Police officers are regarded as the front line first responders to family conflict and domestic violence. For better or worse, the police have an opportunity to effect change whenever they enter into the domestic foray – whether an arrest is made or not. This affords them a window into the chaos within the effected family system and the opportunity to bring calm to crisis. In many cases, the correct response to intimate partner violence should include aftermath intervention when the dust has settled from the crisis that brought police to this threshold. At these times the communication between family and police may be operationalized, improved and redefined. When this is done it establishes a baseline of trust, empathy, and resilience.
WESTBOROUGH, MA – March 30, 2017 Police officers are being trained in crisis intervention techniques across the country and Canada. This training offers plenty of practice role-playing scenarios that come directly off of the call sheets affording a reality-based training opportunity. I recently spent time riding with members of the San Antonio PD mental health unit and have the greatest respect for the officers with whom I rode. In contrast, some departments regularly have highly trained clinicians riding with officers bringing expertise in mental illness and abnormal behavior across the thin blue line. It is thought that by sharing knowledge at working with unpredictable, drugged out, psychotic and delusional and angry who police encounter on a daily basis better outcomes may be achieved. No single model is best and all are still in the growing stages of establishing protocols for bringing those most disturbed individuals in from the margins. More and more officers are receiving CIT training every year.
The important part of crisis intervention training comes in the interdisciplinary relationships that are forged in by this methodology. Trust and respect between the police and its citizens builds slowly one person at a time. Community policing is not a new concept but fiscal priorities often prevent its full implementation. Just the same, there must be trust and respect between the police and the purveyors of crisis intervention and mental health risk assessment including doctors, nurses, and health care practitioners. This also takes time and training and the shared belief in the model.
“When officers are faced with a deadly situation, when there is a gun pointed at a cop, there is no time to go into mental health measures,” according to Grace Gatpandan, spokesperson for the San Francisco Police Department
The use of force continuum belies each officer contact and guides the process when police are called upon to defuse a dangerous encounter. It is best that a mental health contact be made long before violent threats are made – long before terminal rage erodes personal judgment. The community policing doctrine affords this front end contact and encourages officers to know the people living on the beat.
POLICE ENCOUNTERS WITH MENTALLY ILL CITIZENS
The Boston Globe Spotlight series on police encounters with the mentally ill cites one distraught parent who was quoted “I only wanted the police to disarm him not shoot him dead.” Unfortunately for this family, when faced with lethal violence it is the behavior of the subject that drives the ship in terms of what will or will not happen. “When faced with a deadly situation, when there is a gun pointed at a cop, there is no time to go into mental health measures”. All too often people fail to see the cause – effect relationship between citizens with guns or other lethal weapons and the police officer response. The use of force continuum follows the principle of causation by guiding police decision making based on the level of threat.
What came first the threat or the police action? It is the primary action of the citizen the evokes the lethal response by police. If citizens dropped weapons and listened to police officer directives during these high energy and chaotic events there would be fewer deaths. To say they lack training in mental health is preposterous. Almost as preposterous as saying if they were better parents the mentally ill subject might not aim his gun at police or threaten his mother with a knife. No, the responsibility lies with the mental decision-making and subsequent behavior of the subject himself. If mental illness drives the violent behavior than all weapons and substance use must be carefully controlled and eliminated. When people attend psychotherapy sessions and 12-step recovery programs the proclivity for violence is greatly reduced. Inevitably, drug abuse is a co-morbid factor that alters perception and fuels underlying anger and violent tendencies. Who is responsible for this? When drug addition or alcoholism begin – all emotional growth including adult “problem solving” begins to fail until it is fraught with uncontrolled, impulsive violence. Rather than placing blame, greater emphasis on sobriety, counseling and developing emotional resiliency should be encouraged.
