career criminal

The Agony of Releasing a Murderer

Michael Sefton, Ph.D. career criminal, crisis intervention, Dangerousness assessment, domestic violence, domestic violence homicide, Human Behavior , , , , , , , , ,
CITflickCOURTp0719183-1
 
Albert Flick is led out of the courtroom following his initial appearance in the Androscoggin County Court house in Auburn Wednesday morning. (Russ Dillingham/Sun Journal)
 
There is no pleasure when a parole board must decide on whether to release or not a man who violently murdered his wife. Especially the case of Albert Flick – arrested in Westbrook, Maine in 1979 and convicted of the brutal murder of his wife. Mr. Flick asked not to be released perhaps out of some inner sense of foreboding and primal instinct of things to come – if such a thing exists among killers. He is a wolf in sheep’s clothing -underneath he is ravenous.
Fast forward to Sunday July 15, 2018 Albert Flick who had been released from jail for committing the violent murder of his wife again killed a woman with whom he had an infatuation. He had been stalking her for weeks prior to her murder.  He followed she and her two little boys from place to place in Lewiston, Maine.  She had an inner sense that he was dangerous but was fearful of going to the police at the time of her death. Yet she had spoken to friends about her worries. What may have prevented the victim from calling police when she first noticed Mr. Flick was stalking her? Why was she fearful of the very people charged with preventing violence? What may have happened if she had notified the officer on her beat? Or a police officer walking in her neighborhood?
The answer is that Mr. Flick would have had a visitor that in all likelihood would derail his infatuating behavior. If not, he would have had is parole revoked as it should have rightfully been done.  I was a police officer in Westbrook, Maine when Flick murdered his wife in 1979. I was on duty when the call came in to the station but as a junior officer was not dispatched to the scene. The scene was horrific even by todays standards of violence. Nevertheless, the case is well know to me as I later worked closely with the arresting investigator Ron Allanach and his partner Wayne Syphers – both exemplary career law enforcement officers.  Ron went on to earn his doctorate in counseling and was Chief of Police for 8 years at the end of his career in Westbrook. Both men were instrumental at convicting Albert Flick.  Flick is shown in the 1979 photograph below being taken to court in Portland by Detective Syphers who made a heroic effort to save the life of the victim. The female victim ultimately died in his arms in 1979.  Albert Flick should have remained in jail for life and many in law enforcement who remember the case are agonizing over  his release after serving 20 years.
“Clearly, probation is not working. … At this point, I just don’t know what else to do. I think there’s a huge safety risk to women and society when it comes to Mr. Flick.” Prosecutor Katherine Tierney, 2010
WayneSyphers and Flick
Albert Flick with Det. Wayne Syphers (right) at Cumberland County, Maine trial in 1979
Flick was known for a proclivity for violence against women. After being released from his murder conviction Flick was arrested for chasing an intimate partner with a screw driver with intent to due harm. There would be other charges and other arrests that were red flags for the underlying anger he felt toward woman.  A group of us will reach out to Mr. Flick in the coming months for a sit down.
The female victim, Kimberly Dobbie, in this 2018 Lewiston, Maine case had felt threatened by Flick. Her instincts were keen as it related to his potential for violence against her. But she told only her friend and no one else.  She was 30 years his junior and had spurned his love interest. She had twin children who were present during the despicable killing and are traumatized having witnessed their mother’s death. In his book “The Gift of Fear“, Gavin deBecker espoused the value of trusting our primal instincts as they pertain to our personal safety.
Flick had been in and out of prison for crimes involving intimate partner violence and intimidating female witness who were courageous in coming forward against Flick. At some point he himself reported asked to be kept in custody.
“You can’t say that nothing can be done, because nothing will be done,” said Michael Sefton, a former Westbrook police officer who now works in Massachusetts for the New Braintree Police Department.
Keep Me Current, 2011
The judge who authorized Flick’s release is retired from the bench but his stated opinion for releasing Flick was that “he had aged-out and was no longer criminally inclined” yet he himself asked to remain behind bars.  Why?
Technically this was true, Flick no longer fit the stereotypic picture of a repeat murderer.  He was older and physically growing infirm.  Most men who commit domestic violence homicide do not recidivate once released from prison especially those over the age of 70.  While researching a case of family murder-suicide, I have spoken to a man who served 18 years for strangling his wife who was released and became a model citizen and amateur photographer. He published a book of his photographs that were quite good – even sensitive.  This man was not a risk and was somewhat younger than Flick.  So by all reasonable judicial standards Flick was considered a low-risk release. Probation would keep him in line.  Not so fast, information was available from his first release that included repeated violence against women raising a red flag of potential violence in the future.  Plus the horrific nature of the stabbing murder in 1979 was not a factor in the release conditions once he had served his time. Finally, there is also information that suggested that Mr. Flick did not seek his own release as reported above. He may have been institutionalized with the simmering anger he himself expected would again leach from his despicable soul.

