Police and mental health: Would social workers accompanying police protect mentally ill, keep them out of jail?


It has been more than a year and a half since police shot and killed Osaze Osagie.

The parents of the 29-year-old State College man called the police because they were concerned for his well-being. He was making threats towards himself and others, police said at the time.

Officers went to his home on March 20, 2019, but they were confronted by Osagie with a knife, they said. They shot and killed him when he ignored their commands to drop the knife and ran at the officers, according to police.

It turns out he was autistic and had mental-health issues, his parents, Sylvester and Iyunolu Osagie said, insisting police should have called mental health professionals who were familiar with their son’s condition.

“Isn’t there something wrong when you send the police to protect your son and take him to the hospital and they send him to the graveyard?” his mother asked authorities.

After investigating, Centre County District Attorney Bernie Cantorna concluded the officers “acted consistent with their training and were justified in the use of force,” but it led to calls for change in State College. Changes in the way police handle mental-health calls.

And changes that are currently underway, officials said.

Since then, others in a mental-health crisis have died during a police response. Recently in Rochester, New York, Daniel Prude died after he was held down and hooded by police. His brother had called for help over his erratic behavior in March, and a video of the incident sparked protests and demands for more accountability.

And on Sept. 13 in Lancaster, Ricardo Munoz was fatally shot by a police officer. Body-camera footage shows him running at the police officer with a knife as the officer flees and shoots him.

Lancaster County District Attorney Heather Adams is investigating and will make a determination on whether or not the shooting was justified. She released this statement shortly after the incident:

“We continue to review and investigate the circumstances surrounding the shooting and, specifically, the firing officer’s actions,” a statement from the DA’s office read. “As we stated (Sept. 13), and as depicted in a body cam video released by Lancaster city police, our preliminary investigation shows that the officer fired as a man clearly armed with a knife ran toward the officer in a threatening manner.”

Along with protests which turned violent, the death of Munoz — whose family said he suffered from schizophrenia — sparked a community conversation about police response and mental-health issues, and perhaps the need for social workers to be a part of that response.

Is it possible? Some say it is, and law enforcement officials seem to be in favor of it.

Beyond the debate over law enforcement tactics, the Munoz case underscores a prevailing problem in policing: More and more police have become frontline mental health workers and responders – something, for which, the vast majority of officers have received little to no training, advocates say.

Munoz’s family say they called crisis intervention services but were directed to call the police, instead.

What played out after police arrived underscores a confluence of several factors that have shaped the state of Pennsylvania’s mental health system and the implications that has had on policing.

“When we talk to law enforcement they all say the exact same thing. Even with the best training, they are not mental health professionals. They didn’t get into this line of work to become doctors,” said John Snook, executive director of the Treatment Advocacy Center. “They don’t feel they have the resources they need to address these situations. It shouldn’t be a surprise when tragedies happen. We are using the wrong tool to help people.”

Pennsylvania, in fact, per capita, ranks among states that best fund states mental health services, Snook notes. Still, certain aspects of its system makes it difficult for individuals who need services to get care.

Under Pennsylvania law, for an individual to get mental health services, he or she must either be well enough to participate voluntarily or they have to be so ill that they pose a clear and present danger to themselves and others. That’s when authorities can step in.

“Many states across the country say that stigmatizing language is not helpful or appropriate for those with mental health illness,” Snook said. “That’s one of the big problems with the Pennsylvania system.”

Additionally, Pennsylvania’s protocol lacks a treatment component that addresses individuals whose illness makes it difficult for them to stay in treatment, whether they do not want to or are incapable because of their illness or psychosis, Snook said.

The biggest liability, though, may lay beyond the scope of individuals and families: The General Assembly in 2018 unanimously passed the Mental Health Procedures Act, overhauling treatment and care standards across Pennsylvania.

The law broadened access to treatment facilities and outpatient services; it broadened the scope of involuntary examination and treatment, further providing for persons subject, for involuntary emergency examination and treatment authorized by physician; and put in place additional periods of court-ordered involuntary treatment; among a slew of other reforms.

The problem is that no county in the state has implemented it.

The Pennsylvania Department of Human Services does not set guidance for counties or crisis intervention centers to instruct callers to call the police. Crisis response is coordinated at the local level.

