The Crisis Intervention Team International (CITI) Conference August, 2012 Las Vegas Police...
43
The Crisis Intervention Team International (CITI) Conference August, 2012 Las Vegas Police Encounters with Returning Veterans Dan Abreu, SAMHSA National GAINS Center Thomas Kirchberg, PhD ABPP
The Crisis Intervention Team International (CITI) Conference August, 2012 Las Vegas Police Encounters with Returning Veterans Dan Abreu, SAMHSA National
The Crisis Intervention Team International (CITI) Conference
August, 2012 Las Vegas Police Encounters with Returning Veterans
Dan Abreu, SAMHSA National GAINS Center Thomas Kirchberg, PhD
ABPP
Slide 2
Slide 3
CIT Officer Intervenes I do not even know how to begin to
"Thank You" for your class/session "Improving Police Encounters
with Returning Veterans" at the CIT Conference in Atlanta. I have
been home just over a week and was already confronted by a Marine
OIF with PTSD. ! Your video helped me interpret reckless driving
and anger as possible PTSD symptoms...It saved us from having to go
hands on because I was able to reach out with the verbal skills I
learned in your class and this situation did not escalate. In fact,
because of that same video and that scenario where the VET had the
handgun, I was able to ask the right question "do you have any
weapons?". He looked me straight in the eye and began to weep and
asked me to take the weapon for safekeeping until he felt he was
ready to have it back. What a heart wrenching sight to have this
honorable Marine hand over his weapon to me. I gave him and his
wife the Veteran Suicide phone number that I put in my contacts
during your class/session. On Monday, I will contact the VA in my
area and have them follow-up. THANK YOU with all my heart.
Slide 4
NPR Video
Slide 5
New Mexico Incident 1/13/2011 March 10 - 16, 2011News/Opinion
Archive Peace Officer Could APD crisis training have saved a
veterans life? By Patrick Lohmann Negotiations with were short or
nonexistent, according to those at the scene. Most recount hearing
only shouts of Drop the gun! from multiple officers throughout the
ordeal, which, of course, culminated in (his) death. Im really
surprised that weve been in Iraq and Afghanistan for greater than
10 years, and we dont already have this training (CIT). Veterans
sister
Slide 6
Slide 7
Engagement Questions How long were you in the military? Are you
active? What was your military specialty? Were you ever deployed?
How many times? What was it like for you? How long have you been
back? What is it like to be back? Are you in contact with fellow
veterans?
Slide 8
LE Veteran Specific Response In Massachusetts, Norfolk County
District Attorney William Keating developed Beyond the Yellow
Ribbons: PTSD and Veterans, a training video for first responders.
Enhanced CIT Training The International Association of Chiefs of
Police,, issued guidelines - or helpful hints supporting police
officers who are veterans. Virginia Wounded Warrior Program-Veteran
Peer Specialists
Slide 9
The National Post-Deployment Adjustment Survey (NPDAS) N=1388
completed the survey, yielding a 56% corrected-response rate. This
rate is among the highest achieved in national surveys of U.S.
Veterans No gender ratio or geographic regional differences between
responders and non- responders were detected.
Slide 10
Post-Deployment Arrests 9% reported arrest since last
deployment 1% reported incarceration beyond two weeks. 2% reported
arrests for violent crimes Bivariate analyses show arrest linked
to: Younger Age Male Gender Combat Exposure Homelessness Alcohol
Misuse PTSD Drug Misuse Arrest History Active Duty
Slide 11
Slide 12
Slide 13
Slide 14
Slide 15
JDTR Non-Military Trauma (N=387) Traumatic Events Experienced
Non-Military Trauma95% Experienced trauma before age 1873%
Experienced trauma in past 12 months59% Meet criteria for PTSD65%
15 Kristin Stainbrook, AHP Steve Sullivan, Cloudburst Consulting
Group
Slide 16
Trauma in Incarcerated Veterans (2) PTSD Group: More arrests
More MH symptoms More substance abuse Poorer health
Slide 17
What you should know PTSD has delayed onset Many do not
recognize TBI/PTSD symptoms Military Culture/Warrior Mentality
precludes seeking help External Barriers to Care Trauma Combat or
otherwise correlates with arrest risk Substance abuse increases
arrest risk Domestic violence, motor vehicles and weapons are
special considerations.