WESTBOROUGH, MA March 21, 2017 When working as a police officer I was asked to take the statements of women who were asking for protection from an abusive spouse or intimate partner. These requests were usually granted by the on-call judge – especially if children were at risk or a history of physical abuse was suspected. But these orders only last a short time – perhaps a weekend. In order to have restraining orders extended the victim is expected to go to the district court and swear testimony that specifies the reasons for an order of protection including threats or actual physical harm, forced sexual contact, pathological jealousy – whatever. Sometimes this happens and protection orders are extended usually for 6 months. During this time the couple is expected to sort out their differences and engage the help of a family therapist, if possible. This rarely happens.
“Domestic violence is not random and unpredictable. There are red flags that trigger an emotional undulation that bears energy like the movement of tectonic plates beneath the sea.” according to Michael Sefton. A psychological autopsy should be undertaken to effectively understand the homicide and in doing so contribute to the literature on domestic violence and DVH according to Sefton who with colleagues published the Psychological Autopsy of a case from Dexter, Maine where a father murdered his children, estranged wife and ultimately himself (Allanach, et al, 2011).
More often than not, the victim fails to appear for this process and the protective order goes away without any consequences. Why? In the time between the initial emergency order and the Monday morning when the victim is expected to substantiate her initial claims she may have been bullied by her spouse and worked over by his family, his friends and whomever he can enlist in his camp to get her to let it go. She is made to believe that she cannot function without her abuser. When children are involved an abusive spouse will usually say that child protective services will take the children for whatever reason he comes up with. He promises to destroy her credit worthiness, she will be penniless, and he threatens to share lies about her on social media pages for all to see. He may also promise to kill her and cut her to pieces to be used as fish bait – as I have been told in a case being investigated by my former agency. But he swears his love for her always.
This happens over and over.
In some cases the order to extend the restraining order results from elevated risk to the victim and recurring threats of violence. In these cases orders of protection go on for months or years at a time. This type of bullying is an example of the often secretive coercion that takes place in DV and intimate partner abuse is flagrant and often goes unreported. It must be considered whenever an initial order is not sustained especially if the victim fails to appear.
In some cases there is more than one order of protection issued to protect one or more intimate partners. This is a red flag and should have bearing on the bail requirements but seldom does. There should be some follow-up with the original complainant by the police department to investigate her reasons for not pursuing the extended order of protection and determine what impact bullying may have played on the victim’s decision. In rare cases permanent orders are granted because of compelling evidence that the victim and her family remains at risk – usually the result of stalking.
In March 2014, I published a blog in which the Massachusetts Supreme Judicial Court granted a permanent restraining order even though the former spouse was living in Utah and was remarried. In 2014 the Boston Globe did a story on the case written by Martin Valencia essentially raising the spector of the abuser in this case and the current impact the court order has on his day to day life in Utah.
Kevin Caruso was unable to get a job as a youth baseball coach because of a continuing order of protection here in Massachusetts that shows up on his CORI report. He could not own a firearm and was sometimes hassled at airports. The SJC ruled that Kevin Caruso must submit “clear and convincing evidence” that he no longer poses a danger to former girlfriend in a case dating back to 2001. The Supreme Judicial Court in Massachusetts has required that Mr. Caruso provide proof that “he has ‘moved on’ from his history of domestic abuse and retaliation”. It is well-known that male abusers move from one abusive relationship to another. A colleague Dr. Ron Allanach wrote “In the Caruso case, the Court is proactive, sensing the burden is on the offender rather than the victim; thus, the responsibility for proof that Mr. Caruso has “let it go”, poses no danger to the victim and has done the necessary therapy on his own behavior and to figure strategies to change, rests precisely on the shoulders of the offender where the burden should always remain.” The SJC called the frustration felt by Mr. Caruso the “collateral consequence” of the permanent restraining order put in place initially issued as a result of his threats to kill his former girlfriend. Time alone and location has no bearing on whether a permanent order is sustained. No person should live is fear that a former partner is going to appear at her workplace or stand behind her in the line at Starbucks while she thinks about what blend of coffee she might want.
