Applied CID: Safety Plans and Resources

John Wallschalaeger
Role Play Scenario “Parallel Process”

Bexar County Sheriff’s Office

Deputy Mobile Outreach Team

The Center for Health Care Services

Diversion Initiatives

Haven for Hope

Homeless Campus

Restoration Center CHCS

San Antonio Crisis Intervention Team

First Annual CIT International Conference 43

Additional Resources

2010 2009
Diversion Initiatives Blogs Diversion Initiatives Blogs
1. Criminal Justice Meets Behavioral Health: An 1. Developing an Integrated Response for Veterans
Exchange between Attorney General Eric Holder in Bexar County Texas
and NACBHDD’s Leon Evans http://www.diversioninitiatives.net/2009/12/
http://www.diversioninitiatives.net/2010/04/ developing-integrated-response-for.html
2. Police 3x5 Crisis Intervention Quick Referral
2. Leon Evans video: Mental Health Issues on Cards
Healthcare Debate National Gains Conference http://www.diversioninitiatives.net/2009/11/
March 18, 2010 police-3x5-crisis-intervention-quick.html
leon-evans-videomental-health-issues-on.html 3. Facility Saves People and Money

4. Drug Czar Recommendations 9-23-09


5. Documented and Immediate Cost Avoidance

Report 1 of 2

6. The Restoration Center


7. American Psychiatric Association’s Gold Award


8. Out of Jail and Into Treatment-


9. Short Video on Bexar County Jail Diversion


10. The National Council article on “Bexar County’s

Center Offers Alternatives to Jail and the Streets
NCMagazine- gallery/NC%20Mag%20

44 2010—San Antonio, Texas

Additional Resources

Criminal Justice Meets It’s been said that “involving many lightens the load”. That
is particularly true when it comes to helping people with
Behavioral Health: serious mental and substance abuse disorders navigate
An Exchange between a complex network of local behavioral health care,
Attorney General Eric supportive services and income maintenance programs.
While Leon has done a lot of heavy lifting and has even
Holder and NACBHDD’s wrestled bears (yes, that’s plural), even he needed lots
Leon Evans of help. That help came in the form of county and city
stakeholders from law enforcement, private hospitals,
By Gilbert Gonzales, Director of Communications and the courts (civil and criminal), the local hospital district,
Diversion Initiatives, CHCS (Excerpt in full from April probation/parole plus many more, all on the path to
2010 Newsletter) develop an effective and efficient system of care. A key
component has been working with and providing training
Leon Evans is a bear of a man. That’s a good thing for for law enforcement to promote early identification/
Bexar (pronounced “Bear”) County, Texas, and its 1.6 intervention, increased access, and effective continuity
million citizens. Attorney General Eric Holder is a tall of care in providing mental health and substance abuse
and gracious man, our Nation’s “top cop,” who we are treatment. Crisis Intervention Training (CIT) for law
fortunate to have in that position. Both men met for the enforcement partners mental health, substance abuse,
first time on March 8, 2010. What follows is a story developmental disabilities, and advocacy stakeholders
about what came before and what occurred at that in a joint county wide effort to increase officers’ skills
meeting on a cold Washington morning. and expand knowledge and awareness of local county
resources for persons with mental illness. Since 2003,
First, a bit of history. A decade ago, Leon began the the Center for Health Care Services has engaged in CIT
transformation of Bexar County’s mental health and training with proven cost-effective outcomes.
substance abuse systems. The local mental health
authority, the Center for Health Care Services, is That background brings us to the present. For the past
the mental health services provider of last resort, a year, at the request of an international constituency, the
challenging task, to say the least. As a result, Bexar, Center has been in the throes of advance work for the
as other counties across the country, struggles to treat first International Crisis Intervention Training Conference
a population whose illnesses are so debilitating that to be held on June 1-3, 2010. This upcoming gathering
their health-seeking capacity is virtually non-existent. of personnel from 1,000 CIT programs in the U.S. and
As a result, as Evans points out, many people with the a broad array of law enforcement professionals from
most serious mental illnesses are found, not in county around the country and the world led Evans on a new
treatment programs, but rather in overflowing county path pointed right to the center of national behavioral
jails and congested emergency rooms. The jail and health and criminal justice policy: Washington, DC.
prison systems now include a significant number of
individuals with a history of treatment for mental or The trip to Washington, DC, from San Antonio takes
substance abuse disorders by state hospitals and or about three hours or so. It’s a trip Leon has taken many
county mental health clinics. Probation and parole times both to present testimony before Congress or to
systems are bursting at the seams with such individuals, attend White House events. But this trip was different.
many of whom lack community-based care. “We are When one is convening a first-of-its-kind, international
criminalizing so many who could and should receive conference at the intersection of law enforcement and
treatment,” Evans observes. Moreover, the costs of behavioral health, it’s natural to reach out to the nation’s
inappropriate incarceration, inappropriate emergency top officials, such as Attorney General Holder, to provide
room utilization, and for minor medical treatment in words of encouragement and support to the estimated
emergency departments are staggering, far outstripping 2,000 conference attendees. No stranger to the ways of
the costs of known-effective mental health care. The Washington that is precisely what Evans did.
costs of untreated mental and substance abuse disorders
burdens not only families, but also neighbors, law That is why, in the middle of the NACBHDD’s legislative
enforcement, employers, and tax payers alike. meeting on March 8, 2010, Evans absented himself to

First Annual CIT International Conference 45

Additional Resources

medical services, advocates, family, and behavioral

health consumers themselves.

