May 21, 2025 • 28 mins
Sherry Witwer, board president for CIT Utah, shares her insights on improving crisis response systems for people experiencing mental health emergencies and creating alternatives to incarceration through specialized training and community partnerships.
• CIT (Crisis Intervention Team) training provides law enforcement with tools to effectively respond to mental health crises and connect individuals with appropriate treatment
• Mobile crisis outreach teams staffed by behavioral health providers and peers can handle most crisis calls without police involvement
• Receiving centers offer alternatives to jails or emergency rooms, providing specialized assessment and stabilization for those in mental health crisis
• Proper training helps officers distinguish between substance use and mental health crises through scenario-based practice and building community partnerships
• Access to care remains a significant challenge, particularly coordinating services for people with serious mental illness across different systems
• Better case management and peer support services are needed to help individuals navigate complex systems when they're least able to do so independently
• Affordable and supportive housing is essential for recovery and breaking cycles of hospitalization and incarceration
• Including voices of people with lived experience and families is crucial for designing effective mental health services that people will actually use
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Welcome to why Not Me ?
The World Podcast, hosted byTony Mantor, broadcasting from
Music City, usa, nashville,tennessee.
Join us as our guests tell ustheir stories.
Some will make you laugh, somewill make you cry.
Their stories Some will makeyou laugh, some will make you
(00:30):
cry.
Real life people who willinspire and show that you are
not alone in this world.
Hopefully, you gain moreawareness, acceptance and a
better understanding for autismAround the World.
Hi, I'm Tony Mantour.
(00:53):
Welcome to why Not Me?
The World Humanity OverHandcuffs the Silent Crisis
special event.
We're delighted to welcomeSherry Witwer, a dedicated and
passionate advocate for mentalhealth and community well-being.
With an extensive careerspanning numerous roles, sherry
(01:13):
has made significantcontributions across a wide
range of sectors.
This includes communitynon-profits, government and
corporate environments.
She currently serves as boardpresident for CIT Utah, sits on
the National Advisory Board forthe CIT Assist Program and holds
the position of board vicechair for the Utah Housing
Coalition.
Additionally, she is a founderand board member of Peers
(01:37):
Empowering Peers Utah, anorganization devoted to
advancing mental health peersupport.
It's an honor to have her withus today to share her wealth of
experience and insights.
Thanks for coming on.
Speaker 2 (01:51):
Thank you, thank you for the opportunity.
Oh, it's my pleasure.
Speaker 1 (01:55):
I understand that you are the president for CIT Utah.
Can you expand on what that is?
Speaker 2 (02:01):
Yes, I guess, as a matter of introduction, I'm a
longtime mental health advocate.
I've worked in variouscapacities in our mental health
system, primarily in publicpolicy advocacy.
I'm a family member of someonewith a serious mental illness
and that's what has driven mywork and my interest in the
(02:39):
mental health system.
That is, training for lawenforcement, behavioral health
providers and families andpeople with lived experience.
They come together to providetraining for law enforcement and
, more importantly, to have aneffective crisis response.
When someone is in crisis, thatlaw enforcement has the
(03:00):
training and the support of themental health system to help
them respond effectively and getthe person to the treatment
that they need.
Now really positive developmentis that with our crisis
response systems, we havedeveloped mobile crisis outreach
teams that are driven bybehavioral health providers with
(03:23):
peers, people with livedexperience, who can respond to
the overwhelming majority ofthose calls, and that really
provides better outcomes andhelps us to treat mental health
as a mental health condition.
However, there are times whenlaw enforcement needs to be
involved or behavioral healthteam is uncertain in their
(03:46):
response, and so they canco-respond or have law
enforcement take the lead inthat response.
But having that training andthat understanding is critical
to having better outcomes foreveryone involved.
Speaker 1 (04:00):
With what you're involved.
I believe they have created anew number for crisis response.
Speaker 2 (04:06):
So CIT is still an important piece and I don't want
that to be overlooked in ourcrisis response systems, because
(04:34):
there just are times when lawenforcement needs to be involved
.
They are called out and torecognize oh, this is a mental
health crisis and we need to getour CIT team to be able to
respond differently to thatsituation.
Speaker 1 (04:51):
When police are involved, the goal is, of course
, to improve outcomes andprevent situations from
escalating.
How have they responded to thetraining efforts aimed at
teaching the officers to quicklyassess situations and make
decisions?
Given their limited time and,of course, their budget
(05:11):
constraints, have you seen asgood a response as you hoped for
?
Speaker 2 (05:17):
Yeah, I think, first of all, when you talk to law
enforcement, they are inundatedwith mental health calls and
they really would rather not beresponding to those calls, so
they welcome mobile crisisoutreach teams and some of these
responses really takes theburden off of law enforcement
(05:38):
and having to make all of thosedecisions.