“Substantive decisions about bail or no bail holds will be more reliable by having access to the violent history of domestic violence offenders and the protective orders that have been issued time and time again.” Michael Sefton
Allanach, R. Court is proactive. Personal correspondance. March 2014
Sefton, M. 2014, https://msefton.wordpress.com/2014/03/11/collateral-consequences-stay-away-orders-that-are-forever/ taken January 21, 2017
Valencia, Milton. SJC rules on Utah man’s permanent restraining order. Boston Globe March 11, 2014, taken March 24, 2017
WESTBOROUGH, MA December 29, 2016 I have long been an advocate for prompt and comprehensive treatment for those afflicted with mental illness. Now police are increasingly linking up with mental health agencies as a way of diverting mentally ill person’s from jails into treatment for their emotional affliction. In my experience this is no easy task. In some cases criminality and mental illness are not mutually exclusive. Some who suffer with emotional issues like bipolar depression, drug addiction or anxiety may respond poorly to treatment and may need containment. Those most refractory to treatment often become most difficulty to manage in society. The untreated mentally ill have a higher rate of violence than those in voluntary treatment.
As early as 1984, I served the pediatric population in Boston at the Boston City Hospital Pediatric Emergency Department as the on-call clinician in psychology. That same year I was appointed to the ED at Hale Hospital in Haverhill, MA for screening people in crisis. Those who were stable and had support systems in place would be released – usually with an outpatient referral. Meanwhile, patients without at-home safe guards who could not plausibly answer the question “what brought you to the decision to harm yourself?” were admitted to the hospital. Other mitigating factors like healthy living arrangements, employment, sobriety, and no history of suicidal behavior were positive indicators of future outcome. It was a position I loved and is an important clinical role to this day across the United States. Later as a community mental health psychologist in Long Beach, CA, I served the Children’s Service as someone charged with screening adolescents in crisis living across Los Angeles County. In each of these locations I worked closely with social workers, case managers, police and gatekeepers at state and county psychiatric units to find open beds for kids in need.
In 25 years since there has been very little innovation and fewer still treatment beds for those in need. Today’s depressed and emotionally wounded often spend days in emergency department hallways further wounded by a demoralizing system of delivery that is overwrought and has no place to send them. This scenario was the case in 1985 and remains the case in 2016. In Massachusetts and counties across the United States publicly funded hospital beds – including state hospital beds have been eliminated. In the 1970’s and 1980’s the pendulum of advocacy swung toward community-based care and away from hospital-based treatment. This left the chronically mentally ill without a support net for treatment, medication management and long range hope. Many became homeless, unemployable and abusive of drugs and alcohol.
Police provide frontline intervention – often with little training
Police officers became the first line of defense as the hospital beds were eliminated. The mentally ill and those addicted to any number of drugs or alcohol grew homeless and sometimes menacing as they struggle with symptoms. Now police officers are being trained to intervene with these marginalized citizens with crisis management skills. This poses a conundrum for the current zeitgeist of community policing theory in that the notion of dangerousness relies on critical scrutiny of the underpinnings of human behavior and often nonverbal indices of psychopathology. Some believe this is state of the art police science. Departments from Augusta, Maine to Los Angeles, CA to San Antonio, TX are using frontline officers as crisis resolution specialists for police encounters with the acutely mentally ill. Many are paired with licensed clinicians while others are working the streets alone.
The collaboration between police and mental health personnel is not new. But the use of police officers as crisis intervention specialists is innovative and gaining traction in many places around the country. Yet these officers must always be aware of the uncertainty of some encounters with police and those suffering with paranoia or psychotic, illogical delusions, PTSD, or traumatic brain injury that may not respond to verbal persuasion alone. Decisions about when to utilize greater force for containment of a violent person is sometimes instantaneous.
