Police face choice of handcuffs or helping hand for mentally ill

Jason Stivers, diagnosed with bipolar disorder in 2009, said he's been hospitalized at least 15 times. He's had good and bad experiences with police officers.

Photo by Grace Donnelly

Jason Stivers, diagnosed with bipolar disorder in 2009, said he's been hospitalized at least 15 times. He's had good and bad experiences with police officers.

Lena Coleman ran into the bathroom of her West Pullman home to escape her attacker, who was ranting about Satan. The 69-year-old locked the door, climbed out the window and fled to a neighbor’s house where she called 911. Police came looking for the attacker – her son, Phillip. He had experienced a psychotic breakdown.

The evening of Dec. 12, 2012, was the last time Coleman and her husband Percy saw their son alive. Phillip, 38, was pronounced dead at Roseland Community Hospital the next day. Police allege that he was combative, so they tased him several times before and after he arrived at the hospital, according to the family’s lawyer. The Colemans have sued the city and 14 police officers.

Police insist that Phillip’s death was caused by an allergic reaction to a sedative given to him at the hospital, not officers’ actions, according to court documents. His family claims that excessive use of force, denial of medical care and poor police training caused Phillip’s demise.

Like thousands of stories involving people living with mental illness, Phillip Coleman’s story started with a call for help.

In 2014, about 22,000 of the 5 million calls to 911 in Chicago were classified as mental health related, according to the city’s Office of Emergency Management and Communications. As the first responders to 911 calls, police officers often act as “street-corner psychiatrists.” They hold the power to prescribe a jail cell or a hospital bed for people living with mental illness.

Yet the overwhelming majority of police officers don’t have the training to handle these calls. About 14 percent of the Chicago Police Department’s nearly 12,000 sworn officers has had specialized training to work with mentally ill people. The personnel count is based on 2013 figures from the Chicago Police Pension Fund and estimates from the Police Department.

Encounters between police and people with mental illness are a citywide concern. But the issue affects communities of color the most. Only 34 percent of trained officers are stationed in districts that fielded the most mental health calls. Seven of those 10 districts were in predominantly African-American and Latino communities; most are in so-called “mental health deserts,” which experts say contributes to the high number of blacks and Latinos in Cook County Jail and in prison.

“Right now, we’re more willing to build prisons and jails than we are to provide services to people with mental illness. This disproportionately affects poor people and minorities, and people who don’t have families who can help provide care,” said Linda Teplin, a mental health researcher at Northwestern University who helped coin the term “street-corner psychiatrists.”

The problem is rooted in a patchwork mental health care system that has been failing for decades and has resulted in the criminalization of mental illness. As long as police are first responders, advocates say they need to be properly trained.

More important, they say the city, which has shuttered half a dozen neighborhood mental health clinics, needs a plan for shoring up the mental health safety net. In the absence of a plan, thousands of people continue to cycle through an overcrowded Cook County Jail — or in the worst case scenarios, die at the hands of police.

Command and control

Phillip Coleman’s story illustrates why experts and advocates want officers to be trained to defuse mental health crises with the least force possible and connect people to treatment.

“They’re not always thinking to themselves, ‘Oh, I’d better stop doing what I’m doing because this officer is pointing a gun at me and telling me to stop or he’ll shoot,” said Kelli Canada, a researcher who has studied Chicago’s Crisis Intervention Team training program, known as CIT.

An encounter with a CIT-trained police officer can help people receive treatment, potentially stopping the cycle from arrest to court to incarceration.

CIT officers are better at linking people to services and less likely to use force than non-trained officers, according to research by Amy Watson, an associate professor at the Jane Addams College of Social Work at the University of Illinois at Chicago.

If only more Chicago police were trained, advocates say.

As of January, not one officer working the first or midnight shift in the 5th District – which covers West Pullman, where Phillip Coleman’s parents live – was CIT-trained, according to police data. None of the officers who responded to Lena Coleman’s call was trained at the time, police records show.

