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People with Mental Illness are 16 Times More Likely to Be Killed During a Police Encounter

Before this year, we basically weren’t even able to really provide a very effective number of how many people with mental illness were killed by law enforcement officers. We know, across the country, that people with a mental illness are languishing in jails and emergency rooms, because we simply don’t have enough hospital beds for them.

The shooting of Alfred Olango in El Cajon, California, is just the most recent in a string of police shootings of primarily men of color with mental illness or disability. Just last week, police in Charlotte, North Carolina, shot and killed Keith Scott, a 43-year-old father of seven who reportedly had suffered a traumatic brain injury during a motorcycle accident in 2015. In July, a police officer in North Miami contends he mistakenly shot an African-American behavioral therapist, Charles Kinsey, when he was aiming for Arnaldo Rios Soto, a 26-year-old autistic man. We speak to John Snook, executive director of the Treatment Advocacy Center. He is co-author of a recent study that found people with mental illness are 16 times more likely to be killed during a police encounter than other civilians.


This is a rush transcript. Copy may not be in its final form.

NERMEEN SHAIKH: Well, I want to bring into this conversation John Snook, executive director of the Treatment Advocacy Center. He’s co-author of a recent study that found people with mental illness are 16 times more likely to be killed during a police encounter than other civilians. The report is titled "Overlooked in the Undercounted: The Role of Mental Illness in Fatal Law Enforcement Encounters."

John Snook, welcome to Democracy Now! So can you talk about what happened to Olango in the context of what your report found, the way in which police respond to emergency calls having to do with the mentally ill?

JOHN SNOOK: Sure. This is really the nightmare scenario for families with a loved one who has a mental illness, and for law enforcement themselves. These are the sort of situations that we really work every day to prevent. Unfortunately, this seems to have ended in the worst-case scenario. And as we’ve seen around the country with the data, it happens far too often.

And I think one of the things we need to think about is this idea of: When someone is having a medical emergency, why are we requiring law enforcement to step in? Why don’t we have a mental health system that addresses these folks before these situations happen? And again, we don’t want to be in a situation where we’re having to say, "Law enforcement, you need to address this person’s needs," because they aren’t mental health professionals. They haven’t been trained.

And San Diego has stepped in with a program that’s called PERT. It provides basically for a co-responder, who is a psychiatric professional, to come along on some of these calls. But obviously that didn’t happen in this case, and it can’t happen in every case. So we really need to step back and say, "How do we keep law enforcement from having to be on the front lines to be our mental health responders?" and say, "How do we get mental health professionals more involved in these cases?"

AMY GOODMAN: What’s so frightening here is it sounds like Mr. Olango’s sister did everything right. She called up. She said her brother was having a mental health emergency. She called several times. Not only did they send the police, but they waited 50 minutes. Now, if someone wants to report a mental health emergency, which could save other people, what kind of message is sent when you do this and you simply—basically, the message is sent: If you call to help the mentally ill, we will kill you, or we will kill them.

JOHN SNOOK: Well, I think it’s important to step back. And if you think about mental illness like any other illness, and you said, "This person was having a heart attack. Let’s call the police," we wouldn’t be surprised that bad outcomes happen, because that’s simply not what a police officer is there for. What we need to do is get away from this situation where we wait until someone is in a crisis before we provide care.

I think California has taken some steps, but even as we’ve been talking about this, there’s been a broad discussion in California about misuse of the Prop 63 funds, which are funds that ostensibly were to be provided to mental health. And the Little Hoover Commission just put out another report that said, unfortunately, those funds aren’t being used for mental health in the way that they should be. The tracking isn’t there.

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And that’s what we’re talking about, is these situations, we have far too many people ending up not getting care until they’re in a crisis, and then we wonder why bad outcomes happen. And, unfortunately, that’s the case across the country. We simply have too many people in crisis, law enforcement trying to do their best in the worst-case scenarios, and that’s when these sort of tragedies occur.

AMY GOODMAN: We are now talking about, according to the figures in Mapping Police Violence, Mr. Olango became the 217th black American to be killed by police so far this year. Ultimately, John Snook, the most important recommendation you have at this point, as we see what happened from El Cajon to Tulsa to Charlotte?

JOHN SNOOK: I think it’s quite simple: We have to take mental illness seriously. Before this year, we basically weren’t even able to really provide a very effective number of how many people with mental illness were killed by law enforcement officers. We know, across the country, that people with a mental illness are languishing in jails and emergency rooms, because we simply don’t have enough hospital beds for them. We simply aren’t taking mental illness seriously.

