The common man who left no foot prints

“I’m looking for people to stop fights before they happen and I want people to be more aware of the common man”. Juston Root, 41 – from posted video just one day before his death
Hospital video of BPD officer initial encounter with Juston Root on February 7, 2020
On February 6, 2020 Juston Root posted a few minutes of video in which he espoused a disjointed series of thoughts espousing the importance of being aware of the common man and using friends for support. Was Root speaking about himself, perhaps in need of someone? He died one day later in a frightening series of events that lasted seven chaotic minutes leaving this common man dead. Juston Root had a long history of mental illness. On the day of his death, he was seen at a local hospital in Boston displaying what appeared to be a firearm. Interestingly, his parents reported he liked to carry replica handguns sometimes using a should holster. This bespeaks an attraction to firearms and yet he did not own a real weapon. It is not clear why he chose the hospital district on Longwood to make his initial foray. He was said to have made threatening statements to law enforcement officers who he first encountered. What was said? Did Mr. Root threaten the first BPD officer seen in the video? Did the officer get a look at the weapon shown and could he have been expected to recognize it as a replica? Our training and experience set the stage for this level of acumen. Video of the scene showed Root parked in the middle of traffic wandering in and out of the frame. 4 -way hazard lights activated. Was Root so rule bound that even on his last hurrah he had the provision of thought to set his hazard lights? This seems unlikely for someone in a terminal state of homicidal or suicidal rage. What was his state of mind once shot? At some point shortly after this initial encounter a parking lot valet was shot in the head and critically injured. Mr Root did not shoot the parking attendant but this was not clear amid the next moments of radio traffic. The fact that the attendant was injured by friendly fire simply was not reported and likely, was not clear at this point in the investigation. This set the stage for manhunt that quickly came together looking for someone who had shot a parking lot attendant and pointed a weapon at the police officer. It is at this point that Root made a run for it setting into action an all hands on deck police gauntlet that he had little chance of evading.
“There will always times when police officers encounter those with mental health needs especially in times of crisis. Training and education offer the best hope for safe and efficient handling of cases. A continuum of options for detox, dangerousness assessment, and symptom management must be readily available – but here in Massachusetts they are not”   Michael Sefton, 2017
What happened next triggered a chaotic police response that led to his death just minutes after he displayed a handgun aiming it toward a Boston Police Officer. It may have ended right there had the first responding officer rightfully met force with force. The physical reaction of the first officer almost looked as though he was expecting Root’s replica to go “boom”. But he held fire. An officer 20-30 feet further away saw this and fired upon Mr. Root wounding him and hitting someone down range of the incident. Officers are responsible for where the rounds go once they leave their weapon so it is always best they hit an intended target on the range or in the street. It is likely that area police agencies were put on tactical alert. When this happens, adjacent cities and towns clear their call screens and have available units staged at intersections watching for the suspect vehicle. In the end, the weapon he carried was determined to be a replica or toy. In his preamble on February 6, he suggested that people should not call police because they often are not aware of what was happening and 911 calls often result in police “storming in” in an effort to eliminate a threat to the public. Root seemed aware that “a lot of bad things can happen in the name of justice” when people call police in what he says are “fabricated phone calls”. This presentiment may be his experience living with mental illness for decades of his life. Juston Root was known to stop taking prescribed medication aimed at keeping hallucinations and delusions at bay and regulating his mood. The body worn video is chaotic and has been edited. Multiple officers can be heard shouting instructions at Root, a 41-year-old with a long history of mental illness who had brandished a fake gun at an officer earlier in the day. When situations like this occur the adrenaline often drives officers into elevated state of arousal that requires keen environmental awareness to assure actions taken are lawful. The county D.A. in the case has determined that, given the totality of the circumstances, the degree of lethal force directed at Juston Root was lawful. In the moments before he was killed by police gunfire an off duty paramedic made an effort to care for root but was ordered to back away by police. The crash was caught on video tape from the traffic light camera on Route 9 in Brookline. It was sensational and Mr. Root was obviously traveling at a high rate of speed when he crashed. He was attempting to flee. “Moments later, he walks onto the mulched area where Root was shot, approaching an officer standing over an object that appears to be a gun.” Video that is released reveals police officers warning each other about talking openly on tape. Some say there was bravado and even laughter after the threat was gone. ”Is it fake?” the first officer asks. Yes, was the answer and officers at the scene began to understand that Root may have died as a result of officer-assisted suicide. Something no officer ever wants to encounter. Someone so distraught that they put themselves into the line of fire by acting as if they are holding a firearm or other weapon forcing police to use deadly force. It is not clear that this was his intention given the remarks he recorded one day earlier. Mr. Root had grown up with mental illness that was first diagnosed when he was 19-years old. This is quite typical of the major mental illnesses like schizophrenia or bipolar depression that present themselves in late adolescence. The National Alliance on Mental Illness described Schizoaffective disorder as having clinical features of both schizophrenia and major depression. They can be unpredictable and often exhibit signs of hallucinations, delusions, poor impulse control, and suicidal behavior. Among these patients, officer-facilitated suicide would not be unheard of. But Root’s father said he had been stable over the preceding five years although he had a history of carrying fake guns. He was quick to point out that his son often stopped taking his prescribed medication. But in his taped preamble he was not angry and made no threats toward law enforcement. In fact, he indicated that he had friends on the police force although it is likely the friends of whom he speaks were officers he encountered over the years but I am being conjectural. If Mr. Root intended to die by police officer gunfire he may not have activated his hazard lights which can be seen blinking as he staggered away from the wreckage of his Chevrolet Volt. In his video statement he started by saying he had friends on the police force. There was no obvious animosity toward law enforcement. If he had had a genuine firearm and intended to go out in a blaze of glory, he may have made a final stand either at the wreckage of his vehicle or somewhere nearby like behind a tree. That was not the case. Root was trying to get away. No final stand. No “fuck you” to the world. He was down when he was shot and there was a person there to help him who was ordered away. An officer can be heard saying “he is still moving” after the barrage of rounds over 30 in all. Juston Root was mentally cogent enough to activate his 4-way hazard lights after the high speed crash and in video that could be seen when he first entered the Longwood hospital district. Why? A formal psychological autopsy that is transparently guided might find an answer to that question. Hospital Police were on guard and had been victim of a homicide that took place inside the hospital itself in January 2015. Juston Root was here for 41 years living in what he perceived was a dangerous world. He came and grew to have an affinity for law enforcement he left without leaving any foot prints or last words.

