Dontre Hamilton told his family he just needed to “clear his head.”
It was an apt description for the 31 year old suffering from paranoid schizophrenia. For several months prior, he’d been missing the shots that kept the symptoms at bay. Being “off meds” is something we may quip about with an edge of disdain to our voice, but it’s more common than you think with any diagnosis. The better description is being “non-compliant” with your meds. It happens from time to time. Sometimes the meds stop working. Sometimes they make you more miserable than you were before. Finding the right cocktail for your diagnosis and specific symptoms is far from a perfect science, and can be one of the most exhausting struggles once you finally get a diagnosis.
Hamilton was at that spot, but he knew he wasn’t doing alright. He was highly symptomatic, which is an incredibly frightening place to be. In April of 2014, as his brother would later tell reporters, Hamilton was “running scared.”
One day, his search for clarity in the chaos that had taken his mind took him to the plaza across from Milwaukee’s City Hall. NPR’s This American Life covered Hamilton’s story as part of a two part report called “Cops See It Differently” (more than worth a listen, by the way). As they explained, an employee at the Starbucks near there called the police to complain that a homeless man was asleep in the plaza. Two officers showed up, found Hamilton was doing nothing wrong, and went on their way. The story should have ended there.
It didn’t. A beat cop by the name of Christopher Manney showed up shortly thereafter. Manney roused Hamilton for what was an illegal pat down. The aggressive, invasive move was exactly the sort of behavior that could escalate an encounter with anyone suffering from paranoid schizophrenia, and that’s exactly what happened. Manney and several witnesses reported that the interaction led to a scuffle where Hamilton struck Manney with his own baton.
This is why police are instructed not to physically engage with anyone who displays symptoms of mental illness. Hamilton’s erratic behavior upon being roused should have presented a clear, bright, neon-flashing stop sign to the veteran officer who knew it was against department policy to go any further. Manney continued anyway, taking the situation from bad to worse. That scuffle never needed to happen, but in his mind, despite no evidence to back the conclusion, Hamilton’s mental illness itself was posing a threat to public safety.
In the heat of the moment, Manney wound up opening fire on Hamilton, killing him. One might see this as justified… until you realize that Hamilton was shot FOURTEEN TIMES, with autopsy reports confirming that half of those bullets were unloaded into his back. Manney was eventually fired – a moment of justice rarely seen for individuals with mental illness diagnoses who are abused at the hands of the police. A nuance worth considering, though, is that he was fired for the pat down – not Hamilton’s death.
There are a lot of “if”s associated with a story like this. If Hamilton had not been Black… if Hamilton had not been male… if Hamilton had not been aggressively confronted… if Hamilton had not fought back… but the 14 bullets in his back represent the level of skewed threat perception associated with someone who has a mental illness.
Hamilton’s story is the tip of an iceberg of tales that send chills up and down the spines of those who suffer from mental illness and those who love them – stories of the risk inherent in any interaction with law enforcement and the criminal justice system as a whole.
Protect and Serve. Except us.
When we talk about mental illness, we talk a lot about safety. When you’re close to the subject in question, that safety is personal. Is my loved one safe? Is their environment safe? Are those around them safe? Am I safe? All of that makes sense, and frankly, is healthy.
But when we talk about mental illness in a societal context, the conversation becomes a little more complicated. It’s difficult to evaluate what the mentally ill population being “safe” looks like when mental illness manifests in very individualized ways. My safety may not be the safety of someone else with the same diagnosis. Instead of traversing these complexities towards an informed understanding, we generally rally around the point of safety that is most easily discussed in a societal context: public safety.
The problem is that when the only consistent narrative is one of public safety, the more complex part of the conversation – the safety of a population that is marginalized and at risk – gets pushed to the side. Suddenly, they are inherently unsafe. They are the threat. No where is this better realized than in the way we approach the policing of those with mental illness.
Think about it for a moment. When dealing with individuals perceived to present a potential threat to public or officer safety, the resulting posturing adopted by officers is aggressive – arguably combative. Loud, direct orders are barked while officers assume physical power positions intended to intimidate (particularly true when reaching for or having drawn their weapons). Such techniques are intended to impress upon the noncompliant target the seriousness of the consequences in play.
For someone who is not symptomatic or does not suffer from a mental illness, this posturing might work. For those who are symptomatic or suffering from a mental illness that alters or compromises their cognitive functioning, such behavior may be perceived in an entirely different sense. Their mind may distort the officers’ behavior or its context in a way that is baffling or disconcerting to an observer, but is also the manifestation of the fear they are experiencing in the moment.
Under a slew of diagnoses, symptomatic individuals are highly sensitive to auditory and visual stimuli, particularly when it is perceived as aggressive. It can kick their paranoia into high gear, activating a fight or flight response. In these situations, a police officer screaming an order at you isn’t going to prompt the thought pattern of, “I better do what they say.” It’s going to prompt an intense fear, rational or no, that you are in harm’s way. That’s your reality in the moment. That was certainly the reality for Andre Hamilton. Confronted by what he perceived as inexplicable behavior from the authorities, his reality was one of abject terror. He was in a fight for his life.
