Friday, August 13, 2021

Police involved shootings often involve mental illness

Of the more than 200 people killed by police gunfire since the landmark conviction of Derek Chauvin for George Floyd’s murder in Minneapolis, about 15% exhibited signs of mental illness, according to data collected by The Washington Post. They include Ryan LeRoux, a 21-year-old Black man fatally shot last month while parked in a McDonald’s drive-thru lane in Gaithersburg, Maryland.

Responding to a call indicating that LeRoux had refused to pay for his meal or move his vehicle, officers suspected that he was experiencing a mental health emergency, a fact later confirmed by his parents. Police called for a crisis specialist, but after noticing a handgun on the front passenger seat and what they described as uncooperative behavior on LeRoux’s part, officers opened fire before help arrived. Police footage includes audio of LeRoux talking to the county police Emergency Communications Center, stating that he was cooperating with officers on the scene. The video also shows that LeRoux had been reclined in the driver's seat, and that he sat up before officers fired, according to Thaddeus Johnson writing in the  USA Today.  

Despite uncertainties surrounding his death, LeRoux’s all-too-familiar demise in a hailstorm of bullets illustrates yet again how race and the need for mental health support often intersect at deadly police encounters. Since the pandemic’s onset, Black people have accounted for a disproportionate 20% of the nearly 300 Americans with known mental illness who were fatally wounded during police shootings. 

Given our nation’s woefully underfunded web of behavioral health care, police invariably are required to step in as first responders for calls involving mental health and substance use issues. Unfortunately for both police and those in distress, officers are generally unqualified or ill-prepared to handle these complicated and sometimes volatile situations, which account for about 1 in 5 calls

Acknowledging this deficit, a growing number of law enforcement agencies are forging collaborations with nonpolice organizations prioritizing less punitive approaches in responding to mental health emergencies. Loosely defined as crisis intervention team (CIT) programs, these initiatives take many forms. Some involve intensive training that prepares officers to verbally de-escalate conflict, recognize symptoms of mental illness and engage people in crisis, while others pair such officers with crisis experts for behavioral health-related calls.

Sadly, LeRoux’s death makes clear that the availability of certified crisis professionals does not guarantee that these rapidly unfolding, high-stakes encounters will abide by the schedule of the interventionist. And just as important, would it have made a difference in this case if the crisis specialist had made it to the scene in time? 

While more rigorous evaluation is needed, CIT programs have proved largely ineffective against, among other things, use of force. Experts blame this on agencies not fully committing to CIT principles and not integrating crisis intervention into the given area's overall mental health system. Ultimately, however, the bigger issue is that officers simply lack clinical expertise.

Mirroring racial disparities in other aspects of policing, the evidence suggests that Black people exhibiting signs of mental distress are likely at greater risk of dying during encounters with law enforcement. As is often heard after police shootings involving Black citizens, some will ask why LeRoux didn’t just comply. The question is fair, but it’s not that simple.  

This country’s legacy of racial violence and discriminatory policing has instilled generational mistrust and fear of the police that powerfully informs how Black people respond to those in uniform with guns and badges.

In LeRoux's case, he insisted that his hands were in the air, as police had instructed. The audio from the police footage also reveals LeRoux's hesitancy to open his windows, another instruction from police. His explanation to police on the phone: He doesn't want to put his hands down. Who can blame him? Black men putting their hands out of police line of sight has resulted in death during traffic stops – even when the man is moving his hands to follow police instructions, as was the case with Philando Castile, who was killed during a traffic stop in 2017 near St. Paul, Minnesota. LeRoux's possible fear of that is understandable. 

We can personally attest to this kind of fear, which is continually stoked in many Black households by the recurring refrain that policing is a dangerous institution for Black America. The experiences that one of us encountered as a Black male police officer in Memphis, Tennessee, validates this story line. While serving on the force, I was pulled over several times by my colleagues, and although I knew most officers were consummate professionals, I still experienced feelings of anxiety – a harsh reality far too familiar to many people of color. 

This fear can be debilitating. Skeptics suggest arguments about fear are excuses for noncompliance, but terror is real and often triggers a physiological response. Studies show that humans unconsciously react to perceived danger in three ways: fight, flight or freeze. The fear response can be compounded by co-occurring mental health issues and substance use, and it may intensify when power imbalances exist and escape seems impossible – much like the conditions that exist during custodial police encounters.

The fatal shooting of Miles Hall in 2019 provides another example. The 23-year-old Black man in California was holding a gardening tool and having a meltdown when police shot and killed him. Hall's mother had called the police hoping for help with her son. But combustible dynamics often underpin what some might consider defiant responses that police are ill-equipped to deal with.

Such tragedies, coupled with the limitations of crisis intervention programs, have sparked calls to revisit police responsibilities and share certain duties with social service providers and other organizations. 

One longstanding example of this is the Crisis Assistance Helping Out on the Streets, or the CAHOOTS initiative. It's a 24/7 service staffed by crisis workers and medics trained in intervention and de-escalation who are sent to substance abuse and behavioral health calls – mostly without the police – by dispatchers trained to ask the right questions. That means moments like the one experienced between LeRoux and officers waiting for a crisis intervention specialist to show up would occur less frequently.

While the research supporting the impact of CAHOOTS is thin, the principles underlying the approach hold promise for reducing violent altercations between police and the public – and a more culturally responsive CAHOOTS-like model could reduce the racial disparity in fatal police outcomes. 

Given the uneven police contact that puts Black people at greater risk of coming face-to-face with officers amid conditions ripe for physical altercation, such a model, if done correctly, would likely enable Black Americans to reap the greatest benefits.

In the end, the responsibility falls on civic governments to protect and meet the needs of those most vulnerable to unnecessary arrest and coercive police force. A broader community-centered approach must ensure that culturally responsive crisis interventions are especially sensitive to the unique stresses and fears plaguing Black communities.

Such steps would represent a profound investment in improving police-citizen relations.

More important, they would save lives.

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