Policing and Disability: Beyond Training

I wrote a piece for The Nation on people with disabilities killed by police over the last week, writing that the number was four. It was, however, actually at least 9 (the information wasn't available when I filed).

My hope for this piece is to push back at the training and registry narrative that gets so much press, and direct attention (and funds! for the love of all that's holy, funds!) to people in communities instead of police departments. There are shifts to training that would help, but they should be baseline, not "special." I wrote:

So what do we do? When incidents like these happen, departments and some advocates often focus on two deeply troubling solutions: training and registries. Both are based on the idea that police just don’t recognize disability when they see it, or don’t know what to do if they recognize it. Instead, we need to reframe policing, decriminalize noncompliance, and remove police from as many situations as possible.

Please READ THE WHOLE THING.

Restraint and Death of Disabled Civilians in Texas

The New Statesman reports on deaths in restraint or otherwise in custody of mentally ill civilians in Texas. There's a new bill pending, the Sandra Bland Act. The paper reports on the bill, but also investigated deaths. Excerpts:

Klessig is one of at least 33 people with histories of mental illness who died after being restrained by police in Texas over the past decade, according to a first-of-its-kind investigation by the American-Statesman of in-custody deaths. Six of those people wielded weapons; the rest were unarmed, records with the Texas Attorney General indicate.

And

Some of the deaths in police custody also raise serious questions about the way police deal with people struggling with mental illness. In several instances, police appear to have acted contrary to what experts advise — a slower, less confrontational approach to mentally ill people that can prevent violent encounters and death.

And

State Rep. Garnet Coleman, the Houston Democrat who filed the Sandra Bland Act — named for a mentally ill Illinois woman pulled over in Waller County for a minor infraction and later found dead in her jail cell from an apparent suicide — said the additional training would help officers distinguish between “a person who is in crisis and one who is being aggressive … and resolve the situation in a peaceful manner.”

My take: Such bills will help, but relying on officers to distinguish between disabled and non-disabled civilians will leave many vulnerable. We need core, default, changes.

Here's the project webpage. I'll be following it!

Trauma in the Neighborhoods: The Solution Isn't Police Training

The US Department of Health and Human Services has given Chicago 1 million dollars to address "trauma" in its neighborhoods.

But it seems like most of the money will go to training cops. The grant will:

* Establish a Chicago ReCAST (Resiliency in Communities After Stress and Trauma), Institute to design and deliver trauma-informed training to staff from City agencies and partners organizations as well as residents, building greater capacity in neighborhoods most impacted by violence on how to identify, respond and support recovery from to various forms of trauma.
* Expand the Chicago Police Department's Crisis Intervention Team training, mental health awareness training for Office of Emergency Management and Communications (OEMC) call takers and dispatchers, a public awareness campaign to reduce mental health stigma and public awareness of CIT and other resources. As a result, more than 12,000 Chicago police officers and all OEMC 911 call takers and dispatchers will receive basic mental health and trauma training.
* Support, train and link leaders from communities most vulnerable to civil unrest to ensure local involvement and feedback in citywide transformation efforts.
* Implement, launch and promote Chicago Connects, a comprehensive resource directory, crisis text line and web application to improve community organizations' and residents' access to necessary services.

It may be that the ReCAST Institute and training community leaders will do good work, and CIT Team Training is fine if its accompanied with system-wide cultural change. But this is also affirming that law enforcement is the appropriate place to center mental health crisis response. In the long term, we need to do something else.

I believe that budgets control agendas. When we put money tangling up these different things, we build institutional structures that are very, very, hard to change in the future. Moreover, I just wonder where's the investment in mental health centers, which, you'll recall, Rahm Emmanuel closed years ago. I wonder how much of the million dollars is going to police training and how much to community.

I spoke to Leroy Moore - one of the absolutely most important leaders on this issue - recently about CIT Training and he said to me, "Training has been around since 1989 with the Memphis plan … it’s the same story, it’s increased. What I say, and many other people say, we have to switch the focus from police to community. Switching that money to community service, to health service, to alternative phone number [to 911 for mental health calls]."

