Writing reports that work for victims of DV: Tools for measuring risk for DVH

There were times that at the end of a midnight shift in Westbrook, Maine, outside Portland, and New Braintree PD, in Massachusetts that I had reports to write for incidents I had been assigned during the shift. More than once, I snuck out of the patrol office and went home – too tired to write. And more then once, the sleep I so wanted was disturbed by the day sergeant or court officer looking for my report. Or sometimes, when I did stay, my writing was not my best effort because I was tired. Report writing is an art and is now a large part of both the academy training and field training programs. Law enforcement officers are better trained and more highly educated than ever which is essential in these times where every word is public property. The media, the citizenry, and the police hierarchy are all slicing and dicing every paragraph of today’s reports looking for your mistakes, it seems. The reason I write this is that police reports have consequences and if important statements, or officer observations, or photographs are omitted, cases may be lost. It is essential that report writing be taken seriously because, in the setting of domestic violence, lives depend on it.

Just like any report document that is to be handed out to anyone who might request it, particularly underpaid defense attorneys who swim in circles, like sharks looking to devour a poorly written report and its author. Report writing needs to be concise and laser focused. Particularly important is the reason for the call. Why did this victim call today? We know that the abuse tends to escalate successively. Sometimes, it is only when children become involved that a victim will move to stop the violence. In Vermont, a teen boy shot and killed his father when the man drunkenly waved a pistol threatening the family. And in Maine, a 13 year old boy was found to be hiding a 20 gauge shotgun and ammunition on the day he and his family were murdered by his father Steven Lake.  Our analysis of the Maine case led us to understand that the boy was likely intending to defend his mother and sister against a violent and unpredictable father.  He may have been seeking to load the weapon when his father snuck into the unlocked house and overpowered the family. 20 gauge shells were found in the child’s bed and under his pillow.

Image from Mobile ODT
When conducting assessments or forensic exams with a victim of domestic violence (DV), any reported history of strangulation places the person at a higher risk for more serious violence or homicide by the hands of their intimate partner. By recognizing signs of strangulation, healthcare providers can help to mitigate long-term damage, properly document any evidence of abuse, and provide referrals for seeking safety assistance. Sara Vehling 2019

Risk assessment tools provide quantifiable data that may be used to develop actuarial projections as to degree of risk and dangerousness. Report writing now should include assessment tools that uncover potential risk to victims. Jacqueline Campbell, RN has a valid risk assessment tool for determining whether there is high risk to potential victims that can be living in the home while officers are still on scene. Campbell’s work is readily available in the DV literature and known to most of us. The Ontario group in Canada also has a reliable tool – ODARA used by law enforcement agencies across the country. In my agency we adopted both tools after the research was complete from The Maine homicides. The national leadership includes Lenore Walker, in addition to Campbell, who both have published a good deal over 25 years on DV and its cycle. Walker believes that women and families are exposed to great harm when the abuser is out of jail only hours after terrorizing his family. It rarely mitigated the next beating. 

I propose holding the abuser until his first arraignment perhaps as long as 2 days. This allows for a cooling off period. Minutes are like hours while sitting in a municipal cell block often eating fast food 3 times a day. But the 8th Amendment of the Constitution guarantees that bail shall not be unfairly denied or excessively harsh. In truth, the modification of bail conditions in some instances must be done in real time to account for the severity of individual cases of DV and unique red flags. Experts have said that when a victims says ”I know he is going to kill me” then there is a greater likelihood that she may be correct and a protective, safety plan should be put in place. On the continuum of risk, expecting to be killed is only slightly less dangerous as physical attempt to kill or maim. In these most dangerous cases, there are tactical measures that must be written into protective orders such as GPS monitoring, forfeited bail and remand to custody for violation of protective orders, social media restriction, no contact with victim and children, no contact with victim’s family or friends, and supervised visitation, when only appropriate. It is these cases where the police officer’s report must be first rate and bullet proof.

A period of being held in custody until initial arraignment will enhance public safety and public trust in the short run. If applied to all persons arrested because of domestic abuse, then it would not unfairly impact only the poor or disenfranchised. Abuser’s should not be able to buy their way out of jail nor should they be free to wander their communities stalking their supposed loved ones. Steven Lake who killed his family and himself in Dexter, Maine posted his love for his children nightly and had piteous social media “friends” encouraging him to “fight for his children”. Little did they know he was planning the onerous events that would end the Lake family timeline forever. The Maine Law Review in 2012 reviewed changes in conditions of bail and cited our research over 12 times in its review of conditions for the release of persons in jail for domestic violence. Protective factors include the abuser having full employment and a substance free environment.

As the reader begins to understand report writing requires a visceral response and poignant understanding of this hidden social maelstrom. There are legitimate reasons for seeking “no bail” holds on some people arrested for domestic violence when high acuity and high risk exist together. These have been posted by me in the Human Behavior blog.


Campbell, J. (1995). Assessing dangerousness. Newbury Park: Sage. 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

Ronald Allanach et al. (2011) 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.

Vehling, S. (2019) Taking your breath away – why strangulation in domestic violence is a huge red flag. Blog post https://www.mobileodt.com/blog/taking-your-breath-away-why-strangulation-in-domestic-violence-is-a-huge-red-flag/ taken March 15, 2022

Mac Walton. (2019) Bail Reform and Intimate Partner Violence in Maine, 71 Me. L. Rev. 139. Available at: https://digitalcommons.mainelaw.maine.edu/mlr/vol71/iss1/62

Domestic Violence Homicide: crafting protective orders with teeth and laws to support victims in fear of being murdered

Domestic violence homicide shares common red flag warnings that are discernible when prosecutors take time to connect the dots.

