Analysis of Facts helps Reduce Harm to victims of DV

DOMESTIC VIOLENCE REVIEW BOARDS
WESTBOROUGH, MA  January 5, 2018 As we begin to make program recommendations for reducing intimate partner violence it is worth noting that change comes very slowly in protecting those who are most at risk. There is still a paucity of protective measures in place to assess and contain those who are most violent in our society. Retired New Braintree Police Sergeant Michael Sefton was in Augusta, Maine in October 2011 providing testimony about the results of the psychological autopsy conducted by Michael Sefton, Ph.D. Brian Gagan of Scottsdale, AZ, and Ron Allanach, Ed.D. of Conquitlam, BC, Canada and former Chief of Police Joseph Laughlin of Portland, ME.  Dr. Sefton, who holds a doctorate in psychology and is a licensed psychologist provider in Massachusetts provides neuropsychological and forensic consultation on domestic violence including domestic violence homicide and assessment of risk.  The report that was filed came up with over 50 recommendations directly related to reduced intimate partner violence. The report was cited over 12 times in a recent Maine Law Review publication on proposed Conditions of Bail.
PUBLIC INFORMATION
The testimony provided to the domestic violence review board offered details about a hideous case of family violence that ended with the homicide of 4 members of the same family and was culminated by an attempt to burn the bodies after the murders and the killer shooting at police officers responding to the missing victim. But they were too late. Their research was conducted over a 3 month period following the homicide deaths of Amy Lake and her children.  The team conducted interviews with over 60 persons with direct knowledge of Amy Lake, the victim, her two children, Monica and Cody, and the murderer Steven Lake.

Maine Law Review

“Although Maine’s statute lists these prohibitions, it lacks the enforcement tools to protect victims against violence associated with guns and other weapons, which is a major factor in Maine’s domestic violence deaths.” Nicole Bissonnette, 2012
Most researchers agree it is nearly impossible to predict when DVH will occur.  However, the psychological autopsy provides many obtrusive red flags that offer clues to an impending emotional conflagration. The problem in this case was two-fold.  First, the requirement for bail was not seriously considered because Lake had no criminal history – and yet Mr. Lake had demonstrated an unwillingness to adhere to the legal mandates of the order of protection and violated the court order at least 4 times over the year before he killed his family. Given this reality, he should have been held for a hearing on potential dangerousness.  And secondly, the cache of firearms that Lake was known to have kept was not surrendered to police nor was an effort made to obtain the 22 weapons Lake owned by members of law enforcement.
It is not uncommon that red flags are often present early in the relationship.  Many people we spoke to were aware something agregious was going to happen.  These include obsessional jealousy, threats of death, sexual aggression, unwillingness to integrate into extended family, any use of a weapon, and others.  In the course of their research Sefton and Gagan interviewed Dale Preston who was convicted of DVH in 1982 and served 18 years in Maine State Prison for the murder.  When asked what may have stopped him from killing his wife, Mr. Preston indicate “there was nothing that could have stopped me…”  In these cases, a greater awareness of risk or dangerousness is essential and in some cases a person must be contained for the safety of others.  Such containment requires NO direct contact with an abusive spouse, GPS monitoring, house arrest, or no bail imprisonment.
The case in Maine occurred in June 2011 – exactly 1 year to the day after the victim obtained a protection from abuse order from her husband.  The murders occurred 2 weeks before the divorce was to be finalized and were likely triggered by the abuser’s anger over not being permitted to attend his son’s 8th grade graduation ceremony.  The Bangor Daily News presented details of the recent psychological autopsy presented recently in Augusta, Maine.  Over 30 states across America have formal homicide review boards.  “To make this general deterrence aim successful, abusers must not have access to their victims nor to potential weapons, and the risk of punishment associated with breaking the law must outweigh the abuser’s urge to commit the conduct.” said Denaes, 2012. Bail is a judicial condition that allows a person to be released from jail with the promise to appear in court to answer to charges. Bail also provides for public safety by keeping violent offenders in jail when necessary.
I make an effort to review those published from New England states.  Vermont has an excellent annual report of domestic violence homicide and publishes all recommendations and changes in statutory requirements following individual cases of DVH.

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.
Nicole R. Bissonnette, Domestic Violence and Enforcement of Protection from Abuse Orders: Simple Fixes to Help Prevent Intra-Family Homicide, 65 Me. L. Rev. 287 (2012).
Available at: https://digitalcommons.mainelaw.maine.edu/mlr/vol65/iss1/12
Johannes N. Denaes, PUNISHMENT AND DETERRENCE 7 (1974) (“General prevention may
depend on the mere frightening or deterrent effect of punishment—the risk of discovery and punishment
outweighing the temptation to commit crime.”).
See id. at 34-35
Advertisements

Jail Diversion: Reduced costs by spending more on mental health

PART 1

WESTBOROUGH, MA July 6, 2017 Jail diversion is a hot topic across the country. The numbers of persons incarcerated for minor offenses and drug crimes has grown. Many of these individuals have mental illness or drug abuse in addition to their criminality. The interaction between poly-substance abuse or dependence and exacerbation of underlying mental health symptoms is complex. It is the focus of mental health advocates and criminal justice experts nationwide as it pertains to jail diversion and reduced use of force among law enforcement.  In Massachusetts, there is a move away from mandatory minimum sentences for all drug crimes except for those involving the distribution of narcotics. Arguably, the impact on behavioral functioning when persons are gripped with co-occurring illness is a recurrent problem for law enforcement and first responders. I have written about the impact of co-occurring illness such as alcoholism on mental and behavioral health is previously published posts here on Word press Human Behavior (Sefton, 2017). It is difficult to uncover which comes first – the addiction or the diagnosed mental illness and yet they are inextricably linked in terms of the strain on public resources and health risk to those so afflicted. Why is this important?

