N.H. Mental Health Crisis: Calls Unpredictable, Dangerous for Responders

June 19--First responders say they are seeing an increase in the number of mentally disturbed individuals they're called on to help.

And those encounters can be unpredictable, even dangerous.

Manchester police called in a SWAT team and a Bearcat the morning of June 1 after a distraught man allegedly threatened to harm first responders who tried to check on him at the request of a concerned relative.

Residents of 24 Krakow Ave. were evacuated during the incident and streets were closed, before police used tear gas to flush out the disturbed resident, identified as Patrick Clark, 35.

Clark was arrested and charged with criminal threatening and resisting arrest.

The 911 recordings from that day, provided by the Manchester Fire Department, show that a call came from the building manager, reporting that one of his tenants "appears to be in danger of hurting himself, hurting others in the building."

"On top of that, there's the smell of chemicals coming from his apartment," the caller said.

"So you're thinking there could be like a meth lab, is that what you're thinking?" the dispatcher asked.

"I don't know what's going on," the building manager replied. "We have a tenant; he came with great references."

But in the last couple of weeks, he said, "The police have been here many times."

The man had been screaming "racial epithets" from a window and "he's got bottles everywhere," he said.

"I don't know what's going on here but I spoke to him through a window. He does not seem coherent."

The fire department dispatched an engine, truck and rescue unit to "investigate a possible haz-mat situation."

Shortly after they arrived, the report came back from the scene: "Could you expedite police? We've got a threat to the responders."

According to a police affidavit, a SWAT team arrived 45 minutes after the first police officers arrived on the scene. Police called on Clark to exit the building and then moved the Bearcat up to a first-floor window.

Clark responded: "If you don't back off, it's going to be very bad for you guys," according to the affidavit by officer Matthew Brown.

The man then counted down from 10 to 0 twice, "but nothing happened at 0," Brown stated.

"Due to noncompliance of Patrick, CS gas was released into his apartment, which made Patrick jump out the window. Patrick was taken into custody once outside the residence," the affidavit states.

Craig Clough is the paramedic supervisor for American Medical Response, the private ambulance company contracted to provide 911 services in Manchester, Nashua and Candia. He said there have always been mentally ill people in Manchester.

But since the economic downturn, Clough has seen an increase in the number of disturbed individuals his teams are encountering, including more people who are addicted to drugs.

First responders are trained to "go easy and treat these patients cautiously," Clough said, "To make sure they're not putting themselves in harm's way and not doing anything to provoke a violent outburst."

Christopher Hickey, EMS officer for the Manchester Fire Department, said he's seen an increase in the number of calls for psychiatric emergencies, from individuals threatening suicide to folks who stop taking psychiatric medication.

"They get so lost down the rabbit hole, they end up needing some emergency intervention and emergency treatment," Hickey said.

He said the ongoing drug epidemic is only adding to the crisis: "It seems to be the root cause of a lot of things."

Hickey said Patrick Clark's mother had called his landlord that day, asking him to check on her son. She told him Clark "had some psychiatric issues and had been self-medicating with meth," he said.

When he checked on Clark, the landlord reported a strong odor, and the first responders who arrived also smelled ammonia, Hickey said. "For us, that's a telltale sign of a possible meth lab."

There was also a report that the man had several long rifles in the apartment. That turned the situation into "a barricaded subject with high-powered weapons," Hickey said.

And that's what triggered the call for the Bearcat.

"It is basically just a safety thing," said Fire Chief Daniel Goonan, who said police and fire officials worked well together that day.

"You don't know if the person has mental issues; you don't know what you're dealing with," he said. "All you know is you have a person claiming he has firearms and you don't know if he's going to use them."

In such situations, police use the armored vehicle to provide cover for the responding officers, Goonan said. "They're putting the Bearcat between themselves and a possible shooter."

He's heard the complaints by some city residents about the "militarization" of police forces. But Goonan said he sees it differently.

"To me, this thing worked out perfectly," he said. "Nobody got hurt."

A few years ago, when first responders began encountering more dangerous individuals and situations, the fire department held what's called MOAB (management of aggressive behavior) training for its personnel.

"We were dealing with so many patients with mental issues and so many people who were violent, we were concerned for the safety of our guys," Goonan said.

Hickey said first responders try to defuse a situation first. "A lot of times, the first responders can be the voice of reason for these people," he said. "Sometimes it works; sometimes it doesn't."

And they're trained, he said, "if it gets to be something that's too unsafe, to just back out."

The 2014 death of Brentwood police officer Stephen Arkell was a grim reminder of the dangers first responders can face. Arkell was ambushed by a gunman when he responded to a residence to investigate reports of a domestic disturbance.

Goonan said Manchester fire department is looking to do more training with police, for instance in how to respond to an active shooter scenario like what occurred in San Bernadino, Calif.

"We really need to break down the silos and this needs to be a complete EMS effort," Hickey said. "We need to know we're all on the same page."

Copyright 2016 - The New Hampshire Union Leader, Manchester