In Maine, Texas, and across America, the criminal justice system – including prosecutors, too often fail to protect victims of domestic and family violence from their abusers — even when the “red flag” warning signs are obvious as they were in both these cases. In this post, and the March 15 post, I talk about the importance of report writing and truly  understanding DV on a visceral or gut level. To truly understand what is going to happen requires a realization that just below the surface may lie a wolf in sheep’s clothing. 

What happens next?  The failure to see what danger exists as officers interview victim and abuser. This is often because no dangerous assessment has been initiated and secondly, because there are too few prosecutors and judges who connect the dots and understand the cycle of domestic violence. Protective orders must contain contingencies for those abusive partners who do not respect the order of protection and violate its provisions at will. Any violation should be met with revocation of bail and immediate arrest. 

I will post the 10 risk factors below for specific warning signs common to DVH. This begs the question, why are cases of domestic violence homicide not more fully examined with a psychological autopsy? These examinations might add to the body of knowledge and create impetus for change in DV law including bail conditions as suggested in the Maine Law Review in 2012 and again in 2017. There needs to be more bite to protective orders so that victims can move on with their lives rather than live in constant fear as I have posted over and over. Recently, in 2017, the Maine Law Review listed changes in bail conditions that were recommended by Nicole Bissonnette, an attorney and member of faculty at University Law School in Portland, Maine. Heretofore, these have been largely ignored by legislators in Maine. Ms. Bissonnette has written about Bail reform in at least 2 papers published in the Maine Law Review as noted above. I will write about these two Maine Law Review papers shortly.

In early 2021, the police in Austin,Texas were beset by a horrific case of domestic violence homicide. On April 18, 2021, a former police officer killed the family while picking up his son for a monthly supervised visit. The child’s mother encouraged these visits as important to the boy’s development and relationship with his violent and sadistic father. While exchanging pleasantries, the child’s father shot and killed his former wife and step-daughter.  And he killed his daughter’s young boy friend and immediately fled. Detective Broderick was captured 20 hours later and is being held. Yes, the abused was a former law enforcement officer. 

Texas law requires surrender of all guns following a domestic assault. The question remains, had Broderick been relieved of his firearms or did he acquire a weapon after leaving the police department? In Texas, “timely relinquishment of firearms is an essential dynamic of violence prevention. We must work together to ensure that individuals subject to a weapon forfeiture order surrender their firearms immediately” according to Travis County District Attorney Jose Garza in a May 2021 story. So we are led to believe that he turned in his firearms and was relieved of his license to carry a concealed weapon. It is not specifically reported that these conditions were met. However, as it pertains to GPS monitoring a judge believed that because he had been compliant with conditions of his release, including wearing the GPS ankle bracelet for 3 months, that it was no longer required. Why?

This comes in response to the murder of three members of a single family, allegedly by a former police detective who had been ordered to stay away from his wife and step-daughter. He was in direct violation of the order. His court-approved  visitation with his son was to be supervised and on April 18, 2021 during a time where Mr. Broderick was to pick up his son, the murderous assault was initiated: killing 3, including his former wife and adopted daughter. What were the red flag triggers? Was something missed?

In the Texas case there were people who knew what might occur, like murder of former wife, the issues surrounding Broderick and his loss of employment and pending felony trial were among the many triggering factors.

Common sense look at facts

Police need broad discretionary authority in dealing with any violation of orders of protection including no bail holds and danger risk assessment

Following the 2020 arrest for sexual assault of a child, Broderick resigned from the Travis County Sheriff’s Department. He was initially held on $100,000 bond. A family friend remarked, “I kind of had a feeling that this is where he was going, because he was lost,” she explained. “He lost everything. He lost his family. There was a protective order for a reason.” He was lost?  That gives him the right to violently kill his former wife, adopted daughter, and her male friend? Many in our society are lost and do not go on to commit violent homicide.

Like the Austin homicide, in other cases I have reviewed, trends “someone knew” what would happen if the abuser was released from custody. This is a red flag. And facts indicate Mr. Broderick had a violent history including rape of a child and most certainly should have been kept in custody through his trial. What possible good could come from releasing this man into society? And more specifically, why was the victim’s plea for greater protection apparently ignored? At the very least, Mr. Broderick should have been wearing the GPS monitoring bracelet when he was out of custody. The judge who allowed him to stop wearing the GPS monitor should be removed from the bench for such a poor judgement call that she indicated was based on her experience with usual cases. This was not one of the “usual” cases and the fact that someone knew what might happen and kept quiet is despicable and should be made a felony crime of obstruction of justice.Any threat of death and use of firearm removes anything usual about a case of intimate partner violence.

The 16-year old child, who was among the victims, begged for a more restrictive supervision of her step-father who had been released from jail and was not required to wear an ankle bracelet after only a period of 3 months. An order of protection was brought against former police detective. There was a protection order in place but even the teen knew that orders of protection were “not worth the paper they were written on.” 

“Because Mr. Broderick committed this heinous crime after he paid a money bond to be released on charges related to sexual assault against a child, Texas law permits his detention without bail.” Wes Wilson, KXAN television Austin, TX

There is a case to be made for careful analysis of behavioral health functioning of abusers. That seems to be common sense right? But this sometimes does not occur. As a law enforcement officer in Massachusetts, I made an effort to introduce risk assessment tools to quantify a subject’s dangerousness. This is important but is not yet universally adopted here in Massachusetts. Nearly 10 years on, the psychological autopsy conducted in 2011, looked at the red flag warnings that are common to DVH everywhere – including the case in Austin. What brought my attention to the case in Maine was the purported prosecutorial impotence argued by Christopher Almy, the county district attorney, that there was “nothing that could be done to protect the victim, Amy Lake and her two children, from her estranged husband Stephen Lake. That statement was inspiring. Imagine if you and your family were depending upon the police to protect you as Amy Lake was? Everything that could be done was in place. But the protection order had no teeth. So Steven Lake snuck into the Amy’s home at 5 AM and staged a despicable murder scene, ultimately killing the children he claimed to love while Amy was forced to watch. Ending with her shotgun murder and is own death by suicide. 

