Violence and psychotic people

Among the most dramatic and menacing forms of mental illness are the psychotic disorders. These include people who have uncontrolled paranoid schizophrenia, bipolar disorder, depression with psychotic features, substance intoxication, and perhaps intermittent explosive disorder. Violence is not associated with mental illness per se.  There are factors that increase violent behavior among those who are mentally ill including persecutory ideation like suspiciousness and fear, and co-occurring alcohol dependence.  The most important way in which to reduce violence among citizens who are mentally ill is to provide some form of treatment to them.  Those who go without substantive treatment including psychotherapy are at greatest risk for becoming aggressive or violent according to Coid et al. (2016). These are the citizens who fly above the radar and are seen pacing the street corners in cities everywhere reciting from some unwritten preamble.  People walking avoid eye contact further pushing them to the margins of civility.  Eventually, the bottom falls out and the preamble comes to an incoherent end.  Either they move on or they are picked up for evaluation.

There are even greater numbers of psychotic people living under the radar.  Making their way in society, flying by the seat of their pants.  These people are often cared for by family members including elderly parents. When they relapse or “go off the rails”, caregivers often need the help of police to gain compliance with their loved ones.  Sometimes the police are called to restore the peace and compel the emotionally disturbed person into treatment.  For those individuals who relapse and are substance dependent i.e. alcoholic, the risk for violence is elevated.  These people require special understanding and sensitivity in order to establish a trust and to help them see their behavior patterns and risk taking behavior for themselves.  No easy task.

More recently, meta-analyses and case register studies concluded that psychiatric disorders are associated with violence, but that the relationship is largely or entirely explained by comorbid substance misuse. Fazel et al. (2009)


Fazel S, Gulati G, Linsell, L, Geddes, JR, Grann, M. (2009) Schizophrenia and violence: systematic review and meta-analysis. PLoS Med. 6: e1000120.
Coid, JW,  Ullrich, SP, Bebbington S, Fazel, R,  Keers, R (2016). Schizophrenia Bulletin, Volume 42, Issue 4, Pages 907–915, https://doi.org/10.1093/schbul/sbw006 taken May 9, 2019

Police Stress Intervention Continuum: An introduction for LEO’s and command staff to reduce officer suicide