The importance of treatment for substance dependence and mental illness cannot be understated as violent encounters between law enforcement and the mentally ill have been regularly sensationalized. The general public is looking for greater public safety while at the same time MH advocates insist that with the proper treatment violent police encounters may be reduced and jail diversion may be achieved. The referral infrastructure to provide a continuum of care in this growing population is available in very few places across America.

Models of Care

Yet in places like Bexar County, Texas the county jail population has dropped by over 20 percent as a result of crisis intervention training for police officers and mobile mental health teams to intervene with those in crisis. I have seen this for myself during a visit with the San Antonio Police Department where I rode with two members of the Mental Health Unit – Officers Ernest Stevens and Joseph Smarro. It takes training, medical and psychiatric infrastructure, community compassion, and active engagement with members of the community often left to fly under the radar to effectively reduce the jail population. When necessary those most in need must have 24-hour availability for detoxification, emergency mental health, and access to basic needs such as food, clothing, and medicine. In San Antonio they offer so much more including pre-employment training, extended housing, interview preparation including clothes, and opportunity for jobs.

Behavioral Analysis and Law Enforcement

The unpredictability of behavior in those who carry a “dual” diagnosis has emerged in the criminal justice system when jail diversion programs and treatment options are brought forth raising the specter of frustration over the limitations within the system. Cities everywhere are grappling with how best to intervene with the mentally ill in terms of alternative restitution for drug-related misdemeanor crimes in lieu of mandatory jail sentences that many crimes currently require. Some believe, as much as 20-40 percent of all incarcerated persons suffer with mental health diagnoses and are not getting the treatment they require. To provide a bare bones system would add billions to state and federal dollars spent on the needs of inmates at a time when measurable outcomes for in house care are limited.

In my practice I see many cases of co-occurring pain syndromes with other physical debility such as stroke or traumatic brain injury. Generally the emotional impact of two or more diagnosed illnesses yields a greatly reduced capacity for adaptive coping and puts a great stress on the individual system. The importance of addressing co-occurring substance abuse or dependence is now well recognized and with treatment can result in healthy decision-making, growth in maturity, and greater self-awareness. If legislators have a serious desire to reduce statewide numbers of incarcerated persons a comprehensive plan must be considered for both pre-arrest and post-arrest. Infrastructure for enhanced understanding of addiction and greater treatment options must be explored through a joint public and private initiative.

PROPOSED JAIL DIVERSION INITIATIVE

PRE-ARREST JAIL DIVERSION – No crime committed

If police encounter subjects with a known history of mental illness through their community policing efforts they should return the subject to his family or primary psychiatric caregiver – this might be a physician, physician’s assistant (PA), a nurse practitioner (NP), even a psychologist for immediate crisis intervention. Depending upon the nature of the police encounter such as during the nighttime hours the subject may be transported to a local emergency department for psychiatric evaluation. This model has grown less popular because of the growing wait times in local hospital emergency departments – especially for those suspected of mental illness and tends to make them increasingly agitated. Persons with mental illness are often homeless and come into police contact simply on the basis of panhandling or looking suspicious and out of place in the neighborhood. Often they are reported to police because they are talking to themselves, suspicious, and menacing toward pedestrians making them afraid.

The hospital alternative might be to establish regional psychiatric emergency intake centers available 24-hours daily. At one point states had regional hospitals that have been closed down releasing thousands of institutionalized patients into the community. The plan for de-institutionalization was to provide a neighborhood center at which the patient could continue his or her treatment and receive their needed medication to keep them symptom free.

Minor crime committed

When a crime is committed by someone with known or suspected mental illness such as simple assault, disorderly conduct, or shoplifting the responding police officer’s will have discretion whether to bring forth charges or not in exchange for an alternative disposition that would defer jail time. These are not new concepts. Law enforcement has always had the discretion to arrest or not arrest for many minor offenses. The choice often comes down to the subject demeanor and his response to police officer directives at the time of the encounter. In some cases an officer must arrest such as in the setting of domestic violence, child abuse, or as a result of a felony being committed.

In these cases charges may be brought and held as long as the subject entered treatment or remained abstinent from use of drugs or alcohol – the jail diversion plan. If they failed to follow the terms of their diversion plan the charges would be re-instated and sent to district attorney for prosecution.  The alternative is a revolving door of addiction and petty crime that, at times, will escalate into violent crime. As a society more can be done to reduce criminality and jail diversion through empathic, sensitive treatment options.

On DV: old thoughts still ring true

Image
Michael Sefton, Ph.D. Sergeant – Retired 2015

New Braintree, MA August 5, 2013 Whenever a sensational event takes place – especially one involving crime and violence people wonder what could drive such unthinkable human action?  In the police service it is a common occurrence – that people violate the perfunctory right to exist as an individual being with choice and free will. This frequent action dehumanized victims by robbing self-esteem and thereby shaping future decisions relationships and life force.

From a 2013 blog post.