The coming of winter

The coming of winter points to the chance of both influenza and the coronavirus to come together and overwhelm the medical system across America. “Resilience in the face of unprecedented challenges matters more than ever” was the final point made in a Globe column on emotional well-being of hospital patients’ published in today’s Boston Globe. Hospitals everywhere, including the one at which I consult, are starting to see more and more signs of stress and emotional reactivity among patients who are undergoing physical rehabilitation. Many people are feeling alone and isolated. I have been told that had they known that visitors were being limited they may have elected to forego the stop in rehab – often necessary after stroke, cardiac surgery, traumatic brain injury and many other physical afflictions.

Resilience in the face of unprecedented challenges matters more than ever 

Boston Globe 9-20-20

Some people, including the CDC, are worried about the collision of the Coronavirus and the winter influenza and are strongly urging that we should all get the flu shot. Agreed. “New research in the Journal of Internal Medicine now shows a strong association between mental health symptoms and medical care avoidance according to Healthcare Finance. Many are worried about a resurgence in the Covid-19 and a worsening of the pandemic, now with 200,000 American lives lost. All these factors play on the collective psyche as we approach fall and winter and many are avoiding routine healthcare visits and elective procedures in hospital.

The Farmer’s Almanac has predicted a snowy winter in the Northeast. We will see. But people tend to be indoors and hunkered down under normal conditions and the menacing threat of increased rates of Coronavirus infection can raise anxiety and make things worse. The rate of infection remains to be seen. Same goes for the upcoming influenza season beginning in December. What is known, and factual, is the need for social distancing, limiting the community spread by using face coverings and avoiding big crowds such as those currently being seen on college campuses everywhere. In Illinois, Florida, North Carolina, and elsewhere large parties on college campuses have seen spikes in cases of Covid-19. In Maine, a small wedding party of 25 resulted in the community spread to over 300 citizens and 7 deaths due to the coronavirus. None of the 7 deaths had attended the wedding. The virus does not care who is infected.

The anxiety and depression being felt in hospitals everywhere has to do with the loss of control and the uncertainty of the future health of Americans, the discovery of a vaccine, and re-establishing trust in the science and faith in its leadership.

A Failure to thrive: Learned Resilience

Resiliency training has been shown to be a viable professional development and may better inoculate the police officer and paramedic against the range of emotional contagion faced on a regular basis.Books and papers have been written about resilience. In Dexter, Maine, at least one public service employee is at high risk for post-traumatic stress and its potential to corrupt long-term health. Containment and harm reduction should be the focus of the legal system and social service agencies alike in order to bring the importance of emotional resilience and DV orders of protection to life for those other than victims. 

The judiciary and political machinery in states throughout America must speak out about protecting victims and families by not say “there is nothing that can be done” to stop DVH and citizen well-being.  When calls for service become solely a transaction between first responder and customer it may be a sign that professional resiliency is over taxed and career burn-out may be rising from the proverbial ashes of the calls we did before.

Michael Sefton Blog Post 2018

Containment and harm reduction should be the focus of the legal system and social service agencies alike. I have heard from many that the system of bail is broken. In some states, like Maine, the system of bail has not changed in over a century. The judiciary and political machinery in the states throughout America, must speak out about protecting victims and families and never say “there is nothing that can be done to stop DVH”. The Maine Law Review has espoused in the 2012 issue on DV and Bail conditions that there are important changes that should take place to safeguard potential victims. These include GPS tracking and no bail holds for repeat violators of orders of protection. These changes add both security for potential victims and offer law enforcement agencies some degree of deterrence against those “who prowl the world looking for the ruination of of souls”.

Death by First Responder by Michael Sefton, Ph.D.