Evans also pointed out the value of service co-location

that not only brings together physical and behavioral
health together in a single mental health environment but
also brings in adult and juvenile probation and parole
activities, social support, and employment and housing
assistance, providing a one-stop approach. In San
Antonio, to that very end, the Center has been diverting
around 900 individuals with mental or substance abuse
disorders to the “Haven for Hope,” a new $100 million,
1,000-bed facility for individuals who are homeless.
The majority of these individuals historically would have
found their way to incarceration in jail or prison, to
Leon Evans & Attorney General Eric Holder hospital emergency rooms, or to the streets with little
treatment, limited support and little hope. He invited
attend a one-on-one meeting with Attorney General Holder to visit the county to see just what collaborations
Holder to discuss the continued ‘criminalization’ of that blend local, state and Federal resources can do for
people with mental and substance abuse disorders. people with serious mental illnesses.
With an attentive Holder, Evans outlined the challenge
facing local mental health and criminal justice As the meeting drew to an end, Attorney General
authorities, suggesting alternatives to incarceration Holder told Evans, “You are doing great work; this
and their effectiveness from both human and economic is legacy work.” And, oh yes, the Attorney General
perspectives. He spoke of the county’s work to divert will be sharing a “few words” at the CIT International
people with mental illness from jails and emergency Conference. What are they? Come to the conference
rooms into treatment programs that engages courts, and hear them for yourself.
judges, law enforcement, hospitals, and emergency

Police 3x5 Crisis

Intervention Quick
Referral Cards

A set of nine 3x5 cards

are provided to our
CIT Officers during thier
initial 40 hour training.
They are provided as
handy reference tools
and updated before
every new class.

46 2010—San Antonio, Texas

Additional Resources

Providing Jail Diversion for People with Mental Illness

Crisis and Diversion Technical Assistance


 More than one in every 100 adults is now confined in an

American jail or prison. According to figures gathered and
analyzed by the Pew Public Safety Performance Project, the
number of people behind bars in the United States continued to
climb in 2007, saddling cash-strapped states with soaring costs
they can ill afford and failing to have a clear impact either on
recidivism or overall crime.
 In recent years, an increasing number of people with severe
mental illness have come in contact with the criminal justice
 Among the mentally ill, approximately 75% have an ongoing
substance abuse disorder.

Benefits of Diversion:

 Diversion programs have been shown to have positive impacts

on decreasing incarceration time for the severely mentally ill,
while increasing access to, and utilization of, comprehensive
psychiatric services (Dr. Michael Johnsrud, Medical Economist).
 Reduced inappropriate use of ERs and hospitalizations
 Reduction of inappropriate incarceration of persons with
mental illness
 Length of stay in jail is shortened in lieu of increased access to
 Greater efficiency in the use of law enforcement resulting in
increased public safety
 Violence and victimization is reduced
 Costs incurred by taxpayers when a person with mental illness
is arrested, incarcerated, and/or hospitalized is addressed

Proven Resources and Tools available:

 Learn How to Create Community Collaboratives

 Consultation on site
 Leveraging funding to maximize opportunities
 Integrating, blending and braiding local, state and federal
 Training materials
 Materials (program background, plan, job descriptions etc)
 Planning and Implementation Guidelines
 Data and Forms
 Program Design
 Community Input; Governance and oversight
 Evaluation process
 Teleconference, video conference and follow-up

For additional information or to arrange for a consultation please contact:

Leon Evans, President and CEO, CHCS at 210 731-1300, or by Email: levans@chcsbc.org

First Annual CIT International Conference 47

Additional Resources

Bexar County’s Restoration Center Offers Alternatives

to Jail and the Streets
gilberto rendon gonzales, Director, Communications and Diversion Initiatives, The Center for Health Care Services, Bexar County Mental Health
Authority, San Antonio, TX / ggonzales@chcsbc.org

In establishing the Restoration Center, CHCS worked Officers are spending less time in emergency room
closely with local government and public and private waiting rooms, which allows them to return to com-
1,158 stakeholders and drew upon lessons learned from the
nationally recognized, award-winning Bexar County
munity policing.

