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Partnering with the Police

Collins, Amy M.

AJN The American Journal of Nursing: February 2016 - Volume 116 - Issue 2 - p 68,69
doi: 10.1097/01.NAJ.0000480504.01964.33

A nurse-led initiative trains law enforcement to effectively interact with people with mental illness.



Jeannine Loucks has always been a mental health nurse. She says she was first drawn to working in this area of nursing when she was 18 and visiting a friend who worked in a developmental disability center with kids with autism and Down syndrome. After graduating from nursing school, she remembered this experience and chose to work with behavioral health patients.

“They seemed to be the one patient population that was disenfranchised; nobody wanted to take care of them,” she explained. “But I felt a kindred spirit to them and felt I could care for their needs.”

She took a job working with developmentally disabled children at Fairview State Hospital (now known as Fairview Developmental Center) in Costa Mesa, California, and then transferred to Norwalk State Hospital (now known as Metropolitan State Hospital) in Los Angeles County because she wanted to gain experience with what she called “true psychotic behavior.”

“I wanted to work with clinicians who could teach me how to identify symptoms of psychosis,” she said. “How do you treat patients emotionally, spiritually—how do you touch on all these domains?” She stayed in behavioral health nursing, and currently works as the department manager of the Emergency Care Center Psychiatric Emergency Clinical Decision Unit at St Joseph Hospital in Orange, California.

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When Loucks returned to direct patient care in her position at St. Joseph in 2007, she noticed that local law enforcement was not just about catching bad guys. More and more, state hospitals were releasing patients with mental illness out into the community, and police officers were often the first people they encountered. She felt officers needed to be armed with the necessary tools to approach these people appropriately and most effectively.

“Officers today have a difficult job managing crime fighting, community relations, and safety,” she said. “They're also expected to be mediators and therapists. Our ED was experiencing an increase in the number of 5150s [patients placed on 72-hour psychiatric evaluation] written by the police department. I thought to myself, what training do these officers have?”

She did some research and found that in California's police academies, officers go through between 700 and 1,200 hours of instruction, only eight of which are dedicated to people with disabilities: four to people with physical disabilities and four to those with mental illnesses, such as psychosis and bipolar disorders. She decided to reach out to her local police department to see if this could be remedied.

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After speaking with Chief Robert Gustafson of the Orange Police Department, who agreed that his officers could benefit from additional training, Loucks first wrote a survey to gauge the most important things the officers wanted to learn. Based on what she gathered from the responses, she put together a short eight-hour training program that was offered over the course of a few weeks so that all 164 officers could attend. She also taught other people in the department, such as those who worked the front desk, who also encountered the mentally ill.

Her efforts didn't stop there. Chief Gustafson asked Loucks to consider offering the program to people who worked security throughout the city of Orange, such as in large department stores, shopping centers, universities, and other hospitals—so she did a modified training for them. The program was so successful that the chief started getting letters from citizens saying how kind and respectful his officers were. This led Loucks to come up with another idea. “I thought, if this was so successful in my local police department, why don't we do training videos for other departments?”

She went to the Mental Health Association of Orange County, where she was on the board, to suggest that, together with the Orange Police Department, Santa Ana Police Department, and St. Joseph hospital, they help to create a set of 10-to-12-minute videos depicting different encounters police officers might have with the mentally ill out in the field. The result was the creation of five DVDs, funded in part by a small grant from the City of Orange Rotary Club, which have gone out to police departments throughout the state of California and the rest of the country. Any police department that wants the videos can request them from the Orange Police Department free of charge. The videos include physicians and thought leaders from the community who speak about the various diagnoses, and real patients with those disorders.

“If you have actual people who are working in the field—who know and understand mental illnesses such as schizophrenia, bipolar disorder, hoarding, or even autism—and actual patients living with that disorder, it's more credible for law enforcement,” she said. The videos also include reenactments of real cases that the Orange police officers have encountered. They are currently doing a sixth video on Alz­heimer's disease and dementia.

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Last summer, Loucks thought that since the eight-hour training was so successful, why not offer police officers a more comprehensive program? So she wrote a 24-hour training program and sent it to the American Psychiatric Nurses Association, who endorsed it, making it the first nurse-led training to ever receive this endorsement. Chief Gustafson saw such value in it that he made every one of his ­officers attend this new 24-hour session. As a result of this longer training session, the videos, and other initiatives such as a homeless outreach program Loucks helped implement, in February 2015 the Orange Police Department received the James Q. Wilson Award, the state of California's highest award for community policing. Loucks attended the award ceremony.

“It's so refreshing to have a community partner like the Orange Police Department,” Loucks said. “We want the community safe; we want our psychiatric patients treated with dignity and respect; and we want them to be successful in spite of their mental illness. We want to provide them with resources so they're not marginalized or victimized. Our ultimate goal is to make a difference for everybody.”—Amy M. Collins, managing editor

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