Scope of the Problem: Police Suicide and the goal to eliminate it
Police job-related stress is well-identified and reported in the media daily and the rates of suicide nationwide are being debated by Aamodt and Stalnaker. They are actually less than one is led to believe but even one law enforcement officer suicide is too much.
Stress is defined as any situation that negatively impacts an officer’s well-being. The rate of suicide and divorce among law enforcement is approximately the same or lower than the general public according to a meta- analysis conducted by Professor Michael Aamodt.  But there are areas in the country and agencies that have higher rates of self-inflicted death.
When the suicide rate of police officers (18.1) is compared with the 21.89 rate for a comparable demographic population, it appears that police officers have a lower rate of suicide than the population according to Aamodt, 2008.
Incidence of suicide tend to be elevated in cities like Chicago, where chronic gun violence and a murder rate in the hundreds per year means cops see a staggering amount of trauma and may gradually become numb to the exposure of pain and suffering (Joyner, 2009). A Department of Justice report found that the suicide rate in the Chicago Police Department is 60 percent higher than the national average.  According to the Chicago Sun Times, in a note to department members Wednesday, CPD Supt. Eddie Johnson said, “Death by suicide is clearly a problem in Law Enforcement and in the Chicago Police Department. We all have our breaking points, a time of weakness where we feel as if there is no way out, no alternative. But it does not have to end that way. You are NOT alone. Death by suicide is a problem that we can eliminate together” CST September 12, 2018.  Chicago PD is not alone with the problem of suicide among its men and women in blue.
Law enforcement officers (LEO’s) encounter the worst of all experience on a routine basis. The people who call the police may be society’s best upstanding citizens but on this occasion it could be the worst day of their lives and they seek help from police.  Many times it is not the pillars of society seeking help but those people in the fringes or margins of society now victims of violent crime or abuse.
According to Hartley, et.al., 2007, “repeated exposures to acute work stressors (e.g., violent criminal acts, sad and disturbing situations, and physically demanding responses), in addition to contending with negative life events (e.g., divorce, serious family or personal illness, and financial difficulties), can affect both the psychological and physiological well-being of the LEO population.” When these 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. In many agencies, especially smaller departments lacking resources, officers’ languish and sometimes spiral downward without support and without somewhere to turn.  Police officers must have support available to them long before they are expressing suicidal urges.
As programs are identified and service continuum grows the risk of peer conflict over perceived betrayal of trust must be addressed. This must be addressed in the peer support training with emphasis on preservation of life over maintenance of confidentiality or the status quo of abject silence. “In itself, it’s a product of centuries of police culture in which perceived weakness is stigmatized. Cops know their brothers have their back, no matter what, but they still don’t want to be seen as the one who’s vulnerable.” according to a recent Men’s Health article written by Jack Crosbie in a report about suicide in the NYPD published during Mental Health Awareness month in May 2018.
The argument is made that the recurring uncertainty of police calls for service often leave LEO’s with low-level exposure to trauma of varying degrees. It is common that LEO’s move from one violent call to the next without time to decompress and process what they have seen.  The repeated exposure to trauma can slowly whittle away LEO resilience – defined as the capacity to bounce back from adversity. In a national media study published by Aamodt and Stalnaker, legal problems were a major reason for the law enforcement suicides yet no other study separately cited legal problems. In another study, relationship problems accounted for the highest percentage of suicides at 26.6% (relationship problems plus murder/suicide), followed by legal problems at 14.8%. In nearly a third of the suicides, no reason was known for LEO suicide.
Police suicide has been on the radar of advocates of LEO peer support for months or years.  The incidence of suicide has remained stable across the country but some agencies have higher rates of suicide.  Smaller departments – those with less than 50 officers in general have the highest rates of suicide.  This may be linked to the lack of availability of peer support programs and a paucity of local practitioners to provide professional service with knowledge in police psychology. “While police officers may adapt to the negative effects of chronic stress, acute traumatic incidents necessitate specialized mental health treatment for police officers (Patterson, 2001)”.  A referral to the department EAP often falls flat and makes it more difficult to make the hand-off when peer support is not enough.
Real-time model of change
The use of force continuum is well described in the LEO literature and ongoing criminal justice narrative. What does that have to do with stress intervention in police officers? It sets the tone for officer behavior whenever they meet potential resistance and or increased aggression during citizen encounters. It may also be used for initiating peer support needs whenever an incident use of force has occurred.  LEO’s change the force response based on the situation they encounter in real-time in a flexible and fluid manner. In this same way, peer support programs can flexibly shift to the needs of a presenting LEO and intervene early on – rather than when an officer is at a breaking point. “This continuum (use of force) has many levels, and officers are instructed to respond with a level of force appropriate to the situation at hand, acknowledging that the officer may move from one point on the continuum to another in a matter of seconds.” NIJ publication.  Peer support too, must accommodate a law enforcement officer in real-time to begin the process of building a healthy, resilient response to sometimes horrific exposures and provide a continuum of unbiased employee assistance and when necessary professional consultation.
Protective Factors begin in Academy training
What topics should addressed while LEO recruits are in training?  Ostensibly, the resilience of LEO’s depends upon the opportunity for in-service training in topics of mindfulness, stress management, physical health maintenance, nutrition, and trust.
“Emotional resilience is defined as the capacity to integrate the breadth of police training and experience with healthy, adaptive coping, optimism, mental flexibility and healthy resolution of the traumatic events. In general, resilient people are self-reliant and have positive role models from whom they have learned to handle the stressful events all police officers encounter” according to Leo Polizotti, Ph.D. a police consulting psychologist (Sefton 2018).
Police programs for health maintenance
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The Police Stress Intervention Continuum or P-SIC, involves a system of police support that varies in its intensity depending upon the continuum of individual needs of the LEO including physical debility or other significant components impacting career success and satisfaction. The intervention protocol is flexible and fluid as well. The entry point into the peer support continuum initiates from supervisory observations of LEO history and behavior, peer recommendations, and exposure to a range of traumatic events.

