After the Webinar: One Size Does Not Fit All – Developing Community Specific Crisis Response. Q&A with Amanda Stamps

Webinar presenter Amanda Stamps answered a number of your questions after her webinar, One Size Does Not Fit All: Developing Community-Specific Response. Here are just a few of her responses.


Audience Question: We are seeing an uptick of assaults on EMS paramedics, when responding to calls. How can a first responder anticipate what they’re likely to find on the scene before they get there? 

Amanda Stamps: A lot of that comes with the training at the communication levels, on the questions they ask. I know, and I am not a communications expert, so I will not pretend to be. But I do know that they have a script of questions that they ask. But we’d need to start incorporating more of kind of a crisis question there that they use over in the crisis systems into our 911 systems to determine if the person has mental health issues, what their history is. Essentially, information is what you need. You need to have more information before you get there. And I would hope, and in Arizona, we are training our EMS personnel more. We are training our fire personnel more. We have a CIT version of training for fire department that we use as well. So, I think a lot of times, we have left them out of our training. And I think it’s important that we bring them into training so they can recognize the signs and symptoms better. And also knowing your state laws as far as restraints and legally what you’re allowed to do and not to do as far as mental health crisis goes. But, I think, ultimately, improving your initial information gathering at the communication level is where we have had the most success, by just knowing what we’re getting into more so. And there’s nothing to say, as much as I wish police didn’t have to go on mental health calls, or fire, or any of those people. There’s nothing to say that if the safety requires that you shouldn’t have law enforcement there. I would never say that. I would never say that we should be taking a ton of risky chances with our EMS or unarmed personnel. So, if you need somebody there, it’s always better to have them there before then after.


Audience Question: How do you recommend building our law enforcement crisis response team? Should it be based on voluntary involvement or do we make it an assignment to make sure that we have broad exposure to the ranks? 

Amanda Stamps: That is a great question, and it was something that I didn’t really have time to hit on when discussing the team itself. I personally think it should be on a volunteer basis because just with CIT training, the officers that want to do it are going to do it better. In Mesa, it’s a voluntary position, it is a specialty assignment. So, officers have to test for it specifically. What I will also say is that in law enforcement, we notoriously move around at every single level, whether it be officers, sergeants, commanders, or lieutenants. And that is problematic when you’re trying to build a consistent program because every sergeant has a different opinion. Every command staff has a different opinion about what it should look like. So, I encourage you to get a consensus of people that are already interested in it. Who already has CIT training? Do some kind of check to find out what people are interested and what they’d be willing to do. Because if you bring somebody into a crisis response team that is only doing it to have weekends off, you’re going to have use of force issues. You’re going to have problems that, that come from personality conflicts, because that’s not really their thing, if you put somebody to work that is passionate about mental health problems with somebody that is only on the squad to have weekends off. It’s just not going to be a really good flow. And it’s crisis support training, so, CST if you want it for your EMS or fire department, I think they do it for a lot of places.


Audience Question: How do you handle the serial crisis caller who most often feigns crisis, because their attention seeking but may be in crisis? 

Amanda Stamps: What I always say that if somebody is seeking attention, there’s probably a reason. But how we have handled that is, once we’ve established, that is the pattern. We work with our mental health system to get the mental health providers doing their job to help them. For example, if we have an individual that constantly calls 911, and I can assure you, we have plenty of those in Mesa. If necessary, we work towards getting them court-ordered for mental health treatment. If they are not to that extreme, we try to get them connected to one of our behavioral health clinics, our facilities, any part of our system. And then when they are repeatedly calling us, we bring the mental health providers into the conversation. So, we will actually sit down and have discussions about the clients. Some people will say with HIPPA, we can’t talk together, and that’s not true. When somebody is on a crisis and somebody who’s having an emergency, or you’re trying to have continuity of care with somebody, you can always have those conversations with providers about working together. So, always bring in their providers, and if you can, if you don’t have that option and you have the option to make them court-ordered for mental health treatment based on a petition process or some kind of court order process, that is a great place to start, because then you have a behavioral health provider, or somebody within the system to hold accountable. Because ultimately, that’s not law enforcement’s job. If the person is calling repeatedly, we need to look at their mental health side to see if we can get them in to see the right person and we need to hold that person accountable who is providing their treatment? And I think oftentimes that’s where the problem is, as we either don’t include them or for whatever reason or not, the mental health side is not holding their end of the bargain up. So, if, you, know, who pays their provider’s bills. If, you know, who provides funding to your mental health provider, it’s always good to have a relationship with them as well. So, when your mental health providers are not holding up their end of the bargain, then you can call their funding source and encourage their participation in a better manner.


Audience Question: In your area, are their preparedness drills conducted that are geared towards CIT response and training? And if not, do you think this is feasible? Do you do acting kind of drills for CIT responders, where someone simulates or emulate someone who’s in mental distress, and then we see what the response is? 

Amanda Stamps: All of our CIT training includes an entire day of scenarios. So, we do that scenario-based acting for all of our CIT training. I will also tell you that all of our agencies, and academies do scenario-based training as well. So, yes. We always incorporate that active, drill kind of training and in all of our mental health training, because it is such a unique response when it comes to law enforcement, where it doesn’t involve any guns and whatnot. We definitely feel the need to have it in scenario-based training. So, yes, we do that in Maricopa County. And as you can see on the screen, we have a state association for our crisis intervention team programs. We do advanced training, we try to do advanced training yearly, as well, and when we have that training, if we can, if it’s feasible, we also do the scenario-based training there.


Audience Question: In major events, is that one of the scenarios that you plan for?

Amanda Stamps: In major events, I would say, no, we’re probably lacking on that. As far as like ——- ———– credible stress management debriefs that we don’t connect those two together. Our CIT programs are more on that patrol-based individual response, more so, than a large-based response.



Click Here to Watch a Recording of One Size Does Not Fit All: Developing Community-Specific Response.


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