“You can’t watch this appalling video posted by brave eyewitnesses on social media without seeing police officers’ callous disregard for a black man’s life,” ACLU of Minnesota Executive Director John Gordon said, calling the death “both needless and preventable.” ACLU of Minnesota Executive Director John Gordon
The death scene in Minneapolis, MN was horrific. I am sickened by the bull shit police work that brings forth justifiably angry people who are themselves suffocating in a society who does not regard them as human. I get that and I share the anger they espouse toward law enforcement. That is not how I was brought up and it was not how I was trained. But not all cops are murderers. First off, there was no need to kill this suspect – George Floyd. No urgent call to control his life and ultimately end it. Mr Floyd had not committed a felony nor was he trying to escape or attack the police. The African American male was suffocated to death by the officer placing his body weight upon the carotid artery of the human being who was in custody. It is well known that once someone is under control and in handcuffs the need for such restraint is reduced appreciably. 
“There will always times when police officers encounter those with mental health needs especially in times of crisis and social disorder. Training and education offer the best hope for safe and efficient handling of cases. A continuum of options for detox, dangerousness assessment and symptom management must be readily available – but here in Massachusetts they are not”  Michael Sefton, 2017
I have had previous posts about the use of force continuum. Officer’s can get off the suspect once control has been established. A law enforcement officer can let up the fight and assuredly, most do so when the fight is over. Whether or not suspect X fought the police after being identified as a suspect in a check forgery scheme or not he did not deserve to die. Even if he were the ringleader in the check forgery scheme and cashed thousands of dollars worth of bad checks, he did not deserve to die. He did not deserve to die. The police will say that the suspect fought until his death – trying to hurt or kill police. Perhaps they will say he was thrashing about and kicking – just off camera. Even if he was the use of deadly force would not be allowed. Bystander video tape will prove or disprove this theory. There is also the body worn camera footage that will surely be published into evidence. From the video released so far, it does not appear that Mr. Floyd was continuing to threaten law enforcement after he was handcuffed. It would appear that the police officer whose full weight rested upon the neck of George Floyd did not reduce his use of force to meet the resistance put forth by Mr. Floyd in kind. That is a serious abuse of power and the officer is now being held on the charge of murder in the second degree. 
“It emphasizes accountability, making amends, and — if they are interested — facilitated meetings between victims, offenders, and other persons like the police.” Center for Justice and Reconciliation
Community policing requires not only programs bringing community members together with police officers in various ways including block meetings, police athletics leagues, and “coffee with a cop” but also developing a mutual trust between law enforcement and the people they are sworn to protect. How does this happen? Police chiefs, deputy chiefs, superintendents, command staff, and patrol officers need to press some flesh out in the neighborhoods. Trust and visibility brings forth accountable and transparent policing. By doing so it opens the doors to community membership by inviting input and honest dialogue.  Restorative justice is a process that slowly repairs the harm caused by crime and malfeasance through ongoing dialogue, respect, and genuine contrition even as it pertains to police abuse of power. Community members, including police officers, and victims of abuse meet for talks aimed at transforming mistrust and anger.  Policing reforms are being introduced from coast to coast Most cities have (again) banned the choke hold that was taught but not permitted in 1982 when I first went through police training. On June 22, 2020, a NYPD officer was put on unpaid suspension for again choking out a suspect who was black. The suspect survived the arrest and was checked out at a local hospital. Meanwhile, the work of the police must continue especially now as Americans learn what to expect from the new normal and beyond. Call 911 if you have an emergency and need the police. 

Risky business: Faucci will not vote against the virus

The Corona virus has taken over 120,000 American lives since it began its tornadic viral defoliation of senior citizens and others with preexisting conditions in the Spring of 2020. The virus caught Americans unprepared. Everything has changed. The impact of the virus has been like a tsunami wave around the world whose point of origin is the giant industrial city of Wuhan, China. Only now are countries like Brazil being decimated and will soon top the United States in total cases and deaths. Countries who went into immediate lockdown were less effected like Norway, New Zealand, and Canada. The United States waited too long and the virus took hold. 

States here in North America, like Georgia, Arizona, and California, who grew weary of the economic impact of the virus and put forth ambitious reopening plans are now seeing record numbers of cases for the first time. The rate of infection is now being felt among younger citizens without pre-existing infirmity. 

Concerns about negative secondary outcomes of COVID-19 prevention efforts should not be taken to imply that these public health actions should not be taken,” wrote the CDC in one of its briefing statements. Secondary outcomes include the broad range of emotional responses to the virus including depression from loss of loved ones, sudden unemployment, increasing substance abuse, threat of homelessness, anger and existential anxiety from loss of control and loss of purpose in life. “However, implementation of supports should include a comprehensive approach that considers multiple U.S. public health priorities, including suicide prevention.” 

