Showing posts with label mental health care. Show all posts
Showing posts with label mental health care. Show all posts

Thursday, September 10, 2015

There Is No Excuse For This At All

The Fairfax County VA sheriff released the following video of the actions of her deputies that preceded the death of Natasha McKinney last February. The officers involved have been found to be not criminally liable.




There is no excuse for this at all. I haven't watched every minute of the video, and I don't recommend it as even something to witness in its entirety. It's a document of a horrible and inexcusable "extraction" for transport.

First off, Ms. McKinney should not have been in jail. She should have been seen and treated by mental health professionals for a serious condition that had previously manifested leading to the assault charges against her for which she was arrested and jailed.

Her condition deteriorated in jail to the point where the deputies decided she'd better be transported to the jail in Alexandria since the charge of assault was in Alexandria. The facility would not come for her. Therefore the deputies decided to transport her themselves.

In order to do this, certain jail protocols had to be observed, the first being that the inmate had to be restrained with handcuffs and shackles. Ms. McKenna at first agreed to be handcuffed, then refused.

The video begins with an officer stating the determination to "extract" Ms. McKenna against her will for transport to the jail in Alexandria.

Six officers in hazmat suits are delegated to perform the extraction along with another older deputy sheriff not in a hazmat suit who appears to be in charge of the operation. Three or four deputies -- also not in hazmat suits -- mill around at the end of the hall observing the procedure.

After some struggle, the older deputy manages to figure out how to open Ms McKenna's cell door, and she steps out. She is nude. She says, "You promised not to kill me!" At that point, I nearly lost it. Here are these men in hazmat suits, looking like some kind of hideous aliens, ordering her around and struggling with her, forcing her to the floor, and attempting for over fifteen minutes to secure her in various restraints, all the while shouting "Stop resisting!" and threatening her with a taser.

It's insane.

Part of the insanity is that these men are following protocols and do not know what they are doing. They are trying to achieve something that protocol demands -- the full restraint of the prisoner prior to transport -- without having a clue to how to accomplish it when the prisoner is a rather small nude woman having a serious mental health breakdown who would rather not be restrained, at least not the way these officers want to do it.

She's on the floor, on her stomach. There are four deputies on top of her pressing her head into the floor, and apparently also pressing down on her limbs and back. It's hard to tell from the angle of the videography just what they are doing, but they are clearly having a very difficult time restraining her.

One deputy has a taser and is not on top of her. The older deputy keeps trying to reason with her. The others are shouting and threatening and trying to force her legs and arms into position to shackle and handcuff her.

We've seen it a thousand times, even when people are not resisting at all officers are very seldom able to move arms or legs of detainees into the correct position for shackling and handcuffing without a tremendous struggle. I've often wondered whether they have any idea how to do it in the first place, and whether they understand why what they want to do is nearly impossible when the detainee is face down on the ground with three or four officers on top. It just doesn't work.

And the detainee is often injured, sometimes seriously, as the officers repeatedly attempt and fail to handcuff and/or shackle their quarry.

The procedure itself is faulty. It fails so often in fact that I've become convinced it is a deliberate form of "pain compliance" -- ie: torture -- for the purpose of asserting dominance, not in fact to "secure" the individual.

Ms. McKenna doesn't actually appear to be struggling or resisting; she appears to be responding to the pain being inflicted upon her.

More that fifteen minutes later, she is sufficiently restrained to be put in a prostraint chair for transport to a van which is supposed to take her to Alexandria.

Though they keep saying she's resisting, she doesn't appear to be. "Resisting" in this context seems to mean any movement at all. She's clearly uncomfortable and uncooperative. They want her to sit up in the prostraint chair and she doesn't do it. Ergo, she's "resisting" right? They keep telling her to stop kicking her legs, but she doesn't appear to be, or if she is, the movement is slight and may be involuntary.