Again, CIT is fine, but it's the medical model to solving a problem related to disability.

We need social model solutions.

Expect tens of thousands more words on that to come (i.e. my book and many future pieces).

NYT on CIT (in Portland)

Every day, my news feed serves up a few stories about local police departments undergoing Crisis Intervention Team training. Yesterday was Northern Wisconsin and upstate New York. CIT is fine. It provides some good resources to police officers, who generally seem to respond well to the training. It's resolutely pathologizing, relying on a medical model of disability, focusing on on-site pseudo-diagnosis as a "mental health" case. These stories tend to be superficial and rarely look at the bigger picture of social context.

The New York Times, demonstrating why it's an important paper, recently tried to do better. Erica Goode, one of their feature reporters, published a long story on Portland, OR, and its approach to mental-health policing, published a few weeks back. It's a good piece of reporting, though of course leaves a lot out (and even unasked)

Portland PD had a bad history when it came to ugly use of force, eventually being investigated by DoJ and agreeing to a number of major reforms. The NYT piece opens with an incident of a man with a sword on a beach at midnight. In the past, departmental policy would have mandated the officers engage, and they probably would have killed him. Now, their "just walk away" policy enabled the officers to leave him there (after some hours).

My questions: What forms of community mental health supports are available to the man with the sword? Was there a way for officers to direct him to getting help, rather than criminalizing him, and was that way available 24/7? Was there a mental health professional on call to come help, or were only armed law enforcement dispatched? Remember, even armed law enforcement who specialize in mental health are NOT licensed mental health professionals, and they would not claim to be.

Erica Goode, the reporter, recognizes this, writing:

Whether the training leads to less use of force by officers, however, is still an open question: The findings of studies have been mixed, although one study to be published later this year suggests that Portland’s program, which is based on C.I.T., is having an effect. And training alone is not enough, experts say. For the approach to be effective, it needs the full backing of a police department’s leadership, continual checks on its effectiveness, and collaboration with the mental health community.

“The training is great, but it’s not magic,” said Laura Usher, coordinator of crisis intervention team training for the National Alliance on Mental Illness. “The thing that actually transforms the way the system works is when everyone gets together.”

I recently spent a few days in San Antonio, where they are trying to build systems, and am looking at other models. We also need to flip our questions around and take a social-model, cross-disability, approach.

Leroy Moore, one of the foremost activists around policing and disability (especially in the Bay Area), recently told me this: "I want us to stop asking what the police need, and start asking what the community needs."

CIT-trained officers is likely part of what the community needs, but it's very partial.

The "Training Isn't Enough" Movement

Discussions around police use of force and disabled civilians usually turn quickly to training. In Chicago, for example, several high profile deaths resulted in mandatory CIT training for all Chicago officers - in policy anyway. It's not clear whether funds have been allocated and to what extent the training is ongoing, but that's another story.

But from many activists, particularly those most focused on the intersections of racism and ableism in police use of force, skepticism about training is becoming more prominent (it was always there). For example, Kerima Çevik was recently interviewed by Leroy Moore about policing and disability for Poor Magazine. It was a wide ranging interview and you should read all of it, but here's an excerpt:

Çevik: Racial profiling severely reduces the probability of police accepting my son, a Hispanic presenting male, larger than his peers, walking down the street with an unsteady gait, holding an iPad without challenging him. Which would inevitably lead to them trying to stop him, taking his iPad, and verbally demanding proof his speech device was his and their response to him not being able to respond would be to try and arrest him for stealing it. Situations like the scenario I just described, that I call ‘Mustafa’s Dilemma’ and what happened to Tario Anderson is what haunts me. That is where I am now. I am in this moment of polarization along racial lines seeking solutions to avert this and other nightmare scenarios I’ve witnessed occurring to countless disabled people, for the sake of my son and all his peers.. Training has been done. Trained officers used deadly force in encounters with clearly identified disabled teens and adults. I’ve changed my entire advocacy strategy based on this truth. The best way for a person in Mustafa’s Dilemma to remain alive and safe is to avoid any circumstance in which police engagement is necessary as much as humanly possible.

