Mental Health And Police Violence: How Crisis Intervention Is Failing Efforts are growing to remove or reduce the role of police in responding to people in a mental health crisis. Critics and proponents alike say a widely adopted program has too often failed.

Mental Health And Police Violence: How Crisis Intervention Teams Are Failing

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Police are often the first responders to people suffering a mental health or substance abuse crisis. Those situations make up an estimated 20% of police calls. Advocates are calling for a fundamental change to how police respond to someone in one of those emergencies. And as NPR's Eric Westervelt reports, departments are reluctant to abandon a widely used program designed to help in these situations, a program that has proven largely ineffective.

ERIC WESTERVELT, BYLINE: In Rochester, N.Y., this past March 23, Daniel Prude was unraveling. A light snow was falling at 3 a.m. when police confronted him. The black 41-year-old was running through the street naked and babbling, suffering a mental breakdown worsened by drug abuse. Officers put a hood over Prude's head, apparently to stop him from spitting at them. Three officers then pinned him to the ground, pressing his face into the pavement for two minutes. He stopped breathing. Prude was taken off life support at a local hospital a week later.


JOSEPH PRUDE: I placed a phone call for my brother to get help, not for my brother to get lynched.

WESTERVELT: Joseph Prude called 911 on his brother that night. Daniel, who was visiting him from Chicago, had already been seen by a local hospital for erratic behavior and suicidal thoughts the previous day. A lawsuit by the Prude family says Daniel was undergoing an acute manic psychotic episode. The Monroe County medical examiner ruled his death a homicide, citing asphyxia due to physical restraint by police, and intoxication from the drug PCP as causes of death.

KRYSTAL SCHULIK: We know what happened that night for Mr. Daniel Prude, and we don't want to say anymore names.

WESTERVELT: Krystal Schulik is a drug and alcohol counselor in Rochester. She and other mental health professionals in the city are trying to change how the police respond to exactly these kinds of crisis calls. Handcuffs and hoods - no. Calm and cool talk - yes.

SCHULIK: Change your tone of voice, your body language, hell, you might have to get on the ground with them, give them eye contact. All of that is so important when de-escalating such a scale of an event. He was not well.

WESTERVELT: Here's the thing - Rochester police, on paper anyway, have a program that aims to de-escalate confrontations with someone in a mental health meltdown, someone just like Daniel Prude. Rochester created one of New York state's first crisis intervention teams, or CITs, in 2004. The crisis intervention team model came out of Memphis, Tenn., in the late 1980s after police shot a mentally ill man in crisis who was also intoxicated. CIT programs soon spread from Memphis to more than 2,700 police departments across the country. But some of those who've helped create the CIT model and do the trainings today say many police and sheriff departments have deeply misunderstood it.

RON BRUNO: All we have to do is give them a little training and send them out there to handle crisis situations. That's the kind of mentality, the thought process, that we have utilized for way, way too long.

WESTERVELT: That's Ron Bruno, a veteran 25-year police officer who is now executive director of Crisis Intervention Team International. The group runs trainings and works to change the dynamic between police and people in a mental health crisis. Bruno says some departments have done it right, but others see CIT training as merely a check-the-box, one-week exercise. And he says the even bigger breakdown - cities too often fail to create a program and integrate it into the wider behavioral mental health care system. Bruno says crisis teams, when done right, aim to take officers out of responding to mental health calls unless absolutely necessary because the person is actively violent.

BRUNO: We need to build community resources that can respond and take care of a crisis without having law enforcement involved. If we build the crisis response system that is non-law enforcement, we will get more people connecting before it hits that level of danger.

WESTERVELT: But today, that's rarely happening. To critics, the way these crisis teams have been built is yet another example of police tinkering with reform but failing to actually make substantive change. And studies show crisis teams are not very effective. An analysis last year in the Journal of the American Academy of Psychiatry and the Law concluded that police crisis intervention teams have helped to reduce arrests of people with a mental illness. But it also concluded the programs too often fail in their fundamental goal to de-escalate and reduce violence. Dr. Renee Binder at UC San Francisco co-authored the study.

RENEE BINDER: It hasn't shown any consistent reduction in the risk of mortality or death during emergency police interactions. So it has not significantly decreased the number of individuals who are killed or injured.

WESTERVELT: Former officer Ron Bruno says the moment is now ripe for departments to examine the real goal of a crisis intervention team - to turn the response over to a specially trained mobile unit. That team can be made up of mental health clinicians, medical professionals and maybe peer support specialists who've been through mental health or drug and alcohol challenges, people who can lend an empathetic ear, de-escalate and channel the person to services, not jail.

BRUNO: All I'm talking about is a non-law enforcement crisis response team. Whatever disciplines you want to make up that team, it works.

WESTERVELT: Only a few cities, including a pioneering program in Eugene, Ore., have created that kind of effective system. Rochester police would not respond to detailed questions about its crisis intervention team or whether any of the officers in the Prude case had any of that training. Last fall, five months before Prude's death, the commander of Rochester's CIT, Sergeant Steve Boily, argued that the program was working well during an interview with local ABC affiliate WHAM. But Sergeant Boily he also conceded that additional training wouldn't always be enough.


STEVE BOILY: Some people are too ill, too angry, too violent that no matter what training, some bad things are going to happen.

WESTERVELT: Some bad things are going to happen now echoes eerily prescient in Rochester where the police chief has been fired, protests continue and where Daniel Prude's family is still demanding answers, changes and justice.

Eric Westervelt, NPR News.

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