Police and People in a Mental Health Crisis

By Dick Hall-Sizemore

The Senate Judiciary Committee reported many of the Democrats’ criminal justice reform bills at its meeting last week. I will discuss the most important ones, in some depth, in installments, rather than all at once. This first installment is on the interaction between police and mentally ill folks.

For many years, police officials and sheriffs have warned of the problems posed by mentally ill persons committing crimes, often petty ones, as well as by those having a crisis and acting more violently. This problem has been increasing over the years. (The reasons for this increase are beyond the scope of this post as well as beyond the scope of the knowledge and expertise of the author.) Law-enforcement officials have said publicly, repeatedly and correctly, that their officers have not been trained to deal appropriately with these folks.

One answer has been to provide some basic training to officers on a voluntary basis on how to recognize when people are behaving as they are due to mental health issues, as well as developmental issues such as autism. The training also includes techniques to use in de-escalating situations involving mentally ill people. Finally, these specially-trained law enforcement officers work closely with mental health providers to get assessments and treatment for mentally ill people they encounter.

This approach, called “crisis intervention teams” (CIT), got started in Virginia in the New River Valley region in the mid-2000s and was incorporated into state law in 2009. The Department of Criminal Justice Services (DCJS) and the Department of Behavioral Health and Developmental Services (DBHDS) have worked together to establish support for these programs, along with training standards.

Coupled with the concept of having law enforcement officers trained to recognize signs of mental health distress and to de-escalate situations is the availability of a site to which law enforcement can take these people for mental health evaluation and help, rather than taking them to jail. These are the CIT Assessment Centers. As of 2015, there were 37 CIT programs and 32 CIT Assessment Centers, providing coverage for nearly 95 percent of the state’s population.

SB 5014 (Edwards, Roanoke) would require that all law enforcement officers receive the basic CIT training, either through their basic minimum training or as part of the recertification requirements. Furthermore, the bill would require every locality to establish, or be a part of, a CIT program. The committee voted unanimously to report the bill. It has been re-referred to the Senate Finance Committee for consideration of any fiscal impact.

Marcus-David Peters, killed by Richmond police officer Photo credit: Richmond Free Press

As valuable as the CIT program has been, many activists have contended that localities needed to go further in de-emphasizing the role of police in situations in which a person was having a mental health crisis. In the Richmond area, that movement has crystallized around the case of Marcus-David Peters.

The details of Peters’ tragic story in 2018 are laid out well in this Washington Post story. To summarize, Peters was a young Black high school biology teacher, who, in the span of about 30 minutes, went from being a “normal” person to a naked man crashing into three cars, wrecking his car, and then charging across a major street at a Richmond police officer. The police officer, who happened to be Black, tried his taser, but that seemingly had no effect. He then fired two shots into Peters’ abdomen, as he had been trained to do. Peters later died at the hospital.

To the consternation of many, especially Peters’ family, the Commonwealth’s attorney decided to file no charges after an investigation. Body camera footage was one of the key sources of information for the police and the Commonwealth’s attorney.

The cause of Marcus-David Peters has been at the forefront of the BLM demonstrations in Richmond this summer. Many have demanded the establishment of a system whereby a team of mental health professionals, backup up by police, is alerted whenever a situation involving someone in a crisis arises. (This has been dubbed a “Marcus alert”.)

SB 5038 (McPike, Prince William) would provide for such a system.  At its core would be a “mobile crisis co-response team.” That entity is defined as a “group of mental health service providers working with registered peer recovery specialists and law-enforcement officers as a team.” The function of the team would be “to help stabilize individuals during law enforcement encounters and crisis situations.” They would “respond to crisis situations involving persons whose behaviors are consistent with mental illness, substance abuse problems, or both.”

Activating these teams would be a “mental health first response and alert system” that would route 911 calls indicating a mental health crisis to the mobile crisis co-response team.

The bill would require DCJS and DBHDS to support the development and establishment of these programs and to develop a training program.

Under the provisions of this bill, the establishment of such an alert system and response teams by localities would be optional. Another bill, SB 5084 (McClellan, Richmond) would have mandated their establishment, but there was not sufficient support on the committee for that. HB 5043 (Bourne, Richmond) has the mandate. It has not been heard in committee.