Still, there are times when theyneed to and that's where having
best practice CIT program isinvolved and that means having
everyone have all lawenforcement, get basic mental
health training and build thoserelationships, know who the
partners in the community arethat they can call in crisis
(06:01):
response.
It also is in having aspecialized CIT team that
responds, have them follow bestpractices and that means that
they self-select, that there arepeople who say, yeah, I would
like to work with thispopulation and build these
relationships and know thesystem and know the civil
(06:22):
commitment process and taketheir education and their tools
and training down that path.
When you are talking to lawenforcement about this, they get
it that having that support inresponse and having the best
tools and training for theirofficers is a win-win for
(06:43):
everyone.
A good CIT program hasoversight that involves people
with lived experience and familymembers who can help inform
that crisis response as well.
It's just a very uniquepartnership when done correctly,
and it can make a hugedifference in how things are
(07:05):
addressed.
Speaker 1 (07:06):
Okay, let's do a scenario here.
A police officer responds to acall about a person whose
behavior might typically suggestthey're under the influence of
drugs or alcohol erraticmovements, slurred speech, other
telltale signs.
This individual is also holdinga knife or a gun, something
(07:27):
that could drastically escalatethe situation.
With only seconds to react, howdoes the officer distinguish
between someone experiencing amental health crisis, like
psychosis, or someone who'ssimply high or intoxicated?
Speaker 2 (07:45):
They definitely will encounter people who are using
substances, as you point out,but this is part of the CIT
training.
They do this very thing, wherethey have different scenarios,
scenario-based trainings, andthey help to create some time
and some distance from what'shappening to be able to make
(08:06):
those calls.
And, there's no question, theyoften don't have a lot of time.
But that's where having officerswho have had some time on the
street first of all before theybecome CIT officers, so that
only time and experience canreally help them differentiate
between what are we dealing withhere and then having that
(08:28):
training and ongoingrecertification for officers,
because there are always newthings that come out that they
need to be aware of, and I justthink that kind of training is
so critical, and CIT is criticalin helping to divert people.
So, rather than taking people tojail, if there are receiving
(08:49):
centers which is another thingthat has been developed and is
starting to get traction where,rather than taking people to
jail or even an ER, they go to areceiving center which can do
an initial assessment and decidewhat level of care the person
may need, and it helps lawenforcement in being able to
(09:10):
take the person to a safe place,that's a real tool as well.
That has been very important incrisis response.
We need more of those inassisting law enforcement and
behavioral health in crisisresponse.
Again, helping to take all ofthe decision-making off from law
(09:30):
enforcement and have them getbehavioral support, behavioral
health support in that responsejust makes a big difference for
everyone.
Speaker 1 (09:40):
I'm really interested in getting back to that center
you mentioned, but first couldyou tell me what a typical day
looks like when you're settingup a conference for police
officers or other firstresponders?
What does the schedule involveas they go through the process
of learning all this material,which seems like a lot to take
(10:01):
in?
Speaker 2 (10:03):
So 40-hour training for CIT in Utah and I can just
speak to how it is.
It's a 40-hour training inorder to get that certification
and they bring in experts whocan talk about.
Here's what mental illness is.
Here are the differentmedications, here are the
different ways it can present.
(10:25):
Here is how someone who is inpsychosis can present and
talking about a condition calledanosognosia, where the person
does not have insight to theirillness or that they're ill, and
it's not just denial or beingdifficult or belligerent.
They truly do not believe theyhave a mental illness.
(10:46):
And helping law enforcement toidentify that and bringing in
speakers who have expertise incivil commitment law, who are
family members, who are peoplewith lived experience having
them spend time at differentlocations with people who are in
recovery is really important.
(11:07):
So it's just giving an overviewof the system.
The big part of CIT is helpingto build those partnerships so
law enforcement knows who tocall, who are the contacts,
where are the resources in ourcommunity that they can lean on,
and really it's creatingrelationships.
(11:29):
So much of CIT and, frankly,with the whole mental health
system, so much of providing aneffective mental health system
is building those partnershipsand relationships and points of
contact, so that people know whoto call and how to have an
effective response.
And that's what the training is.
Speaker 1 (11:49):
Now you mentioned a treatment center.
When someone reaches a pointwhere intervention is necessary,
you mentioned a treatmentfacility where they can go to
for diagnosis and support.
What factors determine whetherthey end up in jail, going
through that legal process, orare directed to a treatment
(12:09):
center instead, where they canget help and potentially avoid
incarceration?
Speaker 2 (12:16):
That is a big question and that's constantly
being discussed how do we helplaw enforcement get as much
information about what's takingplace as possible?
Get as much information aboutwhat's taking place as possible.
Part of this is we encouragefamilies to be able to talk to
law enforcement and give theminformation and give them some
(12:36):
history and background, havingthe behavioral health contact in
that crisis response.