Officer distress in Bangkok, Thailand

“Today police morale and emotional health have hit rock bottom, he said, because of a number of factors, including botched policy-making when it comes to their career path that doesn’t take into consideration the officer’s needs and desires.” Bangkok Post December, 2019

And the year 2020 was not any better and very likely triggered added stress and tension among the working wounded in Bangkok and beyond. Shortly after I visited Bangkok, in early 2020 a member of Thai Army service in the Northern Province went off and killed his superior officer and over 20 people in his community. Very rare in the Thai history. My former Chief and I had met another commander from the Northern Province detail and liked him a lot. He smiled and seemed confident before returning to the Northern Province. Gun violence in Asia is rare and mass shootings are more rare still.

Next came the virus. Thailand got out in front of the contagion and closed things down and required both social distancing and masks. The total number of cases per 100,000 souls is much less than here and most other places.

Meanwhile, Thailand is offering a softer, gentler service to those officers who sign on to be law enforcement officers trying to accommodate the needs of the police service.

Shoot – Don’t Shoot: Mental Illness and the Use of Force

Police agencies expend a great deal of LEO resources dealing with citizens with mental illness. The Washington Post (2015) and the Boston Globe (2017) both did large feature stories on police use of force against mentally ill persons. The profiles were gut wrenching but only one example illustrated the emotional toll on law enforcement officers who are involved in fatal use of force situations. The Boston Globe Spotlight Series entitled The Desperate and the Dead was published in 2016. I have written about officer involved use of force for over 5 years now. The interaction between poly-substance abuse or dependence and exacerbation of underlying mental health symptoms is complex. The interaction of the two is sometime lethal as reported by the Globe Spotlight team. 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. Lethal force results as a function of the behavior of the subject and his capacity to listen and follow directions when he is confronted by law enforcement. It is impossible to utilize de-escalation techniques in all cases of police-mental illness encounters.