The Psychological toll of pandemic is beginning to show after festering for 3 months. The loss of employment, fear of foreclosure, food shortages, price gouging, addiction, and family conflict each increase the bonifide stress associated with the disease and its impact on the human family. People are becoming rattled. The President understands this and wants to exploit the opportunity by holding a campaign event. Trump brushed off concerns about the virus ahead of his highly anticipated rally in Tulsa, Oklahoma, because the number of cases there “is very miniscule”, despite the state’s surging infection of according to a report in the Boston Globe.  Instead, the rally was miniscule and embarrassed the President. 

Top physician and epidemiologist, Anthony Faucci has stated that given the unprecedented and unpredictable nature of Covid-19 that lessening of current social distancing protocols, the use of masks in public, and contact tracing are the best hope for keeping the number of new infections trending downward and to lessen the number of people who die from Covid-19. States who reopen for business without these same precautions are at risk for spikes in cases and more death. Since mid May we have heard from Dr. Faucci less and less as the White House has tried to imply that these concerns are unwarranted and there is “very little of the virus left”. 

President Trump, himself something of a germophobe, has put the needs of the campaign before public health and safety for the sake of his raucous and fervent base. In doing so, he will create a campaign spike that will be measured by new cases and deaths in the next 3-6 weeks time. That is on him and the courts who failed to put limits on the event or cancel it all together in Tulsa, Oklahoma on Saturday June 20. Since February, the president has not taken the pandemic with the kind of leadership that demonstrates his understanding of the virus and respect for those who have succumbed to the disease. 

Meanwhile states like Georgia, Texas, California, and Florida are having thousands of new cases because governor’s of those states have failed to need the warnings of Facci and others. The sudden conflagration of new cases is not the second wave that we have been warned about. The jump in cases correlates with opening businesses without any adherence to protocols. See Tulsa, OK. 

In Florida, the average age of new cases who are hospitalized has dropped to 37-years old. “Those thousands of new cases also signal that, in a week or two, some portion of those people will show up in the hospital, and, about a week after that, a number of them will be dead, even as clinicians have learned more about treating severe Covid-19” said the Boston Globe. For his part, albeit in a greatly reduced capacity, Dr Faucci predicts that a tidal wave of infections is coming unless we do what most medical experts agree starts with respect for social distance recommendations, sanitary hand hygiene, and mandatory quarantine for those who test positive for the virus or are feeling unwell.  

We all know this by now, and it is hard to swallow unless you are among those people who claim to have super immune functioning and refuse orders to wear a mask in public?  Sadly, many will become infected and go on to infect others, unwittingly, all the while they feel nothing and are emboldened by the President who insists the risk of getting the virus at a campaign event is miniscule. Perhaps some readers of this post or others like it do not believe the numbers and chalk it up to fake news.

The emotional impact of the virus has yet to reach its peak. But the racial unrest may be one indication that many are becoming unhinged including a small number of law enforcement officers who lack empathy and understanding of the human effects of stress on unconscious bias and veiled bigotry.  Faucci is getting on the virus. Let us leave the prognosticating to the scientists who are watching the numbers and tracking those who are carrying the virus without symptoms, and may not know it yet. 

 

Harlem domestic violence homicide calls for transparent psychological autopsy

The psychological autopsy is an individually designed case study that elicits a broad range of factual data regarding the behaviors of a decedent in the immediate day or days leading up to domestic violence homicide. The study is especially important when first responders and essential workers are involved all the while a pandemic ravages the city in which they live.

Michael Sefton, Ph.D. Direct Decision Institute, Inc.

The recent domestic violence homicide in Harlem raises the specter of an essential city worker who killed his sister-in-law while his wife called for help. The police stopped the attack resulting in the death of Ubaldo Gomez but not before he shot and stabbed a women in the head with a kitchen knife. The fact is that domestic violence has increased during the pandemic as it does at other of life’s stress points. Did the fact that the alleged murderer was an MTA employee considered to be “essential personnel” have an impact on his mental health that may have been foreseen? What role, if any, did his role as an auxiliary police officer for the NYPD have in the terminal event? A psychological autopsy would answers these questions and establish a worst case scenario of frontline exposure to trauma and possibly offer insight into underlying history that may have been anticipated and stopped. Certainly the hierarchy at 1 Police Plaza will have an interest in this case.

