Tuesday, December 10, 2013
A few times each week, across the United States, police shoot and kill mentally ill people in complicated, often incredible circumstances.
In Houston, Texas, a pen-wielding, wheelchair-bound double amputee is fatally shot in the head when police are called to a group home for the mentally ill. In Saginaw, Mich., six police officers gun down a homeless, schizophrenic man in a vacant parking lot when he refuses to drop a small folding knife.
In Seattle, Wash., a police officer fatally shoots a mentally ill, chronic alcoholic as he crosses the street, carving a piece of wood with a pocket knife. In Portland, Ore., police check on a man threatening suicide and wind up killing him with a single gunshot in the back.
"Some of them, it seems the person is almost executed," said Ron Honberg, director of national policy and legal affairs at the National Alliance on Mental Illness, the country's premier mental health advocacy group.
And yet, there has been no national outcry, no effort to tally the number of unnecessary deaths and no discernible leadership from the U.S. Department of Justice and other organizations, including NAMI, to effectively stem avoidable bloodshed.
A Portland Press Herald/Maine Sunday Telegram investigation found no federal accounting of or reliable national data on police shootings of mentally ill people. State and local statistics are spotty and inconsistent, but a review of available reports indicates that at least half of the estimated 375 to 500 people shot and killed by police each year in this country have mental health problems.
In Maine, 42 percent of people shot by police since 2000 -- and 58 percent of those who died from their injuries -- had mental health problems, according to reports from the Maine Attorney General's Office. In many cases, the officers knew that the subjects were disturbed, and they were dead in a matter of moments. And virtually all of the officers who pulled the trigger lacked training that might have prevented a tragedy.
The problem appears to be growing, cropping up regularly in news reports and at law enforcement conferences across the country. Mental-health and law-enforcement experts attribute some of the increased attention to greater public awareness of and sensitivity to mistreatment of the mentally ill.
But while the Justice Department counts every assault, robbery and drunk-driving arrest -- as well as every police officer shot on duty -- it gathers no numbers on mentally ill people shot by police. Without concrete data to quantify the problem, target solutions and assess results, mental-health and law-enforcement experts agree that the issue cannot be addressed effectively.
The newspaper also found that, without a mandate from Congress to attack the problem nationally, there's widespread reluctance to scrutinize police shootings of the mentally ill and little impetus to question the effectiveness of Justice Department grant programs that address the issue in very limited ways.
At the same time, there's broad agreement that an inadequate public mental health care system, further eroded by $4.53 billion in state-level budget cuts since 2009, has put police on the front lines of a crisis in our society that few officers are adequately trained to handle.
As a result, police officials across the country report spending more time and money responding to calls for service that involve mentally ill or emotionally disturbed people, but little data has been gathered to quantify the strain on public resources.
NO CONCERTED NATIONAL EFFORT
The Justice Department's Civil Rights Division has been invited to investigate and crack down on perceived police misconduct involving mentally ill people in a few major cities, including New Orleans, Seattle and, most recently, Portland, Ore.
In November, officials in Oregon's largest city accepted a Justice Department settlement that could cost taxpayers more than $5 million per year. It calls for sweeping policy changes that favor de-escalation tactics over use of force and will add 32 positions aimed at improving police interactions with the mentally ill.
Despite these occasional actions, however, the newspaper found that the Justice Department has failed to lead a concerted, national effort to effectively stem a problem that dates back to the 1980s. That's when police started experiencing more encounters with the mentally ill, as states began closing large, public psychiatric hospitals and counting on community mental health services that have yet to meet expectations.
The Justice Department spends millions of dollars each year on grant programs to help a relative handful of the 18,000 police departments in the United States improve their interactions with the mentally ill. For the most part, the federal agency lets local communities decide whether to adopt special policies or provide special training that might improve officers' response to people in crisis.
The Justice Department typically only steps in when police shootings of the mentally ill or other minorities ignite public outrage. Then, its Civil Rights Division requires police departments to make after-the-fact, local policy and operational changes -- including crisis intervention training promoted by NAMI and other organizations -- that can produce questionable, unverified results.
