Monday, October 13, 2008

Seattle police form unit to work with people with mental illness

From the Seattle Post-Intelligencer:

The former social worker on Ravenna Avenue Northeast used to help the vulnerable. Now, she's the one who needs help.

When she's delusional, the 66-year-old can be violent toward neighbors. In two years, her neighbors have called police a dozen times.

As Seattle Police Officers Scott Enright and Suzie Parton pull up one afternoon in September, they can barely see her home behind a wall of overgrown blackberry bushes. They wonder if she will be calm, confused or even safe.

She has physically attacked one neighbor and dumped cat box filler through another's sunroof. One night, she pounded on a sleeping 3-year-old's bedroom window, beckoning the child to come outside.

"That was super-scary for that family," said Parton, part of the Crisis Intervention Unit, which specializes in working with the mentally ill.

The woman isn't sick or dangerous enough to be detained for psychiatric help. Yet, when she's been arrested, her mental problems made her incapable of facing criminal charges.

With resources limited for the mentally ill, police often are the first to get called when someone is having a psychiatric meltdown. In a unique approach, the Seattle Police Department dedicated two officers to cases such as this one, hoping to prevent crises before they turn tragic.

Part cop, part social worker, Enright and Parton look for solutions for people who commit crimes because they are undiagnosed, off their meds or lacking access to services. They coordinate with social workers, probation officers and mental health professionals, hoping to get unstable people off the streets and into treatment, or jail.

"Getting them the treatment and social services they need meets a public safety need, which is what we're about," Enright said.

They focus mostly on misdemeanors, hoping to intervene before mental problems cause someone to commit more serious crimes. Many offenders have more serious records and a history of drug or alcohol abuse. Some cases don't result in arrests, yet the person is a constant source of 911 calls. Sometimes, they look into noncriminal matters that might otherwise slip under the radar, such as neighbor disputes that exhibit odd behavior.

"A large part of our work is threat assessment," said Sgt. L.G. Eddy, who heads the unit. "Sometimes we find when they go out and chat that there is way more to it than what got reported that day."

Among cases they've worked on:
  • A naked man at Westlake Center who was arrested more than 20 times in a
    year, costing taxpayers about $50,000. The officers met with the man's
    caretakers at a state-funded group home and pressured them to pay closer
    attention. He's been under control since.
  • A schizophrenic man who frightened neighbors by repeatedly shouting from his balcony.
  • A North Seattle man whose rants toward his mother prompted the officers to
    dig further and discover a "freaky" arsenal of weapons in his bedroom, including clubs with metal spikes, samurai swords and playing cards fitted with metal razor edges.

"I think our intervention prevented some real newsworthy violence," Enright said. "But obviously you can't know what you prevented because you prevented it."

Still, the officers emphasize that people with mental illness aren't any more violent than the general population.

"But they get a lot more attention when they do something violent," Parton said.

Enright and Parton form an investigative arm of the unit, which started in 1998 as a training program to teach patrol officers better techniques for defusing confrontations with mentally ill people who are aggressive. It followed two tense situations in 1996 and 1997, including an 11-hour standoff with a sword-wielding man downtown, which officers resolved peacefully.

Eddy pushed to expand the program by dedicating an officer who would serve as a liaison to social services and Mental Health Court. In 2001, Parton, a veteran hostage negotiator who has a background in social work, was the first to join. Enright, a former motorcycle officer and Anti-Crime Team member, was first assigned four years ago.

Having the specialized unit and training doesn't compensate for a lack of publicly funded resources for people who are in need of mental health care, Eddy said.

"All the police training in the world is not going to take care of this issue," she said.

In the near future, the officers could be teamed up with county mental health professionals, who hold the authority to decide when someone should be involuntarily committed for 72-hour emergency psychiatric help. The project is one of many the King County Council approved last week as part of a $50 million plan to expand services for the mentally ill and reduce mental-health related incarcerations by 30 percent. The money will come from a one-tenth of 1 percent sales tax increase.