A lot of times the behavioralhealth system will know the
person and will be able toenlighten law enforcement in
what's taking place and be ableto have an effective response
that way.
And so it's about helping lawenforcement to get as much
(12:58):
information as possible.
This means also there needs tobe effective training for call
takers, dispatchers, and helpthem to get that information as
well.
Speaker 1 (13:11):
Right.
When someone calls 911 forassistance but provides
insufficient details, it leavesthe responding officers
unprepared for what they mightencounter.
Counter Situations involvingcivil disturbances can be
particularly volatile, makingthem some of the most dangerous
(13:31):
scenarios for police to handlewithout the proper information.
Speaker 2 (13:35):
That's right and it's not always possible in every
area, depending on the size ofthe police department, but
ideally there's time to say weneed a CIT team to respond to
this and that's ideal where wehave these trained teams that
respond and are able to usetheir skills in that response.
(13:57):
I would say overall we reallyneed to provide more avenues for
families to be able to giveinformation and explain what is
happening and provide backgroundand history to the situation as
well.
Speaker 1 (14:13):
When individuals enter this facility you spoke
about, does it remove the legalaspects or do these legal
elements remain in place?
How does this all connect andwork together?
Speaker 2 (14:25):
Yeah, so they're going to sort things out.
There.
There are 23-hour stays and soit gives them time to sort
things out, to decide what levelof care the person needs and
then let the legal system andthat's got to work its way
through as well.
But again, understanding thatbehavior is driven by a serious
(14:49):
mental illness or psychosis oranosognosia is important
information in knowing how tohelp the person from there and
with the legal system, how tomanage the court system with
that person as well.
Manage the court system withthat person as well.
Speaker 1 (15:04):
As someone who's been involved for about 20 years,
what positive changes have youobserved, particularly in the
last five or six years?
It often seems like five yearsis the window it takes for
things to process and startworking effectively.
So in the past five years, whatspecific changes have you seen
(15:26):
that you'd say are definitelypositive and moving in the right
direction?
Speaker 2 (15:31):
Well, I think we've been talking about one area,
which is crisis response.
I think that has been a bigimprovement.
I think having a number thatpeople can call 988, to be able
to get assistance and just helpto sort things out on their end
A person with lived experienceor family to have that resource.
(15:53):
So I think the establishment ofmobile crisis outreach teams
that use behavioral healthproviders and peers is very
significant, very important.
Receiving centers are veryimportant as well.
So I think those are big areas.
I think, in some ways at least,for general mental health and
(16:14):
wellness, we're talking moreabout that.
I think we're focusing more.
We understand that mentalhealth is something we need to
address and try to interveneearly, Focusing on mental
wellness, and try to interveneearly focusing on mental
wellness.
I think that has beensignificant.
For the most part, I thinkwe've addressed stigma in a
significant way, although forpeople with very serious mental
(16:37):
illness.
In some ways it may be rougherfor them where there's less
tolerance and patience aroundthat, but for the general
population, I think we've madesome big improvements in that
way.
Speaker 1 (16:50):
Having observed these transitions, what key areas do
you believe still demand greaterscrutiny and effort?
While these topics may havebeen initially explored, they
clearly warrant deeper attentionand development.
Can you identify any areaswhere you would assert okay.
This absolutely requires us toprioritize and address it
(17:14):
thoroughly, because you see theneed for it to get better for
everyone.
Speaker 2 (17:19):
Yeah, I think we do need to be focusing first of all
on access for everyone.
How can people get timelyaccess?
When someone decides, yes, Ineed help, how do we help them
get help quicker and in a waythat works for them?
So there's that.
But if we look at thispopulation with serious mental
(17:39):
illness, we need to be focusedon how can we provide better
services for them.
This is a population thatcycles through different systems
our criminal justice system,the ERs, hospitals and too often
the care we provide isfacility-based and so focused on
(17:59):
okay, now they're in thisfacility, now they're in this
facility, but we're not talkingabout how do we help people get
from point A to point B.
And that really is carecoordination.
And that needs to happen on ahigh administrative level, where
you have partnerships in placebetween agencies and departments
(18:21):
, where there are points ofcontact that the buck stops with
this person in helping toaddress people with mental
illness, because people withmental illness will show up in
various different systems.
There has to be a point ofcontact within the mental health
system that the other systemscan go to for assistance, and
(18:42):
that means wherever a personwith mental illness appears, the
mental health system needs tobe there and be there also to
help that person be diverted andnavigated to the services they
need.
So on an administrative level,that needs to happen, but also
on a boots-on-the-ground level,we just need more peers.
(19:06):
We need more case management Oneof the most cost-effective
interventions and one of themost effective interventions
when we can have people who canhelp people with serious mental
illness.
Just get from point A to pointB when someone is very ill to
tell them okay, you have anappointment downtown at 10
(19:28):
o'clock on a Tuesday.