I have featured some very troubling cases including a case of patricide in Vermont. In that case, Kryn Miner, 44 was shot and killed by his son in 2014 after threatening his wife and stating that he was going to kill his family. Ironically, Miner and his wife has just returned from a wedding. Kryn Miner was intoxicated and had both PTSD and a traumatic brain injury. He was on a waiting list for care at the local V.A. Miner threatened his family with a gun a year before his death but the event was never reported to police. Current and former police chiefs said that without large-scale police retraining, as well as a nationwide increase in mental health services, these deadly encounters will continue. The loss of veterans from suicide remains a significant moral shortcoming.

“When officers are faced with a deadly situation, when there is a gun pointed at a cop, there is no time to go into mental health measures,” SFPD Chief Grace Gatpandan said in 2015. 

Washington Post (2015) Lowery, W. et al. DISTRAUGHT PEOPLE, DEADLY RESULTS: Officers often lack the training to approach the mentally unstable, experts say

Gun violence is a public health problem. The American Medical Association is now recommending physicians ask their patients whether there is a firearm in the home. Especially among older adults, divorce and substance abuse contribute to the risk of suicide by means of a firearm. This information may raise physician awareness and set off warning signs especially in patients without social support. According to David Rosmarin, M.D. at McLean Hospital in Belmont, MA – Rampage violence or spree violence is rare but always sensational- “violence is the currency of what we do” so MD’s need to become comfortable with the conversation about violent intention. The serious mentally ill account for only 3-5 % of all US violence – substance abuse is a big factor in violence according to Rosmarin.  Violent intention is frequently communicated in advance.  “There were signs along the way that were ignored” according to Rosmarin. These signs may be important when building systems of care and training LEO’s who are expected to de-escalate dangerous citizens and with limited training.

“I called 911 so they could disarm him, not kill him,” Joan Hart told a reporter in 2007 after her suicidal husband, James, 65, was fatally shot by Quincy police in their backyard after charging officers with a knife.

Boston Globe Spotlight Team 2016

The quote about is heart breaking because the outcome of that call for help was not good. All officer involved shootings are carefully investigated as part of normal protocol. People fail to appreciate the impact the OIS has on the officers involved. No police officer leaves his house with the intention to get into a gun fight. “There will always times when police officers encounter those with mental health needs especially in times of crisis and social disorder. Training and education offer the best hope for safe and efficient handling of cases. A continuum of options for detox, dangerousness assessment and symptom management must be readily available – but sadly here in Massachusetts they are not” Sefton, 2016

__________________________________________________
Boston Globe Spotlight Series (2016) Desperate and the Dead.
Washington Post (2015) Lowery, W. et al. DISTRAUGHT PEOPLE, DEADLY
Sefton, M. (2016) Human Behavior blog post: https://msefton.wordpress.com/2016/03/24/deadly-force-continuum-changing-officer-safety/ Taken June 4, 2019