Desperate Victim’s plea for help

Michael Sefton, Ph.D. career criminal, Dangerousness assessment, domestic violence, domestic violence homicide, DVH, Human Behavior, terminal rage , , , , ,

DV_note B&W
Victim passed this note to Veterinarian staff – Photo VCSD

WESTBOROUGH, MA  June 6, 2018 A case of domestic violence unfolded on Memorial Day weekend in Volusia County, Florida when a female victim was being held by her live-in boyfriend. The note implores staff members of the DeLand Animal Hospital to call police because her partner was threatening her and had a gun.  These kinds of desperate measures occur occasionally and are dramatic and newsworthy. The staff at the DeLand Animal Hospital are to be commended.  But there are intimate partners everywhere who live in fear just as the indomitable victim who passed this note had been living.

“From coast to coast LEO’s are caught in this moth eaten, patchwork system that lacks resources for both the mentally ill and those addicted to alcohol and drugs.” Michael Sefton, Ph.D. 2018

As the story goes, her boyfriend had beaten her and was refusing to allow her to leave the couple’s home.  To her credit (perhaps life saving) she convinced the man that she needed to bring the dog to the veterinarian.  He agreed but would not allow her to go without him. Upon arrival this note was passed to a member of the hospital staff who knew just what to do.  The man is now behind bars being held without bail – manning his defense.

There is a consensus among experts in domestic violence that victims are abused multiple times – often threatened with death – before they call police for help.

As a society, more needs to be done to fill-in the holes in the system designed to keep families safe.  Safety plans and orders of protection are not enough.  From coast to coast LEO’s are caught in this moth eaten, patchwork system that lacks resources for both the mentally ill and those addicted to alcohol and drugs. The holes in the system allow for violence prone individuals to allude police and coerce victims into silence.  But every once in a while, a silent victim writes a life saving note and gives it to the right person.

Domestic violence happens in family systems that are secretive, chaotic, and dysfunctional.  This lifestyle pushes them into the margins of society – often detached from the communities in which they live.

The abusive spouse makes his efforts known within the system by his barbaric authoritarian demands.  He keeps his spouse isolated as a way of controlling and manipulating whatever truth exists among these disparate family members.  The consequence of this isolation leaves women without a sense of “self” – alone an emotional orphan vulnerable to his threat of abandonment and annihilation.

Successful intervention for these families must slowly bring them back from the margins into the social milieu. Arguably, the resistance to this is so intense that the violent spouse will pull up stakes and move his family at the first sign of public scrutiny.

Police officers are regarded as the front line first responders to family conflict and DV.  For better or worse, the police have an opportunity to effect change whenever they enter into the domestic foray.  This affords them a window into the chaos 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.  When this is done it establishes a baseline of trust, empathy, and resilience.

Community policing has long espoused the partnership between police and citizens.  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.  But the model goes two ways and requires that police return to their calls and establish protocols for defusing future events meanwhile processing and understanding the current actions of recent police encounters. When done effectively the most difficult families may be kept off the police radar screens for longer periods of time that can be a good thing when it comes to manpower deployment and officer safety.