“The Munoz situation is a tragedy and the Wolf Administration hopes that it is resolved so that all involved parties obtain justice,” said Ali Fogarty, communications director, for the state Department of Human Services. “While every case is different and there is not state-level policy regarding how individual calls for assistance should be handled, the Wolf Administration is providing support to the City of Lancaster as they look to provide more training on mental health and trauma across their offices in line with the Office of Advocacy and Reform’s work to make Pennsylvania a trauma-informed state.”

Snook said the tragedy in the Munoz case might have been avoided had these safety nets been in place. He is encouraged that Lancaster officials are talking about this issue.

“These tragedies are indicative of how the current law doesn’t get at caring for this population,” he said. “They fall through the cracks. We have the law in the books, but it requires counties to step up and implement it and counties just haven’t done it yet.”

The cracks in the system have had lethal consequences to both law enforcement officers and the public. Studies have shown that when police respond to crises involving people with severe mental illnesses who are not being treated, the consequences are deadly.

A recent study by the Treatment Advocacy Center found that a person with mental illness is 16 times more likely to be killed by a law enforcement officer as compared to someone who has no mental illness.

“What we hear from police is that those are the calls they dread most,” Snook said. “It’s easy to look at things after they happen…but at the time police officers in most instances don’t have any idea what is going on. Even if the dispatcher was told there was a mental health issue, sometimes the officer doesn’t get the information.”

The study, “Overlooked and the Undercounted”, also found that, by the most conservative estimates, at least 1 in 4 fatal law enforcement encounters involves an individual with serious mental illness. As many as half of all law enforcement homicides ends the life of an individual with severe psychiatric disease.

Moreover, gaps in the mental health services sector have transformed Pennsylvania’s jails and prisons into warehouses for the mentally ill. Debate continues, for instance, over the 2006 closure in Dauphin County of the Harrisburg State Hospital.

In an in-depth year-long investigation in 2015, PennLive found that 28 percent of the estimated 87,756 inmates in Pennsylvania’s correctional system had a mental illness. About a third of them had a “serious mental illness” – defined as the most chronic and debilitating of mental disorders, like schizophrenia and bipolar disorder.

Lancaster City Bureau of Police

The Lancaster City Bureau of Police building on West Chestnut Street. September 17, 2020. Dan Gleiter | [email protected]

Police and mental health

John Fiorill said in his time as a police officer, which included 27 years with the Lancaster Bureau of Police, he noticed an uptick in police calls involving subjects with a mental illness.

“We deal with them more in urban police areas than a rural area,” said Fiorill, who is now with the Pennsylvania State Lodge of the Fraternal Order of Police.

It’s hard to quantify just how many calls police respond to involve someone who has a mental illness because, often times, that information can’t be shared.

“The only way to know if the person has some type of emotional issue is if the police officer has been there before or another patrolman has been there before and shared that information,” Fiorill said. “The social agencies that treat them can’t share that information with you because of HIPPA violations.”

Derry Township Police Chief Garth Warner said his officers typically wouldn’t know if someone is struggling with mental health issues.

“Sometimes officers are aware of these things, but more often than not, the officers are going into these situations not knowing what to expect,” Warner said. “There are occasions where the officers may have dealt with the person before, or the information is given to the dispatcher to let the officer know, but in the majority of these cases, the officers are handling these calls and getting information as the situation progresses.”

If a police officer arrives on the scene and finds a subject who is depressed, suicidal or having an episode that is not violent, they can help.

“Law-enforcement officers have the opportunity and authority to call crisis intervention, which we do,” Fiorill said.

In some circumstances, police can call for what’s called a 302 — an involuntary commitment, he said. Crisis intervention personnel can respond and interview the subject and they can put them into a hospital facility for short-term observation and treatment, he said.

And officers are trained for these situations, Warner said.

“Officers will talk with the subject and people who are involved to determine what is happening and how we can assist the person,” Warner added. “We can only hope to have them remain stable and calm and non-violent. We will also see if we can get other county mental health and medical agencies involved to assist the person in crisis.”

In their initial training, police officers are taught to identify mental-health issues in subjects, and they have training on how to diffuse potentially volatile situations. Many police departments are bolstering this training, Warner and others said. In Derry Township, Warner said the department has started sending officers to be trained as Crisis Intervention Team members in Dauphin County, and they will use that training in their duties, as well as in assisting other departments.

But even if an officer is aware of a mental-health issue, there isn’t much the police can do if the situation turns violent. They will try to diffuse the situation, if possible, Fiorell said, but safety becomes their top priority.

Warner agrees.

“First and foremost, the officers need to protect the public and defend themselves when necessary,” Warner said. “We also want to help the person in crisis get the assistance they need. Sometimes, there is not enough time nor distance to determine the subject’s mental state when things take a turn for the worse.”

