With voices in her head distracting her, Kimberly Sikalis is struggling to think straight.
"Good morning, I'm the intake worker for the Psychiatric Emergency Services Clinic," a woman with cropped brown hair says to Sikalis.
The woman begins with a series of routine questions to see how Sikalis is cognitively functioning, then she asks Sikalis to do some simple math.
"Starting with the number 100, I want you to count backwards by seven," the woman says.
"Okay, 100, 93..." Sikalis stutters."I can't count the voices keep messing me up."
A brief pause, and Sikalis continues.
Another pause, and Sikalis, though smiling, seems defeated.
"I can't," she says. "It's messing up my concentration."
Sikalis, a communications supervisor for the Howard County 911 center, does not actually have schizophrenia, a complex mental disorder that makes it difficult to discern the difference between real and unreal experiences. Instead, she was wearing headphones connected to an IPod Shuffle to simulate the disorder.
The accomplished 911 manager, named civilian employee of the year this year by the Howard County Police Department, was participating in a Crisis Intervention Training program run by county police. Held last week at the James N. Robey Public Safety Training Center in Marriottsville, the program was aimed at helping officers and civilian police department employees interact appropriately with individuals who suffer from mental disorders.
The training included hands-on exercises — such as role-playing sessions where mental health professionals simulate having a mental disorder and trainees practice how best to communicate with them — and one-on-one interactions with individuals who have mental disorders.
Police Chief William McMahon first embraced the idea of such training in the fall of 2008, when he went to a conference on mental health training with Donna Wells, director of the Howard County Mental Health Authority. The following year, McMahon sent several police officers to a Crisis Intervention Training program in Montgomery County — including Lt. Robert Wagner, who now runs the Howard County program.
In October of 2010, Howard County offered its first in-house, week-long Crisis Intervention Training Program. Last week's was the second.
"It enhances the training that we do as a police department," Wagner said. "It gives us options. ... Sometimes, instead of incarceration, we can direct individuals towards treatment."
More tools in kit
Wagner said police officers often deal with people who have mental disorders. In fact, he said, about one-quarter of those incarcerated have some form of mental illness.
"The more information that we can give police officers about identifying that this is an illness and that there are resources in the community, the more that they can help," said Wells. "Knowledge is power. It really gives the officers more tools in their tool kit."
Wells said that if officers can identify an individual suffering from mental illness and help him get help, that individual is less likely to cause trouble in the future.
"So (police) are not going out to repeated calls with no outcome," Wells said. "Treatment works."
During the training, officers and dispatchers visited in-house care facilities, daytime treatment centers and support groups for people with mental illnesses. Wagner said that during a visit to a treatment center in October, officers encountered a woman who had several interactions with the police because off incidents fueled by her mental illness.
"She recognized us, she talked to us and it really gave the officers a different perspective on her and what medication and treatment can do," he said. "Since then, she's been receiving treatment. … Officers have told us that she has not called us in months, and she used to call us daily."
At another station during the headphone schizophrenia simulation, trainees were asked to deposit fake paychecks and withdraw $20 from a model bank at the training center.
In the first group of six, four people filled out their deposit slips incorrectly. As they withdrew money, a teller would ask if they wanted to open a new credit card account.
"I was trying to act normal at the bank, but I didn't hear a word she said because of this stuff is going on in my head," said dispatcher Megan McAuliffe. "Trying to tune it out and trying to act normal was exhausting."
Wagner, who led a discussion after the exercises, offered the class some perspective: "Just think about listening to that all the time," he said.
Medicated and treated
The group also heard from Deanna Green Ross, who speaks publicly to health and safety professionals about her experiences with mental illness.
Ross said she began hearing voices in her late 20s, but did not want to admit she had a mental illness because of the stigma.
When she was at her worst, Ross would sleep and eat very little, she said. At first, the voices she heard told her she was special, that she was going to be famous and have a lot of money.
Then, Ross says, the voices got mean.
"The voices started coming really fast," she said. At one point, the voices caused her so much mental anguish that she blacked out while driving, she said, causing her car to veer off onto a roadway shoulder. When a police officer responded to the scene to check on her, she was so frenzied that she began taking off her clothes, Ross recalled.
Eventually, she was arrested.
"Do I look like I would do something like that now?" asked Ross, who wore a fitted black suit as she spoke to the class. "Absolutely not. That's because I'm medicated and I'm treated."
Wagner said that interactions with people who suffer from mental illness is what gives the crisis intervention training its punch.
"That's what's great about this training, it's not all in classrooms," he said.