It can be difficult to see Hamilton as a “victim” in the truest sense of the word if you’re not familiar with the realm of mental illness. After all, he did strike a police officer, right? The problem is that an assault needn’t be a factor for that outsized threat perception to take center stage. Consider the case of Jason Harrison from Dallas. As The Guardian reports:
Jason Harrison’s mother, Shirley Marshall, called emergency services on the morning of 14 June 2014, telling the dispatcher that her son was bipolar and schizophrenic and that she was worried about him, and he might need to be hospitalised.
Within two minutes of the officers’ arrival at the house, Harrison lay dying. He was killed by six gunshot wounds to the chest, arm and back, an autopsy found.
In the video released by the family, Marshall answers the door and walks out, telling the two officers that he is “off the chain … bipolar schizo”. Harrison stands in the doorway holding a screwdriver. The police immediately and repeatedly tell him to drop it, then quickly open fire. He falls to the ground. The officers continue to shout at him. As the 38-year-old lies dying, one is heard asking: “Do we handcuff him?”
Before you begin to speculate on whether this was a justified reaction, watch the video in question:
A few things to note while watching this video:
- While Mrs. Harrison had indicated concern for her son and his need for psychiatric care, she at no point indicated that he was violent. The officers’ presumption that he was has more to do with their preconceived notions about mental illness than it does the reality of this situation or most other situations (more on that in a bit here).
- When Jason appears in the door frame, though he is holding a screwdriver, his posture and behaviors are in no way indicative of violent intent or even general aggression.
- A TOTAL OF SIX SECONDS PASS FROM THE TIME THE OFFICERS SEE HARRIS AND THE MOMENT THEY OPEN FIRE.
- When he does make a sudden movement, it is not towards the officers – it is away from them. Had he been lunging towards the officers, his body would have taken up more of the lens on the officer’s body cam, which it does not. The officers still shot him. They shot him in the back as he was running away.
- Not only did the officers shoot, they shot the man SIX TIMES. That’s not threat reduction. That’s irresponsible, unjustified use of force stemming from fear of a mental condition they didn’t understand.
The saddest thing? Had they used the training provided to Dallas police officers on how to respond to this situation – had they used tactics more appropriate to the man’s diagnosis and the situation – Jason Harrison would probably still be alive today. Traditional law enforcement tactics create unnecessary safety risks to the mentally ill, the officer, and the public at large. It doesn’t need to play out that way. When it does, everyone suffers.
This goes beyond interacting with someone who could ostensibly be construed as a potential threat by a third party, though. You don’t need to be holding a screwdriver to have your mental illness interpreted as inherently threatening.Hell, you don’t even need to be wearing clothes.
Consider the story of Anthony Hill in Decatur, Georgia. An Air Force veteran who served in Afghanistan, Hill had been diagnosed with bipolar disorder upon his return, and, by all accounts, had largely done a good job of managing his symptoms.
But ten days before he died, Hill had gone off the medications that had been failing him. The end result was an acute manifestation of psychotic features. He wasn’t acting in a violent manner, but he was not balanced in the moment – jumping repeatedly from his second floor balcony, laying naked on the ground in the courtyard, babbling incoherently to others in the complex who approached him.
Eventually, workers in the complex called the authorities, filling them in on what had happened. When the officer showed up, the series of events that followed were as tragic as they were befuddling. As the New York Timesreported:
Pedro Castillo, 43, a maintenance worker at the complex, said Mr. Hill was naked and on his hands and knees in the parking lot when the officer arrived in his squad car, parking a good distance away.
When Mr. Hill saw the officer, Mr. Castillo said, he stood up and moved toward him with his hands raised, and the officer, who Mr. Castillo said looked frightened, yelled for him to stop.
Mr. Castillo said that he had not seen a scuffle, but that he did see the officer pull out a handgun and shoot Mr. Hill.
Another resident, a woman who did not want her name published because she is an undocumented immigrant, said Mr. Hill had his hands at his sides and raised them parallel to the ground as he drew nearer to the officer. She, too, said the men did not fight before Mr. Hill was shot.
Let’s be clear, again, on the important points in this story:
- No one had reported Hill as behaving in a violent manner – just strange behavior. He did not have a history of violent behavior, either.
- Hill had no weapon. There was no way to even mistakenly think he might have had one; he was completely naked.
- The witnesses closest to the scene said, despite Hill’s apparent psychotic behavior, he had still raised his hands in a non-threatening manner when approached by the officer.
- He was still shot.
Hill wasn’t a threat because of what he was doing or what he had done. He was a threat because of who he was. He was a threat because mental illness is viewed as threatening, as a public safety risk.
This half-baked public safety calculus isn’t serving anyone, and it certainly isn’t protecting those who need the protection most.
