Program gives EMTs, officers skills to help those in crisis

After 17 years in emergency medical services and 10 years as a paramedic, Maribeth Barbuch has pretty much seen it all when it comes to being a first responder.

But there’s always room for more tools in her proverbial toolbox, the assistant EMS chief for the Saukville Fire Department and assistant coroner for Ozaukee County said.

That new tool is the crisis intervention training on how to deal with cases involving mental illness. 

Every dispatcher, jailer and deputy in the Ozaukee Sheriff’s Office and about half of all county municipal fire and police departments have been through the same training.

Now it’s being offered to hospital emergency room personnel.

“I’ve been on a fair amount of calls,” said Barbuch, who also is a lieutenant for Port Washington EMS. “(The training) definitely gave us tools in dealing with patients that are difficult, patients with Alzheimer’s or dementia, or who maybe are on some drugs or alcohol. Definitely more tools in our tool box.”

With more than 60% of all Ozaukee County jail inmates diagnosed as having a mental illness, the growing opioid addiction crisis and an increasing number of veterans who suffer from post-traumatic stress disorder and other afflictions, the ability of first responders to know how to appropriately deal with the mentally ill is more vital than ever, organizers say.

“It’s only going to get worse,” Mequon Police Sgt. Lindsay Graycarek, a member of the Ozaukee Crisis Intervention Training Steering Committee, said at a recent training session attended by dispatchers, emergency room workers and others at Ascension Columbia St. Mary’s Ozaukee Hospital in Mequon.

It’s also helpful with the county’s aging population, Barbuch said.

“We are seeing dementia patients more frequently,” Barbuch said. “The training has helped us in  different kinds of dementia and helps you understand a little more of the disease when they are upset or more altered than usual. There are many sections to the training and they break it down for you.” 

The Crisis Intervention Training program originated in the 1980s in Memphis, Tenn., and was first implemented in Ozaukee County about five years ago, said Mary Luzinski, president of the Ozaukee County chapter of the National Alliance for the Mentally Ill.

Ozaukee was the seventh Wisconsin county to do so. Today there are 18 counties that offer the training.

Luzinski and Ozaukee County Crisis Management Supervisor Laurie Rathke launched the effort. The program took off, Luzinski said, after Sheriff Jim Johnson was elected and made it required training for his personnel.

“We needed that law enforcement component,” Luzinski said. 

Johnson appointed Undersheriff Christy Knowles the department’s liaison to the program.

Luzinski, Rathke and Knowles are on the steering committee with Graycarek.

There are three different training tracks: a 40-hour program for law enforcement; a 16-hour program for firefighters and other emergency responders, ambulance and emergency room workers and jailers; and an eight-hour “refresher” aimed primarily at the mental health of the responders.

Sheriff’s Deputy Mike Schmidt, a 12-year veteran with the department, took the training two years ago.

“We are limited in our background in how to deal with the mentally ill,” he said. “We can better know what they are going through and different ways to respond appropriately.

“I can tell I’m better prepared when we go on calls or on a welfare check. I feel more confident now than I was before the class,” he said. 

Birbach said one of the main benefits of the program is its “training in de-escalation.”

“You never know what you’re going to get” when called to a scene, she said. “You go into a place and you can tell something is going on. You’re dealing with people at a very high emotional level.”

“They see our uniform and they group us (with law enforcement) and think we have arresting powers.”

Skills in using body language, tone of voice and knowing when it’s appropriate to look someone in the eye, and when it’s not are important, especially dealing with assault victims, she said

The training  “can help you get the patient into the ambulance,” she said. 

Since 2015, 266 Ozaukee County law enforcement personnel have been through the training. Since 2016, 159 emergency responders, Luzinski said.

The program is funded through grants from the state and private foundations.

“The training helps them identify people who don’t always need to go to jail. It might be PTSD, autism, dementia,” Knowles said. “It also helps toward officer wellness.”

“The primary thing is that if we can deal with them appropriately then they don’t end up in the court system,” she said. “Just putting them in cuffs and locking them up is traumatic for the person, the family, law enforcement, health professionals, firemen and ambulance personnel.”

“The illness does not say you are not accountable,” she said. “You are accountable for your behavior, but the first stage is treat the mental illness.”

The recent session at St. Mary’s Ozaukee was the first day of the two-day training and, with the training the same throughout the state, it drew responders from Sun Prairie, Hales Corners, Elm Grove and Baraboo, as well as Ozaukee County. The second day’s session was a week later.

For volunteer firefighters, Luzinski said the training is held at night in four-hour sessions to accommodate participants’ work schedules.

The next 40-hour training will be in September, she said.

While mental illness and substance abuse often overlap, responding to a person going through a mental crisis is different than other calls, Luzinski said.

“It’s not something where they will just cool off. It’s not like the person has been drinking and will sober up,” she said.