currently reading: nothing relevant to the subject of this newsletter, which is policing & mental illness
books & publications referenced and/or that have helped shape my ideas on the subject
“Waking Rip van Winkle: Why Developments in the Last 20 Years Should Teach the Mental Health System Not to Use Housing as a Tool of Coercion” by Michael Allen
“Overlooked in the Undercounted: The Role of Mental Illness in Fatal Law Enforcement Encounters” by Doris A. Fuller, H. Richard Lamb, Michael Biasotti, and John Snook
No One Cares About Crazy People: The Chaos and Heartbreak of Mental Illness in America by Ron Powers
Taking Care: An Alternative to Therapy by David Smail
The Noonday Demon: An Atlas of Depression by Andrew Solomon
Axiomatic by Maria Tumarkin
When Police Kill by Franklin Zimring
Hey you,
Something a little different this time. I wanted to write down some thoughts I’ve been having about policing and mental health, and this here newsletter is great for that because I can write in those short segments that maybe aren’t entirely coherent that everyone hates and no one can complain because I’m not getting paid. Anyway I’ve missed you these last few months, and in fact if it’s any comfort (and I know it will be) I’ve written you several missives that I’ve not sent for reasons like “Smalls, what the fuck on earth are you even talking about.”
I will return to more normal form in the future, unless I change my mind about that.
Also, rereading I realize I say “crazy people” quite a bit in this one, which for the record I mean as a term of endearment, being a crazy person myself.
I’ve been thinking about the mental health industry, to no one’s surprise, and I’ve been thinking about policing, and I wish there wasn’t such overlap.
In order to be civilly committed—that is, involuntarily detained in a psychiatric facility—in the United States, you have to be deemed a danger to yourself or others by reason of mental illness. The specifics of the laws vary by state—some, for example, stipulate the patient must lack “insight,” or the ability to tell their thinking is impaired by their illness—but those are the two fundamental tenants underlying all of them: a danger, or likely to cause harm, to others + mental illness. Most states don’t define “mental illness” or “danger” or “harm” in their statutes.
Well—it is the “by reason of mental illness” that worries me, because someone has to decide who that includes. Certainly there are cases where it’s obvious to everyone involved; just as certainly there are cases where it’s ambiguous, where whether or not you have a mental illness depends on which medical professional you happen to see. So if you are crazy, or called crazy by the wrong person, you can be locked up—and I don’t know what else to call it when you’re not free to leave or do what you want or contact your loved ones—for doing the exact same as a non-crazy person, or someone who hasn’t been diagnosed as a crazy person.
In 2017, in Minneapolis, a woman named Brittany Buckley was drinking alone in her apartment on the anniversary of her father’s death. A friend called 911 for a “welfare check”; police and paramedics arrived and informed her she would have to be taken to a hospital.
You know, generally you have a right to refuse medical care, even if you’re obviously injured or pose a danger to others. Like a few years ago an uncle had these strange fainting spells, and at the ER he informed his doctor of his plans to drive a couple of hours to a conference later that day. The doctor said that while it was against his medical advice, my uncle had every right to do so.
Buckley did not get the option to refuse treatment, though she tried to, expressing concerns about the cost of the ambulance. It didn’t matter. They strapped her to a gurney and injected her with ketamine against her will. She woke up in the hospital the next day with a breathing tube down her throat—she had passed out in the ambulance after her breathing slowed and her heart started beating too fast.
When she sued the hospital, she lost. The Hennepin County Attorney’s Office “argued Buckley and her lawyer didn’t adequately show in case law how her rights were violated. At the time of the injections, Buckley was ‘depressed and drinking alcohol,’ which compromised her competency to make decisions herself.” So—have you ever been depressed? Have you ever gotten drunk? That means the police can take you from your home and have you forcibly drugged? They can take you in an ambulance and send you the bill for it? Yes, and that’s not the worst of it if you’re called crazy, especially if you’re black or brown and crazy. Keith Vidal, Decynthia Clements, James “Abba” Boyd, Bradley Ballard, Jerome Murdough, Elijah McClain—they are dead. They were killed. There are thousands more. Roughly a quarter of police shootings are of people with mental illnesses; such numbers do not include those who died in prisons or jails or in other interactions with police. (Ron Powers, in his book No One Cares About Crazy People: “Should a mentally ill suspect (or any suspect) survive an encounter with police, their next stop, quite often, is the modern-day equivalent of Bedlam. The American prison system is an archipelago of barbarity. In many important ways its assumptions and practices bespeak the Middle Ages. This is to some extent inherent in the very fact of a prison system and of the timeless callousness, either inborn or inculcated, of its wardens and guards. In any case, the consequences of imprisonment, to the human mind and body, are incalculably more debilitating than most people care to imagine. Or than an ethical society should tolerate.) The treatment for mental illness in the United States is, not rarely, execution.
The American Psychiatric Association and the American Psychological Association both know this. The psychiatrists, for example, released an official statement on “police interactions with persons with mental illness” in 2017, in which they wrote: “With all of the variables potentially at play, when police are called to respond to a call involving a behavioral health crisis, the potential volatility can result in tragic outcomes… Because people in psychiatric care or in need of such are commonly encountered by police, it is incumbent on organizations such as the American Psychiatric Association to take an active interest in supporting safer communities through advocacy and education for our patients and our profession.” They called for partnerships between law enforcement and mental/behavioral service providers. The psychologists called for much the same thing (“involving psychologists in multidisciplinary teams to implement police reforms, and encouraging private/public partnerships between mental health organizations and local law enforcement”) in early June of this year.
They do not suggest limiting the number of interactions between people, specifically people with mental illnesses, and police. Notably, they also do not call for their members to reflect on their practices of calling the police on patients.