Before you start telling me that these are just isolated incidents, know you are wrong. A joint report from the National Sherriff’s Association and the Treatment Advocacy Center found that, despite being responsible for only 4% of violent crime in the country, over half of those shot and killed by police suffer from some sort of mental illness. Those numbers vary by department, of course. As the Washington Post reported last year, the percentage of New Mexico’s fatal police shootings where the victim suffered from mental illness in 2010 and 2011 was closer to 75%.
Feel better now?
Dodge one bullet, run into another
The thing is – even if an officer doesn’t shoot the mentally ill person in question, even if they are taken in without injury – the legal system is terrible at processing the injustice that lands the mentally ill at their doorstep. Violations like “failure to comply” or “resisting arrest” (read: someone whose symptoms are being exacerbated by inappropriate intervention tactics and subsequently does not behave in a manner that the police would expect of the average member of the public) can land those suffering in hot water and ultimately jail in a world where mental illness is as poorly understood by prosecutors, public defenders, and judges as it is by the officers who start the chain of events and the public from which they’re drawn.
More than 40% of those diagnosed with a mental illness will spend a portion of their life in jail or prison. The Bureau of Justice Statistics in 2006 found that more than half of all prison inmates incarcerated in the U.S. suffered from mental illness. Indeed, there are ten times more mentally ill individuals in prison today than there are in hospitals.
Tragically, prison is the worst possible place for someone suffering from a mental illness. For the same reasons that traditional confrontational tactics used by law enforcement can exacerbate symptoms for these individuals, the hyper-structured nature of prison and the culture within can be a counterproductive environment… to say the least.
Last year, the New York Times conducted a thorough investigation into the treatment of the mentally ill at Rikers Island. Over the course of their investigation, they learned of a secret review that had been conducted by New York City’s Department of Mental Health and Hygiene. As they reported:
The study, which the health department refused to release under the state’s Freedom of Information Law, found that over an 11-month period last year, 129 inmates suffered “serious injuries” — ones beyond the capacity of doctors at the jail’s clinics to treat — in altercations with correction department staff members.
The report cataloged in exacting detail the severity of injuries suffered by inmates: fractures, wounds requiring stitches, head injuries and the like. But it also explored who the victims were. Most significantly, 77 percent of the seriously injured inmates had received a mental illness diagnosis.
As unsettling as that information may be, it’s not necessarily shocking. If you send the mentally ill to a facility without the resources to adequately care for them and put them in the care of those who see themselves as a hammer and the rest of the world a nail, of course you’ll see symptoms mistaken for the insolence corrections officers view as punishable. The failure to respond to their discipline in the way officers have come to expect may only fuel harsher punishment. Just ask Andre Lane. As the New York Times stated:
Andre Lane was locked in solitary confinement in a Rikers cellblock reserved for inmates with mental illnesses when he became angry at the guards for not giving him his dinner and splashed them with either water or urine. Correction officers handcuffed him to a gurney and transported him to a clinic examination room beyond the range of video cameras where, witnesses say, several guards beat him as members of the medical staff begged for them to stop. The next morning, the walls and cabinets of the examination room were still stained with Mr. Lane’s blood.
Stories like these are as plentiful as they are unnerving, but even those who don’t endure traditional abuse face agony in acceptable punitive measures. How so? The go-to punishment for out-of-line inmates, regardless of the presence of a diagnosis, is solitary confinement.
Listen. If you’re ever educated yourself on or lived with mental illness of any sort, one of the key lessons they pass on to you is that isolation is bad for you. Your mind runs off without any kind of check, and you’re more likely to become a danger to yourself. Solitary confinement is like isolation on steroids. It’s not self-selected isolation, but forcible isolation, and has been proven over and over again to exacerbate the symptoms of those struggling with mental illness.
This idea isn’t new or revolutionary or a matter of debate. The National Association on Mental Illness, or NAMI, has referred to the practice of subjecting the mentally ill to solitary confinement as a form of “torture.” The United Nations is on the same page.
It’s not fair to cast all of the problems into the realm of abuse, of course. Much of the problem comes back to resource deficiencies. Recent research from the University of Texas Health Science Center at Houston found that, of the 20% of inmates who entered the system with a diagnosis and prescribed pharmaceutical treatments, only half of those continued to receive their medication and psychiatric care once they were in. While the law requires that prisoners have adequate health care while in prison, in the context of mental illness, this mandate only applies to “severe” cases. Ironically, failure to maintain treatment pushes more and more of the diagnosed into that category.
And then there are cases where sheer ignorance results in tragedy. Take, for example, the case of 36 year old Joseph Duran. The list of his diagnoses was long: bipolar disorder, major depressive disorder, psychotic disorder NOS, antisocial personality disorder, and a seizure disorder – all of which was known to the prison. Following a recent tracheotomy that left him breathing through a tube in his throat, he was placed into a cell on suicide watch as the result of a manic episode.
During that time period, he had his hands through the food port on the cell door, and refused to pull them out. A guard, in turn, emptied more than 16 oz. of pepper spray onto the distraught, symptomatic man before walking away to leave him on his own. When they came back for him eight hours later, Duran had pulled the tube from his neck and lay dead on the floor.
It was ruled a suicide. Given context, it looks a lot more like reckless endangerment.
