On May 2nd, 2014, my third day as Chief for the City of Madison, I was finishing up on some work at my beloved training office when I heard the alert tone sound from my desktop scanner. As cops, we have all experienced that anxious moment wondering if it will be a call assigned to me and trusting that the training I received will translate into a successful outcome. An outcome where we diagnose the issue(s), slow things down, and use our problem solving skills and professional communication abilities to keep everyone involved safe, to muster more resources (where appropriate and when needed) and to strive for the "best possible resolution" (BPR). Fortunately, this reflects the overwhelming majority of the way incidents are handled in Madison.
But on occasion, time brooks no delay. Officers must shift gears into overdrive in order to render aid. Such was the case on this fateful day as I drove to a location off East Washington Avenue where a mentally disturbed man suffering from a psychotic breakdown had stabbed three people, killing two, before then attempting to attack two of my officers. Left with no other options, my officers responded pursuant to their training and were compelled to stop the advancing threat; which resulted in the death of the assailant.
In the inevitable discussions which occurred in the aftermath of this tragic incident, questions were appropriately raised about whether this horrific event could have been foreseen and preventable. Was the individual who did the stabbing "connected" to the mental health system? Was there any attempt at intervention. . .why or why not? (Incidentally, the Dane County Sheriff's Office had experienced a similar instance of a mental health situation turned fatal just prior to our own). Like everyone else, my heart grieved for the victims of these senseless acts, for their family members and friends, for the individuals suffering from and losing their battles with a mental illness episode and for those officers who were forced into untenable situations. As Chief, my thoughts also turned to an examination of those "systems" or "processes" involved: how did we get here and are we doing all we can to prevent more tragedies?
When I joined MPD in 1983, we were coming out of what I call a post "One Flew Over the Cuckoos Nest" phenomenon. For those who saw this classic film, our nation gasped and our collective consciences were shocked as seemingly one investigative story after another chronicled mentally ill individuals being warehoused in institutions, where, in some instances, deplorable living conditions with absolutely no services were brought to light. An "epiphany" of sorts grew out of that experience and the notion of deinstitutionalization, coupled with robust out-patient treatment strategies became the new model. When I hit the streets, Madison was considered a benchmark program to the nation in the creative ways resources would be tied to those living in/with our community.
Anecdotally, I can recall going to the old Badger Bus terminal when it was located on West Washington Avenue and being asked to deal with a patron who got off one of the buses and was just sitting there, looking a little confused and disoriented. Turns out, the individual I dealt with had a small backpack of essentials which included a note which provided a brief plea for "help." The note briefly went on to advise that the family lived in a community that did not have much to offer by way of services, and had placed their loved one on a bus to Madison, hopeful that our City would be able to assist!
Over time, it seemed to me that as budgets grew to be contentious points of partisan bickering and priorities shifted or changed to embrace competing needs, the once resource-rich funding enjoyed by the mental health models of the 80's was nowhere near as robust and there are more people than ever clamoring for service. As all of this reflects my personal opinion (only), I have been on record to suggest that our mental health system has become fractured and is in dire need of greater support. While this view is hotly contested by others who suggest that this is hyperbole and exaggeration meant to be overly alarming, please take a look at the number of calls that my officers are responding to on an annual basis, the increased time commitment required, and the resources that are being expended (i.e., an emergency detention takes two officers and over 8 hours from point of contact to delivery to Winnebago and back. And MPD has done scores of these emergency detentions within the past 12 months). Feedback I get from my officers is that the unique challenges presented in these calls are going to result in more tragic outcomes unless or until there is a commitment to provide more pro-active, pre-emptive, and collaborative interventions BEFORE an individual's mental health issues have declined to critical levels.
When lecturing recruits at the Academy, I always encourage them to find a cause or class of constituents that they are passionate about. Whether committed to the apprehension of drunk drivers, working with kids, devoting yourself to sensitive crimes or taking a keen interest in any one of a host of erstwhile endeavors, the end result will be an officer who is going to stay interested, engaged and challenged to strive for improved responses and outcomes! For me, dealing with those affected by domestic violence and individuals coping with mental health issues have always been at the top of my list. The sheer volume of cases, the emotional toll that it takes on everyone and providing assistance to "victims" are opportunities where the police can have a tremendous impact. As the focus of this blog is mental health, I thought I would share what we are currently doing in this area and what we hope to do in the near future.
Using modest means of capturing the number of calls for service that have an overt nexus to "mental health issues," MPD fields well over 2,500 incidents per year. We will be better able to track and trace our progress in this niche as MPD has been selected to serve as a model test site for a funded study that aims at creating a template for the more accurate identification, retrieval, and disposition(s) for mental health calls.