To be maximally effective, the response teams would need to be available around the clock every day. They would also need to be able to respond within a short period of time. The logistics and expense of establishing such teams are daunting, especially in rural areas. There also would be the issue of training 911 operators to know when an incoming call should be deemed a “Marcus alert.”

SB 5038 was probably not needed in this form. The proponents could have chosen to build upon the CIT framework. (The mobile co-response team provisions are almost identical to the current Code language for the CIT programs.) In fact, one person testifying on the bill told the members that some local CIT programs were beginning to expand their operations to incorporate a multidisciplinary approach to answering crisis calls. She expressed her concern that the proposed bill not conflict with the existing CIT programs. The committee members obviously did not want to hear any objections or concerns, however well intended. Hopefully, in this case, DCJS and DBHDS will develop a format that will provide localities sufficient flexibility to incorporate aspects of both programs.

I fully support the concept of this bill. As law-enforcement officials have been saying for years, they are not the most appropriate persons to deal with persons in a mental health crisis. Having mental health professionals on the scene who know how to talk to a person experiencing such an episode and able to de-escalate the situation will, undoubtedly be valuable, and, quite possibly, save lives. However, there are a lot of questions and concerns that could be raised.

Foremost, the system that would be created by the bill will not be the panacea that its proponents seem to think it will be. From a police officer’s perspective, there may not be enough time to summon or wait for a crisis response team. The tragic irony is that Marcus-David Peters probably would not have benefited from the provisions of the bill named after him. The police officer confronting Peters was not responding to a 911 call; he had seen someone driving toward the Interstate on ramp, hitting three other cars and then slamming into a tree.  Upon arriving at the scene, after notifying his dispatcher that he thought the man involved was having a mental health crisis, he saw a naked man exit the car through the window, feet first, get sideswiped by a car, and raise to a sitting position. That man then saw the policeman and charged at him, cursing and threatening to kill him. A taser did not stop the charging man. The officer later told investigators that he was concerned about a hand-to-hand fight for his service revolver. That is when he shot Peters at close range. If a mobile response team had been available, there would not have been time for it to respond.

This bill has become so freighted with emotion and symbolism that no one is willing to broach any concerns or questions. Despite its problems, the bill represents recognition by the legislature that there is a serious problem and provides localities a tool with which they can provide law-enforcement the assistance it has long said that it needed. The bill passed with no objections and was re-referred to the Senate Finance Committee.

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31 responses to “Police and People in a Mental Health Crisis

  1. I notice that these bills have not been given fiscal impact statements. I don’t think they should be accepted or rejected on the basis of cost, but it matters. That said, we’ve all seen massive police response to some situations that didn’t really warrant it, with officers and equipment milling around (and probably getting in each other’s way.)

    The challenge is going to be getting the personnel with that level of training willing to go into harm’s way on these situations. Was there any discussion of where this new group of heroes is coming from, when they can make a lot more money in regular counseling practices?

    • There was not much discussion at all. Most, if not all, of the fiscal impact will be at the local level. As long as the bill is optional, that should not pose a problem. If it becomes mandatory, that will be a problem.

  2. Baconator with extra cheese

    I’m not sure how a crack team of mental health professionals will subdue a man charging at them after stating he would kill them.
    I feel bad for Marcus and I feel bad for that officer who was put in a very scary situation.
    Who in God’s name will sign up to make $40k a year to deal with mentally ill potnetially violent people with no way to defend themselves? We already have mental health professional shortages in the country. Where do our politicians think they will get about 250,000? And man I hope the localities have some kick ass insurance!

  3. Dick, thanks for another thoughtful, balanced presentation of a complex issue. I share your concerns, which I think you articulate very well.

    My sense is that a mental-health-response team seems like a good idea in the abstract, but it would be folly to impose it statewide from the inception. We have too little experience with it, too many questions, too many unknowns — including cost, as Steve notes above. Let’s implement a pilot project in a locality best situated to benefit from it, learn from it, refine it, and expand it, as appropriate, to other localities.

    Test. Measure. Refine. Test. Measure. Refine.

  4. The situation with Marcus-David Peters was tragic. However, there were extenuating circumstances. Mr Peters was found to have unprescribed Ritalin in his body during the autopsy. While that may sound benign I believe Ritalin is a legalized methamphetamine. From Wikipedia … Methylphenidate (the chemical name for Ritalin) can worsen psychosis in people who are psychotic, and in very rare cases it has been associated with the emergence of new psychotic symptoms.