Absolutely no one wins here. Whether it’s the structure of prison or the lack of psychiatric care or the punishments doled out, the impacts of using the prison system as a mental health care system are severe. As a recent Huffington Post article points out:
The result is that many people who enter prison with a mental illness leave prison with a condition that is worse. “The lack of treatment for seriously ill inmates is inhumane and should not be allowed in a civilized society,” Dr. E. Fuller Torrey, founder of the Treatment Advocacy Center, said in a recent report.
The result is that many people with mental illness who are incarcerated find themselves back in prison again. The fact of the matter is that our mental health system has failed as the federal government continues to deny and ignore the promises made to improve the system by taking responsibility from the states.
The result is that recidivism rates among the mentally ill is soaring. Any hopes of rehabilitation based on any criminal activity are outweighed by the intense and long-lasting affects of incarceration on mentally ill individuals.
Let’s pause for a quick recap, shall we? First, law enforcement approaches to interactions with the mentally ill create unnecessary threats to those with mental illness, the officer, and the public. We then punish the mentally ill for our law enforcement shortcomings by sending them into a system that makes things even worse for them in every way.
Looking at all of these stories and data points, it’s harder to dismiss the fear of law enforcement interaction in the mentally ill population as paranoid, isn’t it?
This matters to you… even if you don’t realize it.
You might be tempted to look the other way on this one. You might be uncomfortable or conflicted. But I need you to understand that this could, and probably will, impact you or someone you love on some level. The National Institute of Mental Health finds that nearly one in five Americans suffer from some sort of mental illness. One in five. ONE IN FIVE.
You or someone you know will probably be impacted by this problem in some way.
But let’s assume that you, by luck or ignorance, can’t think of someone close to you that this could impact. It still matters to you.
Because of how the system is set up and how resources are allocated, realistically, mental illness doesn’t even have to be a factor to illicit what is ignorantly perceived as justified intervention by law enforcement; there just needs to be the perception of some sort of probable diagnosis. Consider the case of Kam Brock.
Brock is a 32 year old Jamaican born woman. You could describe her as eccentric. She’s a creative-type with dreams of making it big in music. You can check out her website here.
In September of 2014, police pulled her over and, despite not finding any marijuana or shake in the vehicle, impounded her car she because “seemed” high. She was never taken in. That part of the story is problematic enough. What came next was far worse.
Brock showed up at the police station the next day to reclaim her vehicle. She was, as she readily admits, emotional. I’d have been emotional too if the cops had claimed my car without a lick of evidence to support the action. I’m pretty confident you wouldn’t need any sort of diagnosis to be emotional over that. In her emotional state, as she made her plea to the officers, she insisted she had been mischaracterized; she’s a good person. Her proof? The fact that President Obama followed her on Twitter. In reaction to this proclamation, she was declared an “emotionally disturbed person” and committed at Harlem Hospital.
At the hospital, Brock was diagnosed with bipolar disorder. She was subjected to sedative injections and put on a regimen of powerful drugs (lithium is NOT playin’ around, folks, and is SUPER RARE as a first line of treatment with bipolar disorder for that very reason). There were very specific conditions for her release. As the New York Daily News first reported:
A “master treatment plan” from Harlem Hospital backs up [Brock’s] story.
“Objective: Patient will verbalize the importance of education for employment and will state that Obama is not following her on Twitter,” the document reads.
It also notes “patient’s weaknesses: inability to test reality, unemployment.”
She was released eight days after being committed without explanation.
Putting aside the fact that the impounding of her vehicle was questionable, and the fact that an understandable emotional reaction is very different from being emotionally disturbed, and the fact that failure to communicate clearly with a patient during their release is indefensible, there’s a reason Brock’s case is uniquely disturbing.
Brock, known as @AkilahBrock on Twitter, IS followed by @BarackObama. She IS gainfully employed by Astoria Bank. She DOES have a side career as an artist. Yet her institutionalization and the conditions of her release were based on abject disbelief of the facts without any effort to verify Brock’s claims. The kicker? She’s now shouldering medical bills in excess of $13,000 for her stay in the hospital, and was told upon subsequent evaluation that the bipolar diagnosis was incorrect from the get go.
Now, I can basically hear the counterarguments and skepticism roiling in your mind right now, so to make sure we can be super clear about what’s going on here before I delve into why this case matters, let’s address these caveats for a second.
No, the President does not actually manage @BarackObama, and, no, someone following you on Twitter does not make you a good person. But that distinction was not being made in this case by any of the parties involved. They just assumed such a Twitter follow was a delusion without ever checking it out.
More to the point, so what if she had believed Obama was personally following her? So what if that did make her feel good about herself? Maybe that would make her a little naive about social media or a little overly enthusiastic about a relatively small deal, but let’s be real. If a bit of ignorance over how social media gets used makes someone emotionally disturbed to the point of necessitated commitment to a psych ward, we’ve all got a few elderly (and not so elderly) relatives we need to be driving to the hospital ASAP. And, to be honest, I’d feel pretty (arguably irrationally) pumped about @BarackObama following me on Twitter, too. I’ve been pretty (arguably irrationally) pumped about the accounts of fictional characters following me in the past. The whole premise that these ideas are worthy of psychiatric intervention is ludicrous.