For too many women who are abused repeatedly during times of crisis there is no place to run and no one to keep them safe. Orders of protection are ineffective and without GPS monitoring and they are nearly impossible to enforce. In a 2011 domestic violence homicide in Maine, the protective order was violated 4 times by Steven Lake who killed his wife and children in Dexter before killing himself in June 2011. That alone was grounds to hold Lake without bail. No police agency removed access to his collection of over twenty firearms. The scene diagrams illustrate how Lake was armed with two firearms and a hunting knife. He murdered his children while forcing his estranged intimate partner to watch. It was thought that he planned a murder spree and he left 9 suicide notes. The final despicable act, as police arrived, was to attempt to light the bodies on fire.

In general, there is little interest in such a comprehensive post hoc psychological examination because there is no pending prosecution. Nevertheless, a psychological autopsy conducted on Lake in the Fall of 2011 revealed a clear timeline littered with red flag warnings that were missed or ignored. The research conducted in 2011 was done pro bono. It undertook over 200 hours of interviews and presented the Domestic Violence Review Board with over 50 recommendations for reducing high rates of domestic violence homicide in Maine (Allanach et al. 2011). The medical autopsy editorialized the case in its final report:

“Despite receiving some mental health counseling it is apparent, in retrospect that the degree of violence and anger possessed by the abuser was not realized.”                                                           

Chief, Maine State Medical Examiner

This latest case in point involved an estranged wife, her sister, and the building manager in Harlem. The three were having dinner when someone armed with a firearm broke into the apartment. It was the estranged husband of one of the women. He was wearing his Metropolitan Transportation Authority uniform, and he had a gun according to the NY Post reports. In the meantime we have been told that the perpetrator was an auxiliary police officer and was licensed to carry a firearm. What triggered this paroxysmal violence? If it was foreseeable, then Mr Gomez should not have had access to his firearm.The psychological autopsy will address prior history of intimate partner violence, protection orders in place, work-related stress, recent health concerns related to the corona virus and Mr Gomez trauma exposure history, and his mental health in the days before the murder. 

Police officials said the transit worker, Ubaldo Gomez, shot his sister-in-law and stabbed her in the head with a knife, while his wife reached out for help. When Gomez refused to drop a 12-inch kitchen knife and tried again to stab the man, a police sergeant opened fire, killing him. In the end, there is always at least a single person who knows what is about to happen and often does nothing to stop it. A family member of Gomez suggested “he had some mental issue, something happened. He was always working day and night. He barely slept. He worked.” as quoted in the NY Post. Whether this duplicity and denial stems from cultural beliefs about the supposed “privacy” of DV, society must change the way in which law enforcement manages these cases. The buy-in from police, legislators, judges, probation, and the public-at large needs to be fully endorsed for real change to happen and for safety plans to work. Many states across America are planning to enact “red flag” rules that will remove weapons from individuals with a known history of domestic violence e.g. choking spouse during fight (Sefton, 2019).


Family members who may be in the crosshairs of these insidious events often see but lack the knowledge to stop the emotional and behavioral kinetics once they start. The fear of being murdered by an intimate partner creates emotional paralysis. In a large percentage of DV occurrences, financial and self-image influences as well as outright fear of the abuser by the victim limit moves toward safety. Therefore, a continuum of interagency cooperation is needed to effectively measure risk and understand the pre-incident red flags that are common manifestations of abuse and often forecast terminal violence, all of which occurred in this case. As the totality of these red flags comes into focus it becomes incumbent upon each of us to take action to prevent domestic violence threats from becoming reality (Allanach, et al. 2011).

It would seem to be vitally important that a transparent psychological autopsy be initiated to gain an understanding of the factual behavior that was observable and measurable in the days leading up to the murder especially given the likely unintended victim. Preliminary reports described Gomez as having a pattern of pathological jealousy and victim stalking. For her part, Gomez’ wife Glorys Dominguez called for help in the weeks prior to the terminal event seeking help.

Allanach, RA, Gagan, BF, Loughlin, J, Sefton, MS, (2011). The Psychological Autopsy of the Dexter, Maine Domestic Violence Homicide and Suicide. Presented to the Domestic Violence Review Board, November 11, 2011

Sefton, M (2019) Violence prediction: Keeping the radar sites on those who would do us harm. Blog post https://wordpress.com/block-editor/post/msefton.wordpress.com/5012 taken May 23, 2020.

Sheehan, K, Moore, T. Woods, A. NY Post May 21, 2020 https://nypost.com/2020/05/21/man-killed-in-nyc-police-involved-shooting-was-auxiliary-cop/?