“Domestic violence is not random and unpredictable. There are red flags that trigger the emotional undulation that bears energy like the movement of tectonic plates beneath the sea.” Michael Sefton (2016)

In an article on the 8th Amendment regarding bail in cases of domestic violence, the Maine Law Review, first in 2012 and an updated second publication in 2017, cited the importance of carefully crafted conditions of bail especially among men who are found to have violated the conditions often by stalking and using social media to intimidate and contact potential victims also by trolling family members in an effort to locate estranged spouse and her children who may be in hiding. Both Amy Lake and Austin, TX mother of 3 expressed an interest in having children remain in contact with extended family in spite of pending serious criminal charges. This opened up access to the perpetrator to information about current living arrangements, employment, after school activities, and other potential clues that raised the risk of further domestic violence and ultimately DVH. In Austin, the victim expressed a wish to allow her estranged husband to have contact with the little boy – his son in spite of pending felony charges brought forth by the 16-year old step-daughter who rightfully feared for her life. Why was her fear ignored or minimized given her history of having been sexually assaulted by her adoptive father and his animosity toward her for reporting the abuse to law enforcement. He blamed her for his loss of career and status as a local detective with the Travis County Sheriff’s Department.

Firearms are a major cause of DVH and in every state are required to be taken from men with active protection orders in place. This was the default expectation in the two cases described here but in the case of Stephen Lake his arsenal of 22 firearms were not removed from his possession in spite of court orders.  Similarly, the Austin killer was left with at least one firearm used to kill his family.  Lake left 9 suicide notes many of which were rambling, angry tirades toward his wife and in laws.  The Austin killer did not take his own life and was captured. This is atypical especially among law enforcement officers raising the specter of possible psychological analysis of his motives. This make the two cases in this post very different at this level. To what extent Texas authorities will endeavor to understand the events that preceded the murders remains unclear although, like the Aurora theater shooting, having a bad guy to study is rare. This means nothing, aside from an opportunity for personality and psyhopathology to be brought up at trial perhaps allowing Mr Broderick to avoid death row.  There is not much in the public media since the crime and his capture. However, gaining a comprehensive understanding of the red flag warnings in this case is recommended and will add to the body of literature on domestic violence. Why he chose not to kill himself is itself a mystery. 

One could argue that the Austin killer shared several commonalities with the Maine case including sexual violence, threats of death, pathological jealousy, violation of the order of protection. The Austin murderer, Mr. Broderick was a SWAT trained police officer who resigned his position after being arrested for sexual assault on his step daughter.  He should not have had a firearm pending the outcome of his case. Stephen Lake, on the other hand, would never stand trial – something he knew was a fact. Lake was keen on the idea that the cost of his divorce was a mere $0.35 cents – about the cost of one bullet. In this case his sister and aunt understood how angry and troubled Mr. Lake had become and said nothing, until we conducted our hours-long interview for the psychological autopsy.


Domestic violence homicide risk factors

  1. Threatens to kill spouse if she leaves him – pathological jealousy
  2. Actual use of firearm or other weapon anytime during domestic violence incident
  3. Access to firearms even if he never used them – veiled threats
  4. Attempt at strangulation ever during fight
  5. Forced sex anytime during relationship
  6. Unemployment of perpetrator
  7. Stalking via social media – one or both spouse use social media to intimidate or garner support
  8. Presence of unrelated “step” child in home
  9. Spouse finds new relationship soon after separating
  10. Low bail release from custody – high bail holds are essential in DVH mitigation

Loneliness, loss, and fading resilience in the tarnished golden years: languishing with loss of purpose

The isolation felt by people in quarantine can leave the average person feeling numb and emotionally languished. Recently, I provided a zoom conference on the psychological impact of the coronavirus in November 2021 from my office at Whittier Rehabilitation Hospital in Westborough, MA. It was well attended, largely by people who are psychologically minded and aware of the points I endeavored to make. My target audience was the people who were struggling and vulnerable to decreased coping during covid-19 recovery. I am unsure we hit the mark I was hoping for with the target audience.  The fallout in mental health from the coronavirus is real and it is now recognized as a public health menace among recovering adults. It is now being seen in children and adolescents with growing concern. Just like younger patients, loneliness and social isolation in older Americans are serious public health concerns putting them at risk for dementia and other serious health conditions including failure to thrive, sepsis, malnutrition, addiction, and mental illness according to a CDC report. For many individuals in quarantine, the nightly happy hour started earlier and earlier raising the specter of worsening substance abuse and addiction. The liquor stores were soon to be considered essential services and package delivery became a common source of re-supply. The impact of isolation, emotional loss, and social detachment undermines public and behavioral well-being across the life span. It is a co-occuring illness among illnesses afflicting millions. I see it in my own family as nerves are frayed now almost 2 years in – first noted in the blog post published in May, 2020 (Sefton, M.). In this fourth wave of the virus called the Omicron variant, people are tired of hearing about social distancing, mask mandates, and rising infection numbers. I see it every day.

I have worked with older clients for over 25 years first as a post doctoral fellow at Boston City Hospital – now BUMC. Long before the pandemic, my work at Whittier Rehabilitation Hospital has been to provide support and direct service to patients’ suffering from debility associated with decline in physical health along with the psychosocial needs and changes. All too often, this includes feelings of loss of control and sadness that is palpable in our short conversations. Many seniors feel invisible and the virus exacerbates these feelings. Declining health further instills the loss of purpose and amplifies the stigma of being seemingly infirm. The lack of purpose germinates from the passing of a spouse, close friends who move or have died, food and financial insecurity. It precedes a death wish and it’s associated demoralization. My mother was infected with the coronavirus in mid-April 2020 before the vaccine was introduced. She lived in the same nursing facility where I lost my 93-year old aunt in the first wave of the virus in May, 2020. My mother survived the virus but it has taken a significant toll on her physical and cognitive well-being. We were not permitted to see my mother during her illness and my aunt was alone on May 1 when she succumbed to the virus.