Slide 18
Slide 19
Vietnam Theater Veterans Current PTSD (1986-88) Incarcerated
3,140,000479,000 (15.2%)223,000 (50%) 34.2% >1 11.5% Felony 19
Source: National Center for PTSD, Fact Sheet: Findings from the
National Vietnam Veterans Readjustment Study, 1988 ~ National
Vietnam Veterans Readjustment Survey (NVVRS)
Slide 20
Veterans Diagnosed With PTSD in VA Specialty Mental Health
Programs Rosenheck et al., 2007;. from VA administrative workload
databases. Slide Courtesy of Paula Schurr, PhD, VA National Center
for PTSD
Slide 21
Trauma in Incarcerated Veterans N=129 28% Combat Trauma 112 87%
PTSD 51 39% Differentiating Trauma Events: Witnessed death or
injury Life threatening accident Physically assaulted Witness bad
event to someone close Childhood physical abuse Sexual
molestation/rape Saxon, et. al., 2001
Slide 22
Travis County Charges 679 charges filed against 458 Veterans
32% arrested 2 or more times 27% felony charges 10% Assault 22% of
felony charges included a weapon Motor Vehicle Charges 19%DWI 43%
Motor Vehicle related charges in top ten misdemeanors 12 % Motor
Vehicle related charges in top ten felonies 34% overall rate Travis
Co Jail Incarcerated Veterans Survey, 2008
Slide 23
Combat Theater 54%Non combat zones 18%OEF/OIF 13%Viet Nam
Travis Co. Data
Slide 24
Discharge Status Travis Co. 86% (396)Honorable 9% (39)Less than
Honorable 5% (23)No response
Slide 25
JDTR Military Discharge Status of Clients N=335 25 Kristin
Stainbrook, AHP Steve Sullivan, Cloudburst Consulting Group
Slide 26
JDTR Military Era (N=335)* 26 87% of JDTR Enrollees had served
in the military Kristin Stainbrook, AHP Steve Sullivan, Cloudburst
Consulting Group
Slide 27
JDTR Point of Diversion N=454 Post Booking67% Pre-Booking18%
Probation/Parole Violation7% Pending8% Kristin Stainbrook, AHP
Steve Sullivan, Cloudburst Consulting Group
Slide 28
Veteran Specific Response? Veterans Courts Diversion
Legislation Sentencing Mitigation DUI Laws (RI) Domestic Violence
Laws (RI)
Slide 29
Veteran Mentors These volunteers are veterans who have served
in Vietnam, Korea, Operation Desert Shield, Operation Enduring
Freedom, and Operation Iraqi Freedom. These men and women volunteer
their time to work directly with the Veterans Treatment Court
Participants. Mentors serve a variety of roles, including coach,
facilitator, advisor, sponsor, and supporter.
Slide 30
Vet/Peer Involvement Definitions used at sites include: JDTR
target population (vets with trauma and/or mental health histories
and justice involvement) Any veteran Veteran status + other
criteria (but not target pop.) Some include family members Most
definitions lead with veteran status and other criteria are
secondary
Denver Post Article Police Stories. After returning from Iraq,
Jason Harvey, a combat soldier with the Fort Carson-based 2nd
Brigade Combat Team, raced his car at speeds of more than 100 mph
on Squirrel Tree Road and played paint ball to replicate battle
situations. It might sound strange, but for me, when I was driving
fast, it made me calm again. Harvey was kicked out of the Army
after he was found driving with a loaded gun on Fort Carson
Slide 34
Denver Post Article Police Stories. Vietnam veterans had a 7
percent higher death rate after discharge than veterans who did not
serve in a theater. The federal Centers for Disease Control and
Prevention found higher rates of motor vehicle crashes, homicides
and suicides during the first five years after deployment to
Vietnam.
Slide 35
New Mexico Incident 12/29/10 Pecos grad, Marine Corps vet dead
after firing at police on I-25 We dont know what happened that led
up to all this, and when he saw those police lights, something
might have triggered that made him do what he did. This doesnt
define him and isnt what hell be remembered for. He was a husband,
a father, a brother and a great friend and this is just a difficult
situation for all involved.