Chaos, Fear and Death from Covid-19: The loss of trust in leadership

The Coronavirus has brought to bear chaos and fear among Americans from coast to coast. I am unsure whether any of us expected the virus would grow and infect over 1 million Americans alone in 6 short weeks. The death toll at the time of this post is just under 80 thousand lives. Personally, my aunt and my mother were both infected with the virus at their living facility. Sadly, my aunt has died from the coronavirus but my mother, has been without symptoms, in spite of testing positive 2 weeks ago. Over 30 percent of Americans know someone who has died or been infected by the virus. The fallout to mental health is real. I see it in my own family as nerves become frayed 8 weeks on.

The virus’s threat to basic needs and personal security has eroded the trust in federal leadership. This is due to the lack of an integrated plan to develop a vaccination, provide testing and contact tracing, support unemployed workers, and reconcile still-rising numbers of Covid positive cases while at the same time as some states begin opening businesses. In doing so, potentially asymptomatic individuals may unknowingly carry the invisible killer into a restaurant, laundromat, or tattoo parlor – all deemed essential services as states like Georgia begin coming back on line. This is a fact, whether or not they meet federal government mandates for “opening up” including 2 weeks worth of reduced rates of infection, decreased death rates, and lowering hospital admissions due to Covid-19.  Many epidemiologists believe that opening businesses too quickly will result in a rise in cases of the virus and an increased rate of death.

Now, the White House Task Force is finding itself in the crosshairs of the invisible and lethal disease as members of the White House staff are being diagnosed with Covid-19 and self-quarantined because of exposure to the virulent disease. Members of the inner circle have been tested and some have been diagnosed with the virus including members of the White House service staff and the Vice President’s personal secretary. In the west wing, there is chaos among the staff as to what precautions should be taken while potentially being exposed to the coronavirus. Dr. Anthony Fauci, who has been the face of the response to the virus is now in a voluntary quarantine as a result of the spread of the virus in the west wing among staff members of the White House. Three physicians have gone into voluntary quarantine as a result of coming into contact with the virus as protocols recommend.

Former President Barack Obama harshly criticized President Donald Trump’s handling of the coronavirus pandemic as an “absolute chaotic disaster” during a conversation with ex-members of his administration. Yahoo News May 9, 2020

Medical personnel across the country are on the front line and they are being recognized for their tireless bravery in the hot zones in American cities like New York, Boston, and New Orleans. The law enforcement and fire service have all shown their appreciation with 7 PM shows of support. This also includes members of newly graduated physicians who have been sent to the front lines of the virus in ICU’s and Covid-19 floors in America’s best hospitals. The stress of this is often overlooked. “Since the pandemic began, newly minted residents who normally wouldn’t take care of patients with severe respiratory illnesses, such as those training to be psychiatrists, podiatrists, or orthopedic surgeons, have been asked to volunteer to work in COVID-19 wards” across the country according to a report by Deanna Pan in the Boston Globe on May 9, 2020. These are teaching moments that have brought out the best in young physicians and the old seasoned veterans who supervise. But the cost has been great with increased rates of suicide since the shutdown began in March including those on the frontlines.

On April 27, Lorna Breen, a physician specialist in emergency medicine took her own life after being witness to dozens of patient deaths during the peak of the coronavirus and contracting the virus herself and surviving it. Dr. Breen was a professional and emergency service medical director of NewYork-Presbyterian Allen Hospital and had no history of depression or mental health diagnoses. In the hours before her death her father, himself a physician could tell something was wrong.

Lorna Breen, M.D.

On the night when the nation’s top virus spokesperson physician Anthony Fauci, M.D. went into voluntary quarantine, the president of the United States had a meeting of his senior staff and none of the members at the meeting were wearing personal protection, like masks. Physicians and epidemiologists are calling for social distancing and personal protection yet the White House resists and engages in ongoing updates and meetings without the use of masks or social distancing. With two White House staffers testing positive for the virus, including Mike Pence’s secretary Katie Miller, the president is making light of the protocols set forth by the CDC and the WHO. This inconsistency and disingenuous message is not lost on anyone.

