When Cops Confront Mental Illness

Last Editorial Review: 1/30/2005

Policing Mental Illness

By Kathy Bunch
WebMD Feature

Reviewed by Dr. Dominique S. Walton

April 23, 2001 -- As a frail, 54-year-old homeless woman, barely 5 feet tall and 100 pounds, Margaret Laverne Mitchell might not have seemed like a threat to public safety as she pushed her belongings in a shopping cart along the streets of Los Angeles.

But when two city bicycle patrol officers stopped and questioned her in May 1999 about whether the cart was stolen, Mitchell suddenly threatened one of the officers with a 13-inch screwdriver.

The response was rapid and deadly. One officer shot Mitchell in the chest, killing the college-educated woman who had worked for a bank before she started hearing voices and took to the streets. Her family later said she was mentally ill.

The lethal shooting of Mitchell, who was black, prompted several investigations and protest marches from activists, who questioned whether the incident was racially motivated. They also asked why police didn't use non-deadly measures, such as pepper spray, to subdue the woman. Ultimately, the city's police commissioner, Bernard Parks, determined the two officers "acted properly."

Across America, police departments -- many under fire for similar incidents -- are seeking new ways to cope with the growing number of calls regarding what officers call "EDPs," or emotionally disturbed persons.

Leading civil-rights groups such as Amnesty International have complained that police officers in many American towns and cities are ill prepared to deal with such people -- a consequence of the 40-year-trend away from institutionalization for the mentally ill.

In a 1999 report, Amnesty International also suggested the number of questionable shootings might be on the rise as police crack down on homelessness and so-called "quality-of-life crimes."

Today, a growing number of departments are copying a program pioneered in Memphis, where a controversial 1988 police shooting of a knife-wielding man with a history of mental illness sparked the creation of a crisis intervention team to respond to such calls. Officers who volunteer receive at least 40 hours of special training in mental health issues, and can respond citywide whenever there is a crisis involving a suspect who is emotionally disturbed.

There, the department sought experienced officers with an aptitude for dealing with emotionally charged situations to volunteer for the advanced training in how to deal with real-life scenarios. The specially trained officers are on regular patrol throughout the city, but are dispatched to calls involving emotionally disturbed people. About 15-20% of the patrol division has received such training, and some of these officers are always on duty throughout the city.

Many but not all experts have praised this approach. In Philadelphia, Temple University criminologist James Fyfe, PhD, a former New York City cop who has testified in more than 60 trials involving police shootings of mentally ill suspects, says all officers, not just specialized units, need training to handle such calls.

"In all of the cases where I testified, the cops screwed up in the first 90 seconds," Fyfe says. "That tells me that the first response is critical."

The evidence is overwhelming that the criminal justice system is shouldering much of the burden once carried by hospitals that cared for mentally ill people. Randy Borum, PsyD, who teaches mental health law and policy at the University of South Florida in Miami, notes that while in 1955 some 0.3% of Americans were in mental hospitals, today that same percentage of mentally ill people are in the prison system.

And in big cities, he says, as many as 7% of police calls involve the mentally ill.

Some of these calls have ended in death. Among them: A New York City man wielding a hammer who was shot and killed as he faced six police officers, and a man in Los Angeles who was shot at 38 times by sheriff's deputies, who said he threw a knife at them.

Experts say one reason such calls are so difficult for police is that most of their training has been in dealing with criminals who generally respond more rationally -- dropping a weapon on an officer's command, for example -- than a suspect who is emotionally disturbed.

"The typical robber or car thief wants to live to see tomorrow," Fyfe says, while mentally ill suspects might flee or lunge at officers when cornered. He suggests that a turning point in public attitudes may have come with the 1994 nationally televised "low-speed chase" of O.J. Simpson across Los Angeles, when no effort was made to rush an arrest of the possibly suicidal murder suspect.

Borum says police departments that have been criticized after shooting incidents typically respond by increasing training for all officers in dealing with the mentally ill. While he believes this can be helpful, he also says some officers by nature are better at defusing crises -- and that unless special units are created, which officers are called to the scene is "the luck of the draw."

"There's a temptation to do only enough to quell the concern of advocacy groups or the concern of the community," he says. He suggests that departmentwide training programs -- a typical response -- are not enough.

"Sometimes they create the illusion that more has happened, when at the end of the day nothing fundamentally has changed," he says.

Some studies, however, have suggested that the Memphis model works. The National Institute of Justice found that the city was less likely to arrest mentally ill suspects and more prone to refer them to treatment programs. What's more, the rate of injuries to police officers responding to such calls declined.

"There used to be a serious amount of trepidation in calling the police," recalls Memphis police Maj. Sam Cochrane, who administers and helped develop the program. Now, he says, family members are more likely to call for help in tense or potentially violent situations. Among the cities that have copied the Memphis model are Houston, Seattle, Portland, Ore., Albuquerque, N.M., and San Jose, Calif.

But while Fyfe agrees there's evidence that police in large cities are doing a better job in responding to the mentally ill, he says a growing number of the cases in which he's asked to testify are in mid-sized cities or small towns that may lack the resources of a Memphis or Seattle.

Fyfe says all officers can be trained in a couple of days to follow some basic rules: To initially keep a safe distance away and clear away bystanders; to designate one officer as the "talker" and for other police on the scene to "shut up and listen;" and -- most importantly -- to take as much time as necessary, even if that runs into hours or days.

"That's some mother's son," Fyfe says. "So the best thing is to take your time."

Kathy Bunch is a freelance writer in Philadelphia.


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