The Boston Globe’s infamous Spotlight team recently published an investigation on yet another way people with mental health disorders are underserved and harmed by the criminal justice system: being shot by police. Spotlight uncovered that in Massachusetts, between 2005 and 2015, more than 40 percent of people killed by police were suicidal or showing clear signs of mental illness. One third of all police shootings, about 165 fatal and nonfatal incidents, involved an apparent mental health crisis. At least seven of the 55 people with mental illness shot by police were deemed by the investigation to have committed suicide by cop, meaning provoked police to shoot them with the goal of being killed. In most cases, the families of the victims called the cops themselves. In 10 cases, police were responding to a 911 call by someone whose family member or friend was threatening or attempting suicide, because they had nowhere else to turn.
This investigation is more in-depth than any that has come before, but this problem is not new nor unique to Massachusetts. Maine’s Attorney General reported that between 2000 and 2012, 42 percent of people shot by police, and 58 percent of those who subsequently died, had a mental health diagnosis. A Washington Post analysis showed that one quarter of fatal police shootings in 2015 involved a person who was mentally unstable.
The recent Vera report, First Do No Harm: Policing and Public Health, helps detail why these unfortunate episodes tend to occur, starting with the continued lack of mental health resources for people and the subsequent overreliance on police officers to act as first responders in a crisis. Law enforcement agencies across the country, including those profiled in Massachusetts, are increasingly recognizing the need for increased resources and training to better serve people with mental illness and improve officer safety. Currently, there are over 2600 Crisis Intervention Training (CIT) programs nationwide, where police are trained on the range of psychiatric illnesses they are likely to encounter in the community, how to respond to people experiencing a psychotic or emotional crisis, the range of resources in the community available to people, and the legal standards governing involuntary psychiatric evaluation and hospitalization. However, about 80 percent of police forces around the country have yet to implement CITs. (Other models of law enforcement pair police and clinicians to create co-response teams meant to de-escalate mental health emergencies as they are encountered.)
Despite these more widespread initiatives (which often burgeon after crises occur), more resources are needed. And communities need to focus on alternatives to hospitalization. As the Spotlight investigation uncovered, hospitalization can be traumatic for people experiencing psychiatric crises and turn them off to future care. Drop-off centers, which are a part of the Mayor of New York City’s Task Force on Behavioral Health and Criminal Justice, and Community Respite Centers, of which there are four in New York City through Parachute NYC, are possible alternatives that allow police to bring people in crisis to an actual facility that’s neither a police station nor a hospital. There’s more that can be done for people before mental instability becomes a crisis, like broadening treatment options to engage people in care earlier, and having teams in place that families or community members can call in the event of a developing crisis.
Police are too often called to help people who are at their most vulnerable and don’t think they have anywhere else to turn. For that interaction to end in gunfire or death is deplorable. However, people should not be forced to call police—which can lead to further involvement in the criminal justice system—in order to get care, attention, or support for a sick family member or friend. The police are responsible for fatal and nonfatal shootings the Spotlight team so eloquently describes, but we are all accountable for the failure of community mental health systems to prevent these situations of last resort.