The rasping, evil, disembodied voices are taunting and nagging, whispering curses and insults as they invade the mind, laying siege to all thought.
Wearing headphones, Frederick city police officers listen to the sounds of schizophrenia, to understand why people who suffer from the illness sometimes respond badly to commands from police or ignore them entirely. For 40 minutes, officers tried to read, to describe a scene and to answer questions while the voices -- on an audiotape produced by people who have experienced them -- hissed in their ears, against a background of white noise.
"It was a constant barrage," Sgt. Greg Gautney said of the exercise, part of a training program that began in January. "You get an idea of what kind of a distraction that is . . . and realize what a person is going through."
That was one goal of the sessions, part of an effort to better serve Frederick residents with mental disabilities.
Incorporating police training, a mobile mental health crisis team and street-safety training for human services workers, the program springs from an alliance of the Frederick Police Department, the Mental Health Management Agency of Frederick County, the National Alliance for the Mentally Ill of Frederick and Way Station, a private organization that provides support and services for low-income people with mental illnesses.
The goal, participants say, is to educate police and give them access to knowledgeable professionals so they can respond properly in cases involving people with mental health problems.
"One of the ultimate challenges of police work is the many ways to handle each situation," said Frederick Police Chief Kim C. Dine. "Thirty years ago, we thought a law enforcement response was the only response. Now we're trying to be more open-minded and enlightened."
Way Station President Scott Rose said, "I don't believe there's another community where the police department is as sensitive to the needs of people with mental disabilities and to working with social services agencies in town as Frederick's."
It wasn't always that way. In August 2002, for example, staff members at a Goodwill Industries facility in Frederick summoned police to a standoff between the staff and a male employee. The dispute had begun as a minor argument. The man was mentally disabled, and a therapist at the scene warned police that a softer approach was needed. When police confronted him, the man swung at an officer and wound up spending the night in jail. Some residents objected to reports of the treatment.
If the officers had known then how to deal with mentally disabled people, "it wouldn't have gone that far," said Sue Holton of Community Living Inc., which provides the man with a home and counseling. "With techniques to defuse disruptive behavior, in this situation, things would have been fine."
Frederick mental health professionals operate a mobile crisis team seven days a week from 1 p.m. to 11 p.m., the hours when many problems arise. When police encounter a person with mental difficulties, they can summon the team to defuse the situation, to provide on-the-spot counseling or for a referral for more help.
Recently, police answered a call about a domestic dispute and found the husband alone, pounding the walls and weeping. They summoned the team and talked calmly with the man while counselors tracked down a relative who could stay with him and arranged counseling for him.
The officers, Rose said, "spent three hours with him. . . . This could have turned into a violent situation had they responded differently."
The crisis team gets as many as 360 calls a month and responds to police calls about four times a week.
"It's eerie how frequently you come across someone" with an emotional or mental problem, Gautney said. "We're usually called when somebody's highly agitated. But if we can find out what triggered that, we can find out what the real problem is."
In February, Gautney and fellow officers went to the home of a woman they knew had a history of schizophrenia, after a neighbor asked them to check on her. When the first officer arrived, the woman brandished what appeared to be a machete. Instead of attempting an arrest, he withdrew and summoned Gautney and fellow officers, who eventually were able to get her to a hospital, where counselors took over.
If the responding officer had taken a strict law enforcement approach, "he could have shot her," Gautney said.
Robert A. Pitcher is executive director of the Mental Health Management Agency of Frederick County, an oversight group that pays for the mobile crisis team and coordinated the police training. Pitcher has trained Frederick County sheriff's deputies and city police officers in dealing with mentally unstable people. "This is a full day," he said, including the voices exercise, role-playing in which officers practiced responding to specific situations, reviewing names of the most commonly used psychiatric drugs and suggesting questions to ask a mentally disabled person.
For example, police are trained to request a person's pill bottle, which provides the medication name and a physician contact.
Pitcher said the training is representative of Dine's focus on community policing. "It says the department as a whole is progressive," he said.
These days, mental health counselors often attend police roll calls. Police train social service workers, who often work at night in troubled neighborhoods, in basic safety precautions.
One recent night, a Way Station employee driving home saw a woman on the side of the road who appeared to be disoriented. The counselor determined that the woman was contemplating suicide and called police for help. Together, they got the woman to a hospital.
"Most people with mental disabilities pose no danger," Rose said. "They need people who know how to talk to them."