That can be very difficult forthem to navigate and there are a
lot of barriers to them, justwith transportation and being
able to know how to find thislocation and get there.
No-transcript, and I thinkwe've made great strides in at
(20:17):
least recognizing that peoplecan do well if they can get
treatment and get the servicesthey need.
But there are people who needmore than just basic outpatient
treatment.
They need that intensive casemanagement within the system to
help them get from place toplace.
It's a simple intervention butwe really don't do it very well
(20:42):
as far as coordinating care forthat person.
The other big challenge that wehave had and you see this
nationwide is the lack ofhousing for people and we need
deeply affordable housing.
But we also need permanentsupportive housing which is
providing on-site supports andservices for people with serious
(21:05):
mental illness or just peoplewho have had a lot of experience
being unhoused or being in thecriminal justice system that
they need more intensive supporton site to help them get from
again point A to point B andhave a safe place to live so
they can even focus on gettingand building a life.
Speaker 1 (21:29):
How do we get legislators to truly understand
the value of funding systemslike health care and judicial
support for the mentally ill?
Beyond just knowing they exist?
They often dismiss it asthrowing money into a black hole
, missing how it's a long-terminvestment.
I've spoken with people who saythey've lost 10 years
(21:54):
navigating these systems,fighting for the right
medication, battling through thecourt system, before finally
thriving.
How do we move past vague callsfor education and make
lawmakers see that this isn't abottomless pit, but a
step-by-step process that,though it may take years,
(22:15):
ultimately transforms lives andbenefits society?
Speaker 2 (22:20):
A key component of that is to be able to show
outcomes, and I can only speakfor the system.
I know we're not great atshowing outcomes and showing
what interventions work.
I think the mental healthsystem has to be able to make
that case and be able to showhere are our outcomes how do
people lose 10 years ofproductivity and, in that time,
(22:44):
what the damage that has done tothat person's life, their
family, their employment, theirlife situation and involvement
in utilizing resources intypically multiple systems.
It is a cost savings mechanismfor everyone to be able to have
an effective, accountable mentalhealth system, to make sure
(23:06):
it's properly funded, but alsothat it's targeting
interventions that we know workand we do know what works, and
using best practices andevidence-based practices and
really being able to identifythese issues earlier on and
really wrapping services aroundpeople who need them, not make
(23:29):
people have to fail severaltimes and cycle through.
Too often what happens is weblame the person and the person
blames themselves, and thatcompounds their feelings of
worthlessness and difficulty,when really we are asking people
to navigate systems that areincredibly broken, fragmented,
(23:49):
siloed, and so then the thinkingis oh, we really need to just
use a hammer, and then peopletend to spend more time in the
criminal justice system.
There's a lot of discussionthere has been for decades now
about how jails and prisons havebecome the new mental health
(24:09):
providers, and that does notwork.
Jails and prisons cause trauma,they compound the problem again
and it is far more costeffective to have interventions
that are community-based, thathave people living in the
community with wraparoundservices.
We know it's more effective, weknow it's more effective, we
(24:32):
know it's cost effective, weknow people can do well.
I guess my answer twofold beingmore accountable in the
services that are provided, andtwo, really focusing on again
point A to point B.
So we have this great programand once the person is released
from that program, then what andI think that's the question we
(24:54):
should continually ask Then what?
Okay, the person's releasedfrom jail, then what?
Discharged from an inpatientfacility, then what?
How do we get them from that toa home in the community where
they can live and engage andlive a life?
And we know that people can dowell if they can get access to
(25:15):
those services.
Speaker 1 (25:17):
While we could dive into countless fascinating
topics and keep this discussionflowing for hours, I'd love for
you to reflect for a moment.
What's one critical insight,idea or piece of wisdom you feel
compelled to share with ourlisteners, Something you
consider truly vital for them tograsp and carry forward in
(25:40):
their lives?
Speaker 2 (25:41):
Yeah.
So I come to this work as afamily member and I think we
really need to hear more fromfamilies, from people with lived
experience, about what worksand what works on again, that
very granular level.
I think too often we havepeople building programs and
(26:01):
systems and service deliverymodels that when you talk to the
person with lived experience ortheir families, they don't know
how to access or they say thatwon't work and so, rather than
continuing to build things thatpeople don't want or won't use,
(26:23):
we really need to have morevoices in that space.
More voices in that space, andif we could get our systems to
be curious, to show somecuriosity around, why do we
continue to have these issuesand these problems?
And not be so protective of thestatus quo but be willing to
(26:46):
hear fresh voices, hear frompeople who are living it, they
could get the most importantdata of all and that will help
them determine how to buildeffective systems.
Speaker 1 (27:01):
Yeah, that's great information.
This has been a tremendousconversation with a lot of great
information.
I really appreciate you takingthe time to come on.
Speaker 2 (27:12):
Yeah, thank you, appreciate it.
Speaker 1 (27:14):
It's been my pleasure .