Trauma informed therapy refers to the critical understanding of one’s emotional history and supports the model of early traumatic experience being one underpinning of many mental health outcomes and threatened resilience later in life. These kinds of experiences have an impact on people who have had loved ones die while in lock down across the country and can engender guilt and helplessness. Often, singular front line medical staff are alone with patients who succumbed to the virus – sometimes holding the fading grip of another disappearing life. This heroic act of empathy happens without fanfare or even a moment to process its importance and acknowledgment of the person’s passing.

Losing Saffie: The agony and loss of a precious little girl who was calling for ‘mum’ when mortally wounded

8-year old Saffie-Rose Roussos killed in Manchester, UK suicide attack

There are few things that I do not believe I could emotionally survive, like the loss of my spouse, employment, and physical and mental vitality. Certainly, the death of a child is among the worst of all human experience for any parent at any age. This story is a heart wrenching, story of depravity and loss. To this day, the loss of one of my children would leave me shattered, angry, and helpless. I hope these individual stories will all resonate with our humility as human beings. 

The chaos and emotion evoked in mass casualty events such as the Manchester, UK bombing, Boston Marathon bombing and the Sandy Hook, CT Elementary School mass shooting leave searing memories that take months to years to process.  We are reminded of the overwhelming sadness we feel when looking at photographs of people we know are no longer with us. The loss of a child is among the more gut wrenching experiences families can ever endure. Meanwhile, members of law enforcement face multiple victims including young children like Saffie-Rose Roussos during large scale mass casualty events that forever leave their marks. I am working with a former paramedic which was dispatched to a motor vehicle crash in 1990 where a family walking across the street was struck by a vehicle being pursued by law enforcement. The first victim he came upon was a 4 year old girl who had obvious signs of death that he cannot shake 30 years on. These next stories are similarly evocative.

 I recently came upon the story of the death of this little girl in Manchester, England. Her name was Saffie-Rose Roussos. From the sound of the description of Saffie, she was a special little girl with an enchanting wit and precocious love of life. All children are special and we recognize the curious joy through which they live each moment and we cherish every nuance. 

On the night of the bombing, Saffie was attending a music concert with her mother and sister when a suicide bomber detonated his bomb in Manchester, UK.  To see Saffie-Rose, one is compelled to ask whether or not there is a higher power? and if so, how could he allow this little girl to be in harms way? Saffie Roussos died on May 17, 2017 asking for her mum and wondering aloud if “she was going to die?” What child should ever ask this question? It evoked in me a tortuous and unthinkable picture of helplessness. But it was far worse for those emergency responders who were called upon to care for Saffie as her life came to an end that night along with the 21 other victims of the terrorist attack. No person who has ever been dispatched to a mass casualty event, like the Manchester bombing, ever comes away without a substantive chink in the veneer of their emotional core. Many in EMS and cops alike quit after mass casualty events.

The story of Saffie-Rose Roussos brings together good and evil and the ruination of one tiny life, one family, one city, one country, and illustrated the abject courage shown by the youngest of 22 victims that night in May, 2017. For this reason, I am sorry for not just the victims of the blast, like Saffie-Rose, and her family. They are devastated to this day, as I would be. But the heroic efforts of first responders who were called upon to provide life saving measures for this child and the hundreds of others wounded in the bombing. Without a doubt, all experience the deep sense of loss and failure at not being able to provide advanced trauma care for Saffie, so that she might live. “Losing a child feels like the ultimate violation of the rules of life” according to HealGrief.org an organization that guides parents through coping with the death of a child. In this case, Saffie is said to have been conscious after becoming injured but could not be saved given the resources available in the chaotic aftermath of the explosion. The protocols call for rapid triage of the scores of people needing help and this is done in the minutes to hours after the event. It is very likely, Saffie did not have the advanced life support needed to manage the hemorrhagic shock she sustained from massive loss of blood. The human body will compensate for loss of blood only until, in shock, it can no longer maintain blood pressure. Survival is measured when fluid can be replaced and loss of blood can be stanched. In children, this compensatory window is much more tenuous and short lived. 

When I worked as a LEO we were taught techniques for trauma intervention that we were told might save our own life or someone else’s life one day in the event of a shooting or massive trauma resulting in life-threatening loss of blood volume. By using a properly place tourniquet, rescuers can stanch blood loss at times of massive trauma such as from a bomb blast that took the life of 8-year old Saffie-Rose Roussos of Leyland, Lancashire in UK. Saffie was killed while attending a concert in Manchester, England in May, 2017. She was the youngest of 22 people killed on the night of May 17, 2017 when a suicide bomber Salman Abedi blew himself up in the lobby of a Manchester concert venue. Terrorism. 

“Medically trained people were with her. And she was asking for help. She knew what was happening. And she bled to death.” BBC 2021. “How do we carry on living with this information? How can we carry on breathing with this information?” asked Saffie Roussos’s father Andrew Roussos. BBC Judith Mortiz report January 17, 2021

BBC Judith Mortiz report January 17, 2021

Saffie’s father Andrew described his described his daughter as a “perfect, precious, beautiful daughter” who “melted people’s hearts” with those big brown eyes,” adding: “It’s like the best artists got together and drew her from top to toe.” according to a story in the BBC that was published during the public inquiry into the bombing last year. It is likely that the Roussos family is feeling the injustice of Saffie’s death. Anger is part of loss and healing and often is unresolved years after the traumatic loss of a child. Especially given the despicable nature of what caused Saffie to become gravely injured.