The use of force must be fluid and officers in the field are expected to modulate the force they apply to the demands of the situation and be ready to respond to changing threat levels. Michael Sefton, 2015
In 2002, I was appointed to a Massachusetts police department having once served in southern Maine right out of college. As a psychologist I made an effort to bring mental health concepts into police work without much fanfare or interest. Mental health topics are not as sexy as defensive tactics or firearm training, I was once told, so finding numbers was sometimes tenuous. There are still many myths about intervening with those who are making suicidal and homicidal threats and training opportunities are taking on more importance. Especially these days. Suicide by cop became a phenomenon that no officer ever wants to confront. All violent police encounters guide officer behavior. “The degree of response intensity follows an expected path that is based on the actions of the perpetrator not the actions of the police” (Sefton, 2015).
Suicide by cop – predicting behavior
In the 2014 FBI Bulletin, Suicide by cop (SBC) is defined as “a situation where individuals deliberately place themselves or others at grave risk in a manner that compels the use of deadly force by police officers” according to Salvatore, 2014. This happens more than one might expect and is often preceded by rehearsal events according to Salvatore. “Suicide rehearsals are practice for the attempts that will follow within a few hours or days. SBCs may be tested. Officers should use caution when recontacted by an individual who previously presented signs of mental illness, had no need for assistance, was standoffish when asked what was needed, or was anxious to assure the officers that everything was fine. The initial contact may have been practice for an SBC.”
The best predictor of behavior is past behavior. The prior demeanor that police have observed in those frequent flyers who pop up on police radar over and again often sets the stage for violent conflict later on. But not always. Situations grow exponentially more grave in the presence of drugs and alcohol raising the level of lethal unpredictability. For many struggling with depression or other serious mental illness being sober or drug free can be the healthiest thing they can do for themselves. The uncertainty of the SBC scenario makes the likelihood of a successful de-escalation a tenuous exercise in the life and death force continuum.
The motives for SBC are multifactorial and undeniably linked to poor impulse control associated with drug and alcohol intoxication. The triggers are identified by Salvatore as “individuals who feel trapped, ashamed, hopeless, desperate, revengeful, or enraged and those who are seeking notoriety, assuring lethality, saving face, sending a message, or evading moral responsibility often attempt SBC”(2014). Some believe they will become famous and earn large monetary settlements for their surviving families following a SBC scenario. Other victims are tortured souls who make no demands and offer no insight into their suicidal motive and are killed when they advance on police or turn a weapon toward responding officers.
Training in police-mental health encounters has slowly taken hold. This innovation in community policing offers hope for reducing fatal encounters. No amount of training in crisis management will reduce incidence of SBC to zero but ongoing training to identify the behavioral indices of imminent violence, psychosis, and suicidal/homicidal ideation will reduce these lethal encounters. Most officers are highly skilled at using their verbal skills to de-escalate a violent perpetrator without using lethal force – even when a higher level of force may have been warranted.
Salvatore, T. (2104), Suicide by Cop: Broadening our Understanding. FBI Law Enforcement Bulletin, September. Taken 12-29-16 Bulletin website https://leb.fbi.gov/2014/september/suicide-by-cop-broadening-our-understanding.
Sefton, M (2015) Blog post Law Enforcement- Mental Health collaboration. Taken 12-28-16, https://msefton.wordpress.com/2015/11/27/law-enforcement-mental-health-collaboration/
WESTBOROUGH, MA January 7, 2017 What happens once the “scene is safe”? Usually the hostile threat is taken into custody – either to jail or a hospital. In the aftermath of high stress events such as talking a violent alcoholic into surrendering there should be an opportunity to follow-up and bring closure. In the time it takes to defuse a potentially lethal citizen encounter the police officer has established a connection – however slim it may be. Aftermath intervention may go a long way to further validate the first steps taken with the initial encounter. With such high incidence of polydrug abuse the threatened violence may take on a surprisingly banal theme and the importance of sobriety may be realized once the scene is safe.
Most officers are already highly skilled at using their verbal skills to de-escalate a violent perpetrator without using lethal force – even when a higher level of force may have been warranted.