NAMI's Honberg acknowledges that even his group has failed to push for a unified, national approach to the problem, though the organization targets over-incarceration of the mentally ill as a major concern. At least 17 percent of the 2.2 million people in U.S. jails and prisons are mentally ill, according to recent studies.
Honberg agrees that similar attention should be paid to police shootings of the mentally ill.
"(It's) not a national priority, and it should be, not only for humanitarian reasons, but for economic reasons as well," Honberg said.
JUSTICE DEPT. HAS SECONDARY ROLE
The Civil Rights Division declined repeated requests for interviews to learn more about its investigations. It finally issued the following written statement:
"For a variety of reasons, police departments are finding that they have to deal (increasingly) with persons in mental health crisis. Police departments have to make sure that they and their officers are properly trained to appropriately handle these situations.
"Our investigations in Portland, (Ore.), Seattle and New Orleans indicated that officers sometimes use force that is inappropriate for a person in mental health crisis and increases the risk of harm to the officer, the individual in crisis, and the community when situations can be de-escalated in a manner that is safe for everyone involved.
"As with all of our investigative findings and agreements, we hope that other departments are reviewing these to ensure that they are doing what is constitutionally required."
Civil rights experts at the American Civil Liberties Union's national office also declined to be interviewed for this report. Like NAMI, the ACLU actively works on the related issue of over-incarceration of the mentally ill, and its website offers several staff members with expertise in various areas of law enforcement.
An ACLU spokeswoman said via email that the organization's response to specific incidents of police use of force, including shootings of the mentally ill, is left to local chapters.
Ultimately, many of the shootings are found to be "justifiable" and represent a tiny fraction of the 40 million Americans who interact with police annually, but that's little consolation to family members and others who say many of the deaths are unnecessary.
"The shootings may be (considered) lawful, but they're awful," said Melissa Reuland, an independent consultant with the Justice Center at the Council of State Governments who has studied the issue since the 1990s.
RESISTANCE TO SECOND-GUESSING
Despite repeated tragedies, the Justice Department has failed to conduct detailed analyses of police shootings, including those involving the mentally ill. Many people close to the issue, including Honberg and other NAMI leaders, say they avoid second-guessing the actions of officers in crisis situations.
"I try to avoid Monday-morning quarterbacking because the police are being put in an impossible situation," Honberg said. Concerns about local control, privacy rights and liability issues also stand in the way of quantifying and attacking the problem, he said.
"There are a lot of disincentives to report" the full impact of police shootings, Honberg said, because law enforcement officials are always trying to avoid the potential for costly lawsuits.
To effectively address the problem, experts say communities need reliable national statistics to analyze where, when and how police shootings happen. They need independent research to identify contributing factors and cull best practices that could help police avoid shootings. Some also believe there should be a national mandatory use-of-force policy to guide law enforcement's response to people with mental illness.
One law enforcement official who's calling for national action is Art Acevedo, police chief in Austin, Texas. He's a member of the Research Advisory Committee of the International Association of Chiefs of Police.
"Bad outcomes around the country reflect badly on all of us," Acevedo said. "The more information and consistency we have around the country, the better off we are as a nation."
A national approach would increase the safety of both police officers and the communities they serve, Acevedo and others said.
It also could save taxpayers money, they said, if government leaders were able to demonstrate that it's more cost-effective to fully fund mental health services and police training up front, rather than risk more expensive responses and sometimes tragic results when crisis situations go wrong.
"It's the only way anything will change," said Michael Biasotti, police chief in Windsor, N.Y., whose recent master's degree thesis study of the apparent rise in mental health-related police calls gained national attention among law-enforcement and mental-health experts.
"It's not just about the (mentally ill) people police are shooting," Biasotti said. "It's about the care they aren't getting and they should be getting so they don't pose a danger to themselves or anyone else."
U.S.-FUNDED GROUPS COMPLICIT?
Some mental health care advocates question whether organizations that benefit from federal funding and laws that encourage "collaboration" on the issue have any real motivation to push for change. These organizations include state and local government agencies, such as police departments, and powerful nonprofits, such as NAMI, the Justice Center at the Council of State Governments and the Police Executive Research Forum in Washington, D.C.