 All bereaved parents lose a part of themselves and often require months or years to understand the extent of their grief and anger.

“I did die that day, inside I’m dead. My heart is so heavy, it weighs me down” said Lisa Roussos, Saffie’s mum, now 3 years on. The Roussos family feels the loss of Saffie-Rose every day. 

Lisa Roussos

The immensity of traumatic loss was never more palpable than in 2012 when the Sandy Hook Elementary School in Newtown, CT came under attack by 20-year old Adam Lanza. Lanza first killed his mother with whom he lived and next drove to the largely unprotected elementary school and opened fire, killing 20 first-grade children and 6 adults trying to protect them.

Adam Lanza, 20, committed one of the most hideous acts of murder in history and is forever described as pure evil. Yet he was evaluated at the Yale University Child Study Center in New Haven. He was seen by a clinical psychiatrist, the report states. Ostensibly, the evaluation “purportedly to determine if Lanza had Obsessive Compulsive Disorder in the context of a putative diagnosis of Asperger Syndrome” in a piece written by Aaron Katersky and Susanna Kim in 2014 about the Newtown Massacre. Adam Lanza’s own father said “you cannot get any more evil” when talking about his son in the months after the shooting. Lanza openly wished that his son had never been born, raising an ironic specter between the loss of a child and being unable to love a child who commits unthinkable violence and died in the process. What possible conciliation may be find in his public statements months after the massacre? There is no denying that the Newtown shooting is among the most horrific and despicable violent crimes of the 21st century. No one will ever forget that December morning and the disbelief and horror it instilled. Other acts of violence toward children are documented. This is by no means a complete chronology.  

Perhaps the greatest sporting event in the United States takes place every April, ending on Boylston Street in Boston, Massachusetts. Martin Richard, 8, a child watching the Boston Marathon in 2013 was killed by a pressure cooker bomb filled with ball bearings, marbles and other shrapnel that was a homemade bomb made to kill and maim unsuspecting families watching the annual running event. Hundreds lost arms and legs in the two bomb explosions. 

Martin Richard, age 8

Martin Richard was a special child.  He is not shown in these bombing photographs. His parents have gone on to honor him with annual community events geared toward raising funds for parks and other community projects. In all, over 300 people were injured in addition to the initial 3 people who died in the bombing – including Martin. “The minute the defendant fades from our newspapers and TV screens is the minute we begin the process of rebuilding our lives and our family.” according to a Richard family statement in the Boston Globe as the Marathon bomber Dzhokhar Tsarnaev was being tried for the murder of Martin and 2 others on Patriot’s Day in 2013. For their part, the Martin family spoke out against the death penalty which was handed down to the surviving marathon bomber who was captured in Watertown, MA after a 4 day manhunt just a few miles from where they murdered MIT Police Officer Sean Collier in their effort to escape. 

We are all enormously impacted by events such as these and are left feeling sickened by the shear numbers of injuries and deaths.  Saffie-Rose Roussos, Martin Richard, and 20 kids at Sandy Hook Elementary School, 17 teens at Stoneman Douglas HS, and 32 students and faculty at Virginia Tech were all victims of violence and we should never forget these events and so many more, in human history.  The families remember the names and the horrors of the day.  The sadness of these losses makes our heart’s bleed and ache for all those who have lost a loved one to violence.  Even when you are the angry parent of a child you wish had never been born, a further violation of the rules of life.  No person who has ever been dispatched to a mass casualty event, like the Manchester bombing, ever comes away without a substantive chink in the veneer of their emotional core.

___________________________________________

AARON KATERSKY and SUSANNA KIM (2014) 5 Disturbing Things We Learned Today About Sandy Hook Shooter Adam Lanza. November 21, 2014

Family Of Martin Richard Opposed Death Penalty For Dzhokhar Tsarnaev, 2015. CBS TV Boston TV July 31, 2020.

The fine art of being present: A Chaplain’s call for the spiritual connection with front line cops

Sometimes being present in the moment is enough to allow feelings of vulnerability to emerge and for healing to begin. Cops, and I dare say fire fighters, are not used to being vulnerable. Often less is more when is comes to shared space, personal pain and having a connection with one or more people who understand. A quiet moment of reflection after a difficult call may be enough to diffuse the experience of trauma and provide damage control going forward. Career hardiness and satisfaction requires that some moments be recognized with a circle of shared vulnerability and authentic empathy that can be just a few seconds to minutes.

Police Chaplaincy since 1800’s

During the coronavirus after a particularly deadly shift, members of ICU teams took a moment to share the names of those who had died in their care. These were somber events that acknowledged the losses and a measure of desolation shared among team members. People undergoing enormously stressful events can unburden themselves only if they acknowledge their inner feeling state. “We’ve seen chaplains accompany COVID patients in their last moments when loved ones could not be present. The year 2020 inflicted deep wounds on many in our communities and chaplains were there offering support,” said Wendy Cadge, the project’s principal investigator and Senior Associate Dean of Strategic Initiatives at Brandeis University

“When we can feel and acknowledge our deepest fear – it can be liberating and reduce the perceived stigma of being vulnerable and in pain.”

Elissa Epel, Ph.D., UCSF, as quoted in NY Times

Police, fire, and first responder agencies across America have called upon the chaplaincy when their membership has experienced an out-of-the ordinary exposure to trauma like fatal car crash, death by suicide, death of a member, school or mass shooting, and more. Some of these are more routine like a notification of the sudden death of a family member. Meanwhile, other incidents leave a searing imprint of the entire event like the shooting of over 20 Sandy Hook elementary school students in Newtown, CT. It has been frequently mentioned that exposure to death and uncivilized brutality has an impact on wellness and personal resilience. Not a surprise. In the case of Sandy Hook how can any member of law enforcement or EMS ever forget that day? But what can be done?