NBC News profile of Dr Breen

Delayed actions at the top have resulted in confusion about what steps the U.S. Government and the individual states must take to reduce the impact of the viral outbreak. The U.S. has the highest number of Covid-19 cases and the highest number of deaths in the world. The streets of America are empty and businesses are shut down and many will never reopen. The unemployment rate is nearly 15 percent. This is the highest rate of unemployment since the great depression. People are worried and in conflict over medical information they are hearing and what they see in the White House increases that conflict.

“It’s a terrifying, solitary, dehumanizing death that these people go through, and it’s going to leave wounds in our society for a long time,” Tara Bylsma, 30, a second-year internal medicine resident at Boston University Medical Center in Boston Globe May 9, 2020

Working on the front lines with patients who are dying is horrific. This is especially painful when there is seemingly nothing that can be done to help them. First responders and frontline hospital workers are trained to provide emergency care. When their training is not effective than feelings of helplessness will grow. These feelings can be overwhelming. At the same time, the rule of law comes into question and there is growing suspicion that the virus is man-made or an overblown scam. People are pushing for release from social distancing and using the argument that their constitutional rights are being infringed upon by forcing them to remain in their homes. Some are becoming angry and out of control.

In late January, 2020, the World Health Organization declared a pubic health emergency because of the exponential growth of the virus in China and later in Italy and Spain. Trump has since denuded the WHO as being overpriced and undervalued as only he is capable of doing. Sadly, Americans were unprepared when it’s first case arrived in February and we were told not to worry the virus would soon disappear. But it has not gone away and the United States is in lock down as a result.

Human to human transmission of the disease was thought ‘not possible’. The pandemic was first publicized and forewarned by a physician in Wuhan, China who ultimately died from the virus. He had been arrested and warned by police against speaking publicly about the risk of the virus and threatened with sanctions.

Meanwhile, President Trump was publicly yammering about his trust in Chinese President Xi Jinping and the deals he was making to benefit the American economy. His focus was not on the growing fear of American workers but the vulnerable economy that President Trump needs to get himself reelected in 6 months. In the meantime, the virus has not vanished nor faded away with warmer weather but continues to claim over 1000 lives each day across the country. Now, with the coronavirus in the White House, the presidential spin over wearing masks and maintaining social distancing takes on new meaning.

How will the political narrative shift now that Trump and his team has been directly exposed to the virus and members of the Coronavirus Infectious Disease team have become quarantined leaving the president alone in the garden for his bite of the apple?

Domestic violence during the Pandemic – The private response to stress

We don’t need anything or anyone, If I lay here, if I just lay here;

Would you lie with me and just forget the world?

Snow Patrol

The coronavirus has changed almost everything in America. Especially the rate of employment. Unemployment claims across the country are through the roof and it will be weeks before money is available to those most in need. The stress of this has increased calls for domestic violence in Massachusetts and across the country. Domestic violence stems from one intimate partner using coercion and control to dominate his spouse usually was a result of deep-felt anxiety and fear of abandonment.

Music sometimes resonate with social issues. The lyrics from “Chasing Cars” written by Snow Patrol reflect the expectation seen in dysfunctional systems that demand loyalty often at the expense of extended family relationships. These lyrics may sound romantic but they illustrate the desire to isolate a partner to the extent that nothing in the world matters projecting an air of being marginalized and seeking comfort in a partner who shares a common detachment. Truthfully, most people need their families, friends, and work relationships making the mournful request in the song somewhat irresponsible yet compelling for many who may be so inclined.

Lyrics by Petula Clark written by Tony Clark in 1964. Music often takes on the poetic plight of the emotionally imprisoned. It reflects social mores and falsely depicts life without hope. Helplessness and wishful thinking as the message of hope.

“Don’t hang around and let your problems show, Forget all your troubles and forget all your cares and go downtown; linger on the sidewalk where the neon signs are pretty, How can you lose”?

The Fresno sheriff’s department filed 77 percent more domestic violence reports two weeks ago than three weeks ago. The Seattle Police Department received 614 calls in the last two weeks — 22 percent more than average rate. Domestic violence prevention organizations in Boston warn of an increase in cases according to the Boston Globe on April 3.

“You’re going to see underreporting because people are afraid. They’re living with their abuser,” Attorney General Maura Healey said in an interview Tuesday. “It’s hard for them to make a phone call. It’s hard for them to go online even.”

