Tactical PsychiatryTactical Psychiatry

Nils Rosenbaum, MDNils Rosenbaum, MDMatthew Tinney, DetectiveMatthew Tinney, DetectiveAlbuquerque Police DepartmentAlbuquerque Police DepartmentCrisis Intervention TeamCrisis Intervention Team

ObjectivesObjectives

APD’s CIT StructureAPD’s CIT Structure Case ExamplesCase Examples Benefits Benefits ObstaclesObstacles Productive CommunicationsProductive Communications MisconceptionsMisconceptions Safety and TacticsSafety and Tactics

AlbuquerqueAlbuquerque

Largest City in New MexicoLargest City in New Mexico Population 545,852Population 545,852 Metro Area 887,077Metro Area 887,077 3232ndnd Largest City in the US Largest City in the US International Balloon FiestaInternational Balloon Fiesta

APD CIT StructureAPD CIT Structure

1046 Officers1046 Officers 125 CIT Fields Officers125 CIT Fields Officers 6 Crisis Specialist- Civilian 6 Crisis Specialist- Civilian 6 CIT Detectives6 CIT Detectives 1 CIT Sergeant1 CIT Sergeant 1 CIT Lieutenant1 CIT Lieutenant 1 Psychiatrist 1 Psychiatrist

Case ExampleCase Example ““King of All Doctors”King of All Doctors” 35 Year Old Caucasian Male35 Year Old Caucasian Male Homeless and Flight RiskHomeless and Flight Risk Found at UNMFound at UNM ParanoidParanoid Persistence Persistence AssistanceAssistance

Benefits to the Benefits to the CommunityCommunity

Psychiatric home evaluationsPsychiatric home evaluations Direct line for familiesDirect line for families Education to families and the communityEducation to families and the community Unencumbered communication between Unencumbered communication between

families and mental health providersfamilies and mental health providers Informing Policy Informing Policy Less intimidating Less intimidating

Benefits to the Mental Benefits to the Mental Health ProfessionHealth Profession

Direct line to policeDirect line to police TranslatorTranslator Peace of mind and direct follow upPeace of mind and direct follow up Credible on site evaluationsCredible on site evaluations -APS-APS

-Social Services-Social Services -Hospitals-Hospitals

EducationEducation

Benefits to Law Benefits to Law EnforcementEnforcement

Expert OpinionExpert Opinion TranslatorTranslator CredibilityCredibility Public RelationsPublic Relations Pick Up OrdersPick Up Orders EducationEducation Direct Line to Mental HealthDirect Line to Mental Health

Obstacles Obstacles

No position existedNo position existed VolunteeringVolunteering Departmental visionDepartmental vision Position FundingPosition Funding StigmaStigma HIPAAHIPAA

Case ExampleCase Example ““Whispering Winds”Whispering Winds” 28 Year Old Hispanic Female28 Year Old Hispanic Female Conducting Surveillance on StrangersConducting Surveillance on Strangers Believed being followedBelieved being followed Ineffective doctorIneffective doctor Pattern of crisis trackingPattern of crisis tracking

From Law Enforcement to From Law Enforcement to Health Care ProvidersHealth Care Providers

Don’t give diagnosisDon’t give diagnosis Give first hand knowledgeGive first hand knowledge Don’t question medical decisionsDon’t question medical decisions Present witness/collateral informationPresent witness/collateral information Complete In-take forms, medical recordComplete In-take forms, medical record Don’t take things personallyDon’t take things personally Ask for their namesAsk for their names

From Health Care From Health Care Professionals to Law Professionals to Law EnforcementEnforcement

Don’t use medical jargonDon’t use medical jargon Avoid unnecessary languageAvoid unnecessary language Make sure what you say is understoodMake sure what you say is understood Don’t questions laws or proceduresDon’t questions laws or procedures Don’t say “Can’t you just arrest him”Don’t say “Can’t you just arrest him” Trust the information givenTrust the information given

ExampleExample

Staffing cases with each otherStaffing cases with each other

MisconceptionsMisconceptions No “wing shots”,weaponsNo “wing shots”,weapons Cops too lazy to take them to jailCops too lazy to take them to jail How often we pull our weaponsHow often we pull our weapons Doctors don’t give shotsDoctors don’t give shots If LEO brings someone they will get If LEO brings someone they will get

admitted admitted Psychiatrist vs. PsychologistPsychiatrist vs. Psychologist

Safety and TacticsSafety and Tactics

Radio communicationRadio communication 10 Code10 Code Safety distancesSafety distances Safe places to standSafe places to stand Objects in handsObjects in hands

Case ExampleCase Example ““Jumper”Jumper” 26 Year Old Male26 Year Old Male Stabbed Throat and JumpedStabbed Throat and Jumped PsychoticPsychotic Substance abuserSubstance abuser Report and follow upReport and follow up

Questions?

• Nils Rosenbaum, MD

narmd123@gmail.com

• Matthew Tinney, Detective

MTinney@cabq.gov

• Albuquerque Police Department

Crisis Intervention Team