1. “A SHERIFF’S PERSPECTIVE ON THE CURRENT MENTAL HEALTH SYSTEM IN NORTH CAROLINA” SHERIFF SAM PAGE ROCKINGHAM COUNTY, N.C. 2015 NAMI Conference in Raleigh, N.C.

2. Mental Health Reform: 2  1840s – DORETHEA DIX crusaded for years for State supported Psychiatric Hospitals for the treatment of persons suffering from mental illness.  She was opposed to just throwing the mentally ill into local jails and prisons with no real treatment. SOURCE: N.C. Center for Public Policy Research, Mebane Rash 2012 article

3. Mental Health Reform: 3  1900s – Change in thoughts on IN-PATIENT vs. OUT-PATIENT care for the mentally ill.  1999 – U.S. Supreme Court, Olmstead Decision, that basically said persons with mental illness need to be treated in the least restrictive sittings. SOURCE: N.C. Center for Public Policy Research, Mebane Rash 2012 article

4. Mental Health Reform: 4  2001 – N.C. passed Mental Health Reform Legislation  2001 to 2011 – Observed approximately 46% increase in community based treatment. County Mental Health programs became managed by Local Management Entities (L.M.E.s) SOURCE: N.C. Center for Public Policy Research, Mebane Rash 2012 article

5. Mental Health Reform: 5  When the call for help comes… what will YOU do?  Reidsville Police 9-1-1 audio recording (background)

6. Mental Health Reform: 6  So… what changed my thoughts on interactions between Law Enforcement and the Mentally Ill?

7. 7 VIDEO – Kenneth Terry, 2004 (Background)

8. Crisis Intervention Training (C.I.T.): 8  After releasing the vehicle back to Mr. Terry’s family, they place it in their front yard with a large sign on it…  “THE ROCKINGHAM COUNTY SHERIFF’S DEPARTMENT HAS A LICENSE TO KILL THE MENTALLY ILL”

9. Crisis Intervention Training (C.I.T.): 9  Following the fatal shooting in the graveyard in 2004, I began assessing what we as law enforcement officers can do better to reduce the chances of someone dying during these encounters while maintaining the safety of the officer and the community.

10. Crisis Intervention Training (C.I.T.): 10  After all, Deputies interact with individuals suffering from Mental Illness EVERYDAY…

11. Crisis Intervention Training (C.I.T.): 11  It was then that I discovered CRISIS INTERVENTION TRAINING (C.I.T.) offered through NAMI and attended a presentation on the program in Statesville, N.C.

12. Crisis Intervention Training (C.I.T.): 12  Afterwards, we met with our local NAMI representatives and formed a Mental Health Committee.  Grant was obtained to cover training costs of offering C.I.T. to Deputies and local officers.

13. Crisis Intervention Training (C.I.T.): 13  Key stakeholders came together and within a year, we had developed a plan and M.O.A. for training and put that plan for enhanced Mental Health Services from all of our stakeholders into action.

14. What was the Expected Outcome?: 14  To reduce the wait time for officers during Involuntary Commitment Process so that these officers can return to their street assignments as quickly as possible.  To reduce the chances of a deadly encounter/ending while interacting with a Mentally Ill person.

15. What was the Expected Outcome?: 15  To provide Law Enforcement Officers with the tools and skillset to de-escalate a situation involving a Mentally Ill individual, so we can get that person in crisis the help needed, thus being able to return them to their home setting quicker.

16. What was the Expected Outcome?: 16  Most of our officers at the Rockingham Co. Sheriff’s Office and throughout all agencies in the county are trained in the 40 hour C.I.T. course thanks to NAMI and our Rockingham County Mental Health Committee.

17. CRISIS INTERVENTION TRAINING FOR OFFICERS: 17

18. What was the Expected Outcome?: 18  We MUST continue to train our Telecommunicators, Jail staff, Hostage Negotiators, and other First Responders in C.I.T.  Now, 6 hours of C.I.T. is also being taught as part of the B.L.E.T. curriculum

19. Costs Associated with IVC Process?: 19 For Rockingham County Sheriff’s Office and FIVE local Police Agencies: 2012-2014 Man hours involved = $136,483 2014 Transportation man hour cost of 722 patients = $34,300

20. Jail Mental Health Issues: 20  Nowadays, we are seeing more and more persons entering our local jail systems with Mental Health issues.

21. Jail Mental Health Issues: 21  Our Jail and Medical Staffs are working harder to better screen arriving inmates to get help to those in need and reduce the chances of suicide in the jail.

22. Jail Mental Health Issues: 22  50% of jail suicides occur within the first 24 hours of incarceration.

23. Jail Mental Health Issues: 23  Arresting Officer’s role in suicide prevention.  Local LME is also working with Law Enforcement in community based suicide prevention& awareness by way of the faith community.

24. Jail Mental Health Issues: 24  Many jail suicides (attempted or successful) are committed by persons NOT being held on serious charges.

25. Problems with Mental Health Reform: 25  After 2001, movement to reduce in- patient beds by turning over Mental Health services to L.M.E.s. Currently, our L.M.E. is trying to establish a 24 hours crisis center. (MUCH THANKS)

26. Returning War Veteran Issues: 26  P.T.S.D.  T.B.I.  Depression  Alcohol & drug abuse issues

27. Problems with Mental Health Reform: 27  Shortages of State in-patient beds.  Increased wait times at local hospitals.  Suicide rates seem to be increasing.  Reduced local and State budgets.  Increased population to be served.

28. What We Have Seen: 28  14 hours standoff w/heavily armed Marine Veteran.  PTSD suicide/attempted murder on Christmas Eve.  Madison area IVC – VIDEO (Background)

29. What We Have Seen: 29  14 hours standoff w/heavily armed Marine Veteran.  PTSD suicide/attempted murder on Christmas Eve.  Madison area IVC – VIDEO (Background)

30. Training Officers in Less Lethal Force: 30  Training for all Sworn Deputies & Detention Officers.  Training for S.R.T. members in deployment and after care for patient.  “Suicide by Cop”.  SAFETY FIRST! (Community, Officer & person in crisis!)

31. Mental Health Care in the Future: 31  Budgets and funding always a big issue tied to Mental Health Care in N.C.  Organizations such as NAMI, as well as Advocates such as yourselves, are the most important component in the future of Mental Health!

32. Mental Health Care in the Future: 32  Continue to train LEOs, Detention Officers & First Responders in C.I.T.  We have learned back home in my county that you can’t always wait on State and Federal Govt. to solve our local problems. STEP UP AND GET INVOLVED!

33. Mental Health Care in the Future: 33  Form Community Partnerships to combine available resources.  REMEMBER – Don’t give up & continue to help those in our communities in need that can’t help themselves in crisis situations.

34. Mental Health Care in the Future: 34  According to an article from MEBANE RASH on the future of the Mental Health System, we must SET A STRATEGY, IMPLEMENT IT, and STAY THE COURSE long enough to evaluate it… I think this makes a lot of sense.

35. 35 Thinking outside the box: DVD VIDEO (Background – Sheriff Page as Reporter)

36. QUESTIONS: 36

37. THANK YOU! 37 SHERIFF SAM PAGE Rockingham County, N.C. (336) 634-3239 sheriffpage@gmail.com TWITTER: @rockcosheriff