Police chaplains is one part of the solution. The Chaplaincy Innovation Lab received two grants totaling $750,000 from the Henry Luce Foundation in the second half of 2020 to continue building and supporting resilience in chaplains and other spiritual care providers across the country. Chaplains often find themselves on the front line and frequently encounter operational chaos when they are called upon to minister to the troops. Yet that rarely stops them. They were there at Sandy Hook in 2012. The new program at Brandeis University in Boston aims to train chaplains to be better equipped for things like Sandy Hook or any community event that impacts large groups of people.

In Boston, the call went out that a firefighter was down. This during a 2-alarm fire in Watertown, MA. The department chaplain Father Matthew Conley was needed “now” at the Mount Auburn Hospital in Cambridge, MA for the Anointing of the Sick – known to many as “the last rites.” Fr. Matt had not been on scene during the incident as it appeared to be a routine call. But like so many calls it went south in a hurry.

Firefighter Joseph Toscano was near death from a medical emergency suffered while on duty fighting the fire. It was a hot summer day. He was 54-years old and had a large family of a wife and 5 children. The family were all members of the Catholic faith at a parish a short distance from Watertown. For many Catholics, the anointing of the sick is something to bring about reconciliation for someone who may wish to ease their suffering on the journey toward death.

Firefighter Toscano died that day while doing the job he was trained to do. The Last Rites involve prayers and the final Holy Communion known as the Viaticum. These were something Fr. Conley had done many times before. But when he arrived at the Mt. Auburn Hospital that morning he was met by a phalanx of Watertown police and fire fighters. As he walked into the emergency department of the large Cambridge, MA hospital he knew right away by the look in their eyes that this was no ordinary blessing. He was called to minister, first, to the dying public servant, his wife and children who had been brought to his bedside at the trauma center. But what’s more, he was tasked with consoling the entire brotherhood who looked to him for comfort and hope when no amount of prayer could bring back their fallen brother. But he listened, and he heard their pain, and validated their experience.

“You are here for all of them”, he would say, “and I am here for you.” Fr. Matt Conley sharing the words of former Parish Administrator Fr. Kevin Sepe at Watertown Collaborative.

The story is told that as Fr. Conley dealt with the enormity of the pain felt by all who felt the sudden loss of the career firefighter, when in-walked Fr. Kevin Sepe, the Watertown Collaborative priest administrator. The presence of Father Conley brought a strong empathic presence to the family who had lost their husband and father and to the first line firefighters who felt the loss deeply. Fr. Matt listened and he offered prayers.

From his years as a priest and police chaplain, Fr. Sepe understood what Fr. Conley was facing in the call to the hospital crisis as the department chaplain. His support was largely nonverbal that day. “You are here for them,” he would say, “and I am here for you,” bringing his presence, peer support, and understanding of the enormity the ministry at hand.

“Police chaplains aren’t there to push a religion on police officers; their role is primarily to listen and offer emotional and spiritual support” from an article in Police One, 2015. The chaplain program has been around for over 200 years and often works in the background subliminally. The military has utilized multi-denominational chaplains to minister the troops as well. These men and women are on the front lines and 3 members of the clergy have paid the ultimate price for their calling during recent wars.

Chicago Police Chaplain Father Dan Brandt

Not everyone is religious and you might believe that a goal of a department chaplain is to advocate one denomination over another. Not the case at all. The chaplain may be a Catholic priest as in the illustrated case or he or she may be an ordained Protestant minister, Muslim Imam, or a Jewish rabbi or some other ordained member of the clergy. As a police officer, I worked with a female protestant chaplain who was very helpful with members of our community. I would not have hesitated speaking with her in confidence if I were in need. The role of the chaplain is to provide support and to listen. She was good at it too. Being present with someone who is in crisis or dying can be among the most gut wrenching of all human experience. Fr. Conley once told me he never goes anywhere without the Sacramental oils for the blessing of the sick. This allows him to be ready to offer the Sacrament should he be called to do so. He felt deeply that this anointing was his duty and one of seven sacraments priests are prepared to offer.

I have given death notifications before and have witnessed the soul wrenching-anguish experienced by those receiving these notifications. It is a horrible experience and I remember most all of these events and am still bothered by several.

For line of duty deaths, chaplain’s ask if prayer might be helpful. The sacrament of the sick is one “of strengthening, peace, and courage to overcome the difficulties that go with the condition of serious illness or the frailty of old age provided by the Catholic Priest. This grace is a gift of the Holy Spirit, who renews trust and faith in God against the temptation of discouragement and anguish in the face of death” according to Michelle Arnold published in Catholic Answers in 2017.

The key to a successful departmental chaplaincy is contact — if you have enough chaplains strategically placed who are artful in “reaching out and touching someone,” two things will happen. Successful interactions will take place and the word will get around. Once calls for a chaplain begin to come directly to a chaplain from the on-scene sergeant or deputy, the chaplaincy has made its mark.  Chaplains can best serve when their role is defined and the confidentiality of their relationship to law enforcement is understood. Police One, 2015

The chaplaincy has been around for centuries in public service. It is making entry into many law enforcement agencies in earnest. Many have had chaplains riding in cruisers for decades like Fr. Dan Brandt in Chicago and his fine crew of law enforcement trained chaplains of all denominations. At some times, this has raised the issue of mixing government with religion. But there are guidelines in place. “In Lemon v. Kurtzman, the justices established the three-pronged “Lemon Test,” which, as it translates to the chaplain’s position, says he must have a secular purpose, must not excessively entangle the government with religion, and neither proselytize nor inhibit religion” said reporter Jon O’Connell in a 2017 report. The police and fire department chaplain is there for support of first responders, not as an evangelist, but as moral reminder of the “sacred nature” of their work, according to Fr. Dan Brandt, the director of the Chicago Police Ministry. In Watertown and now Scituate, Massachusetts, Fr. Matthew Conley brings forth his presence with kindness, reverence, and often good humor making the human connection with those in his purview.