individuals admitted to the Admissions to the Restoration Center’s detox unit

Jail Diversion Program, started in 2003. Earlier, stake- stem from multiple referral sources such as courts,
Restoration Center instead holders had sought to address the community’s pub- the sobering unit, the crisis care unit, Haven for Hope
of the municipal court lic safety needs by developing the Crisis Care Center partners, and walk-ins by people who are homeless.
with medical clearance for law enforcement officers
detention area saved The Restoration Center is a stakeholder partner in
so that drop-offs take about 15 minutes, compared the $100 million, 37-acre, 962-bed Haven for Hope
taxpayers $2,657,610. to an 8-14 hour wait in emergency rooms earlier. The homeless facility. Located just across the street from
Crisis Care Center’s success in returning officers to the Restoration Center, Haven for Hope is scheduled
469 people taken to the service prompted community stakeholders to address
the gaps in substance abuse treatment through the
to be fully operational in June 2010. The ability to pro-
Restoration Center instead of vide 24-hour access to psychiatric crisis assessment,
Restoration Center. sobering services, minor medical clearance services,
to a hospital emergency room The Restoration Center includes a substance abuse pre-employment services, and housing — all in one
before incarceration saved an court and features three distinct programs: area — exponentially enhances the possibility of treat-
additional $703,500. ment success.
>> The public safety unit, which provides injured
prisoner medical clearance and treatment and a CHCS President and Chief Executive Officer Leon
sobering unit (40+ person capacity) that enables Evans attributes the Restoration Center’s success to
safe sobering of persons brought in by law enforce- community collaboration. “We were able to accom-
ment for public inebriation. plish this because we addressed a compelling need,”
he explains.
>> The medical detox unit, which provides 27-bed Catherine Jones, director of Addiction Recovery Ser-
capacity with a 3- to 5-day stay. vices at CHCS says, “We made it a point to provide
>> Intensive outpatient substance abuse services — information to each of our stakeholders, we moni-
specialized day care treatment with intensive and
tored outcomes, we showed our collaborative pro-
supportive counseling programs.
gram partners what was working and what wasn’t, we

A ddressing the silos dividing substance abuse treat-

ment and mental health services is a monumental
task. The Restoration Center, started in 2007 by The
County Judge Nelson Wolff and business leaders such
as Bill Greehey won the support of the Bexar County,
showed that we were saving money, and we showed
that this approach was a good doorway into treatment
as well.”
Center for Healthcare Services, Bexar County’s Mental Texas, legislative delegation for a special funding ap-
Health and Mental Retardation Authority, seeks to ad- propriation to establish the Restoration Center. Melanie Lane, director of the Restoration Center, at-
dress this problem by providing integrated substance tributes success to persistence and staff serving as ef-
The Restoration Center is proving to be cost-effective. fective role models. She explains that they were able
abuse services. In combination with its sister Crisis In its first 180 days of operation, it served 395 home-
Care Center, a 24-hour psychiatric emergency unit, the to introduce real change — in the past, persons could
less people who were diverted from jail, saving tax- not access substance abuse services unless they were
Restoration Center sees 900–1,000 people a month. payers $766,530. The sobering unit admitted 1,627
Working closely with the Crisis Care Center, the Res- sober but the Center knows you can’t get sober until
individuals in 162 days — 1,158 of them would oth- you get services.
toration Center provides law enforcement with quick erwise have been admitted into the municipal court
access to treatment for nonviolent misdemeanor of- detention area at a cost of $2,657,610. An additional Lane, having once been homeless herself, says, “I’m
fenders with substance abuse problems and also of- $703,500 was saved when law enforcement officers glad someone was willing to take one more chance
fers substance abuse services to homeless persons in took 469 people to the Restoration Center instead of on me.”
the community. to a hospital emergency room before incarceration.


48 2010—San Antonio, Texas


3x5 Crisis

your current information.


your community’s CIT

These cards are provided
Please detach for your use.

these cards quarterly with

We suggest you update
as a template for use in
1. Safety and tactics are and will always be your No. #1 priority! UHS EXPRESS MED SAPD Dispatch . . . . . . . . . . . 207-7484
2. Have a cover officer with you and never cancel your cover. 527 N. LEONA SAPD-CIT Officers . . . . . . . . . 358-9697
3. Utilize the three (3) minute assessment of the subject. M-F 8AM TO 8PM Fax . . . . . . . . . . . . . . . . . . . . 358-6903
4. Determine the possibility of violence/further violence. SAT 8AM TO 4PM SAPD INFO CHANNEL . . . . . . 207-8939
. . . . . . . . . . . . . . . . . . (210) 358-3611 or . 207-7484
5. Gather as much information as possible.
Key Pad Code: 9191* BSCO Dispatch . . . . . . . . . . . 335-4630
6. Focus on the subject. (Let your cover provide for safety/security.)
Mental Health Deputies . . . . . 358-6947
7. Utilize your active listening skills. EVENING HOURS Fax . . . . . . . . . . . . . . . . . . . . 358-6943
8. Listen to the subject when he/she speaks. PUBLIC SAFETY UNIT Magistrate . . . . . . . . . . . . . . . 207-7535
9. Avoid orders that will escalate hostility. 601 N. FRIO Community Court . . . . . . . . . 246-1340
10. Develop rapport. . . . . . . . . . . . . . . . . . . (210) 246-1360 Bexar County Jail . . . . . . . . . 335-6271
11. Influence the subject by giving choices. M-F 8PM TO 8AM or . 335-6417
12. Explain how you want to help. July 2009 SAT 4PM TO SUN 8AM July 2009