I have been called to the same home over and over when a violent adult male became intoxicated and gradually overwhelmed and depressed. Each time officers went to the residence there ended up being a fight. We deployed OC spray on more than one occasion each of us getting the pepper in our eyes. This man was hooked up and sent to the hospital time after time. Upon his return (usually within 1-2 days) he would have a short period of sobriety and slowly start drinking and abusing his father again resulting in the same battle we had days, weeks, months ago. Interseting to me was that the younger man was quite reasonable when he was sober. He had no interest in seeing a therapist – nor could he afford one. The important question to me was what steps could be taken to link this guy to a 12-step alcohol (and drug) recovery program? There were meetings in our town and they were free. I thought if he could meet a sponsor than hs abuse of his father might be reduced. In any case, sooner or later someone was going to get seriously injured on a call at this home. We had heard rumors of him wanting to commit suicide by cop.
Community policing has long espoused the partnership between police and citizens said Sefton in December 2013. The positive benefits to this create bridges between the two that may benefit officers at times of need – including the de facto extra set of eyes when serious crimes are reported. The same goes for crisis management. The relationships you build while in the community can serve to help soften the scene and slow down an escalating person of interest who may be looking for a fight. Violence often occurs after a period of brooding isolation that is fueled by alcohol and a bolus of rage.
Police officers are regarded as the front line first responders to family conflict and DV. Now they are being trained to better interact with those thought to be mentally ill. For better or worse, the police have an opportunity to effect change whenever they enter into the potentially hostile foray. This affords them a window into the chaos and the opportunity to bring calm to crisis.
“…there are cases in the literature that identify a pattern of behavior that is observable in the days, months or years preceding these monstrous events that may signal a need for high risk containment”
Taken from Psychological Autopsy of Steven Lake in 2011 presented to Governor’s DV Abuse Board
WESTBOROUGH, MA October 31, 2016 People often see signs of imminent violence in the days weeks or months in the lead up to DVH. As a society, these signs must evoke action on behalf of potential victims. The roadmap to understand domestic violence requires clarity and courage that should not be placed solely in the hand’s of victims.
It is frequent that the abuser tips his hand as to what his intentions might be. In the Lake homicide-suicide in 2011 in Dexter, Maine, Steven Lake hinted to his son that “the cost of a divorce is 25 cents – the price of one bullet.” Lake also verbalized that when he “did it – it would be on CNN.”
- “… He stood in the doorway with a loaded gun and talked about killing himself and/or children and myself. He was bringing up old verbal threats and I thought they were going to come true”
Amy Lake – July 2010
WESTBOROUGH, MA September 15, 2016 The words above were taken from a requested order of protection in the state of Maine in 2010. The threats upon this victim and her family became a reality exactly one year to the day after this order was put in place in 2011. Lake and her two children were murdered by her husband Steven Lake who killed himself as well. Immediately following the killings a Maine district attorney said “there was nothing we could have done to prevent these killings”. These were the words that triggered a team of professionals including myself to research the sequence of events that lead to this event. A formal psychological autopsy was undertaken in 2011 following these murders and over 50 recommendations were generated (Allanach, et al 2011).
I am sick to my stomach as I write about another senseless killing of Wanda Rosa in Methuen, Massachusetts in late summer 2016. The case resembles so many cases of domestic violence homicide – manipulation and control. Ms. Rosa had a permanent order of protection but had recently modified the order to allow Emilio Delarosa to see the child they had in common. Why in the world would anyone allow Delarosa to see his son? He is no role model and the potential for terminal violence was readily apparent as depicted in the order of protection. He expressed his intent to kill his girlfriend on more that one occasion. Delarosa’s history of intimate partner violence had risen to the level of a permanent ban – signaling that the pattern of violence was undeniable and the red flag indicators for domestic violence homicide (DVH) were apparent in the eyes of the police and judiciary when the permanent order was granted.