The painful lesson I’ve learned is that training initiatives fail. The fallout from the slew of deaths that spurred the Black Lives Matter movement is that the majority of those lives lost were disabled Black lives. I learned the police officers that shot both Paul Childs III and Stephon Watts were thoroughly trained and also knew the victims prior to the fatal encounters. This knowledge changed the focus of both my parenting and advocacy.

Later, Moore asks:

Leroy Moore: If it’s not police training then what are your suggestions and it can be for our community (For me I think we only focus on what police need and not what the community need)?

Kerima Çevik: Leroy I agree that we are focusing on what we think police need when we need to reduce police engagement and increase community supports that limit the need for police contact as much as possible. I won’t advise the community but I can tell you what I personally would like to see happen.

I’d like to see efforts made to establish a 911-type number for mental health emergencies/psychiatric disability related crises and more community crisis response teams to answer them. There is a myth that policy makers are exploiting based on a moment in history. This myth that after the Willow brook scandal, we just opened the doors of mental institutions and threw the patients out to wander the streets, and that to this day those same individuals are out there being a danger to themselves and others. The new fear factor story being added to that is we really need to bring back mental institutions. Victim blaming every deceased victim of a catastrophic police encounter with a person with psychiatric disability and sprinkling that disgrace with a healthy dose of posthumously declaring every white male mass shooter as a mental health patient achieves this fear driven train wreck. Uh nope! I think that funding being demanded for the return of the infamous mental institution model of mental health treatment, research, and ‘residential care’ should be given to desegregated, community supported mental health solutions that work in accord with the Olmstead Decision. I think we need to build on peer mentoring and peer respite centers, an idea that has already been proven successful in other parts of the country. I think we need to be seeking preventative solutions that solve the main series of events that ends in catastrophe for so many disabled victims, and that is the present situation where a mental health call is lumped in with a 911 call and therefore has police responding where they shouldn’t be. I think we should be increasing healthy inclusive school environments for neurodivergent students at school by paying school support staff wages that retain them and training them, not calling SROs to handcuff autistic children to squad cars.

Çevik and Moore are essential voices pushing for structural change, rather than simply trying to make the police less likely to misuse force against a disabled victim.

Simulating Police Training - What's the pedagogy here?

My friend RC alerted me to this piece on a police training simulator for learning how to reduce misuse of force when encountering autistic people or people with various mental disabilities. It touts the virtues of the virtual playback versus role-playing-based training.

Through the simulator, deputies are immersed in true-to-life scenarios — exactly the kind of situations they often find themselves in: A father calls the police because his bipolar daughter is off her meds and is destroying the kitchen; a man is wandering around a parking lot with a knife talking to himself; an angry young veteran, suffering from post-traumatic stress disorder, is walking down the middle of the street.

The simulator’s operator changes the scenario’s outcome based on how the deputy responds – and the system recognizes and records each type of response, whether it’s with a taser, pepper spray, a gun or verbal interaction. Just like in real like, no situation is ever the same

“The key here is decision-making. We can test and practice-decision making among deputies in a way that wasn’t possible before,” Lt. John Gannon said.
And Gannon can watch it all unfolding, as if he was on the call himself. He can see if a young deputy misses a knife sitting within arm’s reach of a suspect, or unnecessarily escalates a situation involving someone with mental illness. Then the supervisor and deputies can debrief, going frame by frame through the situation to discuss what was done right or wrong.

“How often do you have a chance to go back and see what someone did, see what someone missed?” Gannon said. “Rather than role-playing, rather than having them learn on the job, we can have them learn and make their mistakes here.”

A few thoughts.

