Global Crisis

New Jersey - Crisis Intervention Training Pays Off.

Police officers in 11 New Jersey counties have received crisis-intervention training to interact more effectively with people who have mental illnesses, and research shows that the program is changing cops' attitudes.
During the weeklong, 40-hour training, officers learn about symptoms, meet with people who have a mental illness, and study techniques to de-escalate difficult situations.
"Trainers educate the officer that a person's behavior is often out of their control," explained Mary Lynne Reynolds, executive director of the Mental Health Association in Southwestern New Jersey. "For example, if someone is in a state of mania, they cannot stand still. So if a police officer says, 'stand still,' the individual can't do that."

I like that last line a lot, as it directly works against the cult of compliance. But there are other models, instead of training each officer to handle these situations. In Baltimore, the idea is to create special mental health cops.

State Sen. Shirley Nathan-Pulliam (District 44) and Del. Charles Sydnor (District 44B) have sponsored legislation that would create separate mental health units for the Baltimore City police department and establish an evaluation system for the unit that already exists in Baltimore County.
The legislation would establish a pilot program requiring both police departments to have units made up of officers trained to understand the needs of those with mental illness.

Meanwhile, in Montreal - training seems of limited use.

Paulin Bureau, director of training at École nationale de police du Québec, detailed how many hours of training are dedicated to dealing with people who suffer from mental health issues and with the homeless.
He said the college offers continuing training to police forces across the province.
But Bureau stressed training isn't an easy fix for police dealing with people who have mental health issues.
Bureau told the inquest cadets might not have to put that training into use in the field for a few years, and by then it would be difficult to recall what they had learned about dealing with someone in crisis.

After 15 weeks of training at the provincial police college, officers don't come out as mental health specialists with the ability to diagnose someone in a short time period, Bureau said.
He said a police officer could get additional training for dealing with mental health issues one year and might not have to use that training for months or even years.

I'm more a fan of the Baltimore model (which is itself the San Antonio model), but even that I think has limited impact. There are medical issues related to mental health and cops need to know them and/or have instant and reliable access to experts. But that's secondary to changing attitudes and approaches to potentially violent encounters.

For me, I've been persuaded that the focus should be on strategic thinking generally, not mental-health specific training. Much more on this to come over the months ahead.

ACLU releases graphic video of 2012 police shooting of mentally-ill black man in Michigan. More than 45 shots http://t.co/rNYQN2HHZM
— Wesley Lowery (@WesleyLowery) October 27, 2014

Milton Hall stole coffee & refused to drop knife. officers fired 47 shots, 11 hit. All cleared by local PD & feds http://t.co/hxIRQX2gfb
— Wesley Lowery (@WesleyLowery) October 27, 2014

Genuine question: when officers encounter someone armed but w/history of mental illness, what would be the ideal protocol?
— Wesley Lowery (@WesleyLowery) October 27, 2014

And then followed a lively Twitter conversation.

I follow Lowery due to his great work in Ferguson, and am glad someone @mentioned me in the conversation to draw me in. The case in question is about the Justice Department not finding anyone culpable in the 2012 shooting death of a man with a penknife who didn't comply. Regular readers will know my phrase - "the cult of compliance" - which comes into such striking clarity in events like this.

What's interesting, and tragic, to me, is that when someone gets beaten or killed in a situation like this, the emphasis is always on the final moment. Police surround or approach an armed individual with mental illness, demand the person comply, they don't comply, and then they kill him or her. The officers are then usually exonerated by the justice system, because at that final moment, there was a real threat to the officers.

But it's possible to re-imagine a strategic approach to such situations to make that threat less likely to occur.

1. Is there a threat? I contend that a man with a knife standing nowhere close to other people is not an imminent threat. Officers who are aware of the mental illness component have to respond differently than they might in other circumstances. For example, here's a video/reports of a drunk white guy with a rifle - police are very careful not to push it to an aggressive confrontation and the situation gradually de-escalates.

Compare that to this case, in which police swarm (warning, video is disturbing) to try and take control, resulting in death.

Part of this is, surely, racial.
Part of this, too, is the knife vs gun. It's less threatening but also seems to mandate a fast response.

I'll be interested to hear what my police readers (yes, I have police readers, smart folks who really want to build better police procedures) say.

2. If there is a threat, what is the least violent way of dealing with it? I am no fan of TASERS, but they exist precisely for situations like this. Police are, however, legally authorized to use their firearms when confronted with a threat to themselves, and a person close by with a knife is a threat.