MA Attorney General Maura Healey in Boston Globe

Domestic violence is a private matter that many people do not want the police to know about. But that is the outdated myth. In keeping DV a private matter domestic partners are victimized on average over 7 times before police are summoned. DV gets worse and more pervasive when times get tough. Now as the country is shut down because of mandatory social distancing, intimate partners are frightened that one wrong comment, or a late dinner, of the wrong glance at a cashier may result in the countdown to terminal violence.

Helpless again.

As cops, we must see it and call it out. Arrest is mandatory whenever there is evidence of physical violence. Among the highest red flag risks is the victims belief that she will one day be killed by her spouse. It is usually an ominous premonition. Law enforcement can plant the seed to recovery by encouraging a viable “safety plan” and leaving the victim a dead cell phone that can allow a 911 call when needed. This may be done in the aftermath of the crisis. If you know of someone in a dangerous interpersonal marriage or relationship talk to them about making a safety plan. They may need a friend or family member one night as a matter of life and death. They should not count on orders of protection because these are often inadequate and ignored.

At times of stress, families struggle to maintain the emotional homeostasis that keeps them safe. The normal roles and hierarchy within a family system may erode.

Michael Sefton 2020

Benchmark behaviors for healthy police service

Law Enforcement flag

What are the bench-mark behaviors that are reflective of healthy police officer career development? How does a young man or woman go from a squared away academy graduate to an over burdened, irascible and embittered mid-career cop? There is a growing literature that suggests officer behavior and law enforcement culture become instilled in the field training process that takes place immediately following successful formal classroom training. The answer to the question about officer embitterment is a mystery but after spending time with members of law enforcement in Chicago in late March 2019 it begins to become apparent that police officers grow and remain productive in an environment of support: both within the organization and within the community in which they serve.

There are factors intrinsic to law enforcement that detract from career satisfaction like the risk of personal harm or death, career ending injury, time away from family, shift work, and forced overtime. This is a well known set of stressors that officers learn shortly after signing on. But things that may be unexpected include the quasi-military chain of command that often stifles education and innovative thinking, professional jealousy, arbitrary executive orders, the lack of opportunity to participate in policy making, nepotism among non-civil service personnel, and the lack of support for the sacrifice made by the field qualified troops for physical and behavioral health injuries. The period of field training differs from job to job. Field training picks up where the academy classroom education leaves off. Newly minted LEO’s all must undergo field training and are assigned to a single field training officer (FTO) who provides on-the-job training about the realities of frontline police work and closely monitors officer behavior and responses in the field.

Field training usually lasts between 12-18 weeks and was first initiated in San Jose, CA in 1972 according to research published in 1987 by McCampbell of the National Institute of Justice at DOJ (1987). “The primary objective of the Field Training and Evaluation Program (FTEP) is to ensure that all probationary police officers receive optimal field training, predicated upon staffing the Field Training Officer position with qualified officers, and to ensure through proper training and evaluation that only competent, motivated, and ethical individuals become Chicago police officers” as published in the Chicago PD Field Training Program and Evaluation Standards (2018). Field training officers have specific training in mentoring with an understanding of the demands of “street work” and the transition from classroom recruit to patrol officer. The FOR training process lasts several weeks as seasoned veterans learn how to be mentors and evaluation the training needs of individual probationary officers. 

The selection of FTO’s differs from department to department and has implication on long-term officer success. Attrition rates exceed 25 % under the FTO’s leadership and tutelage in many agencies. FTO’s can be expected to experience training fatigue and should be permitted time between assignments. “Dworak cautioned about agencies falling into situations in which they over-work their FTOs, resulting in diminished quality of work, and subsequently, decreased value delivered to the recruit being instructed” Wyllie, 2017

“The FTO is a powerful figure in the learning process of behavior among newly minted police officers and it is likely that this process has consequences not only for the trainee but for future generations of police officers that follow.” Getty et al. (2014) There is little standardization of training protocols aside from FTO catechizing war stories day after day with tales from the street followed by endless inquiry over possible decisions based on department protocol as the sometimes defiant FTO sees fit.