When a consumer with mental retardation exhibits symptoms of mental illness 24/7 Hours Of Operation
and requires psychiatric intervention, the consumer CAN be brought to 527 Public Intoxicants
N. Leona Crisis Care Center on a voluntary basis, or if the consumer meets 601 N. Frio
criteria for an emergency detention, as an emergency detention. The need for (210) 246-1360
psychiatric intervention will be established on the same legal and clinical basis Admission Criteria
as for the general population with special attention to the communication and • Adults 18 Years And Up
or expressive difficulties that this special population may have. The consumer • Voluntary ( Facility Not Secured)
may require medical clearance when necessary. • Under The Influence Of Alcohol Or Drugs Or History Of Substance Abuse
In sum, the doors of the Crisis Care Clinic are open to the mentally retarded Exclusion Criteria
population in crisis, with special interest and understanding for their specific • Pregnancy
handicap. • Unstable Medical Condition (See Referal To ER Card)
• Active Seizures
527 N. LEONA (210) 225-5481 (24 HRS / 7 DAYS)
• Danger To Self Or Others / Aggressive Behavior
• Found Down—Unresponsive July 2009

First Annual CIT International Conference 49

Psychiatric patients may show behavioral problems because of medical/surgical conditions.
EMERGENCY ROOM. 2. Do not use analogies.
3. Do not argue or question their delusions.
1. The Patient Was “Found Down” Confused/Disoriented, or
2. Evidence That The Patient Has Taken An Overdose
4. Do not play into their delusions or allow yourself to be manipulated.
3. Was In A Fight (Physically Assaulted:rape) or 5. Do not threaten arrests falsely.
4. In A Motor Vehicle Accident or 6. Do not negate their feelings or seriousness.
5. Unstable Medical Condition 7. Do not overreact to insults of any type: Don’t take it personally.
6. There Are Injuries (Head, Etc) Unable To Move Any Parts Of His Body or 8. Never trivialize a request or the subject, nor patronize.
7. The Patient Is Combative, Violent Requiring To Be Restrained or
9. Do not draw attention to any victims.
8. The Patient Has Seizure or
9. Has Chest Pains/Severe Abdominal Pain/Severe Head Pain/Short Of Breath/ 10. Never place a deadline on yourself and never accept a deadline.
Wheezing or 11. Time is the KEY!
10. Attempted Suicide By Hanging/Strangulation. 12. If you think suicide is possible, ask about it.
11. Pregnant Patients Should Go Directly To Uhs Ob/Gyn-Er or Other Er. July 2009 July 2009
Express Med Clinic (527 N. Leona) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 358-3614 ACTIVE LISTENING SKILLS
(B) San Antonio State Hospital (6711 S. New Braunfels) . . . . . . . . . . . . . . . . . . . . . . 532-8811 M – MINIMAL ENCOURAGERS
(B) University Hospital (4502 Medical) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 358-2524 The use of phrases that encourage the subject to continue talking.
(B) Methodist Specialty And Transplant (8026 Floyd Curl) . . . . . . . . . . . . . . . . . . . . . 575-8168 (Hmm, U huh, Then What, or What else).

50 2010—San Antonio, Texas

(A) Metropolitan Methodist (1310 Mccullough Ave) . . . . . . . . . . . . . . . . . . . . . . . . . . 757-2280 O – OPEN ENDED QUESTIONS
Methodist Behavioral Medicine Inquiry Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 575-0500 Questions phrased in a manner designed to encourage further discussion by the subject rather than a question
(B) Nix Behavioral Health Services (4330 Vance Jackson) . . . . . . . . . . . . . . . . . . . . . 579-3800 that can be answered with a yes or no response.
(G) Nix Heritage Unit (414 Navarro St.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .579-3800 R – REFLECTING/MIRRORING
(A) VA Hospital (Veterans Only – 7400 Merton Minter) . . . . . . . . . . . . . . . . . . . . . . . 617-5300 REFLECTING MEANING – Mirroring both content and feelings plus the future implications.
(G) St. Luke’s Baptist Hospital (7930 Floyd Curl Dr.) . . . . . . . . . . . . . . . . . . . . . . . . . 297-5440 MIRRORING – The other person’s feelings in succinct form.
(A) Southwest General Hospital (7400 Barlite Blvd.) . . . . . . . . . . . . . . . . . . . . . . . . . 921-3255 E – EFFECTIVE PAUSES
(A & G) Mission Vista (14747 Jones Maltsberger) . . . . . . . . . . . . . . . . . . . . . . . . . . . 497-0004 The use of pauses that encourage the subject to continue talking.
(B) Laurel Ridge (17720 Corporate Woods Dr.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 491-9400 P – PARAPHRASING
A concise response to a person that reflects the essence of the speaker’s content in the words of the listener.
(C) Southwest Mental Health Center (8535 Tom Slick) . . . . . . . . . . . . . . . . . . . . . . . 616-0300
(G) La Paz Community MH Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 558-8744
Putting an “I” before the CIT Officer’s statement to make it clear that what follows are the CIT Officer’s thoughts,
Opc County Clerk Mental Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335-2536
feelings or opinions.

