Phoenix Law Enforcement Association

Mental Health is Not a Police Matter

Note: After the recent shooting of a mentally unstable woman who charged Phoenix Police Officers with a claw hammer and the and the inevitable community debate which followed, PLEA Secretary Franklin Marino penned the following article that drives home several relevant points with regards to mental health issues and police use of force. 

I wrote an article In the May-June issue of the Phoenix Law Enforcer, titled “Staffing Shortages = Calls Stacking” and specifically mentioned “A 918 [insane person] transport to Urgent Psychiatric Care (UPC) from the hospital, (which is another article for another issue).” After a Phoenix Police Sergeant was involved in a lethal force encounter during a court-ordered mental health pickup in mid-August, Chief Garcia’s and Mayor Stanton’s knee-jerk reaction to the situation says it’s now time for that article.

According to information from the Department, the Phoenix Police Department does an average of 10 court-ordered mental health pickups per day. In the age of case-managed mental health care, the City of Phoenix has allowed a situation to develop whereby the Phoenix Police Department has become the de-facto taxi service for the multi-million dollar corporation tasked with providing mental health care for Arizona’s mentally ill population. Many of these people either can’t afford to pay for their own care or don’t have mental health care benefits as part of their current insurance plan. Everyone in Patrol knows the drill; a mental health pick up order has been received and faxed over, respond to such and such location, contact so and so, and take them to the UPC facility at 903 North 3rd Street (not that I’ve been there a few times) or the one at 99th Avenue and Peoria because radio has received a court order signed by a judge saying so and so is a danger to themselves and others and needs to be brought in for a psychiatric evaluation.

Having spent over 19 years in Patrol and having done hundreds of these pickups myself during my career, I feel safe in declaring that the vast majority are low-risk contacts and in many cases, the mere presence of a uniformed police officer does nothing more than agitate the person being picked up. Let me throw out a disclaimer here. I am not in any way a mental health care expert however, I completed Crisis Intervention Training [CIT] several years ago, which included:

  • One-on-one dialogue with actual mental health care patients diagnosed with various disorders (we weren’t aware of it until after they provided what I believe is some of the best instruction I have ever received in a classroom setting)
  • Knowing the symptoms and behaviors associated with the most common mental illnesses including:
  • Manic-Depression or Bipolar Disorder
  • Schizophrenia
  • Depression
  • Multiple Personality Disorder
  • Wearing headphones and listening to an audio recording simulating what a paranoid schizophrenic experiences when hearing “voices” which actually creeped me out and had me ready to yank the headphones off after the first 2 minutes
  • Learning how to de-escalate and communicate with a person in crisis (experiencing a mental health episode)
  • A field problem where we had to diffuse a potentially life threatening situation by using all the resources we learned over the duration of the course.

Keep in mind that this was a 40-hour course involving lecture, interaction, video and audio presentations, as well as a practical exercise to put it all together. I’ve also been through another course regarding how to respond to Military Veterans experiencing Post Traumatic Stress Disorder [PTSD] episodes along with special techniques to implement during those calls. CIT wasn’t a two hour “shake and bake” training session thrown together in haste so the Department could say all of Patrol had been through mental health training.

Side note here; we only have enough money to buy just enough ammunition to do the bare minimum on firearms training and regular in-service training has also been trimmed to the bare bones minimum, but now all of a sudden we apparently have money and time to run the whole department through mental health training?

It’s bad enough any time the police have to intervene in someone’s life when there is the potential for a “fight or flight” reaction. However, for a person with mental illness, that reaction is multiplied due to their already distorted perception of reality and things can easily escalate to a use of force incident. Unfortunately, this occurred with the recent incident involving a 50 year old woman that culminated in deadly force having to be used to control the situation. Having the misfortune of being diagnosed as mentally ill is not a crime; it is a medical/psychiatric issue, so the $64,000 question is, “Why are the police doing what trained medical personnel should be doing?”

I’m sure the answer is a complex one, but I think most Patrol officers including myself believe it’s because the Phoenix Police Department doesn’t know how to say “no” to those types of calls that clearly should be handled by other outside entities. If these outside entities are on scene and it is determined that there is a clear threat to public safety or a crime has been or is about to be committed, then by all means call the police.

