Identity de-stigmatized

Even for the most rational individual, getting stopped by a uniformed police officer or deputy tends to cause some measure of anxiety.

Imagine that moment for a person who’s already anxious—someone experiencing the effects of trauma, neurosis or psychosis. He or she may respond erratically, even violently. Suddenly, a routine encounter can escalate into a high-stakes situation.

“Too often people with mental illness end up incarcerated for issues that are related to their mental health issues,” said Dorian Kittrell, director of the Butte County Department of Behavioral Health.

But what if the officer had a heads-up? The outcome can be completely different.

Capt. Andrew Duch of the Butte County Sheriff’s Office recalls just such an incident six years ago. While driving from Chico to Oroville on Highway 99, he saw a man walking in the oleanders just south of Skyway.

“He looked disheveled, had an Army coat on, [was] barefoot,” said Duch. He stopped his vehicle to ask the young man to not walk on the median.

As a matter of routine, Duch asked to see his ID. The man showed him a laminated card from a clinic in another county that identified him as a consumer—“what we call people who use mental health services”—plus listed information about his care provider and diagnosis.

“I remember thinking, and I almost said it out loud, ‘Damn, this is handy!’—because it completely changed the manner of the contact from a possible enforcement action to a public service action,” Duch recalled. As he realized later: “It wasn’t the card … it was the conversation that it started, and how it put me into a different mode of service.”

In that particular instance, a deputy came to give the man a ride. But, on a larger scale, the experience led to a pioneering program that’s brought together area law enforcement agencies and the local chapter of the National Alliance on Mental Illness.

Since December, NAMI Butte County has distributed “White Cards”: laminated IDs with one side for law enforcement’s reference and one side for the holder’s reference. The front contains whatever the person wishes to share; options include name, address, photo, emergency contacts, doctors, conditions and triggers. The back displays shoulder patches of each participating agency—law enforcement and emergency medical response—to help the cardholder recognize the official’s affiliation.

The program is voluntary. No one has to get a White Card, and NAMI does not keep track of who is given cards (nor what’s on any card). NAMI Butte County president Cathy Gurney estimates that a couple hundred have been given out.

Duch says the sheriff’s office plans to start issuing White Cards, too, at its stations and substations. He says BCSO will follow the same procedures as NAMI: voluntary, no registry or records, and all done in privacy.

Local officials cite positive feedback from cardholders, but the program has encountered some opposition.

After the idea got publicity in 2013, a psychotherapist contributing to the website for Mad in America (an organization critical of current psychiatric practices) wrote a blog post expressing discomforting consequences. Even if the project were “well-intentioned,” Dr. Michael Cornwall deemed the White Card “a form of psychiatric profiling” that could lead to authorities stigmatizing noncardholders more than cardholders, keeping track of cardholders and forcing institutionalized or convicted patients to carry cards.

Reached by the CN&R last week via email, Cornwall says he “respect[s] any Butte County mental health system user’s choice to get and carry an ID card.” He also discussed “forced in-home treatment laws in place in 45 states”—recently adopted in the Bay Area and approved in Los Angeles—which “may be the law of the land.” (Cornwall refers to HR 3717, aka the Helping Families in Mental Health Crisis Act, which includes provisions for involuntary outpatient commitment, or court-ordered treatment.)

“So, against that backdrop, the Butte Bounty NAMI/law enforcement mental patient ID cards are even more of a concern because I believe they will be promoted by NAMI nationally, too,” Cornwall said. “I believe they will become an integral feature of the national, draconian forced-treatment legislative agenda of NAMI.”

Gurney and Duch know Cornwall’s position. Both stress the voluntary nature of the program. Besides, the card itself isn’t critical: A person stopped by law enforcement just has to say he or she has a White Card—doesn’t have to produce one—and no one is going to verify the claim.

“It’s just an icebreaker; it’s just a conversation-starter,” Duch said. “That’s all it is.”

Behavioral Health supports the program, Kittrell says, because it’s consumer-driven and “gives clients an opportunity to participate or not right from the get-go, and then have complete control over the information if they do participate.”

Kittrell added that he understands Cornwall’s perspective and agrees that the severely mentally ill have lived with great stigma.

“I, however, see it in a different light: For those people who feel comfortable, who feel they are ready to step out into the light, it gives them an opportunity to do that.”

The White Card, too, may well keep the person out of a dark space.

“They understand it’s not a get-out-of-jail card; if you break the law, you have to pay the penalty,” Gurney said. “But for many instances where police officers may misunderstand the actions of someone who’s in psychosis, this would help that officer better understand the situation that he’s walking into—and hopefully make it so they’re walking out of that situation with one less mentally ill person being arrested and taken to jail, but maybe taken to the right place.”