The 2012 story in Michigan keeps playing out. I talked about it in this CNN piece on 4 police killings in August.  It's the story of Kajieme Powell, who had a small knife. Michelle Cusseaux, who had a hammer. It's the story of every mentally ill (I prefer the term psychiatric disability, for reasons I spell out in the article) individual, especially people of color, who are holding a weapon, are not an imminent threat, but who get killed.

I argue that once police engage and create a dynamic in which the person with the disability has to drop their weapon and comply, or be shot, being shot is inevitable. I wrote, "In each case, police demanded that a disabled person choose between not being disabled or getting shot. Now four more people are dead." And more people will die.

Looking at the whole, I conclude:

The stories follow a similar pattern. The victim had a weapon and did not respond to police commands to drop it, and so they died. Of course, a person struggling with his or her disability is not likely to follow verbal police commands in a moment of stress. Once the equation reached drop or die, death was inevitable.

The only solution is for the police to avoid getting into that situation if at all possible. Unfortunately, this runs directly against police training. Police are trained to display command presence in the face of uncertainly, seizing control of a situation by issuing orders, demanding compliance and using force on those who won't obey. Protect and serve has become command and control.

There are other models. Seattle police now teach their recruits to be "guardians." Others emphasize patience. When Cusseaux frustrated the police by opening and closing the door repeatedly, why not just wait her out? Moreover, where were the Tasers? Taser-overuse is a major problem, but if they have a place in modern policing, surely it's when confronted by an armed psychiatrically disabled person at close range.

I'm increasingly sure that while CIT - AKA the "memphis model" -  provides training and resources for LEOs who take the classes, this particular set of training doesn't save the life of armed mentally ill individuals. Instead, the police have to decide that shooting is the genuinely last resort and avoid creating the "comply or die" or rather "be not disabled or die" situations.

When shooting is genuinely the last resort, and no one is at risk, you don't charge in to take command of the situation, but rather keep maximum space between you and the individual. You deploy maximum patience. This goes significantly against standard police training, but ... it's possible.

And here's the final piece - all of these procedures that might save the lives of people with psychiatric disabilities, they could save your life too. They should become standard.

Yesterday, KQED - NPR in San Francisco - published a long piece on police killings and psychiatric disability in San Francisco. 58% of all police killings involve forms of disability such as schizophrenia, many of them include weapons, and yet there may be ways to rethink strategies that could save some of the lives.

In cases like these, we need to stop talking about mental illness and start thinking through the implications of psychiatric disabilities. We also need police whose first instinct is to de-escalate tense situations whenever and however possible, and, when necessary, solve confrontations with the absolute minimum amount of force.

"Psychiatric disability" refers to mental illness that "significantly interferes with the performance of major life activities," a category that clearly applies to people whose "erratic behavior" got them killed by police.

The distinction matters. In America, being disabled comes with certain civil rights protections. While we generally try to eradicate illness, we are required to accommodate disability. So how does a police officer accommodate someone behaving erratically and holding a knife?

That's very much the same question being asked by KQED staff who reported on the piece. Their examples also link to my broader work on the Cult of Compliance. Police come into situations in which they have been called to help with a person exhibiting signs of mental distress. They are trained in CIT, but they still create confrontational situations, then respond with deadly force.

Each of these stories in the SF piece are complicated. Individually, perhaps, they can be understood and excused and justified. Collectively, though, the message is much bigger.

Often it starts with a call for help. A family member, a caretaker or even a stranger dials 911 seeking paramedics to treat someone in a psychiatric crisis. But when there’s a threat of violence, the first responders are usually police, and what started as a call for help can quickly turn deadly for a person with a treatable illness.

The first case is Errol Chang, whose family needed help getting him to the hospital as he turned increasingly paranoid, so they called the police. CIT-trained officers responded.

A series of escalations led Chang to barricade himself inside the house. The Daly City SWAT team arrived with assault rifles and an armored car.

According to the DA review, police were worried Chang might find a .22-caliber rifle and ammunition hidden separately in the house. The SWAT team held their assault rifles trained on the house and took cover behind the armored car.

So there we have the key fact - there's a chance, however slim, that a man (who ultimately had a knife) might have a rifle, so they operate as if he does have the rifle. They breach the house eventually, Chang stabs an officer in the arm, and gets shot 8 times.

Yanira Serrano-Garcia wasn't taking her medication for schizophrenia. Teresa Sheehan had stopped taking her medication too (she survived being shot). The piece then moves into looking at this question:

Here’s the question before the court: If police know they are dealing with a person with mental illness, and they use confrontational tactics that can agitate the person, are they violating the Americans with Disabilities Act?

I urge you to go read the whole report, look at the long chart of police shootings, and their discussion of the Memphis Model and its deployment in San Francisco. This is a great piece of reporting and needs a wide audience.