DEADLY CONSEQUENCES

With about 15 percent of police trained to deal with the mentally ill, the NYPD grapples with how to respond to pleas for help. A review shows some calls ended in death.

By Anthony Izaguirre

As Dustin Grose recalls how a city police officer’s boot ground his face into the pavement outside his Brooklyn home and how he squirmed as officers hit his prone body, he’s left with one question: “Is it a crime to be diagnosed with a mental illness?”

Grose’s parents called police that January 2007 morning because they wanted their son, diagnosed with bipolar disorder and mild schizophrenia, to take his medicine. But they never imagined the confrontation that would ensue.

A decade later, the New York Police Department still grapples with how to handle the mentally ill. The department responded to more than 120,000 “emotionally disturbed person” calls in 2016 alone.  

Yet despite well-intentioned efforts to improve how police deal with the mentally ill, only about 15 percent of officers are trained to handle such calls, according to a Wall Street Journal report.

Recently departed NYPD Commissioner Bill Bratton told the Daily News police ”have become responsible for treating a host of society’s maladies” – including mental illness. He estimated about 40 percent of police encounters are with the mentally ill.

A NYCity News Service review of news accounts, police reports and lawsuits found at least two dozen shootings, beatings and other violent police encounters with the mentally ill over the last five years.

Some of these cases ended in death.

‘WE FAILED’

In mid-October, a police sergeant fatally shot a 66-year-old mentally ill Bronx woman – leading Police Commissioner James O’Neill to tell reporters, “We failed.”

The shooting death of Deborah Danner also reignited a city-wide conversation on how the police deal with the mentally ill.

A Bronx neighbor called police at about 6 p.m. Oct. 10  to report that Danner was acting irrationally. This wasn’t the first time: Police had responded to similar calls before about Danner, who suffered from schizophrenia.

This time, moments after officers arrived, Danner was shot twice in the stomach. Reports said she charged at officers with a wooden baseball bat.

It is unclear why deadly force was apparently the first measure taken by police.

People in her building told reporters that Danner, who lived alone, often screamed and shouted as if she was arguing with someone.

Danner wrote about coping with her disorder in an essay titled “Living with Schizophrenia.”

“Any chronic illness is a curse,” she wrote. “Schizophrenia is no different – its only ‘saving grace,’ if you will, is that as far as I know it’s not a fatal disease.”

The mayor and the police commissioner called Danner’s killing a mistake. “What is clear in this one instance, we failed,” O’Neill told reporters.

A police union president said the shooting was justified because the victim was wielding a weapon.

A LIST OF DEATHS

More than half of the cases reviewed by the NYCity News Service resulted in death. Nearly all the calls involved an armed mentally ill person who had prior contact with the police.

The list of deaths include Shereese Francis, a 29-year-old schizophrenic woman who was reportedly suffocated by police during an arrest outside her Jamaica, Queens, home in 2012. It includes Denis Reyes, who went into cardiac arrest as he was being hauled into an ambulance after his bipolar symptoms prompted police to go to his Bronx home in 2015. It includes Erickson Gomez Brito, who  battled depression, according to his family. He reportedly swiped an officer’s baton in the hallway of a Brooklyn housing project in 2016 and was shot seven times.  

To be sure, the review is by no means comprehensive. It reflects only a small percentage of overall police interactions with the mentally ill.

While these cases were often covered by local news outlets, there are likely others that did not get media attention. The accounts reviewed by the NYCity News Service and interviews with advocates for the mentally ill suggest these events are not isolated.
The police do not make such figures public and did not respond to requests for data regarding contact with the emotionally disturbed. Even less clear is the role drug abuse may play in exacerbating flare-ups.

High profile confrontations between the police and the mentally ill

‘DON’T RESORT TO VIOLENCE’

Dustin Grose knew his bipolar disorder and mild schizophrenia had frightened his parents. Smoking marijuana did not help his mental condition. He said blood tests would later show marijuana and PCP in his system the morning of his clash with cops.

When the police arrived at 5:15 a.m. on Jan. 13, 2007, Grose said they urged him to go with them to a hospital. He refused, saying he just wanted to stay in his room.

Outside his home, Grose said, an officer punched him in the chest and knocked him to the ground. One cop held a boot on his head while two others struck him repeatedly. When the police handcuffed him and wrapped him in a straitjacket, blood was flowing from Grose’s mouth and nose, he said.

“I was like a criminal outside of my house,” he recalled. “I was sucker-punched, handcuffed, wrapped in a mat and beaten.”

The subdued Grose said he was then “lifted like a luggage,” tossed into an ambulance and taken to Woodhull Hospital. He said he was handcuffed to a bed while an officer questioned him. He was released a few hours later.

Grose filed a lawsuit and received a $17,500 settlement, though police did not admit any wrongdoing. He still questions why he was assaulted and had advice for officers who respond to the emotionally disturbed: “Don’t resort to violence.”

“They really don’t understand or know how to deal with people who are under distress mentally,” he said.

Grose is now 31, a father and engaged to be married. He said he still fears police.

