Mental Health Inc

by Art Levine

  More than half of these tragic encounters involve police departments that haven’t provided their officers up-to-date training to deal with people with mental illness. All too often, police without proper training can feel threatened and overreact.

  • • •

  BUT WHAT KIND OF “TRAINING”? SURPRISINGLY, THE WASHINGTON POST reporting project didn’t mention the most widely used training: the Crisis Intervention Team (CIT) model developed by the Memphis Police Department. Now used by nearly 3,000 communities in forty-five states, CIT incorporates safety and de-escalation training of police officers in partnership with mental health “consumers” and families to help police better understand people going through a mental health crisis. The CIT approach involves not just dry lectures, but role-playing realistic crisis situations, along with police officers apprenticing in the field with more senior members of the police intervention team.

  Memphis adopted the CIT approach in 1988, led by then-Major Sam Cochran, who partnered with NAMI after a police officer killed a mentally ill man. After implementing CIT, the city’s SWAT team confrontations dropped 80 percent, and injuries to police officers dropped from one in 400 to one in 2,333. “It’s a program that reaches out through not only community services [such as NAMI], but training our law enforcement officers to be a first responder,” Cochran told Democracy Now.

  Now leading the University of Memphis’s CIT Center, Cochran’s pioneering approach is increasingly sought after in the wake of highly publicized violent encounters with police—and some lawsuits brought on behalf of mentally ill people gunned down after families called 911 for medical help.

  Years earlier in Fort Lauderdale, the backing for the CIT approach came in part from the leadership of a different sort of police officer: Scott Russell, who patrolled among the homeless people in the city. Russell helped form an alliance essential to CIT’s success with groups that have often been at odds with one another, including family members affected by mental illness, mental health providers and the police. “By bringing positive attention to the issue of the mentally ill,” he said during the training I observed, “we’re giving them a stronger voice that they desperately need.” (Now a captain, Russell heads the youth and special needs services section of the Broward County Sheriff’s Office, which includes that agency’s CIT team.)

  Fort Lauderdale was also taking action because, in the previous two years throughout South Florida, there had been a spate of deadly encounters. These included a “suicide-by-cop” a few years earlier by a crazed man waving a gun around in the street, and incidents in Miami-Dade County to the south, where a shocking eight mentally ill people were gunned down by police who had no specialized training. “Those are the types of incidents police come across,” Russell told the CIT trainees. “You come across people who are mentally ill, who are in crisis or who aren’t functioning normally. What we want to do is provide our police officers with additional skills to recognize some of those factors, to understand what’s happening and also to give them some skills to de-escalate crisis situations—and to refer people to appropriate social services and mental health providers.”

  The officers faced a host of typical mental health crises in their role-playing exercises, most based on real incidents, with gradually escalating threats of violence. Finally, the officers practiced their responses to a crisis that has continued to periodically plague police and the veteran community to this day: an angry, deranged, armed veteran willing to kill himself or others if he can’t get anyone to help. The Fort Lauderdale police sought to counsel and calm Vincent Tamburelli, a tough-looking guy with a beard, who was actually the head of a local clinic’s mobile outreach team, but was now playing an angry Vietnam vet with bipolar disorder armed with a knife. He was lashed to a gate at the Oakland Park Tri-Rail station and threatening to kill people unless he got help—now.

  Tamburelli played it with an eerie authenticity because he’d just been briefed by a police administrator about this real-life incident. “If I don’t get help, someone’s going to get hurt!” he shouted. “I need my medication, and no one will help me.”

  Officers Joyce Fleming and Mary Gillis approached Tamburelli gingerly as he kept his hand near his knife pocket. Fleming took the lead. After asking his name, Fleming gently instructed him, “Just put your hands by your side.”

  “Not yet,” he responded.

  But after some more smooth talk on Fleming’s part, the two officers convinced Tamburelli to lie on the ground to be patted down for weapons. Then she pointed to the imaginary police car in the training conference room where he headed next, without handcuffs, as she urged him, “OK, go ahead.”