While CIT training can help in these situations, like anything we carry in our proverbial toolbox, it is just that; a tool and not a guarantee that the situation will be peacefully resolved. For that matter, a trained mental health specialist such as a psychologist or a psychiatrist could respond to one of these calls and there’s no guarantee the situation will end peacefully. A mentally ill person who appears calm on initial contact can cross the tipping point by the most innocuous things such as an off handed comment, certain colors, behaviors, or even a certain body posture to name a few. When the behavior flips, which can happen without warning, a person can find themselves in the fight of their life. When this happens, the fact that one has Dr. before their name or PhD after it, or wears a badge and a gun means nothing to the person with the mental issue at that point in time.

It’s for these very reasons that police are often called to handle these types of situations. The subject is considered to be a danger to themselves and others. My usual line of logic in dealing with these pickups, particularly when we’re taking them from a hospital setting is, to first let them know:

• They are not in trouble with the police
• I am here because a judge signed an order saying they needed to be picked up
• I have more important things to do, but can’t leave or walk away without them
• They are not under arrest, but Department policy requires me to handcuff them
• I am merely a taxi service taking to them to their next destination
• And last but not least, I hope that all of the above points have sunk in and made sense to whoever I’m dealing with

Thankfully, the majority of the pickups I’ve done in my career have been resolved with no force other than placing the person in handcuffs. There have been a few where it was a knockdown, drag-out fight involving multiple officers before we were able to get the subject restrained for transport and they had to be sedated and four-pointed once we got them to the UPC.

While it wasn’t a mental health pick up call, just a few months ago another Police Sergeant responded on a call from a parent regarding their adult son who had mental health issues that was acting delusional. The sergeant arrived and despite his best efforts, the situation rapidly deteriorated to a physical fight. Due to staffing shortages, his back up had to roll from Sky Harbor Airport. After backup arrived, the Sergeant and the additional officer continued to struggle with the deranged young man till both officers were at the point of physical exhaustion and lethal force had to be employed for their protection. In this case the young man was making an attempt to go for the Sergeant’s handgun.

Since the vast majority of these calls are uneventful, my suggestion would be that we go back to the days of “the nice young men in their clean white coats” and have medical and mental health specialists do the pickups and call us in the event they need police assistance, instead of vice-versa. The Department could consider offering them some basic defensive tactics training and they could be equipped with pepper spray, Tasers and handcuffs. The same could probably be done with the thousands of other mental health related calls we get each year such as checking welfare on someone because they’ve called the crisis line and threatened to hurt themselves for the hundredth time. While hot calls, priority 2 calls, and backups go un-answered, we often wait outside a residence for what can be hours for a crisis team to respond, when a crisis team should have responded in the first place, then called us if they felt that the situation was going to deteriorate and required police intervention.

In those rare instances where the situation does deteriorate it is truly frustrating having to deal with a public that doesn’t understand the true dangers of these types of calls and how they can turn deadly in the blink of an eye. That very same public will be the first to engage in “Monday morning quarter-backing” for weeks on end as they try the cops in the court of public opinion. These are the same folks who all of sudden become police use-of-force experts and will pontificate ad-nauseam from the comfort of their living rooms on how the cops should have handled things. Recently, a person called into a local talk radio show and stated: “Any cop that can’t disarm a 50-year-old woman with a hammer should get the hell off the force.” He went on to say; “the cop needs to get proper training or get the hell off the force.” This was a person that was clearly venting from a purely emotional perspective and of course there were no suggestions from him on what this “proper training” should be.

Here’s an idea: let’s get this guy and anyone else who holds this opinion and bring them down to the Academy for about four hours of Red-Man training. I think we could find some petite female officers who would be more than willing to suit up and play the role of the attacker. The citizens would be given protective gear and a helmet and we would put the female officers/role-players in Red-Man gear and give them a rubber mallet. We could then videotape the training so these self-professed experts could show all of us how to disarm a 50-year-old woman with a hammer. I’m sure that after getting tuned up a few times these folks would quickly see the light and probably change their viewpoint.

On the one hand I guess we should be flattered that citizens see all cops as Kung-Fu Ninja Masters with near magical skills. That same citizen that called the talk show might be surprised to know there actually is training to disarm a person with a claw hammer. The solution to any threat where serious physical injury or death is imminent is two rounds center mass. We aren’t trained or paid to engage in hand-to-hand combat with people that are attacking us with any type of weapon, be it blunt instrument, edged weapon or firearm. The bottom line is that we don’t meet lethal force with less lethal and, if less lethal force options are available, they are always backed up with lethal.

Until things change, we will still have to respond to these calls, so don’t advise, rely on your communication skills, CIT trained colleagues, and above all, don’t hesitate to do what you need to do to protect yourself or others in the event the situation goes sideways because thoughts of political ramifications cross your mind. Stay safe!