It’s totally plausible that a diagnosis of bipolar disorder is appropriate for Brock. You and I are not mental health professionals, nor have we worked extensively with her, so there’s no way we can make that call. BUT IT DOESN’T MATTER. There is no evidence that Brock was a danger to herself or others. Even if the officers and mental health professionals believed that she was incorrect in her claims of employment or Obama following her on Twitter, even if they had been right and those ideas were delusions, they weren’t dangerous ones. She wasn’t articulating or displaying suicidal ideation or intent; she wasn’t making violent threats against others. Nothing in the equation justified institutionalization.
Maybe a few of you are raising an eyebrow at the pot suspicions. Take several seats, please. There’s no evidence to back up those suspicions. And even if she had been stoned at the time of the impounding, possibly associated paranoia isn’t going to stretch into the next day. It’s certainly not going to extend through a terrifying and confusing eight day stay in a psych ward. And it’s not going to be driving a lawsuit six months later.
Plus, if Brock had been a White woman driving that BMW, odds are strong that her vehicle never would have been impounded. Odds are your eyebrow would be in its normal position. Put it back where it belongs, please.
The point of this story is to highlight that these problems are not relegated to a community that bares some sort of official diagnostic label. These problems are systemic and have the potential to impact any of us at any time when those making decisions about who faces the impact can’t be trusted to understand what in the world they’re talking about.
How the hell did we get here?
Maybe you’re angry now, too. You want a fix. You want justice. I’m on the same page. But before we can get to solutions, we need to understand how we got to this point. That understanding is going to take some discomfort.
I’ll start by saying that there’s a reason I spent so much time on the individual stories you’ve read so far. There’s a reason I include their pictures. This piece probably could have been a lot shorter, but it was important that I made sure you saw people and not the public safety risks we’ve been conditioned to perceive.
Don’t think that was necessary? Consider for a second about how many caveats I just had to hedge in each of the stories above. It’s not because I’m sitting there playing Devil’s Advocate for the sake of argumentative evaluation; it’s because those counters were articulated in articles and across social media. When our minds wander to these defensive postures, I am reminded, for the millionth time, that we too often ask the wrong questions. Here’s one: why the hell do we go out of our way to find ways to justify this treatment of mental illness?
Odds are, if research on the subject is to be believed, that we’re working overtime to justify mistreatment of the mentally ill by the legal system because we sympathize with their fears. To be fair, the depth of research on the subject isn’t great, but the research that does exist is damning. In a 2004 article from Drs. Jo Phelan and Bruce Link of Columbia University, published in the Journal of Health and Social Behavior and entitled, “Fear of people with mental illnesses: the role of personal and impersonal contact and exposure to threat or harm,” the authors discuss pervasive public associations with diagnoses – words like “dirty,” “poor,” “ignorant,” “bad,” and, most significantly, “dangerous.”
When that’s how we view the mentally ill, is it any wonder that we don’t have a problem with excessive police responses? Is it all that surprising that we haven’t paid enough attention to how these people are treated in court and in prison? The same study from Phelan and Link found that interaction with those who are mentally ill breaks down these preconceived notions, but when you consider that, for many, rejection of socially pervasive derisive attitudes towards the mentally ill is a prerequisite to having the experiences that truly breakdown the stigma, is it so shocking that the stigma persists? (Chicken or egg, chicken or egg…)
So yes, stigma and ignorance across the board have arguably created the apathy that allows these injustices to persist. They also serve as the root of the behavior we view as unjust in the context of mental illness. Consider the law enforcement component. As Milwaukee Chief of Police Ed Klein pointed out in the previously referenced This American Life podcast, police officers come from the same public being discussed here. The impact of the stigma so readily accepted by the public, unfortunately, is compounded by the training provided to police. I’m not just referencing the tactics we’ve already discussed; it’s the mentality they have beaten into them from day one of training. As former police officer and professor of law at the University of South Carolina Seth Stoughton explains in The Atlantic:
Police training starts in the academy, where the concept of officer safety is so heavily emphasized that it takes on almost religious significance. Rookie officers are taught what is widely known as the “first rule of law enforcement”: An officer’s overriding goal every day is to go home at the end of their shift. But cops live in a hostile world. They learn that every encounter, every individual is a potential threat. They always have to be on their guard because, as cops often say, “complacency kills.”
Officers aren’t just told about the risks they face. They are shown painfully vivid, heart-wrenching dash-cam footage of officers being beaten, disarmed, or gunned down after a moment of inattention or hesitation. They are told that the primary culprit isn’t the felon on the video, it is the officer’s lack of vigilance. And as they listen to the fallen officer’s last, desperate radio calls for help, every cop in the room is thinking exactly the same thing: “I won’t ever let that happen to me.” That’s the point of the training.
