The myriad voices playing through Medford police Lt. Curtis Whipple's headset mimic those heard by a person suffering from paranoid schizophrenia.
For several hours, the veteran officer struggles to watch a movie, take a police report and carry on focused conversations with his colleagues, some of whom are fitted with similar headsets.
"It gave me just a little taste of what some individuals have to deal with on a regular basis," Whipple said, adding sometimes up to six voices at a time offered a confusing and cacophonous counterpoint to his attempts to concentrate.
The "empathy-based" exercise was part of a five-day training in mental health crisis intervention held last month in Utah. Whipple was joined locally by Stacy Brubaker, the new division manager at Jackson County Mental Health, and three others, including a representative of the Jackson County Sheriff's Department.
Brubaker's goal over the next three years is for every law enforcement officer in Jackson County to receive training in crisis response to the mentally ill. The Medford Police Department is fully on board, said Chief Tim George.
"We've got 105 cops to train," George said, adding Whipple will be at the forefront of officer training.
The "voices" segment drove home its intended lesson in education and empathy, Whipple said.
"Of course, at any point in time, I knew I could take my headset off. And, of course, these individuals can't," he said.
Some people at the training handled the exercise well. One person found the voices to be soothing. But others "didn't do well," Whipple said.
"They did tell us, 'If you have ever heard voices, don't do this exercise,' " he said.
The training included three-hour blocks on other issues faced by the mentally ill, including bipolar disorders, depression, post-traumatic stress disorder, schizophrenia, autism, Alzheimer's — and how to best deal with them in a crisis situation. Learning what behaviors might be expected from the mentally ill can help better protect officers, the individual in crisis and the community, Whipple said.
"Mental illness is a medical condition. It's like diabetes. If I had diabetes, no one would think it was my fault," Whipple said.
"But at the end of the day, these are mental health issues and not a law enforcement issue. And they need to be dealt with on that level. Still, we are at the forefront because we are the ones responding."
A lack of mental health services because of budget cuts has collided with increased need and burgeoning drug and alcohol abuse, creating "a huge snowball effect," George said.
"Better training helps us get better at what we do. It benefits our officers and the community we serve," he said.
Police often are the first responders to mental health calls, which have jumped 25 percent to 50 percent in the past two years, George said. MPD officers responded to 664 mental health calls in 2012. Of those, 344 were suicide threats or attempts, he said, and officers had to put someone in temporary, protective custody 397 times.
The numbers keep growing. While most of the mentally ill are nonviolent and do not pose a danger to others, officers are aware that any call from an unstable individual can create a serious officer safety issue, Whipple said.
There is a crisis timeline, Whipple said. Once a situation has escalated to "full crisis mode," it is better to try to wait until the situation begins to ease — if possible, he said.
"Generally speaking, it is best not to put someone in custody at the top of the crisis phase," Whipple said, adding that is also when a person's angry attitude and adrenaline can make him the most dangerous to himself and others.
"Don't look for the quick fix. Look for the best long-term solution you can find at that moment," he said.
Whipple declined to comment directly on specific cases. But two incidents in the past 13 months illustrate the potential for violence in a crisis — each with a very different outcome.
On Feb. 19, a man suspected of having a mental illness allegedly shot at three teens on the Bear Creek Greenway with a black-powder pistol, hitting two but causing only bruising. Within hours, police found the suspect, Joseph Edward Matejko, 53, standing near Bear Creek with a loaded pistol in his hand. He had shaved his head and beard and was covered in nicks and cuts. Police ordered him to drop the gun, and he complied.
"There was a moment when he had the gun in hand," Lt. Mike Budreau said after Matejko was arrested. "It wouldn't have taken much for him to raise it. I want to commend the police officers for showing restraint."
Whipple credits previous officer training in mental health safety for incidents that end without tragedy. Men and women enter law enforcement with a fundamental commitment to help others. But they also are obligated to protect each other and the community, he said.
"We want to do what we can to help the mental health system. But there is no magic bullet. If someone wants to charge an officer with a knife or a gun, that can't be talked down with words," Whipple said.
Such was the case on Jan. 22, 2012, when Medford officers shot and killed a teen who lunged at them with a knife during what family members described as a mental health crisis. Elias Angel Ruiz, 18, had had outbursts at home and was bullied at school before the shooting, family said.
Ruiz had been arguing with his mother and was destroying property at the home, so she called 911. When officers arrived, Ruiz flew out the front door armed with a butcher knife.
In the confusing moments that followed, Officer Brian Hall tripped and fell off the porch as he attempted to fire Taser darts at Ruiz. With one officer down, the Taser apparently ineffective and Ruiz still on his feet with a knife, Officer Jason Antley fired six rounds from his .40-caliber Glock handgun at Ruiz. Five rounds penetrated Ruiz's body, killing him.
