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How to De-Escalate a Mental Health Crisis in Prison

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The yard at the State Correctional Institution at Benner Township is much like any other prison - an outdoor space where general population inmates exercise and socialize. But, Benner is not like other prisons - it is one of several Pennsylvania Department of Corrections (PADOC) prisons that house inmates with serious mental illness.

A confrontation in the yard can go bad in seconds. So, when one of the inmates from the residential treatment unit (RTU) challenged another prisoner with threats, obscenities and vulgarities, it could have easily ended in violence.

But instead of sparking an incident, the officers on duty stayed cool and contacted Melissa Urbanick, unit manager of the RTU, where the inmate lived and escorted him back "home" where he could get the care he needed.

Then, the officers spoke with the inmates who were still in the yard, "Hey, we know what he said was really inappropriate. We know what he said was wrong. But, he has a mental illness and his ability to process things or his ability to understand what's right and wrong is a little bit different than ours."

What could have become violent became a lesson in understanding and empathy.

On September 5, CNN took viewers behind-the-scenes at Benner, where every employee - from corrections officers to clerks, maintenance and culinary staff - receives Mental Health First Aid USA training with an insightful piece called, "First Aid for Mental Health: A New Approach in Pennsylvania's Prison." And training made all the difference that day in the yard.

Melissa is part of the treatment staff who work daily with inmates at Benner who are mentally ill to keep them safe and provide needed therapy. She says Mental Health First Aid has increased awareness about mental health and the special needs of the inmates in her unit.

Mental Health First Aid is a full-blown movement in the United States, with more than 680,000 people trained by more than 10,000 instructors.

Law enforcement agencies across the country have been critical drivers of that movement. The Pennsylvania Department of Corrections has trained every staff member - more than 15,000 people, including those at Benner. A new law in Rhode Island makes it mandatory for all law enforcement officers to receive training in Mental Health First Aid for Public Safety. And officers from Albuquerque to Philadelphia have been trained in the 8-hour course, which gives them the tools to identify when someone is experiencing a mental health or substance use problem.

"This is training that's useful to everyone," Melissa said. "It applies to anyone who's going to have inmate contact and may experience some sort of crisis. They can use the things they learned in Mental Health First Aid to de-escalate that crisis."

She sees that Mental Health First Aid is paying dividends in increased awareness about mental illness among the staff. "They're more aware of a situation before it presents itself. And, of course, having the training gives them understanding of the basic steps of trying to calm the inmate down, assessing their needs and asking if they're suicidal. You can see staff feels a little bit more comfortable dealing with inmates with mental health issues."

As a member of the treatment staff, Melissa receives ongoing training, but Mental Health First Aid is different. "One of the things that stands out to me about Mental Health First Aid training is that it's not specific to a correctional facility. It's something that can be used in the community. It can be applied to any situation."