 

Generally speaking, a police officer’s behavior change is a function of the resilience they develop throughout their careers. Greater attention to physical health and emotional well-being are now being espoused in police academies across the country.   Greater awareness of the correlation with the recent trauma and frequency of exposure to trauma such as the death of a child, exposure to dead bodies, suicide of a colleague, etc. have negative impact on officer well-being.  Perceived support from supervisors and the organization hierarchy builds resilience.

Career success requires that officers learn stress tolerance and healthy habits to manage the daily challenges of police service. Physical exercise and healthy routines often afford the stressed officer an outlet for reduced risk of stress-related physical afflictions in addition to the emotional and health effects of repeated exposure to unpredictable violence.

The cumulative stress associated with a career in law enforcement cannot be understated.  In the setting of police stress and stress support there is an intervention protocol that relates to the peer-support program continuum.  Depending on where officers enter the peer support network will impact the level of intervention they may require in the P-SIC program.  Peer support is not psychotherapy but officers occasionally must hand off the officer in trouble to a  higher level of care.  These hand-offs are key to linking at-risk LEO’s with range of professional support needed to keep them on the job. Yet fear of reprisal for acknowledging the cumulative impact of stress and its impact often derails the hand-off to the professional. The highest risk for suicide to a LEO is when he is denuded of badge and gun because he may be a threat to himself.
The career success they have may be directly related to the application of resiliency training to build and maintain physical and emotional hardiness that lasts a lifetime according to Leo Polizoti, 2018. Before this can happen the stigma associated with reaching out must be reduced.

Points of entry to Peer Support – Stress Intervention Continuum
copyright Michael Sefton
  • Exposure to highly stressful events in close sequence
  • Change in work assignment, district/station, deployment undercover or return from deployment
  • Increased absenteeism – over use of sick leave
  • Increased use/abuse of substances – impacting job functioning, on-the-job injury
  • Community – citizen complaint(s) for verbal abuse, dereliction of duty, vehicle crash
  • Citizen complaints of excessive force during arrest, supervisory or peer conflict, or direct insubordination.
  • Abuse of power 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.

NIJ Publication (2009). Use of Force Continuum. https://www.nij.gov/topics/law-enforcement/officer-safety/use-of-force/Pages/continuum.aspx. Taken November 17, 2018
Aamodt, M. G., & Stalnaker, N. A. (2001). Police officer suicide: Frequency and officer profiles. In Shehan, D. C, & Warren, J. I. (Eds.) Suicide and Law Enforcement. Washington, D.C.: Federal Bureau of Investigation.
Aamodt, M. (2008). Reducing Misconceptions and False Beliefs in Police and Criminal Psychology. Criminal Justice and Behavior 2008; 35; 1231 DOI: 10.1177/0093854808321527.
Patterson, G T. (200l). Reconceptualizing traumatic incidents experienced by law enforcement personnel. The Australian Journal of Disaster and Trauma Studies, 2.
Joyner, T. (2009) The Interpersonal-Psychological Theory of Suicidal Behavior: Current Empirical Status. Science Briefs, American Psychological Association, June.
Sefton, M. (2018). Police Training: Revisiting Resilience Blog post: https://msefton.wordpress.com/2018/07/27/police-training-revisiting-resilience/. Taken November 18, 2018
Hartley, T., et.al.(2007). Associations Between Major Life Events, Traumatic Incidents, and Depression Among Buffalo Police Officers. International Journal of Emergency Mental Health, Vol. 9, No. 1, pp.
John M. Violanti, Anna Mnatsakanova, Tara A. Hartley, Michael E. Andrew, Cecil M. Burchfiel. (2012). Police Suicide in Small Departments: A comparative analysis. Int J Emerg Ment Health. Published in final edited form as: Int J Emerg Ment Health. 2012; 14(3): 157–162.

