HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Thursday, September 11, 2014

Guest Blogger Assistant Professor Kelly Dineen: Mentally Ill While Black

DineenThe St. Louis Police Department (SLPD), which is geographically and jurisdictionally distinct from Ferguson and St. Louis County, has a relatively new chief of police who, in the wake of the events in Ferguson, acknowledged the legitimacy of citizens’ concerns about police interactions and a commitment to restoring communication and trust. Chief Dotson has consistently embraced a progressive stance on police operations, even in the face of strong resistance to maintain the status quo. Less than two months ago, he welcomed the new SLPD headquarters by emphasizing the value of modernizing the department’s infrastructure and practices. His repeated message: “It costs more to live in the past, than it does to invest in the future.”

We saw the cost of living in the past in Ferguson last month as people retreated to old ideas about race, difference, blame, and responsibility. For years these realities led parents of young black men to have “the conversation” warning them to behave especially co-operatively and carefully with police officers; warnings necessary until we abandon past ideas. It is appalling that we still place the burden of safe police-citizen interactions on young, even adolescent men with adolescent judgment. At least there are promising signs of genuine dialogue about the role of race in police practices. 

In contrast, recent events confirm there is little reason for optimism when it comes to the role of mental disability in police practices. It is especially tragic because there is little hope that even “the conversation” can help young people with serious mental illness (SMI). Impaired behavioral control is symptomatic of SMI. People with SMI in crisis are particularly prone to behavior that is erratic, strange, and confusing: the kind of behavior that preceded the recent police shooting of Kajieme Powell.

While tensions ran high in the early days of the nearby Ferguson protests, Mr. Powell had the terrible fortune of being mentally ill while black. He was shot and killed by two SLPD officers August 19 as he paced on the sidewalk talking to himself, reportedly carrying a table knife. While outrage over Brown’s death fueled nationwide protests and compassion, Powell’s death quietly faded after a day of coverage, even after Chief Dotson released video of the shooting and dispatch recordings. Although no one has effectively measured the combined impact of race and mental illness in police use of force incidents, the compounded traits probably exacerbate stigma and bias. Given the general acceptance of the incident as justified in the face of the video that was less than dispositive, I wonder if being mentally ill while black is just too stigmatizing to generate widespread concern.

In fairness, there was some response to the video as disturbing but many declared the use of force legitimate and consistent with training (although there is no official determination by the SLPD yet). The National Justice Center, says legitimate force is the amount “required … to compel compliance by an unwilling subject." But persons with SMI in crisis are not unwilling to comply-they are unable. They may become more agitated, even aggressive when confronted and it’s difficult to respond to aggression by backing up, engaging, and deescalating, particularly without training. It’s instinctual to respond with aggression. This leads to use of force that, though lawful, is avoidable--what David A. Klinger calls “preventable use of force”—use of force preventable by different officer decisions early in the encounter.

Many use of force incidents against people with SMI fall in this category. While they are no more likely to be violent than their well peers, an estimated 50% of all police shootings involve a victim with SMI. To lower these numbers, officers need different tools and different training. Even law enforcement groups including the International Association of Chiefs of Police and the Police Executive Research Forum acknowledge this problem and the need for different training for enhanced safety.

Unfortunately, the SLPD doesn’t require any training for encounters with persons with SMI. Existing voluntary training programs, like Crisis Intervention Training (CIT), demonstrated increased police and citizen safety, fewer arrests and increased community trust. Other small programs like those that pair police and community mental health workers are helping. Even these are incomplete because they rely on identification of a person with a SMI before officers deploy their training. Chief Dotson explained a preventable force incident from April 2014 by saying the officers didn’t know the citizen had SMI before responding. A reactive system I liken to health providers wearing gloves only after an infection is identified: a good start but hardly adequate.

Officers need more than adequate systems for the demands they face. The officers involved are probably haunted by Powell’s death and wish they had different tools at their disposal. One officer was even voluntarily trained in CIT but Powell wasn’t pre-identified with SMI. These problems fundamentally merit more than voluntary, reactive training.

Many have dismissed criticism of the shooting as unfair to the officers, but this is a system failure, not an officer failure. It demeans all officers to suggest they are incapable of using different tools for different situations. They need universal, pro-active training for all officers as well as dispatchers. We owe them the right tools for the problems they face; tools less tangible than firearms. Tools for triage and de-escalation are tools of the future, tools that enhance safety and cost relatively little (CIT cost as little as $175 per officer, far less than the reported $399 for body cameras). So, I ask why aren’t we investing in the future when it costs so much more to live in the past?

-Assistant Professor Kelly Dineen

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