There are countless variations, but the lessons are the same: Hesitation can be fatal. So officers are trained to shoot before a threat is fully realized, to not wait until the last minute because the last minute may be too late.
But what about the consequences of a mistake? After all, that dark object in the suspect’s hands could be a wallet, not a gun. The occasional training scenario may even make that point. But officers are taught that the risks of mistake are less—far less—than the risks of hesitation. A common phrase among cops pretty much sums it up: “Better to be judged by twelve than carried by six.”
Please don’t misunderstand. I’m not saying I think the problem is all cops, or that I don’t value the service provided by officers, or that I don’t appreciate the risks taken in the field. But when, as Stoughton explains,
- policing today is safer than ever;
- when statistical reviews reveal that violent reactions to officers account for only .09% of interactions, with only .02% resulting in injury and .00008% in death;
- when emphasis on de-escalation tactics over confrontation tactics being incorporated into policing policy to date has yielded sharp drops in the use of lethal force against suspects with NO increase in officer fatalities –
At what point do we recognize this dogma of skewed risk calculus as being just as paranoid as the delusions of a schizophrenic?
When officers are trained to be paranoid, and fear of mental illness is pervasive throughout the public, and ignorance over what mental illness is runs rampant, the statistics on police interactions with those labeled by a diagnosis aren’t surprising, even if they are heart-breaking.
When you take a step back and consider the justice system at large, some of this is more a function of circumstance than bias or willful ignorance. There’s a reason we talk about a mental health crisis in this country. It’s not because anyone with mental illness is a threat to public safety, even if we talk about them that way. Frankly, it’s that the needed resources are sorely lacking. The previously cited Huffington Post piece explained the historical roots of this inadequacy, stating:
At some point in the 1970s the decision was made to close state-run mental health institutions. Much of this was motivated by The Community Mental Health Act in 1963. Reports at the time indicated significant abuse of patients and a general lack of credible mental health care. The idea was that funds would be redirected from the states to local communities to manage and monitor the needs of individuals with mental health issues. Unfortunately, this transfer of funds never happened and local communities were simply overwhelmed.
The result is that law enforcement and the justice system are often overwhelmed with mental health treatment demands. As the Treatment Advocacy Center points out, there was one bed in a psychiatric facility for every 300 Americans in 1955. By 2005, that number had plummeted to one bed for every 3,000 Americans. This, combined with struggles someone with mental illness may have with finding and securing insurance or accessing services, and further compounded by the fact that free and low-cost service providers are utterly overloaded with cases, has created an impossible situation for everyone.
Then again, the impact of stigma is seen here, too. After all, if the mentally ill weren’t cast as undesirables, if their stories weren’t dismissed as a result of the very diagnoses that expose them to such injustice, maybe the resourceswould be there.
But even if there wasn’t a resource deficit here, the legal system is often a terrible arbiter of appropriate consequences and treatment for the mentally ill because of how it’s constructed. Laws and penalties are outlined to apply to the neurologically atypical. There has not, traditionally, been a lot of leeway for those involved in terms of applying those laws and penalties to the mentally ill. To be fair, that’s a problem without throwing mental illness into the mix; one need look no further than drug sentencing minimums for an illustration of that. But with little flexibility and few alternatives, we’ve pushed responsibility for the mental health crisis onto the shoulders of a justice system that was never going to be capable of bearing the load.
All of this puts people who care about someone with a mental illness diagnosis in an untenable position. They may, at some point, need help intervening on behalf of their loved one. But what are they supposed to do when the people they should be able to count on in those situations – the people who are supposed to protect and serve – see the loved one with mental illness as someone to protect us from first, instead of needing protection? What agony, to need assistance but wrestle with the reality that said assistance may only compound the present problems.
The arguably justified apprehension this reality fosters for those who care about someone with a mental illness ups the risk quotient for all involved substantially. Without treatment, without intervention, a highly symptomatic individual with a mental illness diagnosis is more likely to spiral and run head on into everything their loved ones are trying to help them avoid. It’s a brutal, often deadly, catch-22.
So yeah, the problem here is still stigma. That stigma fuels police abuse. That stigma is the source of poor resource allocation. That stigma facilitates inhumane treatment in prisons. That stigma is why family and friends don’t reach out for help for their mentally ill loved ones. That stigma is why the issue gets overlooked.
Stigma isn’t just about hiring discrimination or compromised relationships or social discomfort. Stigma against mental illness, borne of ignorance, can be downright lethal.
Are you still questioning why I talk about this?
Finding the Fix
Maybe it’s a leftover from my days as a debater, but I hate talking about problems without also considering potential solutions. If stigma is the root of all evil here, then the first and most important steps towards making things better are personal ones.
Educate yourselves. If you’ve gotten this far in the article, I have hope in your ability to execute on this front, but please don’t stop with this post. Seek out news coverage and academic literature and personal essays that help build your understanding of mental illness and the challenges faced by those who struggle with it. Self-education matters; it breaks down preconceived notions and gives you context for understanding and dismantling bias.