July 2009
Roy Maas Youth Alternatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 340-8077 E – EMOTIONAL LABELING
(A) Solara Day Treament . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299-1152 Identifying the subject’s feelings (You sound happy, or sad, or frustrated)
(A) – Adults Only (B) – Both Adults & Children (C) – Children Only (G) – Geriatric July 2009
July 2009

July 2009
CRISIS CARE CENTER (527 N. Leona)………… . . 225-5481

Quick CRISIS LINE 24/7 . . . . . . . . . . . 223-7233 or 1(800)316-9241 Psychiatric Hospital contact Info
Downtown Baptist Admissions 297-7610
Referral Mobile Crisis Outreach Team . . . . . . . . . . . . . . . . . 223-7233
Eligibility & Intake (1200 Brooklyn St. Ste 300) . . . 223-4061 Downtown Baptist Psych Unit 297-7040
Cards Public Safety Triage Facility (601 N. Frio) . . . . . . . 246-1360 Laurel Ridge 491-9400 fax 491-3550
Methodist Hospitals Admissions ph 575-0500 fax 575-0523
DETOX CENTER (601 N. Frio) . . . . . . . . . . . . . . . . . 246-1360
Intensive Outpatient Substance Abuse . . . . . . . . . . 246-1303 Methodist Specialty Psych Unit 575-8376
Harvard Place (1920 BURNET) . . . . . . . . . . . . . . . . 227-3401 Metropolitan Methodist Psych Unit 757-2465
Northwest Clinic (9502 Computer Dr. Ste.100) . . . 615-5700 Metropolitan Methodist Medical Records 757-2984
Please detach for your use. Zarzamora Clinic (806 S. ZARZAMORA) . . . . . . . . . 434-7001 fax 757-2554
FACT Unit (5802 S. Presa) . . . . . . . . . . . . . . . . . . . 436-8018 Mission Vista 527-1444
These cards are provided Jail Diversion Clinics (2711 PALO ALTO Rd.) . . . . . 533-2577 Nix Heritage (admissions go thru Nix Specialty)
as a template for use in Mentally Ill Offenders Facility . . . . . . . . . . . . . . . . . 628-1833 Nix Heritage Psych Unit 579-3800
Nix Specialty 341-2633 fax 341-3083
your community’s CIT Forensic ACT Team Pager . . . . . . . . . . . . . . . . . . . 258-0251
Telecare South . . . . . . . . . . . . 225-0152 or 1 (800) 673-8336 Northeast Baptist Psych Unit 297-2880
program. San Antonio State Hospital 532-8811 fax 531-7830
Telecare North . . . . . . . . . . . . . . . . . . . . . . 1 (800) 673-6947
Children’s Services (711 E. JOSEPHINE) . . . . . . . . 299-8139 Southwest General Psych Unit
We suggest you update UHS EC Triage 358-2488
Juvenile Services (711 E JOSEPHINE) . . . . . . . . . . 531-1927
these cards quarterly with Mental Retardation Authority . . . . . . . . . . . . . (800)832-5020 UHS EC EM-1 (MD) 358-0682
your current information. (8700 Tesoro Ste.) UHS PCC (RN Supervisor) 358-0683
Mental Retardation (104 STORY LANE) . . . . . . . . . 533-9515 UHS PES 358-2524
UHS Inpatient Unit 358-1260
D.O.B. _________AGE____ GENDER ____ETHNICITY____SSN#_____________________