In October 2004, Chicago police adopted CIT training, which is based on a program created in Memphis in 1988. The training teaches officers how to recognize mental illness, how to interact with people in crisis and how to de-escalate situations involving a person who needs psychiatric evaluation.

The Chicago Police Department works with the local chapter of the National Alliance on Mental Illness (NAMI), which helped develop the training. That includes role-playing with method actors who have been diagnosed with mental illness.

Elizabeth Rahuba is one of the actors. Rahuba, 60, has been “fake tased” a few times while role-playing.

While most officers at the trainings are spot on, she said, others find it hard to override their prior training, which emphasizes controlling and containing situations quickly. CIT training attempts to help police modify what they have been taught to do on the streets.

“It’s so ingrained in their training of command and control that it’s harder for them to switch gears,” Rahuba said.

But Watson said police training is only one aspect of improving how the city responds to people with mental illness. The public health system fails many people with mental illness, she said. Finding treatment for a person, especially in the mental health deserts on the South and West sides, can be time consuming, and jail is often an easier choice for police.

“What other options are there for cops in these encounters?” Watson asked. “Because it’s not just a police problem. Whatever we do from the police end is sort of like patching up somebody else’s problem.”

The importance of training

In summer 2010, Jason Stivers walked into his mother’s South Loop beauty parlor and started screaming at her. He used “every name in the book,” said his mother, Rhonda Stivers. When his father showed up, Jason, who had been diagnosed with bipolar disorder, argued with him over money then attacked him. His parents begged him to admit himself to a hospital for treatment.

Jason refused to leave the beauty parlor.

When eight police officers responded to Rhonda Stivers’ 911 call, Jason became more agitated and fought them. She said the officers tased him before taking him to a hospital.

Rhonda Stivers doubts if the officers who responded to her 911 call were trained in crisis intervention. “There are a lot of times, even when we ask [911] for CIT officers, that they don’t have them,” said Stivers, who shares her experience with police during training sessions. “There are just not enough of them trained.”

Jason, 28, has been hospitalized at least 15 times since being diagnosed with bipolar disorder in 2009, he said. He’s had good and bad experiences with the police and believes that CIT training can make a difference.

In February, police were called to a sober living house on the city’s South Side where Jason was staying after he got into a heated argument with another resident. When a trained police officer showed up and asked him nicely to come with him to a hospital, Jason complied.

But not long after arriving at the hospital, Jason slipped away. In a manic state, he walked the streets until he saw a man who he thought had tried to rob him a few years earlier. He attacked the man, who flagged police for help.

Rather than arresting Jason, the two police officers ran a background check on him and discovered that he was missing from the hospital.

“Then they took me to the hospital and they took me out of the cuffs and told me to just walk in the hospital,” he said. “They were trained. It wasn’t like in the past where they had to use physical force.”

After so many encounters with police, Jason considers himself lucky.

“I could have a bullet hole,” he said, “or I could have a felony.”

Who should be trained?

More than a decade after the Chicago Police Department launched the CIT program, fewer than one in five on the force has completed the training. It’s a voluntary program for CPD personnel.

Seventy percent of the trained officers are assigned to districts, however, many of them don’t respond to 911 calls because of the nature of their jobs.

Rhonda Stivers’ concern about the number of CIT-trained officers speaks to a debate within law enforcement and mental health circles: Should all police officers be trained to handle mentally ill people or should there be a specialty unit?

“Ideally, I wish every officer could go through the training,” said Alexa James, executive director of Chicago NAMI. “But I know not every officer is up to it.”

The community organizing group ONE Northside wants every department employee trained.

But, last fall, after months of pushing for mandatory training, the advocacy group accepted the Police Department’s pledge to double the number of officers – from 200 to 400 who complete the CIT course each year.

At that rate, it will take years to train even half the force.