Points of entry to Peer Support – Stress Intervention Continuum

When law enforcement agencies recognize the human effect of 
SURVIVORS
Stress exposure is a regular occurrence
stress on its officers then the stigma associated with routine interaction with behavioral health specialists will diminish or become nonexistent. Agencies having a Stress Intervention Continuum (SIT) such as this one are more apt to address law enforcement officer (LEO) behavior before it becomes career or life threatening. The model involves specific events that would regularly trigger a referral to peer support or behavioral health. This need not be an official “fitness” evaluation but more of a check-in with peer support, behavioral health, or consulting psychology service. The level of intervention is related to officer history and may be linked to identified deviation from “typical” annual reviews such as when an officer suddenly exhibits a change in regular habits or on-duty comportment.  Cumulative exposure to high stress events should also trigger a routine screening for all officers involved e.g. death of a child or serious injury to fellow officer.   Agencies are getting more adept at tracking call volume and specific events of high community interest. Known events of high acuity/high lethality such as a mass casualty incidents or other high profile/high stress incidents should be cause for officer defusing sessions that might include a group of officers not just a single officer. These sessions should be scheduled soon after the incident occurs. They should include supervisory staff in addition to police officers who participated in the call.  Some agencies are calling for annual stress reviews to include screening by a behavioral health specialist or police consulting psychologist.
When officers are identified there needs to be a planned response using a peer support infrastructure that provides for a continuum of service depending upon the individual needs of the LEO and the supports available including behavioral health specialists. In many agencies, especially smaller departments lacking resources, officers’ languish and sometimes spiral downward without support and without somewhere to turn. 
                                                                                                                         Michael Sefton, 2018
SIT – Points of Entry
  • Exposure to highly stressful events in close sequence e.g. multiple suicides or fatal car crashes, homicide, repeated domestic violence calls involving violence and children, etc.
  • Change in work assignment, district/station, deployment plain clothes undercover or return from deployment to uniform patrol
  • Increased absenteeism – over use of sick leave
  • Increased use/abuse of substances – impacting job functioning, on-the-job injury, vehicle operation
  • Off the job criminality or citizen complaints or neighborhood disputes
  • Community – on-duty citizen complaint(s) for verbal abuse, dereliction of duty, LEO vehicle crash
  • Citizen complaints of excessive force during arrest, new supervisory or peer conflict, or direct departmental insubordination.
  • Use/Abuse of force such as using baton, taser or firearm, recurrent officer involved use of force. Officers are sometimes strongly embittered and angry at this point in their career due to perceived lack of support and powerful feelings career disappointment and alienation.

Sefton, M (2018) Blog post: https://msefton.wordpress.com/2018/11/19/police-stress-intervention-continuum-an-introduction-for-leos-and-command-staff-to-reduce-officer-suicide/ Taken April 24, 2019
Copyright Michael Sefton, 2019