Slide 36
Oregon Incident Anthony Leo McDowell, 50, was killed Jan. 31 at
a home in the 24000 block of Southeast Oak Street. Police were
dispatched to the location after a woman called 9-1-1 and said her
husband -- McDowell -- was suicidal and armed with a gun.
Slide 37
And in some cases, no alternative is available. In Platte
County, Mo., which has no special court, the veteran with
post-traumatic stress disorder who had a faceoff with the police is
scheduled to stand trial on Sept. 12 on charges including felonious
assault on a police officer, though no shots were fired. He had
called 911 for help. A call to deal with a man with a gun is one of
the most dangerous that police officers face. Entering an
unpredictable situation, they are trained to act to protect their
own safety and the publics. When the suspect is a soldier, the
situation grows more complicated. In Gresham, Ore., a veteran was
killed by the police when he stepped out onto his front porch
carrying a rifle; his family had called 911 saying he was suicidal.
In Glendale, Ariz., a soldier newly returned from Afghanistan shot
a man in a bar and then fired at a police officer, who killed
him.
Slide 38
The fatality rate among sailors and Marines in off-duty motor
vehicle accidents is 25.6 per 100,000 personnel - the highest since
the war started and nearing the highest rate in more than 14 years,
when the rate was 25.74 per 100,000 personnel in 1992. For the
Army, the number of off-duty soldiers killed has risen since the
war started, with 150 off-duty deaths reported in 2005, compared
with 135 deaths so far this fiscal year, statistics show. After
Desert Storm, in a 1996 article in Injury Prevention magazine, Dr.
Niki Bell proposed possible explanations for increases in injuries,
including depression, PTSD and symptoms of other psychiatric
conditions developed after the war. Traumas experienced during the
war may result in the postwar adoption of coping behaviors that
also increase injury risk (for example, heavy drinking) and others,
she said.
Slide 39
Vietnam veterans had a 7 percent higher death rate after
discharge than veterans who did not serve in a theater. The federal
Centers for Disease Control and Prevention found higher rates of
motor vehicle crashes, homicides and suicides during the first five
years after deployment to Vietnam. So far this fiscal year, 156
sailors and Marines have died in off- duty accidents, said Cmdr.
Edward Hobbs, a CDC spokesman. This has been one of the worst years
in recent history, Hobbs said. The fatality rate among sailors and
Marines in off-duty motor vehicle accidents is 25.6 per 100,000
personnel - the highest since the war started and nearing the
highest rate in more than 14 years, when the rate was 25.74 per
100,000 personnel in 1992.
Slide 40
National Veteran Sample The National Post-Deployment Adjustment
Survey (NPDAS) involves a random selection of over one million
veterans who served in the U.S. military on or after September 11,
2001, and were separated from active duty in the Armed Forces or
served as a member of the National Guard or Reserves.
Slide 41
National Veteran Sample N=1388 completed the survey, yielding a
56% corrected-response rate. This rate is among the highest
achieved in national surveys of U.S. Veterans No gender ratio or
geographic regional differences between responders and non-
responders were detected.
Slide 42
Discussion Logistical concerns about getting time off work for
counseling and being able to schedule appointments at convenient
times were also expressed by participants in the current study.
Recognition of these treatment barriers will be critical as VA
policymakers undertake efforts to improve access to mental health
care for Veterans, especially for those at higher risk of criminal
justice involvement.
Slide 43
Discussion Veterans with criminal justice involvement were more
likely to endorse items such as, It's up to me to work out my own
problems." This pattern of responding is consistent with the
results of research on civilians with mental health problems, which
showed that the risk of criminal arrest was elevated for those
individuals who perceived that treatment did not have benefit or
was not needed (Elbogen, Mustillo, Van Dorn, Swanson, & Swartz,
2007).Elbogen, Mustillo, Van Dorn, Swanson, & Swartz, 2007
Slide 44
Discussion Misuse were significantly related to elevated risk
of post-deployment arrests among Veterans. Veterans who were
arrested after returning home were more likely to perceive hurdles
difficulties taking time off work a lack of transportation to a
mental health clinic, which they report prevented them from
obtaining treatment for mental health problems.