What is needed for a successful outcome for individuals and families who call for help with a mental health emergency?

What is needed for a successful outcome for police officers and mobile crisis workers who respond to calls for help with a mental health emergency?

Here is what I’ve learned from my many years of experience and self-education.

To begin, ongoing public education is needed about what to say and ask for when calling for help. This outreach should be delivered in inclusive settings that ensure easy access for all.


A successful outcome for a mental health emergency would include:

• Keeping everyone alive.

• Thanking police officers and crisis workers for their service.

• Guiding those suffering from an illness and their families about treatment options.

• Analyzing what happened each time, incorporating feedback from all involved.

Emergency medical dispatchers and 211 employees are the true first responders. Employees of 211 lines are expected to identify mental health crisis calls and direct callers to the right resource. Dispatchers are expected to identify mental health emergency calls and dispatch officers to respond.

The dispatchers have a nationally certified psychology protocol to guide them when they receive calls for help. Protocol 25: Psychiatric/Abnormal Behavior/Suicide Attempt was adopted by the International Academies of Emergency Dispatch in 1988 and has been evaluated and updated over the years.

Jeff Clawson, M.D., who developed the protocol, has told me that neither family members nor those who live with a mental illness have been involved in ongoing improvements to the protocol. That is a huge oversight. People with lived experience of mental illness and their families need a place at the table.


Beyond having this protocol to guide them, emergency medical dispatchers generally get verbal judo de-escalation training and an eight-hour session provided by the National Alliance on Mental Illness. But they aren’t all required to take the weeklong crisis intervention team training. This needs to change.

On every shift, each region of the state should have available trained CIT officers, or collaborative teams including local mobile crisis workers.

Not all officers should be required to take the 40-hour crisis intervention training — just like not all teachers should be required to gain the knowledge and tools needed to be special education teachers. Training should be focused on the motivated candidates. Fiscally, this certainly would be a more viable approach.

Several legislative initiatives have been prompted by outcomes from crisis calls in Maine, including:

• An ad hoc task force convened by then-Attorney General Steven Rowe in 2008 to review the procedures and protocols in place for handling “situations involving individuals in a state of crisis due to serious mental illness, severe emotional distress or suicidal ideation.” The task force’s findings were made available in a December 2008 report.

• The approval in 2009 of a resolve measure mandating that each Maine police chief set up an “incident review team.” These teams focus on whether policies were understood and followed during a police use-of-force incident, and whether training and equipment were adequate.

• A 2012 report by Maine Criminal Justice Academy trustees to the Legislature’s Criminal Justice and Public Safety Committee, summarizing the incident review team process.


I urge interested people to get active, both politically and personally. Individuals can write to the legislators who serve on the Health and Human Services and Criminal Justice and Public Safety committees and attend public hearings on any proposed bills relevant to mental health.

People also should speak up when they witness anyone with mental illness being abused or mistreated in any way.

Mental illness is as devastating in its impact as other major illnesses. It involves great suffering both for those who get sick and those who love them. Sometimes a mental illness can be managed or recovered from; other times, it can last a lifetime. Nobody chooses to get a mental illness, and nobody did anything wrong by getting sick with a mental illness.

We all should do what we can to help others see the humanity of those who suffer with mental illness.

Nancy Pizzo Boucher of Westbrook, a mother and advocate for those with mental illness, serves on the steering committee of the Voices of Recovery Speakers’ Bureau and is a family speaker for Voices of Recovery.

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