Violence prediction: Keeping the radar sites on those who would do us harm

Michael Sefton, Ph.D. Active shooter, Bullying, career criminal, Dangerousness assessment, domestic violence homicide, Human Behavior, Police officer behavior, psychological relevence , , , , , , , , ,
crosshairsIn response to recent acts of both terrorism and recurrent gun violence by home-grown psychopaths more should be done to maintain greater control over potentially violent persons. In the Las Vegas concert venue and the more recent Texas church massacre it becomes
increasingly clear that predicting violence is practically impossible. At least this is
what we are led to believe. And yet when it comes to domestic violence
homicide the similarities in cases are almost carbon copy.
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. Whether this duplicity stems from cultural beliefs that what happens behind closed doors is nobody’s busy change in the way in which law enforcement manages these cases is essential. The buy in from police, legislators, judges, probation, and society 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. These behaviors toward a victim instill fear and point to the perilous danger that exists.
“Someone with a history, particularly a continuing history of violence, can be presumed to be dangerous.” Frederick Neuman, MD
Coercion and Control
Lenore Walker is a psychologist at the Domestic Violence Institute has published a theoretical description of the coercion and control model of DV. Victims are young and vulnerable to being emotionally and physically controlled. The Texas killer Devin Patrick Kelley had all the makings of a violent abuser from the time he was in high school and only now are people willing to talk about his darker side. Kelley was separated from his second wife who was just 19. Victims like this are often kept away from their families, not allowed to work, or when working are not permitted to handle their own funds. Some victims have to explain every cell phone call or text message they make or receive often being met with jealous fury. By robbing their sense of self keeps intimate partners emotionally isolated and insecure. They are often led to believe they could not live on their own and the children they share will be lost to them if they choose to leave. This “so called” male privilege keeps his partner marginalized and in servitude. It appears at first glance that Kelley was looking for the mother of his currently estranged wife likely enraged over steps taken to keep them apart as the divorce progressed through the courts.
Occasionally police or children’s services are called when intimidation and threats become violent. It is important to provide aftermath intervention and follow-up with families where domestic violence or chronic substance abuse occurs or families tend to disappear. Change is required to pay closer attention to those with whom law enforcement has frequent contact. Over and over
surviving family members speak of coercion and control on behalf of the abused.  Lives will be saved when society takes a closer look at red flag violence – these are the preincident indicators that violence and domestic violence homicide are possible. This is not new data nor are the stories very different.
I speak to police agencies and individual officers about DV and DVH offering detail from the psychological autopsy research we conducted on a sensational and tragic case in Dexter, Maine in which Steven Lake killed his 35-year old spouse after 10 years of marriage along with their 2 children. The Lake case was very much like the Kelley murders in terms of the cycle of abuse and its early onset. It was thought that Lake was intending to go on a killing spree but was interrupted in the act by an observant police officer. Recently a police officer participating in the statewide DV task force in Vermont asked whether there is a single most important factor or predictor to the risk of DVH? Some believe the fear of being killed by her spouse and abject cruelty toward step children raise the bar significantly and as such are worthy of crafting one’s DV report and request for orders of protection around. But keeping the victim and her abuser on the radar screen will also reduce her fear and loneliness and offer greater protection. Other risk factors include: choking and recurrent
sexual violence – although victims seldom disclose this out of guilt and fear of not being believed.
People knew what might happen
The Psychological Autopsy of Steven Lake consisted of over 200 hours of interviews with immediate family members on both sides. Steven’s aunt was quoted as saying “I never thought he would take the kids” in reference to an acknowledgment of his depression and anger at the impending divorce. She believed Lake would take his own life in front of his wife and children as a final act of punishment they would never forget. But he went far beyond that as we again saw in the small church in Texas this week. We are getting better at teaching children and families that if the see something they should say something. This is the trademark line of the Transportation Safety Administration in its fight against terrorism. The same might be taught to neighbors and friends when domestic violence is suspected or known to be occurring. If you see something then it is incumbent upon each of us to do something to help those in harms way.
Neuman, F.  (2012) Is It Possible to Predict Violent Behavior? Can a psychiatric examination predict, and prevent, a mass murder? Psychology Today. https://www.psychologytoday.com/us/blog/fighting-fear/201212/is-it-possible-predict-violent-behavior Taken May 12, 2018