"People don't want to upset the flow of federal funding," said Joe Bruce, a nationally known advocate who lives in Maine. "But to change anything, politicians and others in positions of power need to speak up and reverse the way things have been done for years."
Since 2006, the Justice Department's Bureau of Justice Assistance has doled out $5 million to $12 million annually to local, state and federal policymakers, law enforcement officials and mental health professionals under the Mentally Ill Offender Treatment and Crime Reduction Act of 2004.
The act funds the Justice and Mental Health Collaboration Program, which is administered by the Justice Center at the Council of State Governments. The money is used to plan, implement and expand various corrections, housing and training programs across the country.
About $1 million of the $9 million awarded in fiscal 2012 went to the Justice Center to oversee the program, provide technical assistance for grant recipients and promote "state-based capacity building."
The Bureau of Justice Assistance also has awarded $1.3 million in discretionary funds since fiscal 2010 to support the development of mental health courts through the Justice Center as an alternative to the criminal justice system, said bureau spokeswoman Sheila Jerusalem.
In the same period, the bureau spent an additional $900,000 in discretionary funds to help the University of Memphis develop specialized police responses to people with mental illness, Jerusalem said.
Without national statistics or an independent review to gauge the success of its grant programs, the bureau requires recipients to submit performance data on their efforts and includes notable outcomes in its annual report, Jersusalem said. The 2011 report has yet to be released.
Later this month, the bureau also plans to issue a report highlighting efforts in eight states -- Colorado, Connecticut, Florida, Georgia, Illinois, Maine, Ohio and Utah -- to provide specialized training for police response to people with mental illness. In Maine, the report focuses on crisis intervention training provided by NAMI-Maine to 1,400 police, corrections officers and emergency responders since 2000. The report was prepared by the Justice Center at the Council of State Governments.
"We do notice (police shootings of the mentally ill) as an issue," said Ruby Qazilbash, an associate deputy director at the Bureau of Justice Assistance.
"There are a lot of cool models" for improving police response to people in crisis, Qazilbash said. But it would be difficult to recommend or prescribe one model or approach over another, she said, because "in law enforcement, it's really difficult to show what didn't happen."
Chuck Wexler, executive director of the Police Executive Research Forum, disputes the idea that federally funded collaboration makes the groups involved complicit in the lack of nationwide action. He also questions the need for a stronger federal response, such as a mandatory use-of-force policy to guide law enforcement's interactions with the mentally ill.
Wexler agrees that communities need to take a comprehensive approach to the problem, involving mental health agencies in the training of every officer. But he believes the Justice Department's action in Portland, Ore., will be enough to promote necessary change in other communities.
"Other police departments will look at that as an example of where the field is going," Wexler said. "Every department has different challenges. I'm not sure one policy makes sense for every department."
WHEN SHOOTING SEEMS EXCESSIVE
In many cases, mentally ill people shot by police have threatened, injured or even killed others. Sometimes, they have threatened suicide or expressed a desire to be shot by the police. Frequently, the use of deadly force seems excessive, if not utterly unnecessary.
In July, six police officers in Saginaw, Mich., shot and killed a mentally ill homeless man who was wielding a knife in the parking lot of a closed Chinese restaurant. When 49-year-old Milton Hall refused to drop the knife, the officers fired a total of 46 rounds, hitting him 11 times, according to news reports. The police officers were cleared.
In September, a police officer in Houston fatally shot a schizophrenic, wheelchair-bound double amputee at a group home for the mentally ill. A caretaker reported that Brian Claunch, 45, had been acting aggressively, upset that he was denied cigarettes and a soda.
The officer said he thought Claunch was holding a weapon. The item in his hand turned out to be a pen. News reports said Claunch liked to doodle. The police chief put the officer on desk duty and asked the FBI to investigate the shooting.
Also in September, a Los Angeles jury awarded $3.2 million in damages to Valerie Allen, a 37-year-old woman with bipolar disorder who survived being shot three times and Tasered by police in 2009. The 5-foot-3-inch, 237-pound woman was running through a neighborhood, wearing only a T-shirt, when she grabbed a 29-inch wooden stake and knocked down one of two officers pursuing her, said Los Angeles Police Chief Charlie Beck. The officers were cleared by local officials, but the jury found they used excessive force.