So, because she continues to "resist" she's tasered. From what I saw, it appeared she was tasered once while she was on the floor, and three times while she was in the chair. Restrained. In other words, there was no need to shock her -- except for the fact that she wasn't in the exact position they wanted her to be in, and this was unacceptable.

Control is all-important.

Of course when a person is shocked with a taser, they can't obey orders to sit in such and such a position. When they're having a psychotic break, as Ms. McKenna may have been, they are rarely going to obey any order at all.

Police are the least qualified people to deal with a person in crisis, and what they do -- as amply demonstrated in this video -- is seriously detrimental to their own well being and that of their subject.

Ms McKinney appeared to go into cardiac arrest and stopped breathing shortly after she was tased for the fourth time in a few minutes. Medical personnel were summoned but did nothing. In fact, it appeared that CPR was eventually administered by the older deputy who had been trying to restrain her in the first place.

Ms. McKinney was revived [in the ambulance after 20 minutes without breathing or a pulse] and was taken to a hospital where she died in a coma a week later.

The medical examiner attributed her death to "excited delirium." Whatever that is. They say she was covered with bruises and lacerations, and apparently one of her fingers was amputated while she was in the hospital -- due to injuries sustained during the attempt to restrain her.

She shouldn't have been in the jail at all regardless of any charges that may have been made against her for things that happened while she was having a mental health crisis. Those restraint procedures should never have been applied to her (not to anyone). She should not have been tased (there was no need), and she should not have been tased four times within a few minutes.

The whole thing was a cockup, but the officers involved were exonerated of criminal liability, so they don't know that. The sheriff vows "changes" to protocols and procedures for dealing with mentally ill inmates.

She said the jail is where mentally ill individuals are sent more often than not.

This is wrong and insane, but according to those who say they know, Virginia does not have a public mental health care system. Mentally ill individuals who are acting out go to jail. There is no other facility available to most of them.

This is the legacy of Ronald and Nancy Reagan, coming right out of a belief that there is no such thing as mental illness, just behavior problems which can be corrected through medication, surgery or punishment.

Of course death is also a corrective for behavior problems, isn't it?

There is no excuse.

Thursday, February 19, 2015

Mental Health Care and the Problem of Violent Policing

Surely by now many people understand that if they call 911 when a loved one is having a mental health crisis, their loved one is liable to be killed. This is doctrine all across the land. In any case where police are dispatched and they sense a threat of any kind, to themselves or others, they are supposed to neutralize the threat with whatever level of force they deem necessary under the circumstances.

Indeed, even when someone is suicidal and only threatening their own lives, the police doctrine is to "neutralize" the suicidal individual -- with deadly force if needed -- so as to... protect?

Police are dispatched any time a caller to 911 says they fear for their lives, or a loved one is armed and making threats, or there are guns or other weapons in the house, or it looks to them like a scary person is armed, blah blah blah, in other words, most any time there might-could be a threat of some kind to someone or some inanimate object.

If a diagnosed mental illness such as schizophrenia is mentioned, the likelihood of police killing the subject goes way up. Way-way up.

It is what the police are trained and expected to do.

Consequently, I have long said, "Don't call 911 in such cases unless you want your loved one dead."

Often enough in such cases, SWAT teams and snipers are sent on the call, the primary purpose being to kill. Period.

These are rules of engagement the public seems to be oblivious to is unaware of, because practically every day another call to 911 for help in dealing with a mentally ill loved one leads to another death, and families are shocked. "I called for help," they say, "but they killed my loved one instead." Yep. That's right. That's the kind of "help" first responding police are trained and expected to render. Why is this still a surprise? It's been SOP since most of the mental hospitals were closed decades ago.

Because so many loved ones in mental health crisis are killed by police year in and year out -- by my reckoning close to 400 a year, about a third of the total killed by police each year -- there is a nascent movement to revive the mental health care system something like it was before the Reaganite push to dismantle the system in the name of "civil liberties." Yes, that worked out well, didn't it?

Liberty for whom, to do what?