Brandeis Now. Chaplaincy Innovation Lab at Brandeis University receives $750,000 from Henry Luce Foundation. January 23, 2021

O’Connell, J. (2017) Police chaplains take a stronger role in community policing. Scranton Times-Tribune. News article.

McDermott, M and  Cowan, J. Combating Pandemic Fatigue. Quoted in NY Times. October 2020.

At these times: Still words to live by… from 2015

Chief Bert DuVernay on right photo by Susie Mullican
Take care of yourselves, rest as much as you can, read good books, sing loud songs (when you’re alone…would be best) and read a poem now and then”  Ann Sefton, 2015


These were the words of Ann Sefton in a Holiday card sent to my wife and I and are among the best advice I have ever received from my mother or anyone else.  I think they are worthy and spoken from the heart and I intend to share them with anyone who will listen.  The kindness and wisdom in the words struck me as a reminder of the joy and simplicity I seek in my life. Those words along with the espoused words of David Trimble, Ph.D. are beliefs that foster greater self-awareness, self-compassion, firm authority, integrity, and coherence to my life. Here’s to a great New Year! Let’s pray for the end of the Coronavirus and return of our society as we know it. April- 2020 Just an update: my mother Ann is now in memory care at the Bethany Healthcare in Framingham, MA. She introduces me proudly as her husband. My mother continues to experience joy on a daily basis and is receiving excellent care at Bethany. She is resilient and happy and will rest and sing loud songs. She has made friends. She still enjoys election coverage but must wait for now. I have not been able to visit for 3-4 weeks because of the risk of transmitting the virus. Meanwhile, Chief DuVernay recovers from several medical procedures and is on the mend. We wish him Godspeed as he and his wife Teresa plan a long-awaited westward move into shared retirement and grand-parenting. Because of the social distancing mandate due to Covid-19, I regret that I may not have the chance to say goodbye properly to Bert and Theresa. That would make me very sad and put an end our regular ‘Lunch with the Chief’ meetings where many former officers come together and shoot the “you know what” and share time together over lunch and remember our times together. The photograph shown is to recognize Chief Bert DuVernay on the anniversary of his retirement from the New Braintree Police Rep in 2015.  Read The shared words and share them with someone you care about.

Investigating domestic violence, predicting danger, and containing the anger

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Dr Michael Sefton
Domestic violence homicide results when victims decide to move on with their lives and inform a jealous, insecure spouse that they no longer want a relationship. October is Domestic Violence Awareness month. The risk is greatest when victims decide to leave. At first glance one might say “Lots of people break up and do not murder their spouse and family” according to Michael Sefton shown in the photo above. That is a fair statement, but it happens enough in the United States and elsewhere that domestic violence homicide must be considered in the most egregious cases of DV. Last week in Massachusetts a family was murdered because one spouse asked to be let go and people were stunned that they saw nothing to warn them of what was brewing.
“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 (2016).
At what point does a potential victims begin to wonder whether she and her children are safe? We are lead to believe that abusive intimate partners cannot be held in jail unless they are in violation of an order of protection, AKA: restraining order. This is untrue. But time and again, violent and abusive partners stalk and ignore orders of protection – especially using social media tracking software and trolling social media sites like Facebook, Instagram, and What’s App to find victims and watch their activity. It is all about control, pathological jealousy, and instilling fear and terror. Restraining order’s are authorized by a district court judge who is on call night and day in most parts of the country. Restraining orders are not authorized unless substantial threat to the victim exists.  These orders are carefully crafted by investigating police officers whose reports highlight the exact nature of the violence and the reason the victim needs protection. “Protection orders are offered to the victim after the first sign of physical violence. It has been espoused that the police are not called until after the 6th or 7th episode of domestic violence” according to Sefton, 2016.  DV is a secret affair between members of a family who are often ashamed or embarrassed to come forward for help often until things gradually get worse – sometimes years into a pattern of violent dysfunction. Research is clear that separating spouses for the night does not positively impact the level aggression and risk in the household as much as the formal arrest of the aggressor.  What usually happens is the police break up the fighting couple by sending the aggressor off to the home of a friend or family member – less often to jail unless there are obvious signs of abuse. Arrest is mandated by law when physical signs of abuse are apparent. It has become all too often the case that hindsight – taken seriously – may have saved a life. It is when they are attempting to leave that abuse victims are at greatest risk of death due to domestic violence as in the case of Amy Lake, a victim of domestic violence homicide whose case was carefully studied in the Psychological Autopsy of the Dexter, Maine Domestic Violence Homicide (Allanach, et. al. 2011) that occurred in June 2011. Lake’s husband and murderer was heard to state that “if you ever try to leave me I will kill you”.  In research conducted by this author and colleagues we learned that as soon as police leave the scene the risk for violence is increased. We interviewed a man who served 18 years for the murder of his wife and he described in vivid detail how he used nonverbal coercion to manipulate his wife while being interviewed by sheriff’s deputies in Maine. He admitted that as soon as the police were out of the driveway he strangled and drowned his wife for calling them. In our interview, he claimed that she was his best friend. 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 unwitting duplicity stems from the cultural belief that what happens behind closed doors is “nobody’s business” or the conscious result of intimidation should not change the proper law enforcement intervention in these cases. Early incarceration provides opportunity to draft a viable safety plan for potential victims and in some cases, will instill a desire for change in the violent partner. In the meantime, substantive 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 and violent partners to be contained. 
Allanach, RA, Gagan, BF, Loughlin, J, Sefton, MS, (2011). The Psychological Autopsy of the Dexter, Maine Domestic Violence Homicide and Suicide. Presented to the Domestic Violence Review Board, November 11, 2011 Sefton, M (2016). https://msefton.wordpress.com/2016/07/20/the-psychology-of-bail-and-alternatives-to-incarceration/ Blog post: Taken October 9, 2019