From anonymity and stigma grows resilience

Today there is still a great deal of stigma associated with reaching out for peer support within police departments. Officers’ fear being misunderstood and seen as weak if they acknowledge their vulnerability years into the job. The blue line bleeds each time an officer takes his or her own life yet the silence within the ranks is stunning. An officer may act heroically in their efforts to save a child who isn’t breathing and fail.  An officer may be first-in to a call for domestic violence homicide and fail.  An officer may be dispatched to a horrific motor vehicle crash and come upon an overturned minivan with a shamble of entrapped human misery and death and still feel a failing.  These events create a chink in the armor and sometimes reveal gaping personal anguish that accumulates over time. The cumulative impact of trauma adds to the layers that belie the outward calm.  As a former police officer there are calls I covered that are painful to this day. Abject failure. Exposure to subclinical, traumatic events takes a toll of both physical health and emotional wellness and can lead to PTSD, secondary traumatic stress disorder, and burn out.
Prevention of law enforcement suicide is paramount.  As recently as early November, 2018 a former police chief died by police assisted suicide killed by his former officers after charging them with a kitchen knife.  And in Baltimore County, MD, School Resource Officer Joseph Comegna, a 21-year veteran of the force, took his own life at his desk in the public school.  “And unlike line-of-duty incidents, which tend to receive a great deal of media coverage, law enforcement suicides rarely get much press, says Al Hernandez, a 35-year veteran of the Fresno Police Department (FPD) in California. Hernandez helps connect officers to mental health care.” according to Jack Crosbie writing in Men’s Health about a suicide death of an NYPD officer who died in early 2018.
The impact of stress on the lives of LEO’s is well known and can have pervasive impact on officer well-being both in and out of uniform.  Hypertension, cardiovascular disease, substance abuse, and depression are just a few of the behavioral health consequences that may result from repeated exposure. Ongoing vulnerability to traumatic events can result in anger, resentment, strong negative emotions, and reactive embitterment that can erode job satisfaction and job performance (Sadulski, 2017). Critical Incidence Stress Debriefing plays an important role for police by helping LEO’s manage their trauma and post-traumatic stress. It should be provided as part of an integrated system of peer support. Most departments have officers trained in CISD whom provide peer support to brother and sister LEO’s who are in crisis. Key among these relationships is the hand-off to mental health professionals when indicated. Peer support is not treatment and the relationship between the peer support and psychological treatment should be clearly defined.
Each of us in law enforcement has a duty to reduce suicide among the men and women in blue whenever possible. This requires a substantive understanding of the risk factors associated with LEO self-destruction. Chief among law enforcement is the camaraderie that bonds officers together during times of stress. Peer support is a key factor in reduced emotional suffering among law enforcement officers. 
Risk factors for suicide increase when the conventional need for belongingness among law enforcement officers which is thwarted by the estrangement or isolation.  This comes with individual officer discipline, e.g. suspension, or some other factor pushing him/her out that can be isolating and evoke feelings of thwarted belongingness according to Thomas Joiner (2009). Social alienation is a powerful emotional dynamic that results from the experience of being estranged from a core group of supportive friends, colleagues, and immediate family. This occurs in many ways including change in social reciprocity and reduced exposure to primary interpersonal ties resulting in powerful feelings of loss and growing belief of being a burden. This may be the result of disciplinary actions toward the officer, on-the-job injury, or departmental requisite following officer-involved use of force. 
Embitterment has large implication on LEO productivity, career satisfaction, job performance, citizen complaints, and officer health. It grows slowly as a function of career experience perceived support, and critical incident debriefing and peer support are vital to officer longevity.  Mentoring in the field and supervisory support reduce officer isolation and sometimes powerful feelings of negativity that can fester over time according to Polizoti, 2018.  Ostensibly, resilience is the opposite of embitterment. Have you ever worked with someone who rolled with the punches – literally and figuratively?  They can have felony cases dismissed in court and remain nonplussed maintaining a positive attitude and a “better luck next time” belief system.  
Lethal Self-Injury – Acquired Ability
The final risk factor involves a gradual desensitization to pain and human suffering according to Joiner (2009). Over time, exposure to repeated violence, homicide, intimate partner violence, and other “salient fearsome experiences”, the self-preservation instinct gradually disintegrates into a residual fearlessness in the face of life threatening danger and an acquired capacity to ignore the horror and humility of violence with a higher tolerance of pain and substantive capacity for suicide (Joiner, 2007).
Joiner believes that the capacity for suicide is acquired over time from the repeated exposure to trauma such that the reaction to horrific traumatic events, e.g. domestic homicide, loses the ability to evoke a normal emotional response and habituates to a decreased emotional reactivity, a higher tolerance for pain, and a fearlessness in the face of death. Given this proclivity toward feeling “numb” in the face of high levels of violence, over time researchers look for protective factors such as reducing isolation and more frequent debriefing after every critical incident rather than wait until LEO coping goes the way of attachment and perceived support. 

References
Sadulski, J. (2017). Promoting Police Resilience through Peer Support. Law Enforcement. Blog post taken November 20, 2018
Joiner, T. (2009). The Interpersonal-Psychological Theory of Suicidal Behavior: Current Empirical Status. Science Briefs, APA, June.
Polizoti, L. (2018) Critical incident resilience training. Personal correspondence, September.

 



Law Enforcement – Mental Health Collaboration

November 28, 2015 In a recent post the issue of mental illness and police use of force has been the subject of scrutiny.  The pairing of police officers and mental health counselors is becoming a compelling option in some departments.  In a previous blog post I published an essay ostensibly denouncing the utility of these patrols in part because it presents a greater level of risk to police officers, ride-along psychotherapists, and the community at large (Sefton, 2015)

Over 100 persons with known mental illness were the victim of lethal force following a suicide by cop scenario or some other violent encounter resulting in the rapid escalation of the use of force continuum. Police officers train for these situations and are expected to meet force with force.  These encounters sometimes end up in a lethal force standoff where split second decisions can wind up in a deadly outcome.  As quickly as encounters may escalate, police are trained to de-escalate their use of force as the situation dictates.  The use of force must be fluid and officers in the field are expected to modulate the force they apply to the demands of the situation and be ready to respond to changing threat levels.