COUNTY______________ZIP CODE (MUST HAVE)________TELEPHONE______________

July 2009

July 2009

DOCTOR’S NAME / TELEPHONE NO#__________________________________________






TODAY’S DATE________________





First Annual CIT International Conference 51

Downtown Baptist ER ………………………...297-7000
CPS/APS Protective Services – Reporting Abuse or
Main Methodist ER …………………………...575-4444
Neglect Line . . . . . . . . . . . . . . . . . . . . . . . 1-800-252-5400
Metropolitan Methodist ER …………………..757-2280
Battered Women’s Shelter . . . . . . . . . . . . . . . . . . . 733-8810
Methodist Specialty ER ……………………….575-8168
S.A. AIDS Foundation . . . . . . . . . . . . . . . . . . . . . . . 225-4715
Nix Downtown Hospital ER …………………..272-1741
AL-ANON . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 829-1392
North Central Baptist ER ……………………..2.97-4650
CHILD SAFE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 675-9000
Northeast Baptist ER ………………………….297-2650
Alcoholic Rehab Center (MEN) . . . . . . . . . . . . . . . . 633-0201
Northeast Methodist ER ……………………….757-5009
ALPHA Home (WOMEN) . . . . . . . . . . . . . . . . . . . . . 735-3822
St. Lukes Baptist Hospital ER ………………...297-5660
Audie Murphy Memorial Hospital . . . . . . . . . . . . . . 617-5300
Santa Rosa ER ………………………………...704-2880
Baptist Child and Family Services . . . . . . . . . . . . . . 832-5000
Southeast Baptist ER ………………………….297-3650
D.A.’s Family Violence Unit . . . . . . . . . . . . . . . . . . .335-2865
Southwest General ER ………………………...921-3255
Protective Order . . . . . . . . . . . . . . . . . . . . . . . . . . . 208-6824
Stone Oak Methodist ER ……………………...638-2000
Juvenile Probation Office . . . . . . . . . . . . . . . . . . . . 531-1000
Brooks Army Medical Center . . . . . . . . . . . . . . . . . 916-4141
Council on Alcohol and Drugs . . . . . . . . . . . . . . . . 225-4741
Express Med
Family Violence Prevention Services . . . . . . . . . . . 930-3669
(527 N. Leona) for Minor
Family Service Assoc. (Counseling) . . . . . . . . . . . . 226-3391
Medical Clearance….. …………………..358-3611
Red Cross . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224-5151
358-5975 or 358-3614 or 358-3462
El Centro Del Barrio (Out Patient Medical Clinic) . . 922-0103
Family Resource Center psychiatry . . . . . . . . . . . . . 927-1816
Bexar County Jail…….. 335-6271 or 335-6417
National Alliance for the Mentally ILL NAMI . . . . . . 734-3349
Mentally Ill Offenders Facility….. 628-1833
24/7 Homeless Outreach . . . . . . . . . . . . . . . . . . . . 859-5146
Forensic Act Team ..pg 285-0251 ph 436-8018 fax 531-0175
Davidson Respite Home (Autism) . . . . . . . . . . . . . . 260-3557
July 2009

July 2009
Mobile Crisis Outreach Team please call the Crisis Line 24/7
CRISIS LINE – (210) 223-SAFE (7233) OR 1-800-316-9241
TELEPHONE- (210) 225-5481 FAX# - (210) 358-6907

______________________________________________________________ July 2009

NEEDED): ______________________________________________________________

ANY KNOWN MEDICAL CONDITIONS/ PROBLEMS? _____________________________



IF NOT, WHY?___________________________________________________________


July 2009

52 2010—San Antonio, Texas


3x5 Crisis

your current information.


your community’s CIT

These cards are provided
Please detach for your use.

these cards quarterly with

We suggest you update
as a template for use in
Screening Questions For SAPD Referrals or Patients on Emergency Detention

1. IS the person being violent NOW?

2. IS the patient threatening violence NOW?

Crisis Line.
3. IS the patient pregnant? IF YES—GO to UHS ER

4. IS the person having CHEST PAIN?

psychiatric symptoms.
5. IS the person exhibiting a FEVER?
6. IS the person VOMITING?
7. IS the person SHORT OF BREATH?
8. IS the person suspected of taking an OVER-

Monday – Friday, 8:30 AM to 8:00 PM

the influence of any drug or alcohol.

9. HAS the person attempted to HANG
IF YES—Go to the most appro-




10. HAS the person caused SERIOUS BODILY priate ER OR call EMS

Children’s Crisis Services

HARM to THEMSELVES? i.e., Deep Lac-

TELEPHONE: (210)299-8139 FAX: (210)212-8128

The Children’s Crisis Services Unit provides crisis

to provide services to a youth who is medically

The Children’s Crisis Services Unit is NOT equipped
erations, Stab Wound etc.