Thanks again.
Thanks for taking the time outof your busy schedule to listen
to our show today.
We hope that you enjoyed it asmuch as we enjoyed bringing it
to you.
If you know anyone that wouldlike to tell us their story,
(27:37):
send them to TonyMantorcomContact then they can give us
their information so one daythey may be a guest on our show.
One more thing we ask telleveryone everywhere about why
Not Me, the world, theconversations we're having and
(27:58):
the inspiration our guests giveto everyone everywhere that you
are not alone in this world.
You.
Welcome to why Not Me ?
The World Podcast, hosted byTony Mantor, broadcasting from
Music City, usa, nashville,tennessee.
Join us as our guests tell ustheir stories.
Some will make you laugh, somewill make you cry.
Their stories Some will makeyou laugh, some will make you
(00:30):
cry.
Real life people who willinspire and show that you are
not alone in this world.
Hopefully, you gain moreawareness, acceptance and a
better understanding for autismAround the World.
Hi, I'm Tony Mantour.
(00:53):
Welcome to why Not Me?
The World Humanity OverHandcuffs the Silent Crisis
special event.
We're delighted to welcomeSherry Witwer, a dedicated and
passionate advocate for mentalhealth and community well-being.
With an extensive careerspanning numerous roles, sherry
(01:13):
has made significantcontributions across a wide
range of sectors.
This includes communitynon-profits, government and
corporate environments.
She currently serves as boardpresident for CIT Utah, sits on
the National Advisory Board forthe CIT Assist Program and holds
the position of board vicechair for the Utah Housing
Coalition.
Additionally, she is a founderand board member of Peers
(01:37):
Empowering Peers Utah, anorganization devoted to
advancing mental health peersupport.
It's an honor to have her withus today to share her wealth of
experience and insights.
Thanks for coming on.
Speaker 2 (01:51):
Thank you, thank you for the opportunity.
Oh, it's my pleasure.
Speaker 1 (01:55):
I understand that you are the president for CIT Utah.
Can you expand on what that is?
Speaker 2 (02:01):
Yes, I guess, as a matter of introduction, I'm a
longtime mental health advocate.
I've worked in variouscapacities in our mental health
system, primarily in publicpolicy advocacy.
I'm a family member of someonewith a serious mental illness
and that's what has driven mywork and my interest in the
(02:39):
mental health system.
That is, training for lawenforcement, behavioral health
providers and families andpeople with lived experience.
They come together to providetraining for law enforcement and
, more importantly, to have aneffective crisis response.
When someone is in crisis, thatlaw enforcement has the
(03:00):
training and the support of themental health system to help
them respond effectively and getthe person to the treatment
that they need.
Now really positive developmentis that with our crisis
response systems, we havedeveloped mobile crisis outreach
teams that are driven bybehavioral health providers with
(03:23):
peers, people with livedexperience, who can respond to
the overwhelming majority ofthose calls, and that really
provides better outcomes andhelps us to treat mental health
as a mental health condition.
However, there are times whenlaw enforcement needs to be
involved or behavioral healthteam is uncertain in their
(03:46):
response, and so they canco-respond or have law
enforcement take the lead inthat response.
But having that training andthat understanding is critical
to having better outcomes foreveryone involved.
Speaker 1 (04:00):
With what you're involved.
I believe they have created anew number for crisis response.
Speaker 2 (04:06):
So CIT is still an important piece and I don't want
that to be overlooked in ourcrisis response systems, because
(04:34):
there just are times when lawenforcement needs to be involved
.
They are called out and torecognize oh, this is a mental
health crisis and we need to getour CIT team to be able to
respond differently to thatsituation.
Speaker 1 (04:51):
When police are involved, the goal is, of course
, to improve outcomes andprevent situations from
escalating.
How have they responded to thetraining efforts aimed at
teaching the officers to quicklyassess situations and make
decisions?
Given their limited time and,of course, their budget
(05:11):
constraints, have you seen asgood a response as you hoped for
?
Speaker 2 (05:17):
Yeah, I think, first of all, when you talk to law
enforcement, they are inundatedwith mental health calls and
they really would rather not beresponding to those calls, so
they welcome mobile crisisoutreach teams and some of these
responses really takes theburden off of law enforcement
(05:38):
and having to make all of thosedecisions.
Still, there are times when theyneed to and that's where having
best practice CIT program isinvolved and that means having
everyone have all lawenforcement, get basic mental
health training and build thoserelationships, know who the
partners in the community arethat they can call in crisis
(06:01):
response.
It also is in having aspecialized CIT team that
responds, have them follow bestpractices and that means that
they self-select, that there arepeople who say, yeah, I would
like to work with thispopulation and build these
relationships and know thesystem and know the civil
(06:22):
commitment process and taketheir education and their tools
and training down that path.