Maine to Consider “Red Flag Law”

Michael Sefton, Ph.D. career criminal, Dangerousness assessment, domestic violence, domestic violence homicide, Human Behavior , , , , , , ,
WESTBOROUGH, MA April 25, 2018  Maine is the latest state to consider a so-called red flag law. It would let family members or law enforcement officers petition a judge to take away a “high risk” person’s firearms temporarily, if the judge determines the person poses an imminent risk. In a recent post I describe the updated terminology for individuals who are a potential threat called Gun Violence Restraining Orders.  The proposed action would allow law enforcement to remove the firearms of people who are known to be threatening or physically violent toward intimate partners.  “Felons, the dangerously mentally ill, perpetrators of domestic violence – these people have demonstrated their unfitness to own a firearm” said David French, 2018.  In cases such as these police have reasonable cause to disallow gun ownership based not on prior conviction but on the elevated risk to potential victims.
Here in Massachusetts, in August 2013 I published a blog after the death of Jennifer Martell who was murdered in front of her 4-year old daughter by Jared Remy, son of Red Sox broadcaster and former player Jerry Remy.  The younger Remy had received one break after another some say linked to his celebrity father’s influence.  He was never held until a dangerousness hearing could be undertaken.  Had this been done Ms. Martell may be alive today. In 2011, Stephen Lake murdered his wife and children after he was kept from attending his son’s 8th grade graduation.  Lake had exhibited several red flag warnings prior to the murders.  In spite of these he was not held nor were his firearms removed from his control Allanach, et al. 2011.
Several states have debated similar red flag laws in the wake of the school shooting in Parkland, Florida. Supporters argue a red flag law could have prevented the Parkland shooter, but some gun owners say it’s an overreach that threatens their 2nd Amendment rights.
Like many states in the U.S. Maine has more than its share of calls for domestic violence and domestic violence homicide.  “All law enforcement personnel who respond to incidents in which an individual’s mental illness appears to be a factor receive training to prepare for these encounters; those in specialized assignments receive more comprehensive training. Dispatchers, call takers, and other individuals in a support role receive training tailored to their needs.” Communication between members of a response team with awareness and understanding of red flag warnings will reduce the impact of coercion and control that belies the secretive relationships between intimate partners.  It will also bring to light the need for danger assessment and containment of people who are high risk for violence as in the case of Jared Remy in Massachusetts and Stephen Lake in Dexter, Maine.
Red Flag Warnings (2018) https://www.necn.com/news/new-england/Maine-to-Consider-Red-Flag-Law-478687253.html Taken 4-4-18
Allanach, R.A., Gagan, B.F., Loughlin, J., Sefton, M.S., (2011) The Psychological Autopsy of the Dexter, Maine Domestic Violence Homicide and Suicide. Presented to the Domestic Violence Review Board, November 11, 2011

Profiling a package bomber

Michael Sefton, Ph.D. Austin bomber profile, career criminal, Childhood violence, Dangerousness assessment, Human Behavior, Police officer behavior, psychological relevence , , , , ,

OKC bombing
 

Alfred P. Murrah Federal Building in downtown Oklahoma City

 

WESTBOROUGH, MA March 22, 2018 The recent spate of explosive attacks on apparently random victims continues as of this blog post.  People around the world are speculating about the psychological underpinning of a person or persons who can create a bomb and deliver it to some intended victim without being caught.  The explosion at the FedEx depot is something new as compared to the first 4 blasts.  So far 2 victims have been killed by the bombs.  The initial victims were African-American and Latino raising the specter of the bombs being a hate crime.