Permanent orders of protection are rarely granted unless the pattern of violence was so prevalent and unremitting that the potential of harm or death to the victim and her family was unsurpassed as in this case. It is known that Delarosa was manipulative and controlling of his girlfriend getting her to drop charges over and over and later alter the terms of the restraining order – ultimately resulting in her death. Secondly, the person against whom the stay away order is granted must have demonstrated a blatant indifference of the order of the court by having recklessly violated the order over and again. It should not have been altered. In the past 18 months cases meeting these requirements (such as this one) have resulted in intimate partner violent deaths. The Jarod Remy 2013 murder of Jennifer Martin is a despicable reminder of the need for change in cases of DV. Remy killed his girlfriend by stabbing her multiple times as the couple’s 4-year old child bear witness. In spite of laws designed to reduce the likelihood of DVH Rosa was not adequately protected.
Rosa’s boyfriend Emilio Delarosa is on the run as of September 20. He is accused of murdering his former girlfriend after years of abuse, strangled her to death as their 4-year-old boy pleaded with him to spare her life, according to court records. “No Dad” the child was heard to say over and over. As in the Remy case, the 4-year old witnessed his father choking Wanda Rosa until she was dead.
“I suspect there is a strong likelihood that he too will be among the deceased in the coming days as is the common eventuality among those who commit the unconscionable, violence that manifest in this terminal event” according to Michael Sefton, Ph.D., director of psychology and neuropsychology at Whittier Rehabilitation Hospital in Westborough, MA. When some men violate the permanent protection order it is the result of unbridled rage and defiance against a “system” they believe has failed or unfairly humiliated them said Sefton in a release. They are murderous and often turn their rage inward in an act of suicide. I would look for the triggers of what set Delarosa’s terminal rage into action. It could be something as simple as being told he needed to have monitored visitation with is son or learning that the female was seeing another man – both conjectural on my part. After the alleged killing Delarosa was heard to say “It’s over, it’s over, it’s over” when speaking to his sister.
“Domestic violence is not random and unpredictable. There are red flags that trigger an emotional undulation that bears energy like the movement of tectonic plates beneath the sea.” according to Sefton. A psychological autopsy should be undertaken to effectively understand the homicide and in doing so contribute to the literature on domestic violence and DVH according to Michael Sefton who with colleagues published the Psychological Autopsy of a case from Dexter, Maine where a father murdered his child, estranged wife and ultimately himself (Allanach, et al, 2011). In the days preceding the murder there are usually red flags or pre-incident indictors that people see that signal the intentions of the murderer. These clues provide police and the judiciary with data to craft protection plans and are the commonalities found in cases of DVH across the state and across the world. Some red flag behaviors signal the emergence of imminent terminal anger that can be seen in the social media accounts of intimate partners who go on to kill their spouses. I am quite interested in the compelling reasons that Delarosa may have argued that resulted in the change in the permanent order of protection. The outstanding Boston Globe article about the slaying is a sad reminder of the early warning signs of DVH. All the red flags were present. In a blog published in 2013 I list the tell tale warning signs of intimate partner homicide and the need for tougher bail conditions (Sefton, 2013).
The impact on the child will be lifelong. At age 4, children are developing their sense of gender identity in the setting of developmental growth, cognitive maturity, social functioning and continued individuation. Imagine the child who is reunited with his parent after a period of mandated protection due to DV. He is now able to see his family and may be fraught with both excitation and fear. It would be normal for the child to have fantasies of reunification of the family and perhaps self-blame for not having stopped the action of his father. Just like the daughter of Jennifer Martin and Jarod Remy this 4-year old boy will forever be reminded of the life he will not have.
Ronald Allanach et al., Psychological Autopsy of June 13, 2011, Dexter, Maine Domestic Violence Homicides and Suicide: Final Report 39 (Nov. 28, 2011), http://pinetreewatchdog.org/files/2011/12/Dexter-DVH-Psychological-Autopsy-Final-Report-112811-111.pdf.
Sefton, M. The red flags of intimate partner violence. Blog post taken October 2, 2016.
Sefton, M. Prior history of crime not predictive of DVH. Blog Taken October 2, 2016. post: http://enddvh.blogspot.com/2013/07/prior-criminal-history-used-to.