What is driving the killing: Update on the Myth of Mental Illness

After a spate of bomb threats and mass shootings there are still many myths about the attribution of these events and the underpinnings of violence.  The knee jerk reaction is to attribute the recent Thousand Oaks, CA nightclub shooting to a “crazed gunman” but that would unfairly place the blame on the mentally ill.  12 people were left dead in a despicable sequence of events during which the shooter Ian David Long posted that he had no reason for doing it except boredom.  In truth, most people with mental illness are not dangerous, and most dangerous people are not mentally ill.” Liza Gold, 2013. But Long had a history of violence and aggressive behavior that may have been linked to his service as a decorated US Marine. Published information suggests Long’s mother was terrified of making him angry out of fear that he would harm or kill her. Was Long’s terminal behavior attributable to mental illness or the result of traumatic events he experienced in the service of his country?
“Fact is I had no reason to do it, and I just thought….(expletive), life is boring so why not?”  Ian David Long via social media post (now removed)
Psychological experts believe mentally ill persons lack the higher order planning to execute the complex steps necessary for anything more than petty crime – more often associated with co-morbid substance abuse.  It is the co-occuring illness of drug or alcohol addiction that is a confounding variable in all police-mental health encounters.  “Doctors and scientists know that the perpetrators of such violent behavior including incidence mass shooting events are frequently angry young men, who feel they have been mistreated by society and therefore seek to exact revenge” described in a BBC the report Criminal Myths published in November.
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“Confounding variables such as a history of childhood abuse or use of alcohol or drugs can increase the odds of violence.” according to a BBC report debunking the belief that people who commit mass murder are mentally ill  by Rachel Newer in November, 2018.  The vast majority of cases are committed by a person or persons without mental illness.  In fact, people with mental illness are more likely to be victims of crime and are not prone to violent behavior. The Thousand Oaks killer refused any mental health support and was not driven by demons
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.  This is essential and will help to reduce officer involved use of force against the mentally ill substantially.  What to do?

Red flag indicators are often demonstrated in behaviors that are observable and measurable sometimes for weeks and months before the terminal event according to Michael Sefton, 2015.

The incidence of mental illness leading to mass shooting may be illustrated in the 2007 Virginia Tech shootings.  The Virginia Tech shooter Seung-Hui Cho had been treated for depression and was hospitalized on an involuntary basis prior to the rampage in 2007. Cho exhibited a life-long pattern of withdrawal from interpersonal relationships. He was often nonverbal and did not respond to people who reached out to him including direct family members.  His mother prayed for God to transform her son.

I strongly believe that mental illness does not mitigate citizens from responsibility for crimes they commit. I agree that alternative sentencing may be a powerful tool to bring these individuals into treatment. The substantive goal of streamlining encounters between police officers and citizens who suffer with untreated emotional problems belies the mission of these gifted officers and can teach others the role of discretion in mental health encounters.

Ostensibly, building relationships with network psychotherapists, physicians, addiction specialists, court judges, and other support service like Child and Family Services is essential. This is the area of most vulnerability.  When LEO’s fully buy-in to the mental health – police intervention model including the use of de-escalation techniques there must be receiving facilities available to initiate treatment and keep patients and citizens safe. The development of a fully integrated infrastructure for jail diversion, intake, and providing for the needs of the mentally ill is certainly a work in progress.

