Tony Mantor: Why Not Me the World
Sherri Witwer: Rethinking How We help People in Mental Health Crisis
Wed, 21 May 2025
Send us a textSherry Witwer, board president for CIT Utah, shares her insights on improving crisis response systems for people experiencing mental health emergencies and creating alternatives to incarceration through specialized training and community partnerships.• CIT (Crisis Intervention Team) training provides law enforcement with tools to effectively respond to mental health crises and connect individuals with appropriate treatment• Mobile crisis outreach teams staffed by behavioral health providers and peers can handle most crisis calls without police involvement• Receiving centers offer alternatives to jails or emergency rooms, providing specialized assessment and stabilization for those in mental health crisis• Proper training helps officers distinguish between substance use and mental health crises through scenario-based practice and building community partnerships• Access to care remains a significant challenge, particularly coordinating services for people with serious mental illness across different systems• Better case management and peer support services are needed to help individuals navigate complex systems when they're least able to do so independently• Affordable and supportive housing is essential for recovery and breaking cycles of hospitalization and incarceration• Including voices of people with lived experience and families is crucial for designing effective mental health services that people will actually usehttps://tonymantor.comhttps://Facebook.com/tonymantorhttps://instagram.com/tonymantorhttps://twitter.com/tonymantorhttps://youtube.com/tonymantormusicintro/outro music bed written by T. WildWhy Not Me the World music published by Mantor Music (BMI)
Chapter 1: What is CIT Utah and its role in mental health crisis response?
Oh, it's my pleasure. I understand that you are the president for CIT Utah. Can you expand on what that is?
Yeah. I guess as a matter of introduction, I'm a longtime mental health advocate. I've worked in various capacities in our mental health system. primarily in public policy advocacy. I'm a family member of someone with a serious mental illness, and that's what has driven my work and my interest in the mental health system.
As part of my work, I have been and am working with other families and people with lived experience with mental illness. I have been an advocate for crisis intervention team training. That is training for law enforcement, behavioral health providers, and families and people with lived experience.
They come together to provide training for law enforcement and, more importantly, to have an effective crisis response when someone is in crisis. that law enforcement has the training and the support of the mental health system to help them respond effectively and get the person to the treatment that they need.
Now, really positive development is that with our crisis response systems, we have developed mobile crisis outreach teams that are driven by behavioral health providers with peers, people with lived experience who can respond to the overwhelming majority of those calls. And that really provides better outcomes and helps us to treat mental health as a mental health condition.
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Chapter 2: How are mobile crisis outreach teams improving outcomes?
However, there are times when law enforcement needs to be involved or behavioral health team is uncertain in their response. And so they can co-respond or have law enforcement take the lead in that response. But having that training and that understanding is critical to having better outcomes for everyone involved.
With what you're involved, I believe they have created a new number for crisis response other than 911, correct?
Right. There's a 988 number now that's been developed that people can call and get that behavioral health response. And that has been a huge, significant improvement in crisis response. So CIT is still an important piece, and I don't want that to be overlooked in our crisis response systems because there just are times when law enforcement needs to be involved.
They are called out and to recognize, oh, this is a mental health crisis, and we need to get our CIT team to be able to respond differently to that situation.
When police are involved, the goal is of course to improve outcomes and prevent situations from escalating. How have they responded to the training efforts aimed at teaching the officers to quickly assess situations and make decisions given their limited time and of course their budget constraints? Have you seen as good a response as you hoped for?
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Chapter 3: What is the significance of the 988 crisis response number?
Yeah, I think, first of all, when you talk to law enforcement, they are inundated with mental health calls, and they really would rather not be responding to those calls. So they welcome mobile crisis outreach teams in some of these areas. responses with really takes the burden off of law enforcement and having to make all of those decisions.
Still, there are times when they need to, and that's where having best practice CIT program is involved. And that means having everyone have all law enforcement get basic mental health training and build those relationships, know who the partners in the community are that they can call in crisis response. It also is in having a specialized CIT team that responds, have them follow best practices.
And that means that they self-select, that there are people who say, yeah, I would like to work with this population and build these relationships and know the system and know the civil commitment process and take their education and their tools and training down that path.
When you are talking to law enforcement about this, they get it, that having that support in response and having the best tools and training for their officers is a win-win for everyone. A good CIT program has oversight that involves people with lived experience and family members who can help inform that crisis response as well.
It's just a very unique partnership when done correctly, and it can make a huge difference in how things are addressed.
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Chapter 4: How do officers differentiate between substance use and mental health crises?
Okay, let's do a scenario here. A police officer responds to a call about a person whose behavior might typically suggest they're under the influence of drugs or alcohol, erratic movements, slurred speech, other telltale signs. This individual is also holding a knife or a gun, something that could drastically escalate the situation.
With only seconds to react, how does the officer distinguish between someone experiencing a mental health crisis, like psychosis, or someone who's simply high or intoxicated?
They definitely will encounter people who are using substances, as you point out, but this is part of the CIT training. They do this very thing where they have different scenarios, scenario-based trainings, and they help to create some time and some distance from what's happening to be able to make those calls. And there's no question, they often don't have a lot of time.
But that's where having officers who have had some time on the street, first of all, before they become CIT officers, so that only time and experience can really help them differentiate between What are we dealing with here? And then having that training and ongoing recertification for officers, because there are always new things that come out that they need to be aware of.
And I just think that kind of training is so critical. And CIT is critical in helping to divert people. So rather than taking people to jail,
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Chapter 5: What does CIT training involve for law enforcement?
If there are receiving centers, which is another thing that has been developed and is starting to get traction, where rather than taking people to jail or even an ER, they go to a receiving center, which can do an initial assessment and decide what level of care the person may need, and it helps law enforcement in being able to take the person to a safe place.
That's a real tool as well that has been very important in crisis response. We need more of those in assisting law enforcement and behavioral health in crisis response. Again, helping to take all of the decision-making off from law enforcement and have them get behavioral support, behavioral health support in that response, just makes a big difference for everyone.
I'm really interested in getting back to that center you mentioned. But first, could you tell me what a typical day looks like when you're setting up a conference for police officers or other first responders? What does the schedule involve as they go through the process of learning all this material, which seems like a lot to take in?
So 40-hour training for CIT in Utah, and I can just speak to how it is. It's a 40-hour training in order to get that certification. And they bring in experts who can talk about, here's what mental illness is. Here are the different medications. Here are the different ways it can present. Here is how someone who is in psychosis can can present.
I'm talking about a condition called anosognosia where the person does not have insight to their illness or that they're ill. And it's not just denial or being difficult or belligerent. They truly do not believe they have a mental illness.
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Chapter 6: What factors influence the decision between jail and treatment centers?
and helping law enforcement to identify that and bringing in speakers who have expertise in civil commitment law, who are family members, who are people with lived experience. Having them spend time at different locations with people who are in recovery is really important. So it's just giving an overview of the system.
The big part of CIT is helping to build those partnerships so law enforcement knows who to call, who are the contacts, where are the resources in our community. that they can lean on. And really, it's creating relationships.
So much of CIT, and frankly, with the whole mental health system, so much of providing an effective mental health system is building those partnerships and relationships and points of contact so that people know who to call and how to have an effective response. And that's what the training is.
Now, you mentioned a treatment center. When someone reaches a point where intervention is necessary, you mentioned a treatment facility where they can go to for diagnosis and support. What factors determine whether they end up in jail, going through that legal process, or are directed to a treatment center instead where they can get help and potentially avoid incarceration?
That is a big question, and that's constantly being discussed. How do we help law enforcement get as much information about what's taking place as possible? Part of this is we encourage families to be able to talk to law enforcement and give them information and give them some history and background.
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Chapter 7: How can families assist during a mental health crisis?
Having the behavioral health contact in that crisis response, a lot of times the behavioral health system will know the person and will be able to enlighten law enforcement in what's taking place and be able to have an effective response that way. And so it's about helping law enforcement to get as much information as possible.
This means also there needs to be effective training for call takers, dispatchers, and help them to get that information as well.
Right. When someone calls 911 for assistance but provides insufficient details, it leaves the responding officers unprepared for what they might encounter. Situations involving civil disturbances can be particularly volatile, making them some of the most dangerous scenarios for police to handle without the proper information.
That's right. And it's not always possible in every area, depending on the size of the police department. But ideally, there's time to say we need a CIT team to respond to this. And that's ideal where we have these trained teams that respond and are able to use their skills in that response.
I would say overall, we really need to provide more avenues for families to be able to give information and explain what is happening and provide background and history to the situation as well.
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Chapter 8: What are the challenges of effective crisis response?
When individuals enter this facility you spoke about, does it remove the legal aspects or do these legal elements remain in place? How does this all connect and work together?
Yeah, so they're going to sort things out there. They're 23-hour stays. And so it gives them time to sort things out, to decide what level of care the person needs, and then let the legal system, and that's got to work its way through as well. But
Again, understanding that behavior is driven by a serious mental illness or psychosis or anosognosia is important information in knowing how to help the person from there and with the legal system, how to manage the court system with that person as well.
As someone who's been involved for about 20 years, what positive changes have you observed, particularly in the last five or six years? It often seems like five years is the window it takes for things to process and start working effectively. So in the past five years, what specific changes have you seen that you'd say are definitely positive and moving in the right direction?
Well, I think we've been talking about one area, which is crisis response. I think that has been a big improvement. I think having a number that people can call 988 to be able to get assistance and just help to sort things out on their end. A person with lived experience or family experience. to have that resource.
So I think the establishment of mobile crisis outreach teams that use behavioral health providers and peers is very significant, very important. Receiving centers are very important as well. So I think those are big areas. I think in some ways, at least for general mental health and wellness, we're talking more about that. I think we're focusing more.
We understand that mental health is something we need to address and try to intervene early, focusing on mental wellness. I think that has been significant. For the most part, I think we've addressed stigma in a significant way, although for people with very serious mental illness, in some ways, it may be rougher for them where there's less tolerance and patience around that.
But for the general population, I think we've made some big improvements in that way.
Having observed these transitions, what key areas do you believe still demand greater scrutiny and effort? While these topics may have been initially explored, they clearly warrant deeper attention and development. Can you identify any areas where you would assert, okay, this absolutely requires us to prioritize and address it thoroughly because you see the need for it to get better for everyone?
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