CALLS FOR MORE TRAINING

Few would deny cops face pressure on the job. Police officers make decisions in fractions of a second and they must act in self-preservation when confronted by an armed person. When an armed person is showing signs of a psychiatric illness, tensions heighten. The erratic nature of the mentally ill can complicate best police practices.

NYPD protocol requires officers to take an emotionally distressed person into protective custody with as little force as possible or wait for specialized units to arrive.

But only approximately 5,000 of the 35,000 officers in the NYPD have undergone specific training to deal with the mentally ill. When officers are being dispatched to deal with someone showing signs of psychiatric instability, trained officers may not even be sent to the scene. Nothing denotes their expertise during the dispatching process, advocates said.

Members of the Emergency Service Unit, who are typically outfitted with heavy weaponry and militarized garb, are the designated handlers of the emotionally distressed. A press release from a recent graduation of the elite officers noted they had learned how to detect nerve gases, rappel from helicopters and scale the Brooklyn Bridge.

More officers need to undergo the situation-based crisis training where actors are used to play the part of armed mentally ill people, said Carla Rabinowitz, an advocacy coordinator at Community Access, a mental health center. The NYPD needs to make clear who’s taken the course so that dispatchers can appropriately utilize these officers, she added.

The classes in crisis intervention training for New York police began in late 2015. The department reportedly also has since added elements of the course into its academy curriculum. Veteran officers can volunteer to take the class to better handle emotionally distressed people, advocates said.

The program teaches officers to defuse a situation with words, not with a show of force. Brandishing weapons – Tasers, batons and firearms – is strongly discouraged as it increases wariness and fear among the mentally ill. The training also encourages officers to confront their own fears about the mentally ill. De-escalation, rather than aggravation, is the mantra of the crisis training.

But training alone may not be the answer.

The overarching problem, according to Steve Coe, the chief operating officer of Community Access, is that police officers are being asked to act as mental health workers while being law enforcers.

“They shouldn’t be the social workers,” Coe said.

By Anthony Izaguirre and Michael O’Brien

In November 2016, a mentally ill inmate held at the Manhattan Detention Complex punched an assistant warden in the face during a brawl that injured at least seven other jail workers.

Meanwhile, a city corrections board member blamed two suicides at Rikers Island last year on a lack of mental health care, including missed psychiatric appointments.

These incidents occurred in a city jails system system where 42 percent of inmates suffer from mental illness. That amounts to roughly 4,000 detainees – about the name number as all those housed across the state in psychiatric hospitals. Of those 4,000 inmates, 400 are classified as having debilitating psychiatric problems as of Fiscal Year 2016.

Meanwhile, more than three-quarters of the violent incidents inside the five city jails involve inmates with a history of psychiatric illness, according to a city report.

Jails are ill-suited to provide mental health care, advocates say: Inmates are promised appointments with mental health care staff, but sessions are missed one-third of the time. Jail guards are calling for special facilities to handle mentally ill detainees, who often end up behind bars because there’s nowhere else to send them.
“We have so little mental health services in the community, the only way to get any care at all is in a prison setting,” said Dr. Bandy X. Lee, a Yale psychiatrist who completed a residency at Rikers. “What we are doing with jails and prisons is the exact opposite of what we should be doing.”

MISSED OPPORTUNITIES FOR HELP

Promised care frequently does not happen. The city began publicly tracking missed visits with psychiatric staff in April 2016. Between April and the end of the year, reports show, inmates missed close to 85,000 mental health clinic visits. They continue to miss one-third or more of appointments every month, mostly due to a lack of guards needed to escort mentally ill detainees to clinics.

This translates to between 7,000 and 10,000 individual inmates not being seen each month – more than one-third of the inmates scheduled. The city only started releasing numbers on individuals, as opposed to the number of appointments, in July.

To be sure, jails weren’t built to provide mental health care. Guards, charged with maintaining security, face a difficult task. Getting inmates to mental health visits can be complicated by frequent security lockdowns.

“Corrections institutions are so gravely not designed to meet the needs of those who need mental health care,” Lee said. She added that the number of inmates with psychological problems may be much higher than official figure indicate since prisoners try to hide symptoms from police, lawyers and guards.

Mayor Bill de Blasio’s administration plans to spend more than $33 million to construct and staff new clinics: Psychiatric clinics inside jails are slated to triple from four to twelve, according to city records.

Existing units will take on more mentally ill prisoners. Guards and jail health care workers have begun to undergo specialized training, including a week-long course on how to defuse psychiatric episodes like the Nov. 6 fracas at the Manhattan Detention Complex.

The union that represents corrections officers quickly blamed the city’s mental health care agency for endangering the guards hurt in that incident.

“The question we have is where is the Department of Health and Mental Hygiene?” the Correction Officers Benevolent Association wrote in a statement.

“How many more assaults on staff committed by inmates who require mental health treatment have to occur before the DOHMH intervenes and removes the mentally ill and puts them in mental health facilities instead of using Rikers Island and the City’s jails to house them?”

In July 2015, City Council Member Elizabeth Crowley (D-Queens) proposed a bill that would require the city Department of Correction to escort inmates to psychiatric appointments within a “reasonable period of time.” The measure also would require the DOC to make public the waiting times that inmates face getting care.
The proposal is currently before a committee. She hopes it gets a hearing soon.