What does the bomb say about the bomb maker? Bomb construction thought to be a characteristic of underlying ideology and may be linked to motivation.  Certainly explosive devices range in their level of technology and sophistication.  In 1995 Timothy McVeigh created a powerful bomb made out of a deadly cocktail of agricultural fertilizer, diesel fuel, and other chemicals that killed 168 people at the Murrah Federal Building in OKC including many children at a nearby pre-school.

The type of bomb in Austin, TX has not been described by police or federal agents but the frequency of the attacks is unprecedented.  It may suggest that more than one individual is working to produce the explosives and make deliveries or the devices were constructed to stockpile before deliveries were made. The bomber likely lives alone or has a shop where the devices and their components are stored for assembly. His keen interest is in making people afraid and keeping a city in lock down. McVeigh was a former munitions soldier in the Army and may have learned his technique in the process of training with the U.S. Army.

If the Austin devices are the work of a single serial bomber than the frequency and recent change in method of detonation raise the bar in terms of sophistication of delivery but the risk of being caught or making a mistake may also be accentuated.  The police chief in Austin reportedly said that by using FedEx for shipping the explosive the likelihood of capture in short order was increased. An image was obtained of a man at FedEx that eventually became a person of interest.

The person who is behind this seige is likely an angry and detached with few friends.  Being marginalized lends both to his stealth and fuels his anger and resentment.  He may be suicidal and ultimately he final blast is to be part of his exit plan. He quite likely enjoys the sadistic control and media attention he is getting.

The fact that there are so few deaths – versus a massive splash event is not quite clear.  It speaks to ambiguous planning and perhaps unclear motive and may signal the growing disorganization associated with his terminal event. Additional personality features are uncovered with each action.  These are kept from the public domain.  My analyses are conjectural.

Michael Sefton, Ph.D.

Public Awareness Needed for Meaningful Jail Diversion

Michael Sefton, Ph.D. career criminal, crisis intervention, Dangerousness assessment, domestic violence, DVH, Human Behavior, Police officer behavior , , , , , , ,

teachinginprison

“If mental illness drives the violent behavior than all weapons and substance use must be carefully controlled and eliminated.” Sefton, 2017

Westborough, MA December 21, 2017 Jail diversion is a hot topic across the country even here in Massachusetts. Since July, 2017 the Massachusetts Legislature has passed sweeping changes in the Criminal Justice System.  Locally and across the country, the numbers of persons incarcerated for minor offenses and drug crimes has grown in some cases exponentially. 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 and multifactorial. The interaction of the two is sometime lethal as reported by the Globe Spotlight team It is the focus of mental health advocates and criminal justice experts nationwide as it pertains to jail diversion, alternative restitution and reduced police use of force. In Massachusetts, there is a move away from mandatory minimum sentences for all drug crimes except for those involving the sale and distribution of narcotics. Arguably, the impact on behavioral functioning when persons are gripped with co-occurring illness, such as alcoholism, 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 these 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 and treatment infrastructure needed to provide a continuum of care in this growing population is available in very few places across America.

Yet in places like Bexar County, Texas – including San Antonio and 21 other towns or cities – 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. These men are exemplary in their assessment and intervention skill for keeping identified subjects off radar screens and out of the revolving door of the county jail.  It takes ongoing training, medical and psychiatric infrastructure, community compassion, and active engagement with members of the community to fly under the radar and 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.

The unpredictability of behavior by those who carry a “dual” diagnosis has emerged as a confounding factor in the criminal justice system raising the specter of frustration over the limitations within the system. Jail diversion programs and treatment options are needed in order to retain public safety goals and provide for needs of the mentally ill and substance dependent. In Massachusetts, cities and towns 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. The Massachusetts legislature has taken up Criminal Justice Reform and passed a bill in late 2017 making changes in the mandatory minimum sentencing laws.  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 debilities such as stroke or traumatic brain injury. Some of these cases are substance dependent and live lonely, chaotic lives.  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. Programs greater understanding of addiction and added treatment options must be explored through a joint public and private initiative.