I read Franklin Zimring’s book When Police Kill recently, and one of the facts I was most struck by is that law enforcement officers in the US are not, as a rule, killed by knives or blunt objects. It sounded to me like an excessively broad claim when he first said it—actually, if I’m being honest, it sounded like a shitpost. But Zimring is an academic, not a shitposter, and it’s just numbers: between 2008 and 2013, some of the most recent years for which data was available when the book was published, there were no officer deaths from knives or blunt force objects.
When I read this, I thought of Decynthia Clements, a 34-year-old black woman with a history of mental illness who was shot and killed by Elgin, IL police officer Lt. Chris Jensen in 2018. Clements was pulled over by police, whom she refused to acknowledge or roll down the window for. Officers boxed in her car and closed the road. When she started a fire in her car, officers attempted to “extricate her” from the vehicle; as they were approaching, she exited the car holding two knives (which the officers already knew she had). Despite talk among the police (captured on body cameras) of using a Taser or other “less lethal” options a few minutes earlier, Jensen shot and killed her.
I first heard her story on Wyatt Cenac’s show Problem Areas; in the relevant episode, Cenac interviews the then-Elgin police chief, Jeff Swoboda, who says all the right things about de-escalation and accountability and earning the trust of the community and all that shit. But after the interview Cenac shows a clip from news coverage of a protest outside the Elgin police station shortly after Clements was killed. A protester asks Swoboda, “How can you justify any officer pulling a trigger when there is no gun present?” Swoboda replies:
You come at me with a knife, I’m not wrestling with you. I’m not talking about this case at all because I don’t know the facts of this case. But I will tell you, the idea that some people have, that I will never be able to change in your minds, it sounds like—at least some of you—that if you come at me with a knife I need to let you stab me in the chest because I wear a bulletproof vest. That’s not how the real world works. You come at a police officer with a knife, you’re probably getting shot.
In When Police Kill, Zimring writes:
One wonders whether [knives and blunt objects] should really be considered deadly weapons when police in uniform are the target. If these are not deadly weapons, then the hundreds of killings each year by officers responding to the brandishing of such weapons might not appear to be necessary to protecting the lives of American police.
There are people who argue our involuntary commitment laws are in fact too weak, that it should be easier to lock up the mentally ill in psychiatric facilities. Many of these people are families of those with mental illnesses, and a major concern is that it’s often near impossible to get someone a bed in a psychiatric facility voluntarily, if it’s not an “emergency.” The solution, I think, should be more beds, and meeting people where they are, and working to create a better world, as trite and insubstantial as that sounds, but I am sympathetic.
The idea, on the other hand, that involuntary commitment is a moral imperative because crazy people by definition lack the autonomy to decline treatment: it shows an obliviousness to the outside world so alarming one might be tempted to accuse those who hold such beliefs of suffering from a lack of insight. There must be a thousand reasons not to seek or to decline mental health care in America: treatment is expensive, and often not covered by insurance (not, mind you, just because of all those greedy insurance companies, but also because those therapists and psychiatrists who allegedly got into the field to help people choose not to accept insurance and instead to bill at inflated rates); it comes with the risk of stigma; it comes with the very real risk of losing your rights; the medications, to quote Andrew Solomon, “are not very effective, they’re extremely costly, and they come with innumerable side effects.” Maybe you work full time and can’t fit it into your schedule. Maybe you have kids and can’t find childcare. Maybe you’re black and want a black therapist but there are none in your area. Maybe you’re scared they’ll call the police.
A danger to yourself or others. How many cops are currently receiving some kind of mental health treatment, do you think?
A therapist, Colette Shade, wrote in the Baffler recently, “What should I do if a police officer client is taking a course in Killology, named for the ‘philosophy’ of Lieutenant Colonel David Grossman that promises to turn law enforcement and military personnel into more effective killers? Should I report the client to the authorities?”
In all of these ways and more the discretion of the therapist becomes the discretion of the police. Everything becomes a question of liability, and so why wouldn’t the therapist pass the buck to the police, who are, as a general rule, immune from liability?
I wouldn’t describe myself as anti-psychiatry, though I know it might sound like I am. I believe that mental illnesses exist—although I also believe, especially with conditions like anxiety and depression, that they’re more heavily influenced by circumstances and the society in which we live than we care to acknowledge. (David Smail in Taking Care: “To say that a person’s distress arises, at least insofar as it is historically rooted, out of ineradicable experience seems close to condemning them to a lifetime of unhappiness; after all, our society runs on the expectation that, in principle at least, happiness is obtainable for all.”) To blame distress and/or mental illness on brain chemistry alone seems to me misguided; more bluntly, feelings of great despair seem warranted, given our current climate. With that said, I take medications for depression and anxiety which have alleviated much psychic anguish, though certainly not without side effects, and the therapists I’ve had have been wonderful. (The psychiatrists significantly less so.) I don’t mean to discourage you from taking meds or going to therapy or otherwise seeking help, and in fact (especially if you’re in Massachusetts), I’m happy to send you resources. But I would encourage you, if you have a therapist, to ask them about their profession’s entanglement with policing. Their answer will probably tell you a great deal.
In Axiomatic, Maria Tumarkin interviews Erminia Colucci, who’s studied attitudes toward suicide in a number of countries.
It’s just that when talking about suicide takes in culture, chemistry, disease, meaning, soul—“Conversation about suicide becomes almost unmanageable,” Erminia says.
Mental health is people’s way of holding the conversation down like an animal.
The concept of mental health, Erminia thinks, “is not a law. Not a religion, not a dogma.”
There can be no totalitarian theories about depression, mental health, suicide, human nature.
This does not, of course, mean we don’t try to enforce them.
Your friend,
Smalls