Talk to people who’ve lived this nightmare. Remembering that one in five Americans suffer from some sort of mental illness, chances are you’re close to someone who’s struggled, even if you don’t realize it. Proactively seek out conversations that will grant you perspective. As Phelan and Link pointed out, it’s these sorts of interactions that most effectively break down the stigma surrounding mental illness. It makes sense, of course. What better way to take concepts out of the abstract debate arena and into a realm that fosters empathy than to make it inherently personal?
Talk to others about what you’ve learned. For most people, deconstructing bias and the resulting stigma is not something they’re going to up and decide to do one morning. We all need prompting; why can’t you be the prompt? If you’re armed with information, your voice is more powerful than you realize. Use it to do something good.
Teach your children better. If checking bias or privilege was easy, we wouldn’t be looking at pervasive 18th century mental health tactics in 2015. Checking yourself is hard work. It’s a lot easier to teach a child about the world and the right ways to interact with it than it is to force an adult to reshape themselves. Mental health may not seem like an intuitive topic of conversation to have with your kids, but I urge you to go back to that one in five statistic to remember why it matters. It could very easily be a reality for your child. Ease often has an inverse relationship with importance in this world. And you’d be surprised how simple this can become when you start the conversation early:
Just like people look different from one another on the outside, their brains are all a little different, too. Sometimes, people’s brains are so different they need a little bit of help. That doesn’t make them bad or less or dangerous; it just makes them different. It’s ok to be different and it’s ok to ask for help.
Details can come later, but establishing that baseline from the get go will make parsing those details in a productive manner so much easier down the road.
Don’t hesitate to reach out to your local police department in order to find out what their training and response procedures look like for engaging with the mentally ill. If you or your loved one suffers from a mental illness, this is a function of protection and preparation. But as a concerned citizen, knowing what’s going on is the best way you can rally others to help you fix things when needed.
And make no mistake: it’s going to be up to us to push for those changes. City and County of San Francisco v. Sheehan is currently in front of the Supreme Court, and it’s not looking good for those who care about how police interact with the mentally ill.
At the heart of the Sheehan case is whether the Americans with Disabilities Act should extend to police interactions with the mentally ill, particularly in the context of “reasonable” force. Sheehan was a schizophrenic woman living in a group home in California. After threatening her case worker with a knife, protocol was set in motion and the non-emergency police number was called for intervention. Police arrived, and Sheehan threatened them with a knife, as well. The officers left her room and called for backup, but two officers reentered the room and forcibly confronted her (we’ve been over why this is a uniquely terrible idea already), dousing her in pepper spray before shooting her five times. Sheehan was an out of shape, overweight woman in her 50’s, trapped in a room with no other weapons and nowhere to go. De-escalation was never attempted.
Those arguing for Sheehan believe that officers should alter their protocol to accommodate mental illness when available information indicates its necessity. In the same way that officers should not expect someone in a wheelchair to get down on the ground when confronted, they should not expect, within reason, someone whose cognitive functionality may be compromised to respond in the same fashion they would expect an able-bodied and minded person to behave.
All of this is totally doable, by the way. Police departments across the country offer Crisis Intervention Training, and departments in New Jersey, Oregon, Texas, Wisconsin, and Minnesota have, in pockets, begun to require that training. (Spoiler: the world hasn’t ended as a result.) Hell, security teams working in hospital psych wards get trained on these sorts of issues as a matter of standard operating procedure. We’re not talking about some far-fetched concept.
The Supreme Court does not seem poised to rule on the side of reason here, though. In their initial reactions, Justices Kennedy and Scalia have seemed skeptical bordering on indignant, with statements masquerading as questions on the importance of officer and public safety (never mind the fact that these policies better protect both of those groups). Justice Sotomayor has done her best to be the voice of reason here. As Slate reports:
“Unless we want a society in which the mentally ill are automatically killed,” Sotomayor said, before delving into statistics about the hundreds of mentally ill persons who are killed by police officers each year, contrasted with the far fewer officers who are killed under similar circumstances. “Isn’t the ADA … intended to ensure that police officers try mitigation in these situations before they jump to violence?”
Sotomayor (and, ya know, facts) may be on the side of justice here, but odds are – taking into consideration the history of this court and their comments so far – justice will not prevail in this instance. That’s terrifying and nauseating from my perspective; that’s the highest court in the land saying I’m not entitled to the same legal protections as my peers because my difference is not as comfortably perceived as a wheel chair.
Even with a loss, though, the types of necessary measures that would come out of a win can still be encouraged and applied by communities. That’s where these changes matter most, as each community’s police department may operate on different guidelines from the next. Find out what’s going on with yours. If it’s not up to snuff (and NAMI has some great resources to help you in making that determination) raise awareness in your community through social media, attending City Hall meetings, writing local officials, and more. Encourage adoption of NAMI’s recommendations. When communities stand together, change happens.
