The Status Quo in Policing Keeps Failing Those with Mental Illness

Concerns over killings by police returned to the news after the recent release of body camera footage showing a deputy in Springfield, Illinois, fatally shoot a Black woman, Sonya Massey, in her kitchen. After the shooting, the lawyer for Massey’s family noted she had had mental health issues. At the intersection of being Black and having mental illness, Massey was part of a group with one of the highest risks of being killed by police.

What supposed threat did Massey pose? She was tending to a pot of hot water she had left on when deputies responded to her call about a potential intruder. With a counter separating Massey from the deputies, she posed no imminent threat at the time she was shot. What appeared to put one deputy on edge was her remark, “I rebuke you in the name of Jesus.” Deadly force followed as Massey apologized and tried to comply with officers’ hurried commands.

This use of deadly force was disproportionate, unnecessary, and egregious. The deputy’s own agency condemned and fired him. He now is in jail awaiting trial for murder and related charges.

It would be a mistake, though, to see this incident as an anomaly, disconnected from broader patterns in policing. As I have found researching police killings, failures to de-escalate such interactions continue to occur with disturbing regularity. The status quo in policing is failing those with mental illness.

Police’s Responsibilities to Persons with Mental Illness

A bedrock moral principle is that we have special responsibilities to those unfairly disadvantaged and more vulnerable to harm. Sadly, law and policy often fail to live up to that principle, but we do find it reflected some places. The Americans with Disabilities Act (A.D.A.) requires providing accommodations and removing harmful barriers that prevent those with disability from being able to work, learn, and participate in other areas of life.

The A.D.A. covers those with physical and psychiatric disability (i.e., mental illness). A question to come before the courts is whether the A.D.A. requires police to make accommodations for suspects with mental illness. In a 2015 case, the Supreme Court punted on that question. 

Despite the courts’ lack of guidance, there has been growing public pressure on police to change their response to persons with mental illness. To their credit, some in policing have recognized the need to take proactive steps to improve how officers respond to mental health crises. The most common strategies implemented, though, have proved insufficient.

Limitations of C.I.T.

Crisis Intervention Team (C.I.T.) training has become the go-to approach for police departments wanting to improve how officers handle encounters involving persons with mental illness. First developed in Memphis in 1980s, C.I.T. training teaches officers about mental illness, de-escalation, and mental health resources in their community.

Hundreds of agencies have adopted C.I.T. Though law enforcement’s interest in more humane responses to those with mental illness is encouraging, research on C.I.T. has found little evidence that it reduces the risk of injury or death to persons with mental illness.

An example highlights how it falls short. In 2020 in Sarasota, Florida, deputies with crisis intervention training responded to a mental health crisis. Video shows Adrean Stephenson—a frail 63-year-old woman—in the street with a fillet knife. After she took the knife from her neck and pointed it at the deputies, one fired his Taser before the other officer shot and killed her. 

The deputy quickly resorted to deadly force instead repositioning, maintaining distance, and slowing things down. Given the nature of Stephenson’s threat—an elderly woman with a fillet knife—police had other options to de-escalate the situation.

This point strikes at the heart of what makes C.I.T. inadequate. Verbal de-escalation, like what C.I.T. teaches, often does not last long when paired with outdated tactics like the 21-foot rule. This rule instructs officers to shoot suspects with a weapon less lethal than a firearm—like a knife or club—who get within 21 feet.

Many such killings can be avoided. According to the F.B.I., only three officers in the U.S. died from knife attacks during the last ten years of available data (2013–2022). It also is rare for officers in the U.K. to die in knife attacks, yet they are not trained to respond with deadly force. They learn more robust de-escalation tactics than what C.I.T. offers. Such tactics have saved the lives of individuals with mental illness who, in the U.S., likely would have been shot. Notably, data show that those with a knife killed by U.S. police are more likely to have mental illness.

Both/And Approach

In the aftermath of the 2020 Black Lives Matter protests, many called for alternatives to police in responding to vulnerable populations like those with mental illness. More cities have begun experimenting with civilian responders, with promising results. A study of Denver’s program—Support Team Assisted Response or S.T.A.R.—found that it helped keep vulnerable individuals out of the criminal justice system while reducing low-level crime and saving money.

Such programs combined with other services have the potential to reduce police interactions and violence against vulnerable populations. But it is a mistake to think that they can replace police altogether. Programs like S.T.A.R. do not respond to those with a weapon or otherwise violent, relying on police in such instances. So we need a both/and approach: services for vulnerable populations and police with expertise to de-escalate encounters they must handle.

Encouragingly, some have called for more robust de-escalation tactics, as found in training designed by the Police Executive Research Forum focused on avoiding deadly force against suspects without gun and those experiencing a mental health crisis. A randomized controlled trial found the training to be a win-win: it reduced injuries to citizens and police.

So evidence-based strategies are emerging to reduce harm to vulnerable populations. But unless more agencies and municipalities adopt them, individuals with mental illness will continue to suffer harm from police that is entirely avoidable.