Saluting a fallen brother and bringing him home

WESTBOROUGH, MA March 18, 2017 Most people leave their homes and go to work.  Many work in sales or IT or perhaps they teach school.  It doesn’t matter because that all changes when you are a member of the fire service or a brother police officer. Then you become a member of a family that many say takes a hold of you like no other.  There is a bond among fire fighters and a respect that runs deep within the fire service – the family of firemen.  The bonds are forged in the hours of training, answering calls, and sitting chewing on the issue of the day.  And then one day someone goes down.  In police service it’s called the “oh shit” moment when something happens so quickly that your response is purely defensive sometimes too late as in the case of the Flagstaff, AZ 24-year old officer whose body camera recorded the oh shit moment that took his life last year.

tlumacki_watertownfirefighter_metro118
Boston Globe photo

Firefighter funeral traditions show our deep gratitude and respect for the honorable contribution they make to society. When a firefighter dies, he is considered a “fallen hero” and his funeral will indicate such an honor.    D. Theobald

The fire service is even more protective of its ceremonial reverence for the ultimate sacrifice made by a heroic fallen firefighter.  Everything stops. Every one steps up and does whatever is needed to support the surviving family and each other. Someone is usually assigned to stay with the bereaved family 24 hours a day. The ritual of bringing home a fallen fire fighter is age-old. Firefighters remain with the body and bring it home with care and reverence afforded a fallen hero.  This custom was once again brought to bear when Watertown, MA firefighter Joseph Toscano, 54 died while fighting a 2-alarm house fire this week.  The death of a fire fighter is a rare occurrence but happens frequently enough that most people can remember the show of reverence from members of the fire service everywhere.  In 2014, 2 Boston firefighters were killed in a wind-driven conflagration on Beacon Hill and who can forget the 6 Worcester firefighters who lost their lives in December 1999, or the Hotel Vendome fire in Boston that took the lives of 9 Boston firefighters over 40 years ago.

Watertown, Massachusetts has seen its share of catastrophe in recent years in the police and now fire services. The funeral will be attended by thousands of local firefighters and those from across the United States. Fire houses in Watertown, Boston, and elsewhere will make accommodations for out of town brothers and sisters attending the funeral. No member of the fraternal family is ever turned away.  The coffin will be on display for those of us so moved to pass by and offer a final salute to the firefighter and his family.  The honor guard will stand at head and foot in solemn deference for the ultimate sacrifice. The surviving spouse will be strong as she has been for many years over many calls for service.  Her husband has helped so many people.  He has seen much and has dealt with this before.  But as the flag draped coffin is moved into place the release of emotion will be palpable for all.  The fire chief will present the folded flag to Maureen Toscano his wife of over 20 years.  He will offer words of comfort to his five children. They will never be forgotten because they are part of the extended family of firefighters.  The 150-year old ritual of bagpipes will play Amazing Grace while men from Newton, Boston and Cambridge stand guard at the Watertown fire houses to allow every Watertown firefighter to attend the service. To grieve and begin the healing process.

A Catholic Mass will be held.  The streets of Randolf where the family lives will be lined with a sea of blue uniforms each one holding back tears – having been through this before.

As Watertown firefighter Joseph Toscano knows it could well have been any one of his brother officers who fell that day and he would never have stood by for that.  A heroic effort was made to save the life of Joseph Toscano by members of the Watertown Fire, EMS and Police departments. He was rushed to Mount Auburn Hospital in Cambridge – the same place where MBTA Officer Richard “Dic” Donohue was rushed after the 8 minute firefight during the search for the marathon bombers in 2013.  Officer Donahue survived but lost nearly all of the blood in his body. Donahue retired from the Transit Police in 2016 after his promotion to sergeant and deals with chronic pain on a daily basis.  Emergency crews at Mt. Auburn were not able to revive Joe Toscano.

His body was carefully moved from the chief medical examiner’s office in Boston – just 5 miles away to Randolf – but he was never alone. Members of his department including his chief rode on Watertown Engine 1 and a ladder truck leading the hearse and a legion of police officers.  Firefighters from neighboring cities stood along highway overpass with hand salute as Firefighter Toscano was headed home. Among the most powerful of ceremonial rituals is “the last call.”  This occurs when the fallen officer is called on the fire band radio for all to hear – “Firefight Toscano come in….” there is silence.  The fallen officer’s call sign is again dispatched – silence once more.   Finally, the dispatcher indicates that the fallen officer has gone “10-7” signaling that he is no longer on duty – in this case signaling – the end of his watch.  A bell sounds 15 times indicating the firefighters final call.  Often the dispatcher will say something like “You have served your community with honor and reverence, good sir, we will take the watch from here.  Rest in peace – Firefighter Toscano and know you are a hero and will never be forgotten.”


Firefighter’s Prayer


When I am called to duty, God,
wherever flames may rage,
give me strength to save a life,
whatever be its age.
Help me embrace a little child
before it is too late,
or save an older person from
the horror of that fate.
Enable me to be alert,
and hear the weakest shout,
quickly and efficiently
to put the fire out.
I want to fill my calling,
to give the best in me,
to guard my friend and neighbor,
and protect his property.
And if according to Your will
I must answer death’s call,
bless with your protecting hand,
my family one and all.

Police as therapist: the inherent risk of unconditional positive regard 

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.

DVH in MA: 4-year old child begs father not to murder his mother

  • “… 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

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. Amy

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Michael Sefton

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.