  Later, in reviewing her performance, Fleming won high marks from the professional therapists, although some officers in the class felt she was putting herself at risk by not handcuffing him.

  The most detailed critiques of the officers’ performances in different scenarios came from none other than Cochran. For instance, he assessed one officer who successfully talked down a role-player acting like a paranoid man fearful of the CIA controlling his thoughts who was barricading himself in his home. He praised the policeman for his slow-paced and courteous tone, and the empathetic way he spoke to the person in crisis about how he felt about taking his medications. “By getting that individual to talk to you, to reason with him in the here and now, it’s not going to be long before that individual is going to open up the door,” Cochran said.

  Near the end of the training, Cochran spoke about how this work would rekindle the idealism that had brought these officers into police work. “When you ask why you became a police officer, the first sentence out of your mouth is, ‘I want to help people.’ But it’s pretty tough being an officer, and that gets pushed to the back of our minds.”

  “A year from now, you’ll be a different person,” he concluded. “Now it’s up to you to rise to the occasion.”

  In today’s era, it’s hard to remember that compassionate, dedicated police officers still exist. But they do, and in places like Fort Lauderdale or LA County or other cities where well-trained officers respond to a mental health crisis, you can see the difference they’re making.

  The real measure of a successful mental health system, however, isn’t how quickly and empathetically police can respond to a crisis, but how the system helps mentally ill people avoid new hospitalizations, meltdowns and emergency calls in the first place. On that front, at its best, the Los Angeles County Department of Mental Health often succeeded in turning around the lives of some of the county’s most chronically mentally ill people who were fortunate enough to access the agency’s specialized services. Yet, despite good intentions, and in part because of the hellish failure of the LA County jails that damaged thousands of mentally ill people each year, the department’s innovative treatments ultimately failed at enabling most of their clients to achieve independent, fulfilling lives.

  Most clients would never find what the department proclaimed as its vision and mission: “Hope, Wellness and Recovery.” And that goal remained just as elusive for the nation’s troubled kids and adults who never got any high-quality services—and ended up ensnared in institutional settings often nearly as traumatizing as the Los Angeles County jails.

  CHAPTER 11

  Torture in Alabama

  “If you’re so determined to kill yourself, you should put the gun next to your head and pull the trigger.”

  William Knott, manager of the fundamentalist school for troubled youth near Mobile, Alabama, then handed Robert a .380 automatic pistol. The teen, who’d been kept in an isolation cell for days, naked, put the gun to his head, and pulled the trigger.

  FOR MANY MENTALLY ILL PEOPLE AND EMOTIONALLY DISTURBED ADDICTS, such as Unique Moore, the failure to find anything approaching quality treatment in their communities as teens and young adults sets them on a downward slide towards an early death in jail, on the streets, or even in the Medicaid program itself. For others, the chaotic and dangerously incompe
tent local mental health system leaves them vulnerable both to the siren song of the snake-oil salesmen of the behavioral health care field—hucksters for poorly-regulated treatment facilities—and irresponsible overmedication. The key selling points for the antipsychotics that are prescribed so recklessly to young people, the elderly and veterans are that they offer a relatively quick fix for difficult mental health problems, and they can rein in troublesome behaviors. An entire multibillion-dollar residential treatment industry has flourished offering a comparable set of exaggerated claims, while profiting off of the misery and suffering of all those mishandled by their communities’ outpatient programs. These inpatient-style treatment enterprises target emotionally troubled substance abusers and, especially, parents at their wit’s end dealing with difficult, misbehaving kids who are struggling in school and in their lives.

  Nowhere is this more apparent than in one of the most common types of private programs marketed for errant youth: the largely unregulated religious schools marked by fundamentalist beliefs and often violently harsh discipline. Inspired in part by the programs of a fiery Baptist radio preacher, the late Lester Roloff, they have been periodically exposed for whippings, beatings and alleged rapes in media outlets including CNN, Mother Jones, The Daily Beast and The Tampa Bay Times.