    These mental health workers will have to be clairvoyant. They would have to know how to speak with a psychotic person who has also taken unprescribed Ritalin (in what I imagine to be high dosage). Is it reasonable for anybody to assess a situation like this accurately on the spot?

  5. Yet another balanced and objective article from Dick without a hint of culture war odor… thank you!

    My basic problem is that on a per incident basis – we don’t really know what is going on until a first responder shows up – and we typically send police but they do not do triage – and instead handle the issue as they are trained – as police.

    I think if you sent a mental health professional , first, we’d end up with some of them killed from someone who had mental health issues AND were violent.

    We seem to be hell bent or chewing on this – but I think we still need a top level triage function who then would delegate.

    Even fire and ems will not respond to situations they are trained to do with – until their is safety. I think it would be wrong to send a mental health professional to deal with a deranged person who is a danger to others.

    This is not the same as what happened to Creigh Deeds whose son needed a mental health facility and the system failed to function.

    • As I understand it, there would be a team that would include a police officer that would respond. My nagging question is: What does this team do when they are not responding to a mental health crisis?

      • but even if there is a mental health issue – it does not mean that it is safe for mental health professionals to respond.

        I think we forget that mentally ill people can exhibit all manner of behaviors and some of them are deadly and need to be dealt with by someone who knows how to deal with deadly people.

        No mental health professional is going to wade into an incident with the principle has weapons and is threatening to use them…

        Are we thinking about this clearly?

      • They do the same thing EMS does when there are no calls or fire departments do when there are no fires. Sit at the station and watch tv or play cards. Maybe wash your vehicle.

  6. James Wyatt Whitehead V

    Does the law lay out the standards for a member of a crisis intervention team? Are the standards rigorous enough to qualify effective intervention? After the intervention where do the afflicted go? If I remember right Virginia still lacks mental health facilities to address these needs. Put a few CIT’s on the street and the beds will fill up fast.

    • The law just says “mental health service providers” and “registered peer recovery specialists”. Presumably, DBHDS and DCJS could set some more specific qualifications for the team members. Also, DCJS, in consultation with numerous other agencies, is directed to develop a training program for persons involved in the mobile teams.

      You are correct in asking where the afflicted go. There is a shortage of residential mental health beds. And there are numerous shortcomings for provision of care in the community. That is why the jails have become the de facto facilities for housing the mentally ill.

  7. Comments here have been good, but I might put a finer point on the Marcus-David Peters incident since that is what likely prompted the proposal.

    Even if money, training and certified personnel were not issues, it would not have changed the outcome for Marcus-David Peters. Even with 20 strategically located teams throughout the city, with the team already sitting in cars and the engines running would not have made any difference. They would not have arrived in time.

    The officer did the best he could in that very difficult situation. Had Mr. Peters overpowered the officer and taken his weapon, a much larger tragedy might have occured. The officer could not risk the potential of a mentally disturbed individual in a highly volatile state on the loose in a populated area with his service weapon. Some may not want to hear that, but it’s the truth.

    What might have helped in that situation?

    1. A more reliable less-lethal force option might have helped. The officer used the option he had, but to no avail. Research should continue in this area.

    2. I believe I have read in FBI charts that the majority of officer involved deaths occur when there is only one officer on the scene. (It would take time to find that reference.) The officer’s legitimate perception of danger is influenced by not having backup. We need more police officers, not fewer to potentially save lives.

    • Baconator with extra cheese

      I have said the same thing about solo officers. If officers had partners I would expect some of the fear, and thus overreaction, factor to go down and hopefully cooler heads will prevail in the few, statistically speaking, controversial interactions.
      But the vocal public seems to be asking for a solution that may not exist in reality, other than police becoming detectives after crimes have been committed.
      What woukd have happened if police stood down while Marcus ran onto 95 and either got ran over or even worse caused a car wreck killing someone else? The public would have equally called for that officer’s head. Even without Marcus charging him, which he did, that officer was in a no win situation that put multiple innocent parties at risk. I am guessing this new “policing” with mental health professionals will also put the general public at risk at times (including children during domestic calls). There needs to be some honest public discussion about that fact before politicians move forward without telling the public the potential consequences. I can also imagine the cops will avoid any physical confrontations and just call the social worker in to “talk them down”.