MPD is also one of only six nationally recognized mental health training sites in the United States. We have worked diligently to dedicate significant blocks of time (at both pre-service and in-service) to train up our personnel. The quality of the training is "best practice" oriented with career professionals from the mental health field collaborating with subject matter experts from within our own Department to simulate realistic, scenario-based training. We have facilitated and hosted training in crisis intervention strategies, both for MPD personnel as well as training other agencies interested in pursuing the MPD approach. And, we have worked constructively on system and response improvements with community partners such as NAMI and Journey Mental Health.
Currently, MPD has a contingent of eighteen officers, distributed throughout the five districts, who have volunteered their passion and talents in working calls for service that have a mental health dimension. These officers have often brought mental health backgrounds with them to the MPD, have received additional training, and will try to "jump" a call, when possible, to assist a co-worker in working through a mental health case. Often I have seen these volunteers coming into work early, staying late, and networking with family and service providers to create some measure of support. This cadre of volunteers has done a terrific job but they have to be true to their Patrol assignments and their availability is subject to other calls for service in their beats. I am so impressed with the efforts of this group that we are hoping to "grow" their numbers.
But this is not enough. We have to do more. The cavalry is not coming through that door with encouraging news---the State continues to turn a deaf ear to the urgencies local communities are facing by their shutdown of Mendota Mental Health to us; compelling law enforcement to convey subjects under emergency detention to Winnebago, in Oshkosh. Not only is this counter-intuitive to the needs of the client/patient, it takes cops away from their community for extended periods of time, thereby compromising public safety. (Our attempts to negotiate the re-opening of Mendota have not yielded any movement and so I have sought/received permission to sue the State from the City of Madison). (Preliminary briefs are being calendared for court).
Sitting on "panels" discussing the issues with private and public sector stakeholders have stimulated interesting perspectives and pledges to move forward in a spirit of cooperation . . .good hearted souls, great organizations, and lofty intentions. But at the end of the day, it comes down to money and a catalyst to act. Frankly, I have grown weary with the rhetoric and have not seen any substantive change(s) that provide me with any hope for real movement in the near future.
And then there are the encounters with constituents that I meet at community forums or they call or write with tales of incredible desperation and sadness that make me cry. Like the woman who cornered me after a community discussion about issues affecting the West District last fall. The meeting had gone far longer than anticipated and as the room cleared, she approached me, tentatively, and started to explain her predicament in trembling tones that turned to tears. In a nutshell, her adopted son was diagnosed with a significant mental illness and was spiraling downward. The woman was petrified that her son could end up in the criminal justice system as a result of his unpredictable behavioral mood swings. She was mortified thinking about him being thrown in jail if police responded to him solely on the basis of unlawful behavior without being mindful of his unique mental health issues. The most I could offer this woman was a pledge to send out one of my volunteer mental health officers to try to devise a response plan that would then be made available to our west side officers should her son suffer a breakdown at home.
As if the foregoing considerations were not already sufficiently disturbing, as an officer who has worked many challenging cases dealing with someone in crisis, it is difficult to not take these cases home with you. You wonder if you have done everything you could. You wonder if the person you left will truly live up to the promise(s) you extracted to not hurt themselves. You hope that there will be someone/anyone who will be there to take the next step with this person in conflict. You agonize about whether you should have insisted on pressing for an emergency detention, despite the best advice from trained practitioners that the legal threshold for this involuntary commitment was not met. The reason I know these questions are asked is because I ask them of myself, to this very day, years after I was the last official police contact with Laurie Dann only days before she then traveled to Winnetka, Illinois, and killed a young child attending elementary school before killing herself.
So, based on the foregoing commentary, on 2/1/15, MPD is going to take five officers out of Patrol Services. One officer is going to be assigned to each district. These officers are going to be called Mental Health Officers (MHO) and they are tasked to working mental health incidents, exclusively. I want these officers to be able to get in front of these compelling cases before they become runaway tragedies. I want these MHO's to work with family, to work collaboratively with Journey and private health providers in trying to devise a pro-active plan for individuals on the cusp of crisis rather than us always catching people at their worst. I want them to do follow-up with cases that have been flagged by officers assigned to Patrol.
From a timing standpoint, there probably isn't a worse time for me to launch this pilot initiative. Command staff and line officers are all concerned that the removal of five officers from Patrol, at a time when calls for service are climbing, is ill-advised. Perhaps they are right. But I believe that we have reached a critical crossroads where somebody has to step up and do more. I guess that will be us---until the cavalry arrives.