intervention and support to youth under the age of

11. IF person is intoxicated—are they UN-

18, diverting them to the least restrictive environment

Crisis situations involve those in which the youth poses

cause serious harm to themselves or others may be at

CRISIS LINE: (210)233-SAFE (7233) OR 1-800-316-9241

displays behavior that is escalating in severity and may

necessary. After 8:30 PM and on the weekends call the

risk of disruption of the preferred living situation due to

a threat to their own safety or that of another individual,
July 2009 July 2009

compromised, pregnant, and violent person who is under


Antipsychotics Antidepressants Sleepers Antianxiety

Old Drugs Old Drugs Brand Name . . . . . . . Generic Benzodiazpines
Brand Name . . . . . . . Generic Brand Name . . . . . . . Generic Buspar . . . . . . . . . . Buspirone
Loxitane . . . . . . . . . Loxapine Elavil . . . . . . . . . . . Amitriptyline Valium (Bz) . . . . . . . Diazepam Antiparkinsonian Agents
Moban . . . . . . . . . . Molindone Ascendin . . . . . . . . . Amoxapine Ativan (Bz) . . . . . . . . Lorazepam Brand Name . . . . . . . Generic
Navane . . . . . . . . . . Thiothixene Tofranil . . . . . . . . . . Imipramine Klonopin (Bz) . . . . . . Clonazepam Cogentin . . . . . . . . . Benztropine
Thorazine . . . . . . . . Chlorpromazine Norpramin . . . . . . . . Desipramine Serax (Bz) . . . . . . . . Oxazepam Benadryl . . . . . . . . . Diphenhydramine
Trilafon . . . . . . . . . . Perphenazine Pamelor . . . . . . . . . Nortriptyline Librium
12. (Bz) . . . . . . . Chlordiazepoxide
IS the person ELDERLY (>60 Artanie . . . . . . . . . . Trihexphenidyl
IF YES— go to the most
Stelazine . . . . . . . . . Trifluoperazine Sinequan . . . . . . . . . Doxepin Restoril (Bz) . . . . . . . Temazepam appropriate ER
years) ?
Mellaril . . . . . . . . . . Thioridazine Anafranil . . . . . . . . . Clomipramine Tranxene (Bz) . . . . . . Chorazepate Methodist Specialty & Transplant Geri Psych
Serentil . . . . . . . . . . Mesoridazine Ludiomil . . . . . . . . . Maprotiline Xanax (Bz) . . . . . . . . Alprazolam
Haldol . . . . . . . . . . Haloperidol Luvox . . . . . . . . . . Fluvoxamine Dalmane (Bz) . . . . . . Flurazepam
Orap(for Tourettes) . . . Pimozide Vivactil . . . . . . . . . . Protriptiline Sonata . . . . . . . . . . Zaleplon Northeast Baptist Geri-Psych Unit
Prolixin . . . . . . . . . . Fluphenazine Ambien . . . . . . . . . . Zolpidem Nix Downtown Heritage Geri-Psych Unit
New Current Drugs MAOI’s( multidrugs&foodinteractions/ Noctec . . . . . . . . . . Chloral Hydrate
Brand Name . . . . . . . Generic Hypertensivecrisis) Halcion (Bz) . . . . . . . Triazolam
Geodon . . . . . . . . . Ziprasidone Vistaril/Atarax . . . . . . Hydroxyzine
Risperdal . . . . . . . . . Risperidone Nardil Phenelzine Lunesta . . . . . . . . . Eszopiclone IF YES—REFER TO
Zyprexa . . . . . . . . . Olanzapine Parnate Tranylcypromine Prosom (Bz) . . . . . . . Estazolam
Seroquel . . . . . . . . . Quetiapine Marplan Isocarboxazid Doral13. IS the person a CHILD (<18
(Bz) . . . . . . . . Quazepam
CHCS Children’s Crisis Services …….299-8139
Abilify . . . . . . . . . . Aripiprazole Emsam SelegilinePatch years)?
Versed (Bz) . . . . . . . Midazolam 711 East Josephine M-F 830-2000
Clozaril . . . . . . . . . . Clozapine (Transdermal) Periactin . . . . . . . . . Cyproheptadine Southwest Mental Health Center …….616-0300
Invega . . . . . . . . . . Paliperidone Rozerem . . . . . . . . . Ramelteon Laurel Ridge Hospital ……………….491-9400
Saphris . . . . . . . . . . Asenapine July 2009 July 2009
Methodist Specialty and Transplant ...575-8168

First Annual CIT International Conference 53

Flanapt . . . . . . . . . . Iloperidone
Nix Specialty ………….341-2633 fax 341-3083
University Hospital EC PES ………...358-2524
4. IS the person having CHEST PAIN?
5. IS the person exhibiting a FEVER?
6. IS the person VOMITING?
7. IS the person SHORT OF BREATH?
8. IS the person suspected of taking an OVER-
9. HAS the person attempted to HANG
THEMESELVES? IF YES—Go to the most appro-
10. HAS the person caused SERIOUS BODILY priate ER OR call EMS
HARM to THEMSELVES? i.e., Deep Lac-
erations, Stab Wound etc.
11. IF person is intoxicated—are they UN-
12. IS the person ELDERLY (>60 IF YES— go to the most
years) ? appropriate ER
Methodist Specialty & Transplant Geri Psych

Mental Health Deputies 358-6947 fax 358-6943


SAPD Dispatch ………………….207-7484

Bexar County Sheriff Dispatch ….335-4630
SAPD MH Unit ………………….358-9697
Northeast Baptist Geri-Psych Unit
Nix Downtown Heritage Geri-Psych Unit
13. IS the person a CHILD (<18 CHCS Children’s Crisis Services …….299-8139
years)? 711 East Josephine M-F 830-2000
Southwest Mental Health Center …….616-0300
Laurel Ridge Hospital ……………….491-9400
Methodist Specialty and Transplant ...575-8168
Nix Specialty ………….341-2633 fax 341-3083
University Hospital EC PES ………...358-2524
July 2009
July 2009
Mood Stabilizers Seizures
Brand Name . . . . . . . Generic
Eskalith/Lithonate . . . . Lithium Carb.(mood) Brand Name . . . . . . . Generic
Depakote (both) . . . . . Divalproex Celexa . . . . . . . . . . Citalopram
Benzodiazepine (both) Remeron . . . . . . . . . Mitazapine
Lamictal (both) . . . . . Lamotrigine Wellbutrin/Zyban . . . . . Buproprion