Finally, we’re starting to see some movement. There’s a bill on the Hill that’s waiting for Senate action that would address these sorts of incidents, these issues with the most severely mentally ill, provide additional funding for police training, provide care for folks before they get to this point. Unfortunately, that’s still sitting in Congress. That’s the sort of thing that we need done. We need to have people recognize that this is a crisis that our nation is facing, and, unless we do more, we’re going to keep having these sort of incidents happen.

AMY GOODMAN: John Snook, we want to thank you for being with us, of the Treatment Advocacy Center, joining us from Washington. Dan Gilleon, attorney for the family of Alfred Olango, the unarmed African-American man who was shot and killed Tuesday by the El Cajon police just outside San Diego, Dan also representing the officer Christine Greer, the plaintiff in a sexual harassment lawsuit against Richard Gonsalves, the officer who killed Mr. Olango. And thank you so much to Christopher Rice-Wilson, associate director at Alliance San Diego.

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Overlooked in the Undercounted: The Role of Mental Illness in Fatal Law Enforcement Encounters.
Executive Summary

An estimated 7.9 million adults in the United States live with a severe mental illness that disorders their thinking. Treatment in most cases can control psychiatric symptoms common to these diseases, but the system that once delivered psychiatric care for them has been systematically dismantled over the last half-century. Today, half the population with these diseases is not taking medication or receiving other care on any given day.

Hundreds of thousands of these men and women live desperate lives. They sleep on the streets, overflow emergency rooms and, increasingly, overwhelm the criminal justice system. Numbering somewhat fewer than 4 in every 100 adults in America, individuals with severe mental illness generate no less than 1 in 10 calls for police service and occupy at least 1 in 5 of America’s prison and jail beds. An estimated 1 in 3 individuals transported to hospital emergency rooms in psychiatric crisis are taken there by police.

Individuals with mental illness also make up a disproportionate number of those killed at the very first step of the criminal justice process: while being approached or stopped by law enforcement in the community. Enormous official and public attention has become focused on the official undercounting of fatal police shootings; barely noted in the uproar has been the role of severe mental illness – a medical condition that, when treated, demonstrably reduces the likelihood of interacting with police or being arrested, much less dying in the process.

By all accounts – official and unofficial – a minimum of 1 in 4 fatal police encounters ends the life of an individual with severe mental illness. At this rate, the risk of being killed during a police incident is 16 times greater for individuals with untreated mental illness than for other civilians approached or stopped by officers (see Methodology). Where official government data regarding police shootings and mental illness have been analyzed – in one U.S. city and several other Western countries – the findings indicate that mental health disorders are a factor in as many as 1 in 2 fatal law enforcement encounters.

Given the prevalence of mental illness in police shootings, reducing encounters between on-duty law enforcement and individuals with the most severe psychiatric diseases may represent the single most immediate, practical strategy for reducing fatal police shootings in the United States. Evidence-based treatment for severe mental illness exists. The disproportionate risk for criminal justice involvement associated with mental illness occurs chiefly among the less than 2% of the adult population with untreated severe mental illness. Treating the untreated is a proven practice for reducing the role of mental illness in all criminal justice involvement, including in deadly law enforcement encounters.
But – in a data- and cost-driven world – making the case to invest in any solution requires reliable data about the scope and nature of the problem to be addressed. Reliable data about fatal law enforcement encounters in general do not exist, much less data about the role of mental illness in them.

Here’s why:

• More than a half-dozen federal databases tasked with tracking and/or reporting the number of fatal law enforcement encounters in the U.S. have been developed in recent decades, but not one exists that produces complete and reliable statistics (see Appendix A: Federal Government Homicide Databases). Underreporting is so endemic that one audit of the government’s efforts concluded “the current data collection process results in a significant underestimation and potentially a biased picture of arrest-related deaths in the United States.” We can learn the average prenatal litter size of a feral cat in America but not the number of civilians killed during encounters with law enforcement.

• Common themes run through the databases’ individual shortcomings: reliance on methods guaranteed to produce incomplete or inconsistent data, lack of centralized oversight to create account ability, insufficient funding. One national database was incomplete by design (Police Use of Deadly Force, 1970-1979); another mandated by Congress but abandoned after a short life (National Data Collection on Police Use of Force Database). None is supplied with universal data (Supplementary Homicide Report, National Violent Death Reporting System and others).