    • Police cars have two front seats. They could spend the extra money to have two police officers per car. Some places do that.

  8. This reminds me of when I was in college studying political science and related disciplines. Everything can be fixed with a law or regulation.

    This is very different from Fairfax County’s Diversion First program that uses alternatives to incarceration for people with mental illness, co-occurring substance use disorders and/or developmental disabilities, who come into contact with the criminal justice system for low level offenses. That program, which starts after arrest, shows good promise. But deciding who to send to a dangerous situation based on a law is just stupid and bound to cost lives.

    • “Everything can be fixed with a law or regulation.”

      And who will be enforcing these laws and regulations? Won’t law enforcement officers be let go after we “defund the police?” Won’t the remaining officers be most concerned about avoiding jail time themselves for failing to live up to the superhuman expectations we have for them?

  9. Given the Ritalin angle, how is this tragic event different from the whisky drunk who goes on a rampage? I see no difference.

    Does race here make a difference? Apparently so to some. Why?

    I fear we think too much.

    • Baconator with extra cheese

      It’s not any different if the whisky drunk says he’s going to kill you, then charges, and the taser didn’t work.

      • I agree, Baconator.

        Plus I fear to some people this is all about the guy being black, and a policeman protecting himself and the public. So unfortunately for those folks, it is not about a rather typical but tragic event for all involved. Sorry to disappoint Larry, but what it is really about is a Culture War going on in America, driven by race and false claims against a policeman doing his job to protect us all, all of it ginned up in the biased minds of some.

  10. The Peter’s case is tragic but perhaps not the best example to work with, because it seems the officer did the best he could under the circumstances.

    We are more worried about minor cases that needlessly escalate. I agree mental health training is good, but in general, we need more understanding that normal human behavior can be a wide range of responses: upon seeing the cops lights flashing, one person might pull his car over in a different location than another person, and that difference in behavior should not be a red flag to the officer.

    There needs to be acceptance of a range of human behaviors, or if there cannot be acceptance, then there needs to be clear pronouncements to the public of what behavior will result in escalation. In other words, we also need to train the public how the cops are expecting people to act, so we can avoid making the officer angry by not behaving as expected.

  11. If police show up and someone is down with an injury – they call for EMS.

    If there is a fire – they’ll call the Fire Dept.

    If there is a hostage situation, they’ll call SWAT.

    If a traffic pole is down, they’ll call the electric company

    If a traffic signal is not working, they’ll call the DOT.

    If a child is missing – they’ll call search teams

    Sometimes “dispatch” from a 911 call can try to figure out what to dispatch.

    But when a 911 call comes in about someone waving a knife on a street corner – you don’t call the mental health folks first..

    When a policeman – or multiple police are handling a situation where they don’t know the status of the person they’re dealing with – i.e. he could be a stone-cold killer or he might be mentally messed up.. you need a policeman there not a mental health person – at least on the front end of it.

    I’ll not agree with the one-police person problem. Don’t send one police if that leads to fear and innocents killed – no more than you’d send one or more police to some guy holed up with a machine gun picking people off.

    When we kill people, by mistake, we tend to make excuses for it.

    If the same kind of killing happens over and over – with different cops – then something needs to be looked at in terms of training and procedures.

    When “mistake” killings keep happening on video… you better do something… excuses won’t work.

  12. not perfection , but not repeated patterns either especially when they are caught on video and the police have no explanation other than excuses.

    Medical professional do not kill people because an interaction “escalated” and they had to shoot you – big difference.

    If a particular doctor, or a drug or a hospital have a repeated pattern of people dying – they usually are held accountable also. Doctors can and do lose their licenses when the same mistake if made over and over.

    • So let’s examine the implications of what you just said.

      If a doctor has a “repeated pattern” of mistakes and killing people, he or she may lose his or her license. If a police officer makes a single mistake, with no malicious intent, he or she goes to jail?

      There are about 1,000 police shootings per year in the U.S. that result in death. A fraction are controversial, and a smaller number still are confirmed to be violations of the law.

      Between 250,000 and 440,000 people die from medical mistakes per year, and we’re burning down our cities because of law enforcement?

