2014-01-18

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Policing has improved greatly since 1911, but it has a long way to go.
Photo: Bruce R

70 seconds. That’s what it took to take a defusing situation to a blood-soaked tragedy. What happened?

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This is a headline that is all too familiar to me: “‘We called for help, and they killed my son,’ North Carolina man says.” As in scores of cases across the US, the family of 18-year old Keith Vidal called the police when they ran out of options in the face of a schizophrenic episode, and the incident ended in their son’s death — to add insult to injury, they’d only recently lost their daughter in a car accident.

What happened in this case? Why does this keep happening? And what can we do to make sure it never, ever, happens again?

These stories are so common that I knew exactly what had happened after seeing the headline, before I’d even read about the case: a mentally ill family member had been in severe distress, family members couldn’t see any other option than calling law enforcement for help, and something went horribly wrong. The state of mental health care in this country is such that police officers are being forced into the position of psychiatric first responders, which is unfair to mentally ill people, but it’s also unfair to police, who are often poorly trained, if at all, in dealing with mental health issues.

Police officers are not the ideal people to respond to a psychiatric crisis. That’s not their job, and it shouldn’t be. The fact that they are often forced to respond to situations like this, where someone is threatening violence to himself or others, is a testimony to the serious problems with our mental health system: people aren’t getting the care they need when they need it, we don’t have a good system for handling psychiatric crises, and we’re not providing family members and loved ones with the support they need.

Here’s what happened to Keith Vidal, according to a mixture of information from family and police reports.

Early Sunday afternoon, Keith Vidal, a 5’3″, 90 pound teenager with a history of schizophrenia, began wielding a small screwdriver in a possibly threatening way, making family members nervous about his and their safety. Family members say he had not been taking his medication or taking other steps to manage his mental illness, and they wanted to get him to a psychiatric facility for evaluation and treatment — he had already undergone inpatient treatment, and clearly needed it again.

However, they weren’t able to safely help him to the car so they could transport him. So they called the Boiling Springs Lake police department, which responded with a car at 12:34 PM. Two additional officers from BSLPD followed, as did a sheriff’s deputy from Brunswick County. Now we had officers from two agencies at the scene.

Mentally ill people in crisis can struggle when confronted with a large group of people who appear to be threatening them. Vidal’s history of schizophrenia suggests he may have been having a break with reality, and he could have been experiencing extreme fear and paranoia. The appearance of uniformed officers would undoubtedly have upset him, but his family claims he was talking with law enforcement and they were working together in a charged, but ultimately productive, environment, suggesting that the situation could have been resolved peacefully.

That changed when Unit 104 from the Southport Police Department arrived at 12:48:41. 70 seconds later, the officer radioed dispatch to say that responders had been forced to shoot Vidal in self-defense.

70 seconds. That’s what it took to take a defusing situation to a blood-soaked tragedy. What happened?

Family members claim the officer from Southport entered the room, said “we don’t have time for this. Tase that kid now. Let’s get him out of here.” At least two Tasers were discharged and Keith Vidal ended up on the floor, restrained by two of the officers present. At that point, the family says, the officer from Southport shot their son in the head in front of their horrified eyes, killing him and endangering the officers restraining the young man.

BSLPD and Brunswick County officials have already cleared their officers in the shooting, though they say at least one Taser was discharged, supporting the family report that the Southport officer was the one who pulled the trigger.

A police detective from Southport has been put on leave (it’s not clear if he was the one involved in the shooting, though he probably was), and the prosecutor is investigating the case in response to calls for justice from the family and the community.

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Police recently shot a mentally ill man carrying a shovel after his mother called for help. Dallas police shot (and fortunately didn’t manage to kill) another mentally ill man after his mother called 911 for assistance because he was agitated. Mohamed Bah was shot by police after his mother called for an ambulance. Sean Isensee was shot by police after his parents called for help because he was threatening them.

This is the beginning of a very long list. I think you get the point. When family members and loved ones call 911 for help because someone they care about is in psychiatric crisis, there is a very serious risk that call will have a fatal outcome.

One reason this is happening is because mentally ill people don’t have access to the care they need when they need it. Mental health parity laws and Obamacare are supposed to improve this situation by making it easier to afford care, but they aren’t a perfect solution by any means.Psychiatrists are still less likely than other care providers to accept insurance, presenting a significant barrier to mental health care for low-income mentally ill people (and mental illness is a major factor for poverty).

Those in psychiatric crisis have difficulty accessing beds in treatment facilities and paying for them once they’re there — even under Obamacare, the minimum requirements for insurers are not that great when it comes to inpatient mental health services, considering that they cost thousands of dollars. Meanwhile, states are cutting mental health services left and right.

People in the early stages of crisis or displaying early signs of mental illness often aren’t identified, and don’t get treatment. That means they’re allowed to get much, much worse, with situations devolving to the point where they need immediate emergency care. In such charged situations, a great deal can go wrong — and it would have been prevented by more comprehensive screening and intervention at an earlier stage.

There’s also the fact that family members and loved ones in the United States are often forced to take on caregiving roles against their will. Some mentally ill people cannot work and require assistance with tasks of daily living because of the severity of their illness. Others can navigate the world very well, if they have support in the form of people to help them adhere to medication schedules, treatment plans, and therapy appointments.

Funding for aides, assistants, and live-in care providers is very limited. This forces family members into the position of having to take up these roles or watch their loved ones drown, and creates dangerous situations. Uncompensated family members may struggle with poverty as they’re forced to cut working hours to care for people, while they also don’t get days off, benefits, or relief help, and instead are faced day in and day out with providing care to someone. That can breed resentment and abusive situations.

It can also breed situations where people who are not trained in handling psychiatric situations, and who are too close to the patient to provide objective care, end up calling 911 for help because they’re worried about someone’s safety. Unless a given region has a specialized psychiatric support program (which is very rare), responders usually include police officers — because many areas have a policy that ambulances can’t respond to calls that might be dangerous without law enforcement backup.

When law enforcement officers who aren’t trained in handling psychiatric crises respond, the incident goes downhill rapidly. Mentally ill people may not understand or respond to commands, could be holding objects that might look like or be used as weapons, and could be confused about where they are and what is going on. Since police are trained to prioritize public safety by acting quickly and making snap judgements, they may decide that the most sensible move to make is to “neutralize” the person they’re supposed to help, and they go for the kill shot.

Preventing future police shootings of mentally ill people requires radically reforming our mental health care system, which is unfortunately a topic that only comes up on the rare occasions when mentally ill people kill, not on the common occasions when we are killed. And it requires rethinking the way we handle caregiving, because overloading families with caregiving is a larger political and social issue. Finally, it also requires addressing the shortfalls in law enforcement training so that on the ideally rare occasions that police respond to situations like this, they can neutralize the situation, not the person.

By s.e. smith

 

 

Originally appeared at xoJane

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