Law Enforcement and Mental Illness: A Sometimes Fatal Encounter

Gary Fields write on the Wall Street Journal's writes in "Live of Mentally Ill, Police Collide" the story of a police officer who shot and killed a mentally ill man who charged at him with a butcher's knife.  The man died, and the police officer, whose brother suffers from bipolar disorder, is haunted.  Fields writes:

Law-enforcement professionals and mental-health advocates believe they are seeing an increase in fatal encounters between police and the mentally ill. They point to a narrowing range of treatment options that has shifted more responsibility for the mentally ill to law officers, jails and prisons. 

"No police officer does well with shooting someone, let alone someone with mental illness," said Michael Biasotti, immediate past president of the New York State Association of Chiefs of Police and a mental-health and law-enforcement policy researcher. "That destroys a bunch of people at once."

Fields writes: 

The Federal Bureau of Investigation keeps track of instances of "justifiable homicide," which it defines as "the killing of a felon by a law-enforcement officer in the line of duty," but it doesn't note which of those involve mental illness. While crime rates nationally have fallen almost every year since the late 1990s, justifiable homicides by police officers have risen, from 297 in 2000 to 410 in 2012.

Hidden within that category is what is known informally as "suicide by cop," when a person intentionally provokes an officer into using lethal force. Chuck Wexler, executive director of the Police Executive Research Forum, in Washington, D.C., which researches law-enforcement issues, said he believes this type of suicide is increasing in frequency. 

Then over on Pete Earley's blog, he has video up of an unarmed mentally ill man who was shot by police.  Unarmed.   Mr. Earley writes:

This shooting terrifies those of us who love someone with a mental illness or have a mental illness. I’ve been asked to help this video go viral so that the public will recognize the need for better police training. Please do your part and send it out.
http://youtu.be/4U1GOTzvBLQ

And over on Clinical Psychiatry News, ClinkShrink is talking about law enforcement from a totally different perspective.  She received a call from a homicide detective who wanted her suggestions for how to interrogate a suspect.  Not quite the job of a forensic psychiatrist, but she talks about the ethical issues in a way that only ClinkShrink can.  See Consultation to Law Enforcement.

Ducking Around

Ooooh, let me tell you: I love vacation.  I really love vacation.  I'm back.  It's cold here, and I spent the day unpacking and doing laundry, and getting ready to start my week.  I returned calls, went in to the office and checked my mail, emailed, postal mailed, and watched the Ducks win the Rose Bowl.  Sad, because even though we Shrink Rappers like ducks, I have my own personal Badger out in Pasadena cheering for Wisconsin, and it's a sad football day for him, I'm sure. 


Roy did a great job of holding down the blog.  Please give him a hand.  Clink was off on another one of her adventures.  For some reason, vacation is not fun for her if there isn't the possibility that she'll fall thousands of feet, get eaten by some form of wildlife, or have her life depend on properly functioning equipment while she gurgles beneath the sea.  She's the only person I know where "I had a fantastic time" is followed by an injury report.


Roy's Happy New Year duck was taken from the Havre de Grace annual New Year's Duck Drop.  From the Aegis:

It was a glorious night for ringing in a new year. Temperatures, unusually inviting for a New Year's Eve in Harford County, hovered around 43. Wind was non-existent. And many people had gathered around the Havre de Grace Middle School grounds for the annual Duck Drop and fireworks to welcome another new year.

In other stories around the web, if you're a distracted duck, you might have notice that it's hard to find Ritalin or Adderall-- perhaps another example of DEA limits allowing Big Pharma to be being overly ducky about reducing supply of the cheaper, generic medications.  From the The New York Times, do check out "A.D.H.D. Drug Shortage Has Patients Scrambling."  


And if you're a duck contemplating filing for Social Security Disability, do read Dr. Steve's post on Thought Broadcast about The Curious Psychology of "Disability."  With 41 comments on that post, I'm going to swim away from the temptation to comment myself. 

And finally, for those ducks who want to know the latest on Electronic Medical Records, check out Shrink Rap News over on CPN for "Notes from SAMHSA's EHR Summit."  If that doesn't make you want to be served up with orange sauce, then nothing will.

So I love vacation, but I did miss all the Shrink Rappin.'  Happy New Year to everyone!  

From Clink: I don't have a duck in this race, so I thought folks might enjoy a seahorse instead. He's black with white stripes and seems to be perched on top of the green moray eel's head. Yes, the eel was that close.

No significant injuries this time.  A slight jellyfish sting and lots of no-see-'ums, that's it.

My Three Shrinks Podcast 36: Just Do It

[35] . . . [36] . . . [37] . . . [All]

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Folks, we have heard your requests for us to upgrade our sound quality. That is coming up, probably in Podcast #38. Yes, the Google Ads have paid only about 5% of the cost of the upgrade, but we may keep them on the site until they've hit $100, as I believe that is the minimum for a pay-out ($19.05 for September).

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October 8, 2007: #36 Just Do It


Topics include:

• Crisis in the Treatment of Incompetence to Proceed to Trial. In the recent Online AAPL Journal, an article by Wortzel about problems with assessing defendants who are not competent to stand trial and restoring them to competence. [hmm, wonder whose topic this one is] At any given time, these people occupy about 10% of our nation's state psychiatric hospital beds. A complicated discussion ensues about who pays for forensic mental health care and how the system results in decreasing access to care for uninsured non-forensic patients.
  
  
• We respond to a question to the NYT Ethicist column, by Randy Cohen, which you can read here (as well as his answer). [Note: we last saw Randy when he stopped by to respond to a discussion about a previous column of his about suicidal people making wills.] The question involves whether it is okay for a physician, who is a psychiatrist, to prescribe a stimulant (Adderall) to his college kid for the purpose of improving test-taking performance. (We discussed the practice of treating family members in a prior post, My Patient, Myself.) A secondary question involves that kid sharing the medication with a friend. We also discuss the issue of using performance-enhancing amphetamines for non-illnesses, in addition to the potential for a performance-reducing effect due to side effects (which is also taken on my Gawker's Unethicist). (We also ask for help from any DEA agent listeners.)
  
  
• Clink celebrates her 25th Running Anniversary. She's been just doing it for a quarter century.
  
  
• Price Transparency for Psychotropic Drugs. Dinah discusses her post about the list of prices for antidepressants. Roy unsuccessfully looks for the prices of these drugs on the Maryland Medicaid website.
  

Coming up in Podcast #37... SSRI Poop-out (aka tachyphylaxis) and other good stuff. Oh, and here's a pic from my Vegas conference trip. Yummy!

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Find show notes with links at: http://mythreeshrinks.com/. The address to send us your Q&A's is there, as well. This podcast is available on iTunes (feel free to post a review) or as an RSS feed. You can also listen to or download the .mp3 or the MPEG-4 file from mythreeshrinks.com. Thank you for listening.