When you are talking to lawenforcement about this, they get
it that having that support inresponse and having the best
tools and training for theirofficers is a win-win for
(06:43):
everyone.
A good CIT program hasoversight that involves people
with lived experience and familymembers who can help inform
that crisis response as well.
It's just a very uniquepartnership when done correctly,
and it can make a hugedifference in how things are
(07:05):
addressed.
Speaker 1 (07:06):
Okay, let's do a scenario here.
A police officer responds to acall about a person whose
behavior might typically suggestthey're under the influence of
drugs or alcohol erraticmovements, slurred speech, other
telltale signs.
This individual is also holdinga knife or a gun, something
(07:27):
that could drastically escalatethe situation.
With only seconds to react, howdoes the officer distinguish
between someone experiencing amental health crisis, like
psychosis, or someone who'ssimply high or intoxicated?
Speaker 2 (07:45):
They definitely will encounter people who are using
substances, as you point out,but this is part of the CIT
training.
They do this very thing, wherethey have different scenarios,
scenario-based trainings, andthey help to create some time
and some distance from what'shappening to be able to make
(08:06):
those calls.
And, there's no question, theyoften don't have a lot of time.
But that's where having officerswho have had some time on the
street first of all before theybecome CIT officers, so that
only time and experience canreally help them differentiate
between what are we dealing withhere and then having that
(08:28):
training and ongoingrecertification for officers,
because there are always newthings that come out that they
need to be aware of, and I justthink that kind of training is
so critical, and CIT is criticalin helping to divert people.
So, rather than taking people tojail, if there are receiving
(08:49):
centers which is another thingthat has been developed and is
starting to get traction where,rather than taking people to
jail or even an ER, they go to areceiving center which can do
an initial assessment and decidewhat level of care the person
may need, and it helps lawenforcement in being able to
(09:10):
take the person to a safe place,that's a real tool as well.
That has been very important incrisis response.
We need more of those inassisting law enforcement and
behavioral health in crisisresponse.
Again, helping to take all ofthe decision-making off from law
(09:30):
enforcement and have them getbehavioral support, behavioral
health support in that responsejust makes a big difference for
everyone.
Speaker 1 (09:40):
I'm really interested in getting back to that center
you mentioned, but first couldyou tell me what a typical day
looks like when you're settingup a conference for police
officers or other firstresponders?
What does the schedule involveas they go through the process
of learning all this material,which seems like a lot to take
(10:01):
in?
Speaker 2 (10:03):
So 40-hour training for CIT in Utah and I can just
speak to how it is.
It's a 40-hour training inorder to get that certification
and they bring in experts whocan talk about.
Here's what mental illness is.
Here are the differentmedications, here are the
different ways it can present.
(10:25):
Here is how someone who is inpsychosis can present and
talking about a condition calledanosognosia, where the person
does not have insight to theirillness or that they're ill, and
it's not just denial or beingdifficult or belligerent.
They truly do not believe theyhave a mental illness.
(10:46):
And helping law enforcement toidentify that and bringing in
speakers who have expertise incivil commitment law, who are
family members, who are peoplewith lived experience having
them spend time at differentlocations with people who are in
recovery is really important.
(11:07):
So it's just giving an overviewof the system.
The big part of CIT is helpingto build those partnerships so
law enforcement knows who tocall, who are the contacts,
where are the resources in ourcommunity that they can lean on,
and really it's creatingrelationships.
(11:29):
So much of CIT and, frankly,with the whole mental health
system, so much of providing aneffective mental health system
is building those partnershipsand relationships and points of
contact, so that people know whoto call and how to have an
effective response.
And that's what the training is.
Speaker 1 (11:49):
Now you mentioned a treatment center.
When someone reaches a pointwhere intervention is necessary,
you mentioned a treatmentfacility where they can go to
for diagnosis and support.
What factors determine whetherthey end up in jail, going
through that legal process, orare directed to a treatment
(12:09):
center instead, where they canget help and potentially avoid
incarceration?
Speaker 2 (12:16):
That is a big question and that's constantly
being discussed how do we helplaw enforcement get as much
information about what's takingplace as possible?
Get as much information aboutwhat's taking place as possible.
Part of this is we encouragefamilies to be able to talk to
law enforcement and give theminformation and give them some
(12:36):
history and background, havingthe behavioral health contact in
that crisis response.
A lot of times the behavioralhealth system will know the
person and will be able toenlighten law enforcement in
what's taking place and be ableto have an effective response
that way.
And so it's about helping lawenforcement to get as much
(12:58):
information as possible.
This means also there needs tobe effective training for call
takers, dispatchers, and helpthem to get that information as
well.
Speaker 1 (13:11):
Right.
When someone calls 911 forassistance but provides
insufficient details, it leavesthe responding officers
unprepared for what they mightencounter.
Counter Situations involvingcivil disturbances can be
particularly volatile, makingthem some of the most dangerous
(13:31):
scenarios for police to handlewithout the proper information.
