Street protests and town hall meetings swiftly followed the shooting death by police last week of 26-year-old Mario Woods in San Francisco’s Bayview district.

Officers were responding to reports of a stabbing in the area, and found Woods with a knife. Police say they tried to disarm Woods using bean bag rounds and pepper spray before opening fire on him on a city street. A cell phone video of the shooting was posted to Instagram, and quickly went viral.

The incident has caused many to call for police reform and better training. Yet three of the five officers involved in the shooting had already attended SFPD’s 40-hour Crisis Intervention Training class. In fact, Chief Greg Suhr says his department has the most crisis intervention-trained officers in the country. This kind of training is focused on responding to those in a mental health emergency – it’s not clear whether this was the case in the Mario Woods incident. But with the mental health care system strained and cash-strapped, the burden of these emergencies is increasingly falling to police.

So far, roughly 22% of the department has taken the Crisis Intervention Training course. But can 40 hours in a classroom prepare police officers for what they’ll face on the streets?

Inside the classroom

On the last day of the San Francisco Police Department Crisis Intervention Training class, around 20 officers sit at attention. Some cross their arms.

“I’m not going to be talking to you about tactics today,” one officer says. “That’s not what this class is about.”

Experts present statistics about issues like suicide and post-traumatic stress. There’s a history lesson on homelessness. And then there’s role-playing: one student acts the part of a police officer while another pretends to be a suicidal man with a knife in a public park.

“What do you have in your hand, sir?” the officer says. “Wanna do me a favor and could you drop it? Let me just see your hands.”

The officer earns the man’s trust by speaking calmly, and asking questions about his family. The man drops his knife.

“Alright, I put it down,” the man says. “You’re not going to bum rush me, right?”

Mock bystanders are in the background, chanting, “Hands up, don’t shoot!” The officer finally gets the man in the back of the police car.

In the scene, the suicidal man is calm and quiet, and it doesn’t take much to convince him to change his plans. When the role-playing is over, one student raises his hand and points out that if the officer really encountered a man in the park with a weapon, things would have gone down differently. He says a so-called “lethal”, meaning a gun, would probably be involved.

“We’d probably have a lethal out as well. He's got a knife. If he advanced at us, he's going to get to us before we get to him,” the officer says.

That’s the rationale that Chief Greg Suhr gave in the Mario Woods shooting incident last week. Officers felt threatened, so they opened fire.

“Doing all this talking and everything, when we're out on the street, it's a different scenario,” the officer continues.

It is different in the classroom: it’s a controlled environment. And that gives officers a chance to slow down and learn different de-escalation tactics.

They also learn how to refer people to treatment services. There’s not much else they can do to help solve long-term psychological problems. But there’s one sergeant in the department whose job is to try.

The Psychiatric Liaison Unit of One

Kelly Kruger works in the Psychiatric Liaison Unit out of Special Victims, but it’s a unit of one – just her. When officers struggle to find a way to help someone who is mentally ill, they call Kruger. It’s her job to help those people find services and get the diagnoses they need. And there’s a lot of need.

I meet with her in her office.

“Holy moly, I do wish I could settle down a little bit,” Kruger says.

Her office is filled with hundreds of files everywhere, plus a filing cabinet of more, well, files. She flips through sheets of paper, each one telling the story of a different person.

I ask her if she knows how many files she has. She stumbles, and eventually says, “No, it would be too much to add up.”

Kruger says the number of cases she’s had to respond to has at least doubled since she started her job roughly a decade ago.

Before that, she spent over 20 years as a psychiatric technician at hospitals and with Mobile Crisis Units in San Francisco and Oakland. She applied for this job because she didn’t think law officers grasped what it meant to have a mental illness at the time, and she thought she could help. Every day, she’ll get about 40 phone calls.

The biggest fires

Her days start around 11am, and end at about 2am. Since she alone is the Psychiatric Liaison Unit, she doesn’t have much time to respond to every call.

“Back when I worked for the Department of Public Health, I’d do a full assessment, be thorough,” Kruger says. “Now I just sort of run around to the biggest fire.”

So she focuses on the fires she can control, like one woman who won’t let her elderly parents use the restroom in their house. The woman also vandalized some neighbors’ cars. They’re the ones who went to the cops. And those cops went to Kruger.

We drive over to the woman’s home in the Bayview district. Kruger sits down with her on the curb for a talk. Minutes into their conversation, Kruger asks, “Have you been able to stay clean and sober yourself, as far as substances go?”

The woman confesses to Kruger that she’s been smoking crystal meth as a painkiller.

“And I’m cool, and I’m calm. I was honest with you. I was able to control it,” she says.

Kruger wants to know if her parents are safe. Then she tries to see how she could help.

“This is what I need to know, though, and I appreciate you being honest with me, if we could arrange for a better living situation for you, where you'd have your own space, would that be something you'd be interested in?” Kruger asks.

They exchange phone numbers, and then we leave. I ask Kruger if she thinks progress was made.

“I feel like it was a positive experience. You build trust by being consistent with the things you say, so certainly no harm was done,” Kruger says.

Slow down, stay calm, and open your ears

Kruger encourages her colleagues to respond to these situations the way she does: calmly, with open ears. Her boss, San Francisco Police Chief Greg Suhr, has made it a department-wide policy for officers to respond to a psychiatric crisis slowly. The Crisis Intervention Training is to give them practice in doing their jobs like Kruger does hers.

“So by receiving the training they are taught to slow it down, set up a perimeter, if we have to be there all day, we'll be there all day,” says Sergeant Mario Molina, who organized the most recent class.

Molina says you can see examples of this working.

“There was a gentleman that had stolen a car, went into a fire escape ... the officers closed off the street, went and talked to him – it took awhile,” Molina says.

And after a few hours just talking to the man, they realized he really wanted to see his cat. So they brought his cat up to him.

“We got this guy down from the fire escape,” Molina says. “You know, without getting harmed.”

Measuring the success of mental health training

But Kelly Kruger acknowledges stories like those aren’t enough to show what’s working and what isn’t.

“It's getting the word of mouth, the feedback, but that isn't at the level as if we had people doing real research,” Kruger says.

There haven’t been any studies showing that crisis intervention training is effective in San Francisco. But there has been research elsewhere. Since 2011, SFPD has based its training on the so-called "Memphis Model,” which was launched in that city in 1988, after police shot and killed a mentally-ill man wielding a knife.

The model is now in use in over 2,500 police departments nationwide. Some studies show that implementation can lead to a reduction in arrests and police use of force for people with mental illnesses.

When a crisis happens

But Sergeant Kruger doesn’t think the success of crisis intervention training can only be measured by shootings or arrests. If an officer’s life is at risk, she says, force will be necessary.

“The officer is going to respond the same way, regardless if they're mentally ill, if someone is trying to take the life of somebody else or their life,” Kruger says.

So far, about one out of five San Francisco police officers have taken the crisis intervention training course. That’s a start, but it still means there’s not always a trained officer available to respond to these kinds of calls. Trained or not, whoever does respond won’t have the time Kruger has to develop a long relationship. They’ll have a few minutes, maybe even seconds, to figure out what to do.