Most psychiatric crises are resolved with the support of family and friends and with appropriate medical intervention. It is only when there are public disturbances, that police become involved. We expect the police to risk their own lives, for our own safety.
They face complex situations, requiring them to make difficult decisions on the spur of the moment. We should always be supportive of police action, even when the outcomes result unfortunately in injury and/or death but victim families have a right to know the true circumstances of incidents that go horribly wrong, and receive an authoritative assessment of what could have been done better.
This blog has already reviewed the story of the death of 19-year-old Brazilian student Roberto Curti in 2012. His death followed police attempts to bring him under control by tasering him multiple times, when he was suffering from an acute drug induced psychosis, with manic agitation.
The story of Adam Salter is an example of the injudicious management of mentally ill patients in this case not involving the use of Tasers.
Adam had grown up a happy well-adjusted young man with a good job until he developed schizophrenia, and became depressed.
He died at 36, in November 2009, after stabbing himself in the chest with a knife. He collapsed bleeding, on the kitchen floor but was struggling to reach the knife on the kitchen sink when his father came to his rescue.
His father called emergency services, and set about trying to calm his agitated son, putting his arms around him. An ambulance paramedic arrived first who thought his injuries were not fatal and his condition stable.
When the police arrived they took control of the situation. They asked his father to leave, because of the danger, and instructed Adam to submit to their commands. Instead their presence increased his agitation and he again struggled to get to his feet. The move towards the knife contrary to their orders, was thought to be threatening, when he was in all likelihood just still suicidal.
At this point another police officer entered the kitchen from another room, shouted Taser three times, but then shot him three times with a hand gun, killing him,
This incident demonstrates:
- that police authoritarianism can worsen such tense situations, and increase patient agitation.
- that police may over-react in emergencies. The patient was suicidal and wounded, and unlikely to have been able to harm anyone other than himself.
- that they terminated his father’s supportive presence, and ended his medical treatment.
- that they failed to try alternative non lethal measures. Instead they shot to kill, without proper warning.
The mentally ill rarely obey orders and may be unable to do so because of uncontrollable inner turmoil and agitation.
To attempt to restrain them and physically bring them under control simply heightens their distress. Repeated tasering is agonising, and greatly increases the risk of death probably by compromising their heart and lung function.
95% of more than 500 patients dying in the United States since Tasers were first introduced, were unarmed. This suggests a need more accurate diagnosis and assessment of risk. The present police approach is appropriate for aggressive and armed individuals, but for the majority who are unarmed and in need of medical attention, a calm, reassuring, and conciliatory approach is likely to be more successful.
The emphasis should be on sedatives, not weapons.
This post is a contribution to a community debate we should have, about what we can do better in such emergencies for a major and increasing problem in our society.