“I think it’s a matter of priorities,” said Fred Kinsey, a member of ONE Northside and senior pastor at Unity Lutheran Church in Edgewater. “This is the kind of training everybody needs, this is something all police officers need to know. They’re the first responders in our society, for better or worse.”

But some mental health experts don’t want everyone trained.

It’s difficult to change the attitude of an officer who’s not interested in the subject or thinks the mentally ill should be locked up, said Suzanne Andriukaitis, the former executive director of NAMI of Greater Chicago who helped create and run the department’s CIT course before retiring last year.

She’s not concerned about the percentage of the department that has completed the training. “What is important is that they have CIT officers trained on all shifts and in all districts.”

But police personnel who’ve completed the course say there aren’t enough CIT-trained officers on many shifts, especially on the South and West Sides. “I would love for every cop to go through it,” said one officer who’s not being identified because CPD did not give him permission to be interviewed.

Another officer said it’s the “macho” guys who think they know how to respond to every situation who would benefit from the course. But they’re not likely to undergo training because it’s not required, and they don’t think they need it.

Arthur J. Lurigio, professor of criminal justice and psychology at Loyola University Chicago, said it’s appalling that most of the Chicago Police Department is not trained to handle Code Z, or “mental” calls, as they’re still sometimes called over the dispatch.

“We really need more CIT presence on the West and South sides,” said Lurigio, who’s studied the effectiveness of CIT programs. “Given the size of the city, the numbers of people with severe mental illness in the city, given the manner in which police encounters with people with mental illness can quickly escalate into situations that demand arrest. I really think we need more CIT officers in every area.”

The 7th Police District, which covers Englewood, West Englewood and a small part of Greater Grand Crossing, had the third-largest number of mental-health related 911 calls in 2014.

Photo by Grace Donnelly

The 7th Police District, which covers Englewood, had the third-largest number of mental health-related 911 calls in 2014.

The department’s No. 2 cop said as much last year when testifying before Congress.

“Because no more than 20 percent of our patrol officers are CIT-trained, less than a majority of mental health-related calls were responded to by a CIT-trained officer,” First Deputy Superintendent Al Wysinger told members of a U.S. Senate committee examining how law enforcement deals with disabled Americans.

He warned during his April 2014 testimony that police and the public are at risk if officers don’t have CIT training.

Wysinger told U.S. senators his department needs more CIT-trained officers, which would help decrease burnout among the officers handling these “particularly challenging” calls. The department did not make him available for an interview.

One way to increase those numbers would be to require the training. Jeff Murphy, the Chicago Police official who launched CIT in 2004, opposes the idea.

“CIT should be voluntary, it should be limited,” says Murphy, who oversaw the department’s program until retiring in 2010 after 40 years on the force.

If you train everyone, then officers won’t develop enough expertise to handle these kinds of situations. “You need to practice it.”

And he doesn’t think the answer is giving this specialized training to all recruits going through the Police Academy, as some experts recommend.

Officers need more experience and context before they can benefit from the information, Murphy says.

Whenever officers receive the training, one major challenge is counteracting the “command and control – do as I say or else” mindset police are steeped in, Murphy said.

“Most of the time the tactical response usually is not called for, but that’s what usually happens” when an untrained officer responds to a call involving someone who’s mentally ill, he said.

“It’s like gasoline on a fire,” he said. “It’s amazing how fast things can spin out of control.”

That’s why specially trained officers with a lot of experience handling such situations should be called on, Murphy said, adding: “There are officers who should never handle a mental health call.”

That doesn’t make sense to criminologist Tracy Siska.

“I don’t understand why you wouldn’t train everybody,” said Siska, executive director of the Chicago Justice Project, and a visiting professor at the University of St. Francis.

He suspects it comes down to dollars; city officials don’t want to spend the money to train more officers, Tracy said.

If the city won’t make CIT training mandatory, Siska suggests officers get paid extra for completing it, similar to Chicago Fire Department personnel who receive a pay bump for undergoing scuba training. Siska said 80 percent of the department is scuba-trained.