Speaker 2 (13:35):
That's right and it's not always possible in every
area, depending on the size ofthe police department, but
ideally there's time to say weneed a CIT team to respond to
this and that's ideal where wehave these trained teams that
respond and are able to usetheir skills in that response.
(13:57):
I would say overall we reallyneed to provide more avenues for
families to be able to giveinformation and explain what is
happening and provide backgroundand history to the situation as
well.
Speaker 1 (14:13):
When individuals enter this facility you spoke
about, does it remove the legalaspects or do these legal
elements remain in place?
How does this all connect andwork together?
Speaker 2 (14:25):
Yeah, so they're going to sort things out.
There.
There are 23-hour stays and soit gives them time to sort
things out, to decide what levelof care the person needs and
then let the legal system andthat's got to work its way
through as well.
But again, understanding thatbehavior is driven by a serious
(14:49):
mental illness or psychosis oranosognosia is important
information in knowing how tohelp the person from there and
with the legal system, how tomanage the court system with
that person as well.
Manage the court system withthat person as well.
Speaker 1 (15:04):
As someone who's been involved for about 20 years,
what positive changes have youobserved, particularly in the
last five or six years?
It often seems like five yearsis the window it takes for
things to process and startworking effectively.
So in the past five years, whatspecific changes have you seen
(15:26):
that you'd say are definitelypositive and moving in the right
direction?
Speaker 2 (15:31):
Well, I think we've been talking about one area,
which is crisis response.
I think that has been a bigimprovement.
I think having a number thatpeople can call 988, to be able
to get assistance and just helpto sort things out on their end
A person with lived experienceor family to have that resource.
(15:53):
So I think the establishment ofmobile crisis outreach teams
that use behavioral healthproviders and peers is very
significant, very important.
Receiving centers are veryimportant as well.
So I think those are big areas.
I think, in some ways at least,for general mental health and
(16:14):
wellness, we're talking moreabout that.
I think we're focusing more.
We understand that mentalhealth is something we need to
address and try to interveneearly, Focusing on mental
wellness, and try to interveneearly focusing on mental
wellness.
I think that has beensignificant.
For the most part, I thinkwe've addressed stigma in a
significant way, although forpeople with very serious mental
(16:37):
illness.
In some ways it may be rougherfor them where there's less
tolerance and patience aroundthat, but for the general
population, I think we've madesome big improvements in that
way.
Speaker 1 (16:50):
Having observed these transitions, what key areas do
you believe still demand greaterscrutiny and effort?
While these topics may havebeen initially explored, they
clearly warrant deeper attentionand development.
Can you identify any areaswhere you would assert okay.
This absolutely requires us toprioritize and address it
(17:14):
thoroughly, because you see theneed for it to get better for
everyone.
Speaker 2 (17:19):
Yeah, I think we do need to be focusing first of all
on access for everyone.
How can people get timelyaccess?
When someone decides, yes, Ineed help, how do we help them
get help quicker and in a waythat works for them?
So there's that.
But if we look at thispopulation with serious mental
(17:39):
illness, we need to be focusedon how can we provide better
services for them.
This is a population thatcycles through different systems
our criminal justice system,the ERs, hospitals and too often
the care we provide isfacility-based and so focused on
(17:59):
okay, now they're in thisfacility, now they're in this
facility, but we're not talkingabout how do we help people get
from point A to point B.
And that really is carecoordination.
And that needs to happen on ahigh administrative level, where
you have partnerships in placebetween agencies and departments
(18:21):
, where there are points ofcontact that the buck stops with
this person in helping toaddress people with mental
illness, because people withmental illness will show up in
various different systems.
There has to be a point ofcontact within the mental health
system that the other systemscan go to for assistance, and
(18:42):
that means wherever a personwith mental illness appears, the
mental health system needs tobe there and be there also to
help that person be diverted andnavigated to the services they
need.
So on an administrative level,that needs to happen, but also
on a boots-on-the-ground level,we just need more peers.
(19:06):
We need more case management Oneof the most cost-effective
interventions and one of themost effective interventions
when we can have people who canhelp people with serious mental
illness.
Just get from point A to pointB when someone is very ill to
tell them okay, you have anappointment downtown at 10
(19:28):
o'clock on a Tuesday.
That can be very difficult forthem to navigate and there are a
lot of barriers to them, justwith transportation and being
able to know how to find thislocation and get there.
No-transcript, and I thinkwe've made great strides in at
(20:17):
least recognizing that peoplecan do well if they can get
treatment and get the servicesthey need.
But there are people who needmore than just basic outpatient
treatment.
They need that intensive casemanagement within the system to
help them get from place toplace.
It's a simple intervention butwe really don't do it very well
(20:42):
as far as coordinating care forthat person.
The other big challenge that wehave had and you see this
nationwide is the lack ofhousing for people and we need
deeply affordable housing.