      Your analysis, such as it is, is based on selective promotion of specific incidents. It is not data driven.

      The rioters in Richmond were motivated in part by what happened to Marcus-David Peters, which has been discussed at some length in this thread. Additionally, there are repeated calls for the officer involved in that shooting to face jail time.

      All in the name of “justice.” I think not.

    • When a surgeon operates on someone, the tool in his or her hand may save a live or take one. If something goes wrong and the surgeon panics, it may end up being the later. It takes a special individual to handle that pressure. Not everyone is well suited, but that doesn’t make them Jack the Ripper.

      Police officers carry firearms because that is a tool of their trade. The intent is that they use the firearm only when necessary, and to save lives. It doesn’t always work out that way. Sometimes people make mistakes in the heat of the moment. Sometimes they panic. It takes a special individual to do this job well. Some people may not be suited for it. Only when malice can be proven, or in cases of extreme negligence should they face jail time. I support a national database of removed officers.

      There is a perception that horrific mistakes only happen to minorities. That’s a perception based primarily on the selective promotion of some incidents over others. It’s not true. Here’s an example.

      The victim in this video was not a minority and not breaking the law. The police banged on his door because of a noise complaint. Most likely it was that very noise inside the apartment that prevented him from hearing what the police officer said when he knocked.

      The victim didn’t know there were police officers at his door. He brought a gun with him to answer the door, and was shot by police. The shooting was not justified as revealed in other videos. The victim was kneeling down to drop his weapon at the time of the shooting. I believe the police officer on the other side of the door panicked and shot prematurely. I don’t think he intended to kill an innocent citizen, but he did, and will face the consequences.

      This incident is fully as horrific as any involving a minority, but it isn’t discussed much outside of AZ.

  13. James Wyatt Whitehead V

    What happened to Officer Michael Nyantakyi? I remember he was cleared and the ruling was he acted justifiably. How have things turned out for him? What does RPD do to help the officer deal with the aftermath of the Peters tragedy? I have watched the body cam video and it is clear that the last thing Nyantakyi wanted to do was open fire but what else could be done in that moment? Many mourn for Peters but who mourns for Nyantakyi?

  14. See, here’s the thing, Police are not supposed to kill people , not even injure them. They’re trained to do that even when they arrest violent folks.

    When we say they _only_ killed a “few” by “mistake” – it’s not like Doctors who start out with people already sick or dying and in the process screw up. Many, many people are also actually saved from death by Doctors. I think we’re comparing apples and oranges here.

    The big issue with police is escalation, the how and why a stop with a healthy person – ends up with him being dead – and on camera – it does not look like the police had “no choice”. One can see if they had drawn a gun or were swinging a bat, etc.. obviously violent intentions…

    And it’s on camera – and people wonder how it went so bad so quick and someone ended up dead.

    It’s very, very inadequate to say that a “few mistakes” have been made and as a result a “few” people died at the hands of police.

    And typically the police try to say it was something about the person who got killed, it was them who caused it. But the cameras don’t bear it out.

    That he would not “comply” – like FLoyd… or that the police felt threatened and had to use deadly force (as they have been “trained” to do).

    You cannot do this – over and over – and have it on Camera – without a lot of bad reaction following it. It’s just unacceptable.

    We have to change so that this kind of thing is extremely rare – almost unheard of – not a common occurrence where the police defend it and people of color become even more convinced that something is wrong.

    • James Wyatt Whitehead V

      It looks like we are going to find out with Virginia police reform bills. I hope it does some good. I would like to think that your idea of a rare occurrence becomes a reality one day. But based on what I saw in Wisconsin I don’t think that day is anywhere on the near horizon.

    • LarrytheG – That’s a rant, not a study, not data and not particularly helpful.

      “The portion of U.S. residents age 16 or older who had contact with the police in the preceding 12 months declined from 26% in 2011 to 21% in 2015, a drop of more than 9 million people (from 62.9 million to 53.5 million).”

      https://www.bjs.gov/index.cfm?ty=pbdetail&iid=6406

      The 53.5 million is a stale figure, but it presents a likely order of magnitude for today. How many incidents from that number would constitute “rare?”

      • Keep in mind, the figure above is a count of the individuals 16 or older who have had encounters with Police within the last 12 months. The actual number of police encounters is much larger, since some people have more than one encounter within a given year.

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