The Police Department deserves credit for implementing the program, said the man who created the nation’s first CIT program in 1988 in Memphis after police shot to death a mentally ill man.

“You do have to praise Chicago for doing it,” said Sam Cochran, who retired from law enforcement and now teaches at the University of Memphis and serves as co-chair of CIT International Inc.

But he questions whether Chicago officials are committed enough.

“That chief has got to set the tone,” Cochran said, referring to Superintendent Garry McCarthy.

The department’s CIT coordinator — one of three people who work for CIT full time, down from nine just a few years ago — needs to have “direct access to the chief,” Cochran said. That was the case when Chicago’s program was first launched.

Cochran said three people isn’t enough to handle CIT training, and there needs to be “a significant number of CIT-trained officers on each shift” – enough for at least one CIT-trained officer to be dispatched on each of the thousands of calls received each year.

There also should be a CIT-oversight committee regularly assessing how well the system works, Cochran said.

“They’re doing the best they can, but give them another 10 years and see what they can do.”

Looking for solutions

Cook County is considering a pilot program for a community-based crisis triage center to give police more options for handling people with mental illness, said Lanetta Haynes Turner, executive director of the Cook County Justice Advisory Council.

Mental health professionals would work with low-level offenders like shoplifters, loiterers, trespassers and drug users, Turner said. In many cases, these are people who self-medicate in an attempt to silence their mental anguish and commit crimes of survival. People could receive treatment for drug abuse, mental health services, emergency care or a bed for a couple days.

The county is looking at examples in cities across the country, including Reno, Nevada, and New York.

“There are a lot of models, but the idea is that as the police officer first encounters those individuals, they can make the decision about whether or not to arrest them,” Turner said. “They can give them the option: Either you go to this drop-off center voluntarily or we will have to lock you up.”

The city and county could save a lot of money, she said. It cost $143 a day to house someone at the Cook County Jail, and even more for a person living with mental illness. The city saves Police Department resources because officers don’t have to arrest and process somebody or pay overtime, especially for hospital transports related to mental health calls. The county courts save by reducing the caseload for the low-level offenses typically associated with people with mental illness; many of these cases end in dismissal, as The Chicago Reporter revealed in a November 2013 investigation.

Officials are sorting out logistics for the proposed triage center, Turner said.

While the county moves ahead with plans for a center, police need to do a better job of tracking officers’ encounters with people living with mental illness, experts say. All mental health crisis calls are not coded properly, making it difficult to gather accurate data and determine patterns and trends in terms of arrest rates for people with mental illness or use of force against them.

In a statement, police spokesperson Martin Maloney said making all the paperwork electronic and including mental health indicators on all reports related to an encounter would allow the department to track and analyze data connected to mental health calls. He said CPD is working to implement this change but offered no timeline.

It’s also unclear how mentally ill people have fared in the aftermath of the city’s decision to close six mental health clinics in 2012. Judy King of the Community Mental Health Advisory Board argued that the city should assess access to mental health services and how they are being used. There’s a need for better data about how many people stopped using the public health system after the closings and how many people are registered for services but don’t go to their appointments.

“If you look at communities like Englewood or Roseland,” King said, “is the utilization low because there’s low demand or because there’s a lack of outreach … is it related to stigma?”

Treatment should be an option for people living with mental illness, said Jason Stivers, adding that police should stop arresting them for minor, nonviolent offenses.

“If they need detox, detox. If they need rehabilitation services, rehabilitation services; inpatient, outpatient, whatever,” Jason said. “But that should be first, before you decide to throw them in jail.”

This story was produced as part of the Social Justice News Nexus, an initiative at Northwestern University’s Medill School of Journalism that brings together reporters, community watchdogs and journalism students to cover issues that affect Chicago. Learn more at sjnnchicago.org. The Social Justice News Nexus is supported by the Robert R. McCormick Foundation.