Mental and Physical Health Screening

At time of arrest the individual must have some level of mental health assessment if mental illness is suspected or documented. When I was a police officer prior to 2015 we often asked the D.A. to provide a court clinic assessment of the suspect to rule out suicidal ideation or delusional thinking. This must also include a screening for dangerousness especially when a subject is arrested for intimate partner abuse. Next a health history questionnaire should be undertaken to screen for co-occurring illness – both physical and mental. If a diabetic suspect is held without access to his insulin he is at great risk of death from stroke. Similarly, a person arrested for assault who suffers from paranoid ideation is at greater risk of acting violently without access to psychiatric medication. Finally, an alcoholic brought to the jail with a blood alcohol level greater than 250 is at great risk for seizures and cardiac arrhythmias when delirium tremens begin 6-8 hours after his last drink. The risk to personal health in each of the scenarios above must be taken seriously and the obtained data should be factually corroborated. Police departments across the United States are pairing up with private agencies to provide in-house evaluation and follow-up of individuals who fall on the borderline and may not be easily assessed by the officer in the field.

Diversion Safety Plan with Mandated Revocation

Next, the probation and parole department must obtain an accurate legal history prior to consideration for bail. A nationwide screen for warrants and criminal history based on previous addresses is essential. In many places these are being done routinely. In the case of someone being arrested for domestic violence he may have no convictions thus no finding of criminal history. For these individuals the dangerousness assessment may bring forth red flag data needed for greater public safety resulting in protection from abuse orders, mandated psychotherapy, and in some cases, no bail confinement when indicated. Releasing the person arrested for domestic violence without a viable safety plan increases the risk to the victim and her family, as well as the general public – including members of law enforcement.

Bail, Confinement, Mandated Treatment

There is some thinking that higher amounts of bail may lessen the proclivity of some offenders to breach the orders of protection drafted to protect victims and should result in revocation of bail and immediate incarceration when these occur. Mandated treatment may be more successful when legal charges are held as leverage where after 6 months of sober living and regular attendance at 12-step recovery meetings charges can be dismissed or modified to each individual case.  This takes a complete overhaul of the front end of criminal justice system and requires buy-in by judges, district attorneys, and individual family members.

When it comes lack of compliance and repeated domestic violence, I have proposed a mandatory DV Abuse Registry that may be accessed by law enforcement to uncover the secret past of men who would control and abuse their intimate partners. This database would also include information on the number of active restraining orders and the expected offender’s response to the “stay away” order. In cases where the victim decides to drop charges there should be a mandatory waiting period of 90 days. During this waiting period the couple may cohabitate but the perpetrator must be attending a weekly program of restorative justice therapy, 12-step recovery and substance abuse education. Violations of these court ordered services are tantamount to violation of the original protection order (still in place) and victim safety plan and may result in revocation of bail. If the waiting period passes and the perpetrator has met the conditions of his bail than he may undergo an “exit” interview to determine whether or not the protection order / jail diversion plan may be extended or whether he/she has met all requirements.  In any case further police encounters will be scrutinized and prior charges may be re-instated or filed as needed.

Michael Sefton

Sefton, M. (2017) Human Behavior Blogpost: https://msefton.wordpress.com/2017/03/30/police-are-building-bridges-and-throwing-life-savers/ taken December 10, 2017

Jail Diversion: Reduced costs by spending more on mental health

Michael Sefton, Ph.D. career criminal, CIT, crisis intervention, Human Behavior, Police officer behavior, psychological relevence , , , , , , , , ,

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.