“New officers can be taught when to legally arrest and use force, but the academy cannot instill in each trainee the breadth of intangible, community, value-based decision-making skills that are necessary to manage unpredictable incidents in varying situations.” Getty et al. (2014)

FTO’s are closely monitored by the department training hierarchy and are required to provide daily observation report as to the demonstrated progress of probationary police officers toward developing competence in over 10 areas of police-related duties including decision making, judgment, court testimony, use of force, etc. At the end of each 28-day cycle FTO’s submit a detailed review of progress and potential deficiencies that arise. In Chicago, IL a probationary police officer (PPO) must complete a minimum of 3 28-day cycles with an FTO. It is known that FTO’s help to instill the police culture in PPO’s including policing by the book and prevailing beliefs and attitudes as they exist within individual agencies. I strongly believe that FTOs play a role in reinventing the police service and lowering the stigma associated with behavioral health and response to exposure to trauma.

Job satisfaction is greatest soon after the law enforcement officer is taken off field training and designated “field qualified”. Following the 12-18 week field training officers remain on probationary status for up to 2 years from date of hire. There is some thinking that FTO behavior rubs off on PPO’s and can impact career identity including misconduct later on long after field training has ended. Officer resilience depends upon solid field training with adequate preparation for tactical encounters, legal and moral dilemmas, and mentoring for career development, job satisfaction, and long-term physical and mental health.

Chicago Police Department (2018) FIELD TRAINING AND EVALUATION PROGRAM http://directives.chicagopolice.org/directives/data/a7a57be2-1294231a-bf312-942c-e1f46fde5fd8c4e8.html taken March 29, 2019.

Wyllie, D. (2017) Why the FTO is one of the most important police employees. Police One https://www.policeone.com/police-products/continuing-education/articles/338249006-Why-the-FTO-is-one-of-the-most-important-police-employees/ Taken March 30, 2019 Sun, I. Y. (2003a). A comparison of police field training officers’ and nontraining officers’ conflict resolution styles: Controlling versus supportive strategies. Police Quarterly, 6, 22-50. Getty, R, Worrall, J, Morris, R (2014) How Far From the Tree Does the Apple Fall? Field Training Officers, Their Trainees, and Allegations of Misconduct Crime and Delinquency, 1-19. McCampbell, M. S. (1987). Field training for police officers: The state of the art. Washington, DC: National Institute of Justice.

Domestic Violence amid worries of pandemic

Brian Gagan of People Results, a Scottsdale, Arizona consulting firm on the left with Dr. Michael Sefton, a psychologist provider in Massachusetts are interviewed by media outlets in Maine following publication of the Psychological Autopsy of Steven Lake, a northern Maine man who murdered his wife and children after being denied permission to attend his son’s 8th grade commencement celebration. The Psychological Autopsy is a detailed case study designed to uncover cues to precipitating factors in DVH. The research conducted in 2011 undertook over 200 hours of interviews and presented the Domestic Violence Review Board with over 50 recommendations for reducing high rates of domestic violence homicide in Maine. 

At times of stress, families struggle to maintain the emotional homeostasis that keeps them safe. The normal roles and hierarchy within a family system may erode. The social distancing required during the coronavirus outbreak has frayed many people into irrational and sometimes dangerous behaviors. Domestic violence thrives at times when the strain of social order violates family routine. Fear and uncertainty over physical health coupled with 7/24 news reporting of death and suffering can be overwhelming for some. 

As with many out of the ordinary times, the incidence of domestic violence increased amid fears of contracting Covid-19. In a Chicago suburb a man killed his wife and then himself as the couple waited for word on the virus swab they had taken together. Neither person tested positive for the virus. Their bodies were discovered after family member grew concerned after not hearing from them over several days. 

According to a Washington Post, Patrick Jesernik killed his girlfriend because he feared they had both contracted Covid -19. His girlfriend, Cheryl Schriefer was murdered after she developed symptoms including shortness of breath. The couple were discovered to be dead by Will County Sheriff’s deputies whose preliminary report suggests murder suicide. 

Star of Will County, Illinois Sheriff’s Department

Domestic violence homicide when Covid-19 strikes fear – coercion and control take over

There is no telling what triggered this tragic event. The Will County Sheriff’s Department had no prior contacts with the couple so no pattern of DV could be established. However, with fear of becoming infected with the virus it is plausible that Mr.Jasernik believed he was ending what he wrongly assumed would be a horrific end of life for them both amid the growing pandemic. 

Some hotlines for people suffering from anxiety and depression have reportedly received more calls, particularly in areas where the coronavirus is spreading rapidly like Maryland and Portland, Oregon, but the National Suicide Prevention Lifeline did not report an increase last week. (The phone number is 1-800-273-8255.)