By accompanying officers on calls, mental health workers could see how someone is behaving in the moment and not after he or she is in a controlled environment, Eddy said. The officers' cases generally are referred to the city's Mental Health Court, which was the fourth in the nation when it was established in 1999 as a means to treat the underlying disorders behind some criminal behavior.

Unlike a traditional adversarial system, the court is set up so that all sides work toward rehabilitating the client. A defendant who is eligible agrees to enter an intensive, closely monitored two-year treatment and housing program.

"These officers take the extra time and effort to learn how to better deal with these clients," said Russell Kurth, the public defender assigned to Mental Health Court.

The officers often consult him on the best way to bring someone in and move quickly to find someone who broke a court order or missed a hearing, Kurth said.

For the officers, it's satisfying to see when they arrest someone who turns his or her life around through the court.

Enright points to the man who amassed the weapons in his bedroom.

"I still see him every once in a while. He's still on probation and really doing well," Enright said. He noted, however, that a court order prevents the man from contacting his mother, which was tough for the family.

Parton was working last month to untangle the case of a newlywed who had for years successfully coped with bipolar disorder. A few months ago, she fell apart, and when her family tried to take her to the hospital for a mental exam, she tried to run.

With no other options, the woman's mother called police. The officer who responded tried to stop the daughter, who threw a punch. The woman, who had no prior criminal record, is now charged with assault and spent weeks in jail when she needed treatment, Parton said.

"Sometimes I just want to answer 911 calls," she said. "You want to have a happy ending, but sometimes in this work, you can go weeks without one."

A ticket to Mental Health Court isn't automatic, especially if the person is deemed not competent to stand trial because of his or her illness. In a majority of misdemeanor cases, that means the charges are dismissed and the person is released.

That frustrates the officers, who think the state's competency laws should at least provide supervision for someone who committed a crime and is released. People with competency issues can be civilly committed, but only if the state can prove that they are an imminent danger or gravely disabled, and that there is no alternative. As a result, patients are committed in only a small percentage of cases.

The officers say that creates a revolving door of "frequent fliers" who are back out on the street with no treatment.

"I appreciate that we're in America, and I appreciate civil rights. But I think people need to have the opportunity to get better, and when they're not in their right minds, I don't think the choice should always be, 'Don't put them in the hospital,' " Parton said.

Changing the state's involuntary commitment law to mandate treatment for those with a significant history of violence was one of several recommendations from a task force appointed to examine the state's mental health system. The task force was convened after James Williams, a repeat violent offender with schizophrenia, killed Shannon Harps on New Year's Eve.

King County is discussing other options such as a "crisis diversion center," where police could take someone who can't be detained for referrals to services.

Back at the Ravenna Avenue home, the former social worker isn't home when Enright and Parton arrive, although her back door is wide open. Her shopping cart is tipped over into a bush. Trash, mostly dozens of empty Lean Cuisine cartons, flows out the door onto the back porch. The woman has no plumbing and is known to use buckets around her yard as toilets, Parton said.

On a prior visit, Enright was forced to handcuff her after she assaulted a neighbor. She had forgotten by the next visit.

Living alone and with no immediate family, the woman was worried about her roof. Enright climbed up for her and took care of it. "He inspected her gutters, and that was it. She just loves him now," Parton said.

As the officers call out the woman's name, another concern emerges. Vandals have recently begun picking on the woman. Someone recently broke in and left a message in graffiti on the kitchen wall: "Do you feel me crazy lady?"

"I don't want her to become a victim," Enright said.

They decide to enter the home and trudge through the garbage. They peek into
a bedroom and stop. Splashed across her walls and pillows is a dried, brown substance that resembles blood.

The officers don't see or smell a dead body, but fearing they might have entered a crime scene, they back out. Enright calls for assistance from a patrol sergeant, and once he arrives, they re-enter. They find an opened bottle of barbecue sauce on the bed.

Enright and Parton breathe a sigh of relief, but wonder if the stains are another prank on the woman.

A week later, they learn from neighbors that the woman came home. So, they plan to visit again and are working with Adult Protective Services as the city begins proceedings to appoint her a legal guardian.

"Last year, we were more concerned about her neighbors' well-being," Enright said. "This year, we're more concerned about her well-being."