54 2010—San Antonio, Texas

Neurontin . . . . . . . . Gabapentin Serzone . . . . . . . . . Nefazodone
Tegretol (both) . . . . . . Carbamazepine Effexor . . . . . . . . . . Venlafaxine
Trileptal (both) . . . . . . Oxcarbazepine Prozac . . . . . . . . . . Fluoxetine
Topamax (both) . . . . . Topiramate Paxil/Pexeva . . . . . . . Paroxetine
Keppra (sz) . . . . . . . Levetiracetam Zoloft . . . . . . . . . . Sertraine
Gabitril (sz) . . . . . . . Tiagabine Cymbalta . . . . . . . . . Duloxetine
Zonegram (sz) . . . . . . Zonisamide Symbyax . . . . . . . . . Fluoxetine & Olanzapine
Depakene/Stavzor . . . . Valproic Acid Lexapro . . . . . . . . . Escitaloprom
Desyrel . . . . . . . . . . Trazodone (Used mainly as a sleeper)
Stimulants: ADHD Meds
Brand Name . . . . . . . Generic
Ritaline/Concerta/Metadate/ Methylphenidate
Dexedrine . . . . . . . . Dextroamphetamine
Adderrall . . . . . . . . . Dextro/Amphetamine
Focalin . . . . . . . . . . Dexmethylphenidate
Provigil/Attenance . . . . Modafinil
Strattera . . . . . . . . . Atomoxetine
July 2009 Vyvanse . . . . . . . . . Lisdexamfatimine July 2009
Intunir/Tenex . . . . . . . Gucinfacine
First Annual CIT International Conference 55
Hotel Map

56 2010—San Antonio, Texas

2010 Conference Committee


Sgt. Yvonne Vann- Bexar County Sheriff’s Office

Sgt. Romana Lopez- San Antonio Police Department
Jeanie Paradise– The Center for Health Care Services
Gilbert Gonzales–The Center for Health Care Services

Steering Committee Members:

Homer Arias
Marco Cabrera
Barbara Campbell
Angela Diehl
Dr. Melissa Graham
Terri Mabrito
Justin Marshall
Luis A. Mendez
Susan Mercado
Sara Moreno
Roger Morin
Jesse Sanaseros
Veronica Tailes
Lupe Torres

Additional Committee Members not listed were also a vital key in bringing the
First Annual CIT International Conference to you. We thank them all.

First Annual CIT International Conference 57

Conference Exhibitors
Exhibitor Times:

Tuesday, June 1, 8 a.m. – 5p.m.

Wednesday, June 2, 8 a.m. – 6p.m.

Thursday, June 3, 8 a.m. – 10:30 a.m.

Acadia Health Care Services Laurel Ridge

Aftermath Maguire Publications, LLC

Anasazi Software The Mandt System

Applied CID Meridell Achievement Center

Astra Zeneca Pharmaceutical (2 Exhibitor Spaces) NAMI San Antonio

Barbara Schneider Foundation Nardis Public Safety

Bexar County Sheriff’s Office NIX Health Care System

The Center for Health Care Services Patience Home Health

DAPA Behavioral Health San Antonio Chapter of HAPCOA

Eli Lilly San Antonio Police Department

Elisa Fashion Jewelry Serenity House Drug and Alcohol Treatment Centers

Hillcrest Behavioral Health/Psych Solutions Inc Southwest Mental Health

Janssen Pharmaceutical (2 Exhibitor Spaces) Telecare Corporation

La Paz Behavioral Health The Wood Group

58 2010—San Antonio, Texas

Conference Sponsors


National Center
Behavioral Health

First Annual CIT International Conference 59

My Notes

60 2010—San Antonio, Texas

My Notes

First Annual CIT International Conference 61

My Notes

62 2010—San Antonio, Texas

My Notes

First Annual CIT International Conference 63

My Notes

64 2010—San Antonio, Texas

My Notes

First Annual CIT International Conference 65

My Notes

66 2010—San Antonio, Texas

My Notes

First Annual CIT International Conference 67

My Notes

68 2010—San Antonio, Texas

Proud Supporters
of Crisis Intervention

Deputy Sheriff’s Association

of Bexar County
816 Camaron #214
San Antonio, Texas 78212
Office: 210 223 2213
Fax: 210 225 7606

Laurel Ridge

Serving Children, AdoleSCentS & AdultS

Substance Abuse • Psychiatric • Dual Diagnosis • Detox

Military Specific Programs
Day Treatment / Partial Hospitalization
Residential Treatment Programs (Child / Adolescent)

210.491.9400 / 800.624.9897 | www.laurelridgetc.com 17720 Corporate Woods Drive

From the moment you arrive you
will be embraced by the personal
touch that generations of Texans
have experienced at the NIX. We
bring together the finest physicians
and the latest technology with an
unrivaled staff dedicated to your
personal attention.

Complete continuum of care

• inpatient and outpatient
• behavioral health
• physical rehabilitation
• home care services
Excellent primary care
physicians and specialists*
Five convenient locations

NIX Medical Center • 414 Navarro

NIX Alamo Heights • 5307 Broadway
NIX Specialty Health Center • 4330 Vance Jackson
NIX North Orthopaedic Center • 9150 Huebner Road
NIX Primary Care Center • 700 S. Zarzamora

For more information call (210) 271-1800

or visit www.nixhealth.com
* Physicians are independent practitioners and active members of the Nix medical staff.