  The 2012 Tampa Bay Times series, for example, opened with a description of a fifteen-year-old boy who was exercised to the brink of death and flown by helicopter to a hospital with kidney failure three days after entering the Gateway Christian Military boot camp in Bonifay, Florida. The school, still open today but claiming to adopt a more moderate approach, is part of the largest fundamentalist “treatment” chain for adults and youth in the world, Teen Challenge, with over eighty programs—often subsidized by taxpayer dollars through court referrals—in America, with a total of 1,100 centers in 118 countries. Regulations in the US are so loose that the controversial organization has been investigated but rarely sanctioned for such actions as allegedly using patients as unpaid workers in a reported telemarketing scam in Sanford, Florida, or hiring a convicted sex offender as co-director of its Winthrop, Maine, program. Nine states, including Florida, Alabama and Missouri, have wide-ranging “faith-based” exemptions protecting various church programs and schools from direct government oversight (while twenty-six states have no requirements for any private schools, religious or secular.) Teen Challenge has even opposed the use of twelve-step methods because references to a “higher power” in AA are, counselors tell patients, “Spitting in the face of Jesus.”

  National and regional leaders didn’t answer my questions about these accusations, but the president, Joe Batluck, wrote me, “Teen Challenge or Adult & Teen Challenge is a US-based network of eighty-five independent religious nonprofit corporations that works with individuals struggling with chemical addiction. TC’s fifty-eight-year track record is unparalleled in the field of addiction. The faith-based model has proven greatly helpful by many of the graduates.”

  Similar promises of miraculous changes have lured parents to send their kids to these programs for years, even to a facility in a gritty, run-down section of the predominantly African-American town of Prichard on Mobile’s north side. Captain Charles Kennedy, who’d been a cop for forty-four years, didn’t quite know what to expect in October 2011 when he followed up on a call from a California mother worried about her son, who was attending the local Christian school for troubled teens, Restoration Youth Academy (RYA). A few days earlier, Kennedy, then with the Prichard Police Department, had received a phone call from another California mother, Rosa Getierrez, who told him that her son had run away from the same facility, claiming maltreatment and, after holing up at a Mobile motel at her expense, returned home.

  The program’s executives and allied pitchmen-consultants promised parents “hope for their teenagers’ future, when hope doesn’t seem possible,” as its website declared. “We have a highly trained staff with a heart for kids in need of guidance.” And so many desperate parents were grateful for that. “I was scared I would find my son hanging from a rope or a dead from a needle,” says Leslie Crawford, a Connecticut mom, about why she sent her truant, drug using son to RYA at a cost of $1,500 a month.

  Kennedy was greeted at the school’s forbidding metal front gates topped with razor-wire by the manager, William Knott. Kennedy thought Knott was friendly, a man with nothing to hide. He didn’t know then that Knott had already been cited in two lawsuits—leading to settlements of nearly $1 million or more—for his role as chief enforcer of sadistic beatings at a now-closed Mississippi facility, Bethel Boys Academy, under his authority as “Head Drill Instructor.”

  Kennedy knew the concerns raised by Barry’s mother and the allegations of the Getierrez boy—included in a police report faxed from California—weren’t solid enough to prompt an official criminal investigation, so he tried to charm his way into places he might have needed a warrant to see. Knott provided a tour of a bare-bones classroom inside interconnected mobile homes and an adjoining cafeteria with eerily quiet, unsmiling children.