SHOOTING REVIEWS SPUR SETTLEMENTS
Incidents like these have brought Justice Department intervention in a few cities.
In July, the federal agency announced a consent decree forcing reforms in the New Orleans Police Department. The action concluded a two-year investigation that found widespread corruption and discrimination, including regular use of unreasonable force against people in mental health crisis, sometimes when "it appeared that no use of force was justified." Investigators noted in their report that New Orleans received $8.3 million in Justice Department funding in the last three years.
Also in July, the agency announced a similar settlement after an eight-month investigation in Seattle. Investigators found that officers often used excessive force against people who are mentally ill and/or intoxicated, a population that accounts for 70 percent of use-of-force incidents in that city.
Investigators concluded further that many questionable cases in Seattle escalated from minor crimes and improper investigatory stops, such as the 2010 killing of Native American totem carver John T. Williams. The mentally ill alcoholic was shot while crossing a street and carving a piece of wood with a small knife.
Williams, who was hearing-impaired, didn't respond to an officer's command to drop the knife. The city paid Williams' family a $1.5 million settlement -- half of the $3 million that Seattle has spent for police misconduct cases in the last six years, according to the Justice Department's complaint.
In October, the Justice Department announced a settlement in Portland, Ore., where investigators found that police regularly used unnecessary or unreasonable force during interactions with people who have or appear to have mental illness. The agency concluded that nine of 12 people (75 percent) who were shot and killed by cops in Oregon's largest city in the last three years were affected by mental illness.
The 14-month investigation was triggered, in part, by the 2010 killing of Aaron Campbell, who was unarmed and distraught over his brother's recent death when an officer shot him in the back. A grand jury cleared the officer, who said he thought Campbell was reaching for a gun.
LACK OF DATA STYMIES ANALYSIS
A major roadblock in analyzing police shootings of the mentally ill is the fact that the federal government doesn't gather complete, reliable data on police shootings in general.
The Justice Department collects detailed annual statistics on robberies, assaults and even shootings of police, but shootings by police escape the same scrutiny.
In recent years, the federal agency attempted -- but has since abandoned -- an effort to count arrest-related deaths of people who appeared to be mentally ill.
The FBI's annual Uniform Crime Reports reflect statistics voluntarily submitted by about 17,000 of the country's 18,000 police departments, representing about 95 percent of the nation's population.
However, the FBI tallies only police shootings that result in "justifiable" homicides; 373 to 411 of these shootings occurred each year from 2006 through 2010. Unjustified police shootings are counted among all other homicides. The FBI doesn't specifically count any incidents involving mentally ill people.
The Bureau of Justice Statistics, another arm of the Justice Department, also collects information on police shootings that is voluntarily submitted as part of its annual Arrest-Related Deaths survey.
Started in 2003, the program initially was tied to federal grants, so states had an incentive to report data, bureau officials said.
When the money ran out, impetus to fill out the two-page form waned, so bureau statistician Andrea Burch now goads reluctant states into filling out the form and gleans additional data from media reports, she said.
The bureau's last report, comparing survey results from 2003 to 2009, showed that 375 to 497 people were killed annually by police. The survey report doesn't specify weapons used, but it's usually a gun, Burch said.
In 2009, the bureau added a survey question about the behavior of each person who died during arrest, asking "Did the deceased exhibit any mental health problems?" However, the bureau has since withheld the results of that question and plans to remove the question from the 2013 survey because Burch found inconsistencies in reporting from state to state and problems with the question itself.
"We did not feel we were collecting data that was valid and reliable," Burch said.
The question required subjective judgment of officers involved, Burch said, and the officers often felt hampered by privacy laws and unqualified to register a mental health opinion. The question also didn't take into account other reasons for emotionally disturbed behavior, such as intoxication.
Furthermore, Burch said, the person filling out arrest-related death forms in each state changes frequently and usually isn't the officer involved in the shooting. In Maine, for instance, it's an administrator at the Chief Medical Examiner's Office.
