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In the past 12 months, four Sonoma County residents in severe mental distress -- a teenager, a mother and two men -- have been shot and killed by members of three local law enforcement agencies.

The circumstances leading to their deaths remain under debate. But mental health care advocates and law enforcement officials agree one thing is clear: They are partly victims of a mental health care crisis in Sonoma County that is getting worse.

"The sad part is that many of our mental health services are being reduced drastically in our community and now the community essentially doesn't have anywhere to turn to for those services," said Tom Bullard, Rohnert Park public safety director.

"We've had to take on roles that the mental health community filled for many years. That's a great burden for law enforcement."

One of his officers, 27-year-old Robert Lankford, shot and killed 31-year-old Heather Billings on Sunday after responding to a distress call from Billings' mother. The 911 call alerted police that a person had become violent and "might have some psych issues."

Police said Lankford fired after Billings failed to drop a two-inch blade and came toward the officer, an account disputed by family members.

In June, with the closure of Sonoma County's Norton psychiatric hospital looming, Sheriff Bill Cogbill asked the Sonoma County Board of Supervisors for $360,000 to pay for a five-year program of crisis intervention training for peace officers.

The training is modeled after a 20-year-old program in Memphis, Tenn., now being adopted by police departments across the country.

But sober words came this week from Maj. Sam Cochran of the Memphis Police Department, the man behind what has become popularly known as the Memphis Model.

"You can have training, but if your community services system is not in place or falling apart, you're going to have a rough time," Cochran, the coordinator of the Memphis community's Crisis Intervention Team, said.

Last year, Sonoma County closed the Norton Center psychiatric hospital, and the area's last inpatient psychiatric beds are slated for closure at Santa Rosa Memorial Hospital's Fulton campus.

This week, staff at A Step Up, the county's only residential treatment program for those diagnosed with both mental illness and substance abuse, learned their program was being considered for significant cutbacks.

Cochran, who has been with the Memphis program since it began, made it clear he was not familiar with Sonoma County's crisis intervention training and was not in a position to comment on it.

But he warned that much more than training is needed to address the continuing mental health care crisis that many communities are facing.

"Law enforcement has to start considering becoming an advocate" in the ongoing effort to preserve mental health services, he said. Anything less, he said, could lead to "a false hope and false sense of security."

Earlier this month, 19 sheriff's deputies, 10 Santa Rosa police officers and one Healdsburg officer completed the local crisis intervention training program. The training involves much of the same curriculum as Cochran's Memphis program.

Mike Kennedy, section manager for forensics and special programs for the county mental health program, said the goal is to help police officers recognize the signs and symptoms of mental illness and be able to identify effective techniques for dealing with people.

The local program immerses officers and deputies into the world of mental health services, bringing them face to face with mental health care professionals, those who suffer mental illness and their families.

Subjects covered include suicide intervention, crisis and tactical communication and tactics for the use of less lethal force.

Kennedy said a main goal is to teach officers to differentiate between criminal behavior and an acute psychiatric episode.

"In certain situations, these techniques can really help a lot," Kennedy said. "But when they're faced with their own safety issues or somebody has a weapon, then they have to use their law enforcement training to keep themselves safe."

Cochran's words were not lost on those behind the local training program.

Rosemary Milbrath, executive director of the Sonoma County chapter of National Alliance on Mental Illness, or NAMI, said, "I do believe that our CIT is a team approach. I believe that strongly," Milbrath said. "I hope our community will decide that mental health issues impact our entire community, not just people who have these disorders or their families. To expect law enforcement to handle this alone is not reasonable."

Mike Kerns, chairman of the Sonoma County Board of Supervisors, called the four deaths "a red flag for improving mental health services and treatment in our community again."

Public officials said counties all over the state are facing deep cuts in mental health services because of the state budget crisis.

Money from Proposition 63, passed in 2004, is dedicated to mental health care services, but some call it too restrictive.

"It doesn't cover any programs that you're currently operating," Sonoma County Supervisor Valerie Brown said. "How do you cover new programs when you can't fund the programs that were working?"

Billings' death Sunday has again raised calls for a civilian review board to independently investigate police shootings.

"With the most recent incident in Rohnert Park, enough is enough at this point," said Maria Peluso, chairwoman of the Sonoma County Democratic Central Committee.

In a statement released Friday, she called on supervisors to establish the review board and "find a way to provide mental health services to those in dire need, before this type of tragedy repeats itself."

Cochran said the Memphis model that Sonoma County and other cities and counties across the country are emulating is not a cure-all.

"We continue to battle issues," he said by phone from Memphis. "But we have a platform to battle issues. When NAMI speaks, we're right there next to them. When we speak, NAMI is right there."

You can reach Staff Writer Martin Espinoza at 521-5321

or martin.espinoza@

pressdemocrat.com.