But we also need permanentsupportive housing which is
providing on-site supports andservices for people with serious
(21:05):
mental illness or just peoplewho have had a lot of experience
being unhoused or being in thecriminal justice system that
they need more intensive supporton site to help them get from
again point A to point B andhave a safe place to live so
they can even focus on gettingand building a life.
Speaker 1 (21:29):
How do we get legislators to truly understand
the value of funding systemslike health care and judicial
support for the mentally ill?
Beyond just knowing they exist?
They often dismiss it asthrowing money into a black hole
, missing how it's a long-terminvestment.
I've spoken with people who saythey've lost 10 years
(21:54):
navigating these systems,fighting for the right
medication, battling through thecourt system, before finally
thriving.
How do we move past vague callsfor education and make
lawmakers see that this isn't abottomless pit, but a
step-by-step process that,though it may take years,
(22:15):
ultimately transforms lives andbenefits society?
Speaker 2 (22:20):
A key component of that is to be able to show
outcomes, and I can only speakfor the system.
I know we're not great atshowing outcomes and showing
what interventions work.
I think the mental healthsystem has to be able to make
that case and be able to showhere are our outcomes how do
people lose 10 years ofproductivity and, in that time,
(22:44):
what the damage that has done tothat person's life, their
family, their employment, theirlife situation and involvement
in utilizing resources intypically multiple systems.
It is a cost savings mechanismfor everyone to be able to have
an effective, accountable mentalhealth system, to make sure
(23:06):
it's properly funded, but alsothat it's targeting
interventions that we know workand we do know what works, and
using best practices andevidence-based practices and
really being able to identifythese issues earlier on and
really wrapping services aroundpeople who need them, not make
(23:29):
people have to fail severaltimes and cycle through.
Too often what happens is weblame the person and the person
blames themselves, and thatcompounds their feelings of
worthlessness and difficulty,when really we are asking people
to navigate systems that areincredibly broken, fragmented,
(23:49):
siloed, and so then the thinkingis oh, we really need to just
use a hammer, and then peopletend to spend more time in the
criminal justice system.
There's a lot of discussionthere has been for decades now
about how jails and prisons havebecome the new mental health
(24:09):
providers, and that does notwork.
Jails and prisons cause trauma,they compound the problem again
and it is far more costeffective to have interventions
that are community-based, thathave people living in the
community with wraparoundservices.
We know it's more effective, weknow it's more effective, we
(24:32):
know it's cost effective, weknow people can do well.
I guess my answer twofold beingmore accountable in the
services that are provided, andtwo, really focusing on again
point A to point B.
So we have this great programand once the person is released
from that program, then what andI think that's the question we
(24:54):
should continually ask Then what?
Okay, the person's releasedfrom jail, then what?
Discharged from an inpatientfacility, then what?
How do we get them from that toa home in the community where
they can live and engage andlive a life?
And we know that people can dowell if they can get access to
(25:15):
those services.
Speaker 1 (25:17):
While we could dive into countless fascinating
topics and keep this discussionflowing for hours, I'd love for
you to reflect for a moment.
What's one critical insight,idea or piece of wisdom you feel
compelled to share with ourlisteners, Something you
consider truly vital for them tograsp and carry forward in
(25:40):
their lives?
Speaker 2 (25:41):
Yeah.
So I come to this work as afamily member and I think we
really need to hear more fromfamilies, from people with lived
experience, about what worksand what works on again, that
very granular level.
I think too often we havepeople building programs and
(26:01):
systems and service deliverymodels that when you talk to the
person with lived experience ortheir families, they don't know
how to access or they say thatwon't work and so, rather than
continuing to build things thatpeople don't want or won't use,
(26:23):
we really need to have morevoices in that space.
More voices in that space, andif we could get our systems to
be curious, to show somecuriosity around, why do we
continue to have these issuesand these problems?
And not be so protective of thestatus quo but be willing to
(26:46):
hear fresh voices, hear frompeople who are living it, they
could get the most importantdata of all and that will help
them determine how to buildeffective systems.
Speaker 1 (27:01):
Yeah, that's great information.
This has been a tremendousconversation with a lot of great
information.
I really appreciate you takingthe time to come on.
Speaker 2 (27:12):
Yeah, thank you, appreciate it.
Speaker 1 (27:14):
It's been my pleasure .
Thanks again.
Thanks for taking the time outof your busy schedule to listen
to our show today.
We hope that you enjoyed it asmuch as we enjoyed bringing it
to you.
If you know anyone that wouldlike to tell us their story,
(27:37):
send them to TonyMantorcomContact then they can give us
their information so one daythey may be a guest on our show.
One more thing we ask telleveryone everywhere about why
Not Me, the world, theconversations we're having and
(27:58):
the inspiration our guests giveto everyone everywhere that you
are not alone in this world.
You.
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