  After the tour, Kennedy asked to speak alone with Barry, the son of the mother who had called him. (The names of all minors in the program have been changed to protect their privacy, unless they or their parents agreed to let their full, real names be used.) Knott agreed, but only permitted Kennedy to talk to the boy in the main office, which had three large windows and relatively thin walls, offering Kennedy and Barry almost no privacy. Barry, small for his age and clearly frightened, was brought in by Knott and placed in a chair opposite Kennedy. Knott then left the room, but hovered outside, shouting in a loud, angry voice to kids in the hallway. Kennedy saw tears welling in Barry’s reddened eyes, so he reached over and pulled the boy’s chair close to his, and said in a low voice, “Look at me, Barry. Don’t pay any attention to what is happening out there. I am a police captain, and anything you say stays with me—no one else.”

  Soon the truth began tumbling out: Barry said he’d been threatened during his trip from California with a beating if he misbehaved, and once he was hustled into the compound, he was strip-searched and forced to start a brutal regimen of exercises, stark naked, in a room next to the office the two of them were now in. Kennedy later learned that this exhausting “Physical Training”—or “PT”—was common for the program’s pseudo-“cadets” and included push-ups, jumping jacks and running in place.

  Barry said he was also punched in the stomach, hit in the head and slapped in the face by Knott and two other drill instructors whenever he seemed to be flagging. At one point, Knott then pushed the naked boy to the ground and demanded that he do more push-ups—which Barry told Kennedy he did until he collapsed from fatigue. At that point, Barry recalled, Knott crouched down next to him, and, after yanking his head up by his hair, started pounding his skull against the floor while shouting, “You will exercise until I get tired!”

  When Barry could no longer move, he was dragged by his feet into a cramped, empty isolation room and locked up for two days, wearing only a pair of boxer shorts. The door was typically opened by the staff only to allow bathroom breaks and to shove some spoiled food inside. “I asked myself why my parents spent all of their money to fly me here to put me in a place like this,” Barry wrote in pencil in a sad, handwritten note he later sneaked into Kennedy’s hands.

  After interviewing Barry, Kennedy asked to speak to some other boys, those who’d been identified by Rosa Getierrez’s son as victims of abuse. After gentle quizzing and coaxing by Kennedy, a few of them eventually revealed that they had been hit, choked and body-slammed by Knott and other staffers.

  Most of the kids, however, were too scared to talk to Kennedy, but as he pursued his investigation, he found more appalling cases of degradation and physical abuse. Ryan, a thin black kid from Brooklyn, told Kennedy he had been held upside down in shackles and hit with a belt. He still bore the scars of the leg irons and handcuffs when Kennedy spoke to him during a subsequent visit to the facility. A
few fellow students who dared speak to Kennedy confirmed Ryan’s story of Abu Ghraib-like abuse. One boy who’d recently escaped the facility wrote a letter to Kennedy in 2012 that said, “I saw Ryan, a cadet who had escaped several times, was put in shackles in his arms and legs and went to school, breakfast, lunch, dinner, church in these shackles. I also saw Mr. Bernie [an instructor] pick up Ryan from his leg shackles and dangled him in the air.”

  • • •

  CHARLES KENNEDY HAD ENTERED A PORTAL INTO WHAT SOME CRITICS have called “The Jesus Gulag.”

  The template for these schools was set by Roloff’s Rebekah Home for Girls in Corpus Christi, Florida, in the 1960s, which featured vicious corporal punishment and children locked in isolation rooms where Roloff’s sermons were played endlessly. He defied a state law requiring inspection of all child-care facilities, despite affidavits from sixteen girls at the Rebekah school that they were whipped with leather straps, severely paddled and handcuffed to pipes.

  Roloff famously declared at a 1973 hearing following one of his arrests, “Better a pink bottom than a black soul.” With dozens of ministers linking arms with him in 1979, he blocked state inspectors from entering the Rebekah Home to remove children in a stand-off that became known as “the Christian Alamo.” In 1985, the state forced the closing of the home, which then moved to different states with looser oversight under an array of names, a common practice for both secular and religious “troubled teen” programs. The school briefly returned to Texas in 1998 when then-Governor George W. Bush solidified his popularity with Christian voters by deregulating faith-based programs.