• In the absence of reliable official data, more than a dozen news organizations, nonprofits and individual bloggers are operating independent databases (see Appendix B: Independent Databases Tracking Fatal Law Enforcement Encounters). These coalesce around the probability that approximately 1,000 people die annually in officer-involved shootings – more than double the number any federal agency has ever reported. Because these databases rely on published anecdotes or crowdsourcing, they, too, inevitably understate the actual numbers. And because, like government databases, each uses different methods, they also inevitably arrive at different numbers.

• Despite their limitations, independent databases have proven to be so much more complete and accurate than any government source that a bizarre feedback loop of incomplete information has emerged: Because government agencies themselves lack complete and accurate data on fatal law enforcement encounters, they collect their data from media and other online datasets. But because media and online sources don’t have definitive data from government, they generate incomplete data. Before expanding its methodology to include Google Alerts and other online resources, the Bureau of Justice Statistics (BJS) estimates that its Arrest-Related Deaths (ARD) program captured only half of the fatalities it was created to track. By expanding its methods, the agency reports that completeness has improved but estimates that 31%-41% of likely fatal law enforcement encounters are still not captured.

These gaps pale by comparison with the information void surrounding the role of mental illness in fatal police encounters. The ARD program operated by the BJS is the only federal database that has ever set out to systematically collect and publish mental health information about police homicide victims. It is currently suspended because an audit determined that the available data did not meet the agency’s quality standards.
Among the independent databases, only three – including the Treatment Advocacy Center’s Preventable Tragedies Database – report directly on the role of mental illness in fatal police shootings. In their analyses, both The Washington Post and The Guardian newspapers reported that at least 25% of the fatalities involved individuals with severe mental illness. Official studies in Las Vegas, Nevada, Australia, Canada and the United Kingdom report the prevalence to range from 33% to more than 50%.

Reducing fatal law enforcement shootings of people whose encounters with police are the result of psychiatric disease is in the best interest of the individuals involved and society. The Treatment Advocacy Center makes the following recommendations to foster solutions that will reduce this loss of life and the many social costs associated with it:

• Treat the untreated.
Shifting the responsibility for responding to acutely ill individuals from mental health professionals to police has criminalized mental illness at enormous cost to individuals with the most severe psychiatric diseases, the criminal justice system and society. The mental illness treatment system must be restored sufficiently so those with mental illnesses receive treatment before their actions provoke a police response. Lawmakers need to enact and implement five public policies to achieve these goals:

o Increase the number of treatment beds for individuals suffering from acute or chronic psychiatric conditions.

o Reform treatment laws that erect barriers to treatment for at-risk individuals, including laws that require courts to wait until individuals become violent, suicidal or gravely ill before intervention becomes possible.

o Make full use of laws that provide access to treatment for individuals too ill to seek treatmentfor themselves.

o Expand the use of court-ordered outpatient treatment (assisted outpatient treatment or AOT), assertive community treatment (ACT) and other evidence-based practices that demonstrably reduce the likelihood of individuals with severe mental illness becoming police calls.

o Make treatment funding decisions that consider both the cost of treatment and taxpayersavings that result from providing treatment that reduces criminal justice involvement, homelessness and emergency medical services and other public costs.

• Accurately count and report the number of fatal police encounters.

The U.S. government does not possess a comprehensive, accurate database of fatal police encounters. Factors that contribute to the absence include the lack of reporting requirements that arerealistically funded, the absence of standardized definitions and methods to produce consistentdata, and the lack of centralized oversight. Congress must enact legislation to direct resolutionof these issues and to fund the operation of a reliable federal database of fatal police interactions nationwide.

• Accurately count and report all incidents involving use of deadly force by law enforcement.

Fewer than half of police shootings result in a death. Counting only fatal shootings produces an incomplete picture of the use of deadly force and its attendant impacts, including injury and disability. A system for tracking and incentivizing the reporting of all use of deadly force by law enforcement must be established and maintained.

• Systematically identify the role of mental illness in fatal police shootings.

Severe mental illness is an identifiable factor in at least 25% and as many as 50% of all fatal law enforcement encounters, but its role has been rendered virtually invisible by the failure of the government to track or report its presence. Questions to identify psychiatric factors must be included in the official surveys used to capture data about both fatal and nonfatal police shootings.