That includes the use of deadly force when there is an immediate threat of serious injury or death.

While Fiorell likes the idea of social workers assisting police, there are a lot of considerations.

“You would need quite a few of them to cover each shift. It becomes a logistics problem and a financial problem,” Fiorell said. “There needs to be a lot of discussion on having social workers working with the police. We’re not opposed to it, we want to have every avenue that’s available to make our job easier to serve the public. Sure, we want social workers, but we need to sit down at the table and decide how to accomplish that so we meet the needs people are calling for.”

Warner said he would have concerns about sending social workers or mental-health experts instead of the police.

“What can seem like an innocuous call for officers these days can turn deadly in an instant,” he said.

But Warner said he supports a partnership that embeds social workers or mental health professionals with the police. And in Dauphin County, that is already happening.

Dauphin County press conference on the death of of TyÕrique Riley

Dauphin County district attorney Fran Chardo said the county has recently begun a program pairing people experienced with mental health issues with police officers to respond to calls.

Joe Hermitt | [email protected]

Dauphin County District Attorney Fran Chardo said he is pleased with the Stepping Up Initiative, which debuted this year.

The program has hired two “co-responders” who can respond with police when officers come in contact with people with mental health issues. Chardo said one of them works full time with the Harrisburg Bureau of Police and the other works with police in Susquehanna, Lower Paxton and Swatara townships.

“The co-responders ride with the uniformed officers of those departments and respond to calls involving individuals who have severe mental health needs,” Chardo said.

They also provide the Crisis Intervention Training that Warner’s officers are taking part in. Chardo said the goal is to have at least a quarter of the county’s officer’s CIT trained, improving their abilities in handling calls that involve mental health.

The program was developed through Dauphin County’s Criminal Justice Advisory Board and is being financed with a $180,548 grant from the state Department of Human Services and money from the county’s Violent Crimes Task Force.

Chardo said he hopes to expand the program soon.

Changes in State College

Though police have to make split-second decisions when it comes to deadly force, and they may not always have time in those moments to take mental-health into consideration, it leaves a lasting impact on families.

Six months after Osagie was killed in a police-involved shooting in State College, his parents filed notice that they intended to sue over his death, arguing police mishandled the confrontation, though the DA’s investigation found it was a justified shooting as Osagie was running at the officers with a knife.

Osaze Osagie

The family of Osaze Osagie, an autistic, African American, State College resident, is calling for an extensive investigation into the police-involved shooting that resulted in his death last year.

Douglas Shontz, spokesman for the Borough of State College, said he could not address the Osagie case directly since Osagie’s parents intend to sue. But he said the police department and borough have been making strides towards improving police tactics and policies. He noted these initiatives are not necessarily related to the Osagie case, but are part of ongoing improvements.

One new effort is the appointment of a civilian oversight committee for the police department. Shontz said this committee is in the early stages. Just what their authority will be and what kind of duties and responsibilities they will have is all a part of the ongoing discussions, in which they are seeking community input, he said.

Shontz noted the police are welcoming of this board, and State College Police Chief John Gardner even said in discussions about the board “we’re not afraid of it”

“It was uplifting to hear” Shontz said. “That means our police department’s ultimate goal is to serve the diverse community we have here, making our community welcoming and safe.”

Shontz noted almost all of the borough’s police officers have had Crisis Intervention Training, and all police policies and procedures are published on the borough’s website.

The borough has contracted with the International Association of Police Chiefs for a review of all of the departments policies and procedures. The report came back last month, and officials are still studying it, Shontz said, adding its recommendations and priorities will be publicly discussed in the coming weeks.

“Overall, our police department has been willing to change and adapt,” Shontz said. “We are constantly at the forefront of change and being a standout law enforcement agency in central Pennsylvania.”

This is happening at the county level, too.

Centre County District Attorney Bernie Cantorna said since Osagie’s death, the Task Force on Mental Health Crisis Services has been formed to look at the big picture of mental-health issues and police involvement. They’re looking at everything from diagnosis to long-term treatment to police involvement, mapping out the entire system and seeing where changes need to be made.

The task force is in the final stages of putting together their recommendations, which should be presented towards the end of this year, he said.

“In the short term, there has been much more coordination between law enforcement and mental-health professionals,” he said.

The task force is going to map out a series of best practices on when to send crisis workers instead of, or along with, police, he said.