Police as therapist: the inherent risk of unconditional positive regard 

Michael Sefton, Ph.D. career criminal, Dangerousness assessment, Human Behavior, Police officer behavior, psychological relevence, Relationships, Suicide by cop , , , , ,

WESTBOROUGH, MA January 12, 2017 Changes in the responsibility for those afflicted with major mental illness must remain in the hands of medical and psychiatric providers who are trained in contemporary diagnosis and treatment models. Yet a growing mental health strategy has emerged to train and educate first responders – including the police to deescalate and divert those with mental illness from jails into treatment.  The problem with diversion here in Massachusetts and New England is that a continuum of care is lacking. Since the closure of the state hospital system here in Massachusetts the community-based treatment centers have been overwhelmed by the volume of cases they must see.  To say they have failed is shortsighted and disingenuous and behalf of the Globe Spotlight team.

Make no mistake about it, putting police officers in the place of psychotherapists and psychiatrists is not going to happen here or anywhere. But cops are being asked to act as mediators to diffuse encounters with persons with suspected mental illness. The intention is to reduce violent encounters between the police and those with mental health issues. “Most people with mental illness are not dangerous, and most dangerous people are not mentally ill” according to Liza Gold, 2013. Yet in the past several years there have been many high profile officer-involved shootings involving people afflicted with a variety of psychiatric conditions including major depression raising the specter of suicide by cop.

POLICE ACT AS CRISIS MEDIATORS WITH MENTALLY ILL

It is very risky putting the police in the role of crisis intervention specialists to manage those who may be emotionally distraught. For one thing the high incidence of drug and alcohol intoxication in these cases makes any negotiation or mediation almost impossible. I was always taught that until the patient is sober there is no meaningful assessment or interaction is possible.  Police are the front line responders to crises of all kinds. Asking them to serve in this new role presents a level of officer specialization like never before.  Some officers are being asked to offer unconditional positive regard to those encounters in an effort to slow the scene giving time for intervention to take hold.  In some places like San Antonio, TX and Vancouver, BC it works.  But it has taken a long time to gain traction. If the goal is to avoid incarcerating those with mental illness this is especially difficulty in the absence of a treatment continuum as I have said.  In the cities just mentioned there is a well established mental health infrastructure that affords the police various options for the unstable citizens they are asked to assist.

In most larger communities a dearth of mental health services exist resulting in a large number of mentally ill persons being held in custody – sometimes a county house of correction or any one of

Dr. Michael Sefton brought out myths of mental illness while serving as a police officer retiring in 2015

16 prisons in the Commonwealth of  Massachusetts. The Spotlight team at the Boston Globe has featured the plight of those who are sent to prison with comorbid mental illness and substance abuse. The fact is that criminality and mental health are often difficult to disentangle.

The National Alliance for the Mentally Ill believe as many as 20 to 40 percent of prison inmates may have severe mental illness and may not be receiving the needed treatment to allow them to rehabilitate.  Yet in the absence of the mental health infrastructure needed to provide treatment – including hospital care for those most unstable, few viable options were put forth.

The Boston Globe fails to inform readers that criminality and mental illness are not mutually exclusive.  Drug addicts break into homes to feed the hunger of their addiction.  In prototypic fashion, the Globe offers no alternative and no solution aside from casting blame on the Commonwealth of Massachusetts. Without a doubt the stories they report are heart wrenching and emotionally palpable for the readers. But not all those in custody who are suspected of preexisting mental illness are helplessly suffering without therapy.  Most are not.  In many cases being incarcerated allows an addict to become clean and sober and begin the first steps of recovery. Those who are most resistant to therapy and fail to attend psychotherapy, anger management, and medication monitoring have a higher risk of violence and substance abuse. This fact must be considered when responsibility for treatment failure is studied.  

Those relationships that suppress the normal, effusive, life force are detrimental to health much like a toxin said Sefton in 2013.

ALTERNATIVE SENTENCING

With so many incarcerated persons with suspected mental illness change must be initiated  by having services available to those on the front lines.  The criminal justice system and the department of mental health have an opportunity to work together now that the pendulum once again swings toward a treatment model. The police can be trained to control the scene through intervention and mediation strategies by slowing things down. When charges are brought alternative sentencing models may offer leverage that include mandated treatment in lieu of jail time.  Studies show that those who remain in treatment are less violent than those who fail or drop out of treatment, Torrey, et.al., 2008.