The current population of jail inmates is said to have a higher percentage of people suffering with mental illness than ever before.  Since the early 1970’s an effort has been made to deinstitutionalize those with severe mental illness leaving many to flounder in the streets.  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.

Police are increasingly linking up with mental health agencies as a way of diverting mentally ill person’s from jails into treatment for their emotional affliction. This is necessary to free police to serve the public interest more efficiently and safely. Treatment options are quite limited especially in rural communities who may be underserved by specialists in psychiatric emergencies.

psychology2
British Psychological Society (BPS) photo

Police in Augusta, Maine have paired with crisis counselors two nights per week in order to provide support and expertise to police in the handling of mentally ill suspects with emphasis on de-escalating and diverting subjects from jail. Larger agencies routinely interface with mental health experts.  Courts across the country have in-house clinics that can provide up to date assessments of persons with suspected mental illness or risk for suicide and homicide.

In Massachusetts many smaller police agencies must pay overtime for police officers to sit in hospitals or outside of jail cells watching a mentally ill person who has been arrested.  Specifically, if a police officer arrests a person with a known history of suicidal ideation it has been policy among many agencies to provide an officer to monitor the prisoner to assure for a safe transfer to court. This is very expensive for small departments and takes a police officer off the road sometimes for 48 hours until the prisoner can be brought before a judge. Coupled with a high prevalence of cases of substance abuse and the growing menace of opioid addiction, police officers have their hands full with cases in which changes in mental status add to the complexity of decision-making and breadth of alternative dispositions.

This author was employed in an agency that generally deployed a single officer on duty.  When a mentally ill person was arrested the agency was forced to call in off duty personnel to transport and supervise the prisoner to assure for his or her safety.  This policy was implemented in any case of arrest whenever a person has ever had a documented history of depression with suicidal statements.  Across Massachusetts police dispatchers have access to a database of names of individuals with documented history of police interaction while mentally ill. This affords the police a heads up when a call goes out involving persons with a proclivity for suicidal behavior.  This protocol was not necessary and offered no help whatsoever to the person under arrest.  It resulted in emotionally vulnerable persons being held in custody longer than necessary out of fear that once released they would be at high risk of suicide and leave the police department liable and open to litigation.

The myths associated with mental illness – especially in the police service are abundant. For example, here in Massachusetts anyone arrested with a known history of suicidal threats needed to be watched while in custody – sometimes for one or two days until they could be brought before a judge. The question of suicidal risk should be made by psychologists and psychiatrists familiar with emergency mental health and crisis intervention.  Police officers are inherently apprehensive about legal action being brought against individual officers for decisions made because of a lack of understanding and training in dealing with those in crisis. District court judges have no greater training in suicide assessment and prevention than the cop on the beat and the decision about suicidal risk should not be left to them.  The police should turn to the experts whenever the question of risk for suicide arises and once evaluated the disposition may be straight forward gradually reducing the myths associated with this difficult population.

I agree with calls for added training for police officers in dealing with the mentally ill as a way of eliminating the myths that obfuscate decision-making and risk officer safety.  Agencies are making greater efforts to divert the mentally ill away from jails and the legal system whenever possible.  But for diversion to work well the city and county need to provide treatment programs at each point a mentally ill person comes into contact with the criminal justice system – from interactions with cops all the way through the courts, according to an NPR-Kaiser Health News report in July 2015. Our current system of liaison between mental health and law enforcement must be forged by greater cooperation and mutual understanding of the needs of those suffering from emotional illness such as depression, PTSD, and now a growing population of the addictions including alcohol and prescription pain killers.