On Wednesday, Cantorna’s office started a brand-new mental-health-court initiative. The goal is eventually to have a full-fledged mental-health court, and this new initiative is a step in that direction, trying to get people the help they need rather than sending them through the criminal-justice system.

“With people with serious mental illness, incidents of psychosis often first appear when they’re 25 or younger,” Cantorna said. “If they get treatment of one to two years in that time period, it can greatly improve the chances of the individual’s success.”

The new initiative is voluntary and is aimed at young offenders of mostly non-violent crimes, he said. If they’re in the court system, they can apply for the program to seek mental-health treatment of 18 to 24 months through their insurance or through the county. If successful in the program, their charges can be reduced or, in some cases, the charges could be dismissed.

“It’s hard to have a mental illness and a criminal record at the same time,” Cantorna said. “We’re trying to identify these cases early on in the system and encourage them to get the treatment they need.”

Police departments in the county field calls daily involving mental-health crisis and successfully address those, but there’s always room for improvement, he said, adding he feels Centre County has been heading in the right direction since Osagie’s death.

Lancaster police and mental health

In Lancaster, Mayor Danene Sorace said that Munoz’ death, and the subsequent protests, made clear that there needs to be an increase in funding for behavioral and mental health services, not only in the city but also at the county, state and federal level.

Ricardo Munoz

Ricardo Munoz was killed in a police-involved shooting Sunday in Lancaster. His family said Monday the police did not need to kill Munoz, who had a mental-health disorder and was suffering from an episode. (Provided by Deborah Munoz).

Though they said they could not discuss the Munoz case because it remains under investigation, Lancaster police addressed policing and mental-health issues.

Dealing with these cases is fairly common in the city, Lancaster Bureau of Police public information officer Lt. Bill Hickey said Thursday.

“We may not know anything about a person’s mental health prior to coming into contact with them,” Hickey said. “We get dispatched to calls for service through Lancaster County Wide Communications. The operators and call takers at LCWC do their best to ascertain the situation and get as much info as they can for the responding officers.”

But, like other police officials have said, much of the medical information is limited by federal regulations to protect privacy.

Lancaster’s police officers are trained to deal with mental health situations. Many of them have received Crisis Intervention Team certification and have training in de-escalation strategies.

And the vast majority of mental-health related calls are non-violent. In most instances, police will try to assess the situation, Hickey said. They’ll try to get help from family members, social agencies or case workers when possible.

Police can ask the individual in crisis if they want to be brought in for a mental-health evaluation voluntarily. If they present a danger to themselves or others because of mental health issues, police can call for an involuntary evaluation, he said. Lancaster police work closely with Crisis Intervention and other agencies in these cases.

But besides a short-term involuntary commitment in some circumstances, mental health situations are mostly based on consent and compliance with treatment, Lancaster police Chief Jarrad Berkihiser added.

When a situation does become violent, Berkihiser said his officers take mental-health issues into account.

“A person’s mental health is a factor and is certainly taken into consideration if police officers were given the information or develop the information once they arrive on scene and there is time to assess the individual, the environment, and if there is a threat to others,” Berkihiser said. “Unfortunately, there are instances where the situation unfolds rapidly and there is an imminent threat to a person or a police officer and action has to be taken to mitigate the imminent threat to save a life.”

He said there needs to be more public education on services available for people suffering from mental health issues. The county has behavioral health agencies, drug and alcohol treatment and crisis intervention programs that are available to assist, and people should not wait for an emergency to seek these services.

Berkihiser added it is vital for police departments to continue training their officers on these issues.

The department has a social worker on staff and hopes to hire a second one soon, Hickey said. The social worker is not a first responder, though, so she does not handle calls for service. Officers will refer to her to follow up on cases involving mental illness.

While having trained crisis intervention teams or caseworkers actually riding with police officers would be helpful, Berkihiser said, it becomes a question of logistics and finances. Can police departments or counties staff that many social workers?

Munoz’ family members said they only called the police because they were directed to do so by crisis intervention.

Ricardo Munoz needed help, his mother, Miguelina Peña, said the day after his death. She said the police could have handled the situation differently — without killing her son.

Ultimately, that type of standard procedure is bound to lead to more avoidable tragedies, Snook said.

“If you think about it, for any other illness, let’s say a heart attack, would you really call police and arrest that person? Everyone recognizes that’s silly and doesn’t work but that’s basically what we are doing,” Snook said. “We have people who have what amounts to a brain attack and we are letting law enforcement handle them.”

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