There is no doubt that there was a problem in the mental health care system as it was prior to the Reaganite dismantlement. It was enormous, for one thing. At any given time more than 4 million people were incarcerated in public and private mental hospitals and asylums across the land. This is about double the outrageous current prison population. Too often, patients had no way out, and many were held for life against their will, and sometimes against the will of their loved ones.

Too often, too, the care patients received in state run institutions was abominable. Private institutions were not much better.

The Reaganite solution was just to shut the institutions down and suggest that relatives and communities take care of their mentally ill -- or let the police do it in their stead.

This policy led to an enormous increase in the homeless population to start with, an increase that has never abated. Prison populations skyrocketed as well. It's often pointed out that a third or more of those in prison are mentally ill and most of them receive no treatment -- apart from periodic beatings, solitary confinement, pepper-sprayings and such like.

There are inadequate community mental health care facilities in the best of circumstances, and in many areas, there are none at all. Families are rarely prepared to cope adequately with a mentally ill loved one, and even their best efforts may lead to tragedy. Especially when they call for Emergency Services to "help."

Service providers and consultants milk the system for money while providing as little care as possible. This is how the system, such as it is, is set up. Mental health care budgets are often the first cut when times are tough -- as they have been for years during this Permanent Recession. Too bad for the victims.

Reviving and restoring the previous system of state run asylums and mental hospitals is probably not the best idea under the current regime of public parsimony and brutality. I can see it easily leading to something like the eugenics programs that operated in this country and abroad, most horribly in Nazi Germany.

A better system is one that operates locally not centrally, and is tied in with the communities served. This was supposedly what the devolution of mental health care from the closure of state hospitals to communities was leading to, but it never did. Instead, the police and prison system expanded to take on the difficult cases, and the rest were pretty much left to fend for themselves as best they and their families could manage. That was the "civil liberties" solution.

It's not working.

Or perhaps it is working but not the way anyone of compassion envisioned.

No, it's cruel and deadly. It's violent and catastrophic. It's corrupt and dangerous.

When a third of the police killings in the country are of mentally ill and/or suicidal individuals, it should be plain as day that there is a structural and institutional problem that might be correctable. Unfortunately, pro-police propaganda has worked well to convince many people that the proper course of action toward those who do not obey police is to kill them, regardless of mental health or suicidal tendencies.

If it's only 400 a year, what's the big deal, right? More than that die in a week in traffic accidents. More than that are killed in a week by non-police firearms. This is a violent country. Always has been.

A compassionate mental health care system would not dispatch police, snipers and SWAT teams on every 5150 call. It just wouldn't happen. Instead, there would be crisis teams available to perform interventions, and care facilities would be available that would provide more than a 72 hour observation window and a few prescriptions for psychotropic drugs -- which can cause more problems if not monitored carefully.

There would be mental health care facilities in the community provided as a public service like any other, staffed by professionals and available on an as-needed basis.

Care would not be restricted to certain hours or days of the week, and appointments would not be so limited that weeks or months pass before someone could check in for care and treatment.

A proper mental health care system would include homeless and addiction services, without discrimination toward patients based on the nature of their homelessness and/or addictions.

All this can be done, probably for less money than the current violent policing and imprisonment "treatments" for mental illness, homelessness and addiction cost, but money isn't the real issue. More public money is going to prison systems these days than to higher education in many jurisdictions, and there is little notice, let alone complaints about it. Mental health care spending is a relatively minor component to many public budgets, and what little is being spent is constantly on the chopping block when public budgets need tightening.

In some places like California, taxes were raised specifically to fund more adequate mental health care provisions, and the additional tax revenue was immediately -- and perhaps permanently -- diverted to fund other state budgetary needs.

We need to be clear with one another and with our elected representatives that the current system of incarceration and killing the mentally ill is not acceptable.

But that's only the first step.

Creating and sustaining an acceptable system will take a massive effort, but it can be done.

The question is, when will that first step be taken?