Mental health patient often rely on community services and social welfare including housing, disability payments, medical care and more.  Access to these services may be tied to participation in treatment including psychotherapy, medication, if prescribed, and substance abuse treatment.  Here is Massachusetts M.H. Advocates reject this notion as unfair a response that remains unique across the country.

The interaction of substance abuse and mental illness is complex.  Persons with drug and alcohol addiction must be expected to become sober with the help of substance abuse treatment and family support. The risk of violence and suicide declines when sobriety can be maintained.  The 12-step programs have great success and are free to anyone willing to attend. Family members may attend Al-Anon or some drug-specific family support group.

Mental health infrastructure is necessary for the system to work.  In San Antonio it has taken 15 years to establish a system that works and saves lives.

Torrey, CF et. al. The MacArthur violence risk assessment study revisited: Two views ten years after its initial publication. Psychiatric Services, vol. 59, issue 2, February 2008, pp. 147-152.

Probationary lapse: Massachusetts officer killed by career criminal

Michael Sefton, Ph.D. career criminal, Dangerousness assessment, domestic violence, Human Behavior, Officer down, Police officer behavior, psychological relevence

Some arm chair psychologists are critical of probation officers in central Massachusetts following the shooting death of a police officer.  Critics believe that Jorge Zambrano should have been in jail rather that be free to take his murderous intentions to the street.  He had at least three arrests that were said to have resulted in resistance and ultimately violence toward police officers.  This information must have been provided to Officer Tarentino at the time of the traffic stop.  Whenever an operator is checked either on the mobile data computer in the police cruiser or by a police dispatcher flags come up indicating that the operator has a history of violence.  This is a necessary officer safety protocol. 

Unfortunately, that same level of safety awareness is not provided to judges when they are making decisions about bail or no bail holds for the like of Jorge Zambrano and thousands of other career criminals who are in and out of court like a revolving door. It is up to the office of probation and parole to provide this essential information on “dangerousness” to judges as they review charges and consider bail in the cases being brought before them each day.  Otherwise, decisions about bail cannot be made with any accuracy leaving law enforcement and the general public at great risk from those who are dangerous. We have seen this disconnect over bail among domestic violence assailants and the family members they terrorize.  Sometimes serious aggression toward a spouse including strangulation and forced sexual contact are ignored or minimized when this violence occurs within the scope of a “relationship” and yet information about violent tendencies must be provided to potential victims whenever a threat exists.  

“There are points when pre-incident indicators scream for containment of violators.  Relationship behavior should be considered – especially when relationship violence is apparent in case after case”.  Michael Sefton, 2015

Bail decisions rarely include the incidence of violent behavior – especially that which occurs toward law enforcement otherwise Officer Tarentino may be alive today.  In an article in the Boston Globe detailing the criminal history of the killer of Auburn, Massachusetts Police Officer Tarentino. Zambrano was a career criminal from what was described in several background articles. I was especially sickened by the remarks of Mr. Scola the attorney for Zambrano.  Scola verbalized his surprise that Mr. Zambrano could do something so violent toward a police officer. I am puzzled by that remark and wonder if Scola has actually passed the bar examination because anyone could see that Zambrano was on the fast track toward a violent explosion of hate.

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“He was a high risk for violence and recidivism,” said DOC spokesman Christopher M. Fallon. 

Former Boston police commissioner Edward Davis, now a private security consultant, said Monday night that judges have to consider a defendant’s “propensity for violence” at sentencing according to a Boston Globe article written in the aftermath of the killing of Ronald Tarentino, Jr..  “There are some people who are not amenable to counseling,” said Davis, whose security clients include The Boston Globe. “When you see a repeat record of violent activity, then you have to get really tough with a person like that and get them off the street.”

“There’s nothing more dangerous than that space, that moment, when a guy who is facing charges that can send him back to jail sits there behind death’s door, sizing up both his chances and the cop drawing nearer in the sideview mirror.”  Kevin Cullen Boston Globe   (5-24-16)