"We tried to come up with a different way to ask the question," she said, "but we kept running into the same issues."
SOME STATES ARE TAKING NOTICE
Without comparative national data, it's difficult to reach conclusions about the fact that at least 24 of 57 Mainers (42 percent) who were shot by police since 2000 -- and 19 of 33 people (58 percent) who died as a result -- had mental health issues, according to reports from the Maine Attorney General's Office.
Some other states and communities are taking notice and keeping track.
In New Hampshire, four of five people shot and killed by police in 2011 had mental health issues (80 percent); a sixth person shot by police also was mentally ill but survived, according to reports from the state's Office of the Attorney General. All six shootings were found to be justified. A review of the New Hampshire attorney general's reports on police shootings from 2007 through 2012 showed that seven of nine people killed by officers during that period had mental health issues (78 percent).
In Syracuse, N.Y., three of five people (60 percent) shot by police in 2011 were mentally ill, according to news reports. One of three people who died in those shootings was mentally ill.
Often, when agencies or organizations add up and analyze police shootings of the mentally ill, they fail to report separate statistics on people who were killed, making it difficult to assess the worst impact of these incidents.
In Santa Clara County, Calif., officials reported that nine of 22 people (41 percent) shot during a recent five-year period were mentally ill, according to a crisis intervention training guide.
In Albuquerque, N.M., 75 percent of police shootings in the last two years had a "mental health context," the state's Public Defender Department noted in its annual report for fiscal 2012.
The Police Executive Research Forum conducted a separate review of use of force by Albuquerque police from 2006 to 2010. Hired by the city, PERF found that 54 percent of people "whose actions led APD officers to use deadly force" had a confirmed history of mental illness. Elsewhere in its report, PERF noted that half of the 37 people shot during that period died from their injuries.
Also in its Albuquerque report, PERF noted that "national data indicate" 65 percent of police shootings involve mentally ill people. However, the origin of that statistic is unclear and PERF's Wexler failed to substantiate the number when asked.
CALLS FOR REFORM EMERGING
In July, the Treatment Advocacy Center in Arlington, Va., issued a report saying it was "problematic" that the Justice Department fails to collect data on police interactions with and shootings of the mentally ill. The national nonprofit promotes laws and policies for timely and effective treatment of severe mental illness.
The advocacy center also suggested that "further study is warranted," given anecdotal experiences of police across the nation who report increases in mental health-related calls.
The recommendation, buried in a 25-page report, "No Room at the Inn: Trends and Consequences of Closing Public Psychiatric Hospitals," is one of the strongest calls on record for improving data collection in this area.
The advocacy center's hope is that better data will show the benefit of spending more on mental health care and reducing the greater cost and safety threat that untreated mental illness poses to both citizens and police.
"The mental health care system has been shifting responsibility to law enforcement for some time now," said Kristina Ragosta, the advocacy center's top lawyer. "Police departments have become default first-responders to people in mental health crisis."
In February, Las Vegas Sheriff Doug Gillespie spoke more broadly on the lack of data on police shootings in general at a national summit on minimizing use of force that was hosted by the Police Executive Research Forum.
"We've demonstrated that we do a very good job of analyzing data proactively from a crime-fighting standpoint," Gillespie said at the summit. "I believe that the issue here with use of force is that we just don't have the data that can help us be more proactive about preventing mishandling of use-of-force situations."
The same month, Gillespie opened his agency to an ongoing review by the Justice Department's Community Oriented Policing program, after a record 12 police shootings in 2011.
CHIEF WANTS NATIONAL POLICY
Also at the PERF summit, Austin Chief Acevedo cited protection of local control as a major barrier to reforming police practices across the U.S.
"I think the biggest problem we have in this country is that we have 18,000 police departments with 18,000 sets of policies and 18,000 ways of doing business," Acevedo said. "We should come together and develop model policies. It's about holding people accountable for their actions and having some consensus on model policies."