1. The pedagogy of police training continues to fascinate me. The police trainers I've talked to are often critical of the method but not empowered to try active learning models. It's mostly talk at officers, dumping information in lecture format. 
2. This simulator, like the more standard role-playing, is obviously active learning.
3. I don't see the evidence in this piece, although it's interesting, that a simulator is better pedagogically than role-playing. In standard role-play scenarios officers work with actors who then go back after and debrief on what the officers did well or poorly in their decision making.
4. Decision making in tense situations is hard.
5. Finally ..

The piece concludes with this insight:

Lessons Learned:

Some of the same techniques can also help deputies when they are responding to someone with PTSD, schizophrenia or bipolar disorder.

“You don’t always have to shoot, taze, pepper spray — sometimes talking works,” Deputy Shawn Walters said.

That's true. The key is to take that insight out of disability-related training and apply it to every encounter, because people don't broadcast their disabilities to the world. It's why I'm skeptical of diagnosis-based training in general. It says: Apply these specific resources to specific cases.

I like police training models which use insights from the disability world to help officers fundamentally change the way they think. 

De-escalation for Law Enforcement in Park Ridge

Nice article in the local paper on de-escalation training for Park Ridge law enforcement.

Last year, a U.S. Justice Department grant secured by the Park Ridge Police Department allowed for officers to take crisis intervention training, a program that aims to prepare officers to deal with citizens struggling with a broad spectrum of mental health disorders, said Deputy Police Chief Duane Mellema.
The training, Mellema said, is largely aimed at de-escalating tense or potentially dangerous situations through communication techniques. Some of the things officers are taught include showing empathy, speaking slowly and calmly, and taking time with the individual.
"If a person thinks you are bothered or in a hurry, you'll have a hard time communicating with them," Mellema said.
Out of 39 incidents last year that involved police response to a situation involving mental illness, all but one was handled without the use of force, Mellema said. The single incident in which force was used involved an intoxicated man who was subdued with a taser because he was walking in traffic on Dempster Street and attempting to get into cars that were stopped in traffic, Mellema said.

Two caveats:

1. Median home value in Park Ridge is $378,000. It's a gorgeous, wealthy, place. Great schools. If we ever decided to move to the north suburbs (which we might, for commute reasons) and our income increases significantly, we'd try to move there.

That means this is NOT a place where race, poverty, and disability intersect in policing. It's easier to work on single-factor places. It still matters as one of my arguments is that the intersection of disability and policing can lead to terrible outcomes anywhere. It's also important to call this out as atypical.

2. "If a person thinks you are bothered or in a hurry, you'll have a hard time communicating with them," - That's true in every encounter. These findings need to be universalized, not compartmentalized to just mental-health cases.

CIT Training in Chicago

A relatively new piece by Mother Jones examines the current state of Crisis Intervention Team training for police in Chicago. As regular readers know, I think CIT training is fine but limited in its utility. It gives officers resources to apply to situations involving certain kinds of disability in crisis mode, but does little to prevent crises or shift police culture.

Still, we ought to have the training available. Apparently there will be over 900 officers trained this year. Will it help?

Some budget context.

No Consensus on Mental Health and Policing

Yesterday, I wrote about the death of Anthony Hill, a man with bipolar disorder, who, while naked and unarmed, was killed by police in the Atlanta area. Here are three stories on how police should respond to these sorts of situations (I'm guessing there are 500+ related deaths a year nationally, but numbers are hard to locate).

New Jersey - Crisis Intervention Training Pays Off.

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

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

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

Meanwhile, in Montreal - training seems of limited use.

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

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

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

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

Police and Psychiatrically Disabled Individuals with Weapons

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

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

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

And then followed a lively Twitter conversation.

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

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

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

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

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

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

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

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

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

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

Looking at the whole, I conclude:

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

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

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

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

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

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

Police Killings in San Francisco - #CultofCompliance

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

The piece is very thoughtful about the "Memphis Model," a Crisis Intervention Team (CIT) training that has been widely reported on over the last few months and which is being implemented across the country, with some success. In a piece for CNN (that I wish had found a bigger audience), I argued the following:

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

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

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

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

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

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

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

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

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

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

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

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

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