For those who have loved ones that suffer from mental illness, or those with mental illnesses who want to educate their loved ones, preparing for emergencies plays a crucial role in mitigating the risks involved with engaging law enforcement for assistance. Law enforcement intervention may not be something we WANT to happen, but the reality is that it may be necessary at some point, and should that happen, preparation is key. A few tips for those who have to make the decision to bring in law enforcement:
- Unless your loved one is a direct threat to themselves or others, call the non-emergency police line. A 911 call conveys the risk of harm to the dispatcher, and may result in officers receiving poorly communicated or calculated risk assessments.
- Provide as much information as possible when you do place the call. I’m talking existing diagnoses, a specific description of behavior leading to the call, explicit details on current behaviors so there’s no misunderstanding about exactly what’s happening, a breakdown of the environment so there doesn’t need to be a ton of speculation over risk factors, etc. The more information and specificity involved, the better your odds of having informed and prepared officers show up at the door.
- Try to be there when law enforcement arrives. Obviously, do not put yourself in harm’s way, but whenever possible, attempt to meet the responding officers prior to their engagement with your loved one. They need you as an ally.
- When you meet the responding officers, framing the conversation as necessary for their protection as well as the protection of your loved one, ask them to recount what had been conveyed to them by dispatch. This ensures that all relevant information was passed on before you move to the next step. Reaffirm the factors that will directly influence an officer’s risk perception (i.e. Are there weapons available? Are there exits to watch?).
- While it shouldn’t be your job to educate officers on mental illness, make it so. Before officers go in, emphasize the importance of de-escalation tactics in interacting with your loved one, and point out how traditional confrontational tactics may compromise anyone’s safety (i.e. Raising your voice may increase his paranoia and make him more likely to behave irrationally or dangerously.)
- Ask what the game plan is for the interaction. It’s not about hearing a step by step outline of the conversation, but it’s important that you know where the officers intend to take your loved one so you can follow and advocate on their behalf.
- Whenever possible, be there during their engagement with your loved one. Not only can this have a stabilizing influence on your loved one, but it allows you to provide guidance where necessary as officers try to do their job. Nobody wants a violent confrontation.
- If legal in your state (and, arguably, it should be in every state), use your phone or another device to record the interaction. While recognizing that not all cops are going to behave in an inappropriate manner, also recognize that it happens. Having a video recording is the best way to protect yourself and your loved one in these cases, especially since body cams on officers are not universally present or reliable. Your recording important if something does happen and you later need to make a case. Your account will be viewed as biased, and your loved one, by virtue of their diagnosis, will hardly be considered a credible witness. The camera is your friend. It also adds pressure to the responding officers to use every de-escalation tactic they can.
- Make sure you and your loved one keep diligent medical records. Should the interaction result in legal proceedings, these records can help protect your loved one’s rights by ensuring they have access to the care they need.
- Know in advance who you need to call if the situation calls for legal representation. Research attorneys to make sure a) you find someone with mental health expertise, and b) you have someone who’s in your price range. Groups like NAMI are an excellent resource for finding the right representation, and some may provide pro bono assistance.
Is this list exhaustive? Of course not. Does it cover every possible outcome, or guarantee a positive one? No way. But it’s a starting point, and it’s better that than finding yourself at a complete loss on how to proceed in the midst of a crisis. The best way to prepare yourself for a situation that often leaves you feeling helpless is to know how best to help yourself and the person you care about should that time come.
Dreams and Nightmares
Perhaps more so than any of the horror stories discussed here (and they are truly horrifying), Kam Brock’s saga is the most terrifying cautionary tale of all for me. It is a reminder that no matter how well I’m doing, how much progress I make, how hard I work… all of it could be gone in an instant. In the blink of an eye, an officer can make a decision founded on ignorance and stigma, and all of that will have been for nothing.
If Brock, without a diagnosis, can be stripped of her agency by law enforcement who infer such a label, where does that leave me?
I had to stop and walk away from the computer repeatedly while researching and writing this post as I thought of my daughter. Her placement on the Austism spectrum is not a mental illness diagnosis, but with that placement comes a high co-occurrence with a wide array of psychiatric conditions, including bipolar disorder. Her odds of receiving a bipolar diagnosis at some point are even higher as is because her mother struggles with it. Forget about where this mess leaves me; where does it leave her?
But it’s not just me and it’s not just my daughter. The fact is that thousands of Americans are at risk here, and to varying degrees. While women with mental illness are statistically more likely than men to end up on the receiving end of the justice system’s injustice, people of color are more likely to slip through the cracks or suffer abuse than she or I ever will. Look at the faces above; they’re not there by accident. Ava and I are also fortunate to have a supportive family at our backs with the means to help us if ever necessary. That’s not the norm.
This is about all of us.
Those with mental illness are arguably best suited to raise their voices against this reality; after all, they live it. But the same diagnoses that make them vulnerable allow their laments to be swept under the rug. When this double edged sword intersects with levels of privilege, the impact is compounded. While I’m a believer in the idea that there should be, “nothing about us without us,” until the day comes when stigma is no longer an issue, we need allies in our corner to achieve the necessary changes.
Hamilton. Harrison. Hill. Lane. Duran. Brock. Sheehan. More names than I can count.
One in five. Remember that. And for the love of everything, do something.