Interviewed more recently, Acevedo said a national model policy on police interactions with the mentally ill should be developed by leading law enforcement, mental health and civil rights advocacy groups. The federal government should require all police agencies to adopt the policy in order to receive grant funding, as it has for drunk-driving laws, he said.
In September, Acevedo adopted a new policy for responding to calls involving people who are known or thought to be mentally or emotionally disturbed. Dispatchers must send four officers and a supervisor, including at least one officer who's specially trained to resolve crises with little or no use of force.
Acevedo said he was prompted to adopt the policy as part of an overall effort to reduce potential use of force and to avoid what's happened in other departments. His department had two fatal police shootings this year; both subjects had long criminal records.
Having a similar national policy for dealing with the mentally ill would help reduce legal liabilities for law enforcement, Acevedo said, because departments would no longer have individual policies that can be challenged more easily in court. He disputed concerns about undermining local control, noting the overarching benefit of having all departments operating under recommended best practices.
"In big cities and small towns, use of force is use of force," Acevedo said.
IMPROVING POLICE TACTICAL RESPONSE
Information is available to departments that want to address the issue.
The website of the Justice Center at the Council of State Governments identifies six "learning sites," including Portland, Maine, where police departments have developed effective responses to the mentally ill and officers are willing to share what they've learned.
The Justice Center also drafted reports in 2008 and 2010 aimed at "Improving Responses to People with Mental Illness." Center staff members visited four police departments and surveyed several others to learn about "specialized policing responses" to the mentally ill, including crisis intervention teams.
The 2010 report, in particular, was produced for the Justice Department with assistance from of the Police Executive Research Forum. However, on the copyright page, all three organizations explicitly deny responsibility for information contained in the report, leaving local departments to determine whether the training strategies or police practices outlined in the report are valid.
The Justice Department avoids prescribing law enforcement solutions or policies for all departments because it has no mandate from Congress to take such positions.
"They're authorized to give out grants and investigate if a problem is identified," said Robert Fleischner, an attorney with the Center for Public Representation in Northampton, Mass., who has represented mentally ill clients in disputes with police for about 40 years.
Developing effective law enforcement policies and practices related to the mentally ill probably should be handled at the state level with help from the federal government, Fleischner said.
A state-level approach would help address the fact that local departments tend to change policy based on one horrible incident, which doesn't always bring the best results, said Melissa Reuland, the independent consultant with the Justice Center.
Crisis intervention teams in particular, which work in some communities, haven't undergone a comprehensive, independent analysis to see what actually works. Reuland said. Supporters say about 2,000 police departments have had crisis intervention training, but only about 1,000 have active programs, she said.
DATA COLLECTION RESEARCH PLANNED
Albuquerque, Seattle and Portland, Ore., all had crisis intervention programs when they saw spikes in shootings of mentally ill people.
"I cannot tell you, except anecdotally, what the impact of CIT is," Reuland said. "I want to be careful so communities don't think (it's) a press-and-play (solution). There is no one-size-fits-all."
Reuland said a major barrier to improving police response to the mentally ill is the inability of local departments to collect their own data. Computer technology, operational policies, reporting habits and officers' expertise vary greatly among departments.
That barrier may soon be broken. The Justice Center, in partnership with the Police Executive Research Forum, recently got a $428,000 Justice Department grant to provide technical assistance and report on efforts to improve data collection on mental- and behavioral-health police calls in Cambridge, Mass., Delaware, Ohio, and Denver, Colo., said Fred Osher, the center's director of health systems and services policy.
The Justice Center is expected to issue a report on the study in 2014, Osher said. Data-gathering methods that prove valuable could be applied at other departments, which would allow the center to gather broader statistical information.
With better data on the real cost of responding to mental health-related police calls, communities may see the value in spending more on mental health care.
"If we quantify the problem in numbers, we can make a case for funding," Osher said.
Ultimately, Austin Chief Acevedo said, saving money may be the prime motivation to change government policies and spending priorities in ways that reduce police shootings of the mentally ill.
"Economic realities being what they are," Acevedo said, "government agencies will be forced to put politics and concerns about local control aside in favor of effective service."
And possibly save some lives.
Staff Writer Kelley Bouchard can be contacted at 791-6328 or at: