We have reached the end of Season 3 on the Center Collaborative. Closing out this year, we’re bringing you a fascinating discussion about how professional peers are making a difference in first responder culture in Eastern Oregon.

Peer Coordinator Sergeant Tyler Reddington, Retired Firefighter and Department Chaplain Kevin Coleman, and Dr. Lindsay Tice PsyD, Clinical Psychologist, discuss: 

• Fire and police often experience the same traumatic events, which is why it made sense to collaborate on the peer program.

• Undoing the old thought-process that traumatic events don’t affect all aspects of a first responders well-being.

• After a series of traumatic events in the community had a clearly negative impact on the first responders, the need for more support was recognized.

• First responders need a place to unload traumatic stress that doesn’t feel like they’re placing an undue burden on family and friends. 

• Trauma isn’t always a big event - it can be a result of the accumulation of traumatic stress from any area of a person’s life over time.

• Peers are a sounding board, encouraging ongoing communication about stresses whether they’re related to the job or not.

• If a person feels they would like more skills or help with processing trauma, they can be referred to Dr. Tice, who is culturally competent with first responder culture.

• The  Eastern Oregon Peer Team is adding peers to the team who have first-hand knowledge of an array of life experiences, for example, divorce.

• They are also adding peers from additional agencies in the area to continue building cross-agency relationships.

• The beginning shift in the resistance of the first responder culture to seeking support, as there is a level of understanding from peers. Seeking help and talking about stresses has been normalized during the culture shift.

• Peers are required to complete a 3 day training to be certified, and also must sign a confidentiality agreement.

• The peer team is working on relationship building with partner agencies by doing presentations, and hosting department breakfasts. 

• They are working to implement a call-tree to be dispatched out to trauma scenes in order to have a timely response to critical incidents to provide support to first-responders.

• After experiencing a significant trauma incident, first responders should be treated as though they’ve been injured, and be allowed time to process the incident before going out on more calls. Not being allowed time to process critical incidents can result in reduced job performance, increased stress, and potentially, the development of PTSD.

• A peer is a person who has had a similar experience who you can talk to about your experiences. Peers also have access to other resources, such as Dr. Tice, if a person needs them.

For more information about the intersection between criminal justice and behavioral health in Oregon, please reach out to us through our website at http://www.ocbhji.org/podcast and Facebook page at https://www.facebook.com/OCBHJI/. We’d love to hear from you.

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Holly Harris, LPC, Deschutes County Behavioral Health Director, and Sheriff L. Shane Nelson, Deschutes County Sheriff discuss:

• The benefits of having a 24 hour walk-in crisis stabilization center with therapists on staff.

• The stabilization center takes anyone unless there is a safety concern, and law enforcement can voluntarily drop people off in lieu of taking them to jail. The attitude is, “Coming from a place of yes.”

• The staff can de-escalate situations early for people by providing basic needs - food, rest, shower, etc - so the crisis doesn’t escalate, and the person can stabilize.

• Diverting people to services rather than taking them to jail makes the community and the jails safer.

• The center opened during COVID, and staff wellness has been a focus through safety implementation, debriefing, the betterment committee, and being mission-driven. It creates psychological safety for both staff and clients.

• The staff was provided with situational awareness and tactical training from law enforcement, and they rarely need to call police for back-up and initiate the involuntary process.

• The stabilization center staff also provided training to law enforcement, but it's not just training - it's about the partnership, and creating the trust to be able to provide the best services for the clients.

• The initial funding came through the sheriff’s department to start the project. The stabilization center later applied for, and received, funding from the IMPACTS grant.

• Approximately 400 people were diverted from jail in one year, with an average of 1500 mental health calls. Having behavioral health taking the non-law enforcement response calls straight from dispatch to respond to behavioral health crisis situations has helped to save an estimated $75,000 in officer time.

• Substance use goes hand-in-hand with the behavioral health problems, and won’t exclude a person from receiving services from the stabilization center.

For more information about the intersection between criminal justice and behavioral health in Oregon, please reach out to us through our website at http://www.ocbhji.org/podcast and Facebook page at https://www.facebook.com/OCBHJI/. We’d love to hear from you.

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Dr. Andrew Orf, partner of Lithia Forensic and Consulting LCC and a certified forensic evaluator, discusses:

• Oregon began the certification for forensic evaluators in 2012 for fitness to proceed evaluations, and the courts now prefer Certified Forensic Evaluators for pre-adjudication services.

• The level of nuance between evaluations, as it is combining the clinical perspective with the legal perspective. 

• The many clinical components to consider, such as neurocognitive conditions, personality disorders, or substance use. 

• Legal considerations for statutory evaluations are related to an individual’s intent. Evaluations are also conducted in order to determine if a person’s qualifying mental health disorder impacted their capacity to form intent.

• The pressing need for more Certified Forensic Evaluators, as a lot of people are in correctional settings, and end up waiting for evaluations.

• When people are acutely ill, there are few, if any places to send them for help, as the bar for civil commitment in Oregon is very high.

• Rapid evaluations increase access, and timeliness in more rural areas, as the majority of certified evaluators are in the Portland, Eugene, and Salem areas. There is a collaborative effort between community mental health programs, district attorney, courts and the defense attorney to identify who needs a rapid evaluation.

• Regular consultation with other evaluators is important for maintaining wellness as a clinician doing the evaluations day in and day out.

• Certified Forensic Evaluators can conduct several different types of evaluations based on the requests from the court, such as: guilty except for insanity, juvenile waiver evaluations, risk assessments, mental health evaluations for qualification, neuropsychological evaluations, and civil evaluations.

• People assume that evaluators are advocates, but they strive to be independent and ethical.

• There are layers of complexity within human beings. People can have multiple underlying conditions that make it difficult to know a conclusive answer as to what drives behavior. Two well-trained, experienced evaluators can disagree on a diagnosis, and neither are necessarily wrong.

• Nuanced and well thought-out evaluations are crucial due to the real world implications and ripple effects for people.

• There is a vested interest from the general public because once the process is initiated, costs pile up. One day at the Oregon State Hospital for a person is over $1000.

• Oregon is in a transitional phase with mental health conversations and legislature. It’s easy for everyone involved to point out the problems, but very hard to come up with solutions.
  

For more information about the intersection between criminal justice and behavioral health in Oregon, please reach out to us through our website at http://www.ocbhji.org/podcast and Facebook page at https://www.facebook.com/OCBHJI/. We’d love to hear from you.

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