OFFICIAL BLAMES FAULTY POLICY

Dr. Robert Cohen, who sits on the Board of Correction, which helps oversee city jails, is well acquainted with medical conditions at Rikers – he worked there as a doctor for 17 years. From 1982 to 1986 he was the director of its medical center. He blames Department of Correction policy for the missed appointments.

“The NYC Department of Correction decided to require escorts for almost all mental health appointments and knew that it did not have the staff to provide the escorts,” he said in an email.

Inmates began missing appointments. The Department of Mental Health notified the correction department “immediately,” Cohen said. This was several years ago. The Correction Department took no action, he said.

In response, Martha W. King, executive director of the Board of Correction, noted the board “has a long-held commitment to quality health and mental health care services in the City’s jails.”  King promised to “continue to work with the Department of Correction and Health + Hospitals to identify and understand the underlying factors creating the documented access issues – and to, collaboratively, develop and implement a plan of action that is based on data and best practices.”

A DOC spokesman said many appointments are missed due to reasons beyond the agency’s control, including sessions canceled by the hospital or due to an inmate’s court appearance, release or refusal to go. Still, data shows that most of the missed appointments are due to the DOC “not producing” a patient.

The spokesman, Peter Thorne, pointed out that, broadly, patients make it to health appointments.

“Under Commissioner Ponte the Department of Correction and Correctional Health Services have made tremendous progress improving inmate production,” he said in statement. “In December 2016, 90.4% of inmates were either seen by a clinician, or had an acceptable reason for not being seen, and we expect this upward trend to continue.”

But this 90 percent figure doesn’t speak to mental health appointments. The city’s data shows no improvement for individuals seeking mental health care. More than 7,000 patients with scheduled appointments didn’t see a healthcare professional in January of this year.

After Perez-Rios was arraigned, his lawyer filed a 730 exam – a request for a psychiatrist to determine whether a defendant is mentally fit to stand trial. Santos said he does not believe Perez-Rios understood the proceedings. “I was trying to get him to take a plea,” said Santos. “’Give me the death penalty,’ he would tell me.”

On Jan. 24, 2016, Perez-Rios hanged himself in his cell.

He entered a coma and died a few days later.

At a public meeting held after the death of Perez-Rios, a representative from the city Health and Hospitals Corp., said the agency would review the suicide and make any needed recommendations to the corrections department. But Health and Hospitals officials declined to say whether the review was completed and would not disclose any recommendations, citing concerns about Perez-Rios’ privacy.

The other Rikers inmate who hanged  himself in 2016, Jairo Polanco Munoz, was arrested in March for stealing a cellphone, according to the Daily News, and was sent to Rikers.

After a routine examination, it was determined that he should undergo a thorough psychological assessment. His first appointment was cancelled when there was a lockdown, the News reported. Three days after being placed in Rikers, he committed suicide. He had a history of serious mental illness, according to the News.

The Department of Correction said it would conduct an investigation. But DOC investigations are confidential and there are no public findings in this case.

Santos said the criminal justice system is ineffective in handling mentally ill defendants.

“You can’t go to a judge and say, ‘Judge, put him there in a hospital, he needs medicine, he needs doctors, he needs real care,’” said Santos, a lawyer for 27 years.
“You’re asking lawyers like myself and corrections officers who have a high school diploma to deal with this,” Santos said. “It’s easy to indict corrections. We ask a lot of these guys and I think it’s unfair.”

FALL DOWN ON FOLLOW-UP

The Department of Mental Health and Hygiene was supposed to help ensure release inmates mental illness get proper care.

But it had a poor track record.

A 2014 audit by New York City Comptroller Scott Stringer found that “despite spending nearly $10 million,” over a three-year period to create mental health treatment plans for released inmates, the city’s health department “has limited assurance” the formerly incarcerated followed through on their treatment plans.

The report found the agency failed to “conduct required follow-up” for 11 percent of “severely and persistently mentally ill” inmates after they were released from custody.

During the 2012 and 2013 fiscal years, the department neglected to check in on 165 of the 1,521 severely mentally ill who were released from jail with a treatment plan. During the same period, an additional 3,880 inmates were released from jail with treatment plans, but without being classified as severely mentally, the audit found. The mental health department was not required to follow up with those patients

When there was required follow-up, it lasted no longer than 30 days after the person was released from jail. The comptroller recommended that the department follow up on every patient released from jail with a mental health treatment plan, regardless of severity.

In June 2015, the de Blasio administration announced responsibility for health care in city jails would shift from two private contractors and the mental health department. Instead, it would be handled by the city’s Health and Hospital Corp., which includes Bellevue. The shift includes care inside jails and follow-up for released prisoners.

Levi Fishman, of  the Correctional Health Services division of Health and Hospitals, said the city has “undertaken a number of proactive initiatives to improve mental health services for inmates.” These include the tripling of mental health units in jails, hiring additional “expert clinicians” and adding more services for young adults and others with “serious mental health issues,” he said.