Officers and witnesses described a wild scene in which two bullets whizzed down a residential street, striking a neighbor's Mazda Miata and a concrete porch. In the midst of the melee, Hall mistakenly feared he had been wounded by a stray bullet after he fell, injuring his hip.
"I think I've been hit," Hall told another officer shortly after he fired Taser darts.
A neighbor later indicated she overheard an officer apologizing to Ruiz's mother shortly after the shooting. "I'm sorry," the officer reportedly said. "I'm sorry. I didn't have a choice."
"Sometimes there are certain things we have to do for the safety of our officers and of the community," said Whipple, who had responded to the scene that day.
Actors provided scenario-based training at the Utah sessions, portraying everything from suicidal subjects to people with post-traumatic stress disorders having a flashback.
In one exercise, an actor portrayed a mentally challenged young man who had locked himself in a workroom closet. Another portrayed his overstressed, undersupported and highly uncooperative older brother, who had called police, Whipple said.
Determining how to best respond to any mental health call is challenging. Diffusing and determining what, if any, crime may have been committed is also difficult. Through it all, the safety of all involved must remain forefront in an officer's mind, he said.
"We are always looking for hooks and triggers," Whipple said.
Triggers are topics that upset a person, he said. Hooks are topics that might help build rapport and help the individual calm himself.
"The goal is to talk more toward the hook side, and stay away from the triggers," Whipple said.
People who suffer from mental health disorders spoke to the trainees about the challenges they face. They offered advice on how officers might do a better job of helping them should a crisis arise, Whipple said.
One former police officer spoke about having been deployed overseas for three tours of duty. After the third tour, the man tried to return to work as a police officer, but then realized he was suffering "severe PTSD," Whipple said.
"He was unable to work. He'd had run-ins with law enforcement. And, because of his background, he was able to explain to us from a police and veteran's point of view what could be done better," Whipple said.
One "bright, articulate woman" described her manic phase to Whipple and the others. She had been hospitalized 10 times for failing to take her medications.
"For her it is the best thing in the world," Whipple said. "She is getting a lot of things done. She feels on top of the world. She's not needing any sleep. You can understand why someone wouldn't want to take their medicine when they're feeling like that."
But, of course, bipolar patients need their medications. Because the crash is inevitable. And can be deadly.
One of the department's drug recognition experts, Whipple said knowing which medications are typically prescribed for certain disorders can give an officer "some insights on which mental illness an individual is dealing with — and how you might best deal with the situation," Whipple said.
Another man who suffered from schizophrenia explained how he had no formal musical training. The man then played a 10-minute, beautifully composed original piece of music, Whipple said.
"And here I am, struggling to play chopsticks," Whipple said. "It just opens your mind and shows you everyone has strengths and challenges."
Brubaker, whose background is in social work, said the Utah training was eye-opening for her as well — especially the scenarios in which she was instructed to carry a simulated weapon into an emotionally charged and potentially deadly situation.
"I definitely gained a new respect for what officers face," she said.
The five who attend the February sessions will become trainers for the rest of the county's law enforcement officers, she said.
All but three members of the Ashland Police Department have received the training, as have several others in departments throughout the valley, said Chief Terry Holderness.
Ashland officers and staff received similar training in Riverside, Calif., several years ago. But budget constraints have limited ongoing training. Holderness said he is looking forward to having local training for his staff.
"We are extremely happy to see MPD taking the lead on this," he said.
Holderness credits the training with helping his officers avoid violent confrontations with the city's large homeless population, which includes many mentally ill individuals.
"This is Ashland. We have a lot of issues dealing with people who have mental health issues," Holderness said, adding most of his officers' "violent situations" actually come not from the mentally ill, but from "people who are intoxicated."
Whipple met Friday afternoon with Brubaker to set up local training sessions for his officers, as well as those from other departments.
The county's new $28.5 million, 86,000-square-foot, two-story health services complex will handle a caseload that is expected to rise from 23,000 clients to 45,000 by the time it opens in 2014. Mental health, alcohol and drug programs, immunizations, vital records, food licenses and disability services all will be available in the new health building, officials have said.
The county also plans to provide a crisis intervention service center that can care for up to five people at a time, and will provide people a chance to feel supported and regroup, Brubaker said.
The issue of mental illness hits home within all aspects of the community, Whipple said. There are officers with autistic children, parents who have Alzheimer's, and siblings struggling with depression or other disorders, he said, adding he's pleased with the changes, and eager to begin the training process.
"I am optimistic," Whipple said. "What (Jackson County Mental Health) is planning is going to work better for everyone."
Reach reporter Sanne Specht at 541-776-4497 or firstname.lastname@example.org.