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Washington POST photo

“And when it comes to mass shootings, those with mental illness account for “less than 1 % of all yearly gun-related homicides” a 2016 study found. Other studies indicate that people with mental disorders account for just 3-5 % of overall violence in the US”  – Paul Appelbaum, M.D. taken from BBC by Rachel Newer 11-1-2018


Nuwer, Rachel (2018) http://www.bbc.com/future/story/20180509-is-there-a-link-between-mass-shooting-and-mental-illness taken 11-10-2018
Sefton, M. (2017) https://wordpress.com/post/msefton.wordpress.com/4561
Mentally ill American’s and their proclivity to act out against authority.
Washington Post (2007) Rescue and Recovery: A story of resilience that began with the scene in this photograph, Blog post: taken on April 16, 2007. https://www.washingtonpost.com/graphics/local/virginia-tech-five-years-later/?noredirect=on&utm_term=.cd170ba2ac09 taken 11-10-2018
Sefton, M (2017) Police as crisis interventionist: CIT as it is meant to be. Blog post: https://wordpress.com/post/msefton.wordpress.com/3653 Taken 11-10-2018
Sefton, M. (2015) Unappreciated Rage: The Dissembling Impact of those living in the Margins. Blog post: https://msefton.wordpress.com/2015/08/27/unappreciated-rage-the-dissembling-impact-of-those-living-in-the-margins/ Taken 11-10-2018

Orders of Protection – Underpinning the Good Safety Plan

Many cases of domestic violence (DV) result in an order of protection being issued.  The protection order is based upon the personal report of the victim which is substantiated by police report and perceived risk and may be implemented 24 hours a day. The approval of a court judge or magistrate  is generally required for its issuance. This order requires that the abuser “stay away” from the victim and is based on the totality of circumstances presented to a district or family court judge at the time of arrest.  Police officers use report narratives to construct the details of the protection from abuse (PFA) or restraining order (RO).  Different states utilize differing nomenclature to define what is the substantive court directive that provides the underpinning of a victim safety plan. They are granted on an emergency basis for 24-48 hours and are sustained for up to 6-12 months following a review by the court.
What happens between the time the initial PFA is granted and when the victim is expected in court to chronicle his or her intimate partner violence is often a mystery.  Victims often fail to show for the initial hearing that allows the initial PFO to go away.  Why? In some cases they become intimidated by their violent spouse who has made promises to straighten up and fly right. This is the core dynamic of intimate partner violence and it is well-described in these pages and elsewhere.
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“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).
In all states a protection order requires that no contact be made via telephone, through acquaintances, text messaging, or in person.  By violating a PFO requires that law enforcement make an arrest of the person in violation. This information becomes the grist of the underlying risk to the victim.  The marginalized abuser sometimes becomes obsessed with his loss of control and may take to cyber stalking in order to keep tabs on his partner.  As just mentioned any violation of the protection order renders the abuser subject to arrest and should require a high amount of bail before he is released from jail.  This is rarely the circumstance as violators easily make bail ironically blaming the victim as the root cause of the marital strain. These are the hubristic remarks of building tension and frustration described in the cycle of violence.
It is important to note that social media has given abusers extra means to “creep” into the privacy of estranged spouses without detection.  It played a significant role in the domestic violence homicide according to the psychological autopsy report of the Dexter, Maine homicide/suicide in 2011 (Allanach, R. et al., 2011).  Social media may also be used to intimidate and unfairly influence friends and family.
Bail amounts differ from state to state and sometimes even from county to county within a single state. The amount of bail should be high enough to inconvenience and deter the abuser from being tempted to coerce and manipulate his victim and family.  Most often the bail amount is low and inconsequential to the abuser who often has no criminal record.  However, changes in bail conditions and risk assessment must be integrated into orders of protection – especially when a single abuser has had more than one PFO filed against him. This sets the stage for measuring the degree of violence one might expect as the abuser becomes further marginalized and feels his control over the victim begin to collapse.  “Someone with a history, particularly a continuing history of violence, can be presumed to be dangerous.” according to Frederick Neuman, MD.
The order of protection belies the fundamental safety plan that is crafted by police and domestic violence experts and is designed to prevent further victim injury or death.

Sefton, M. (2016) Blog post: DVH in MA: 4 year old child begs his father.  https://msefton.wordpress.com/2016/10/02/dvh-in-ma-4-year-old-child-begs-father-not-to-murder-his-mother/. Taken 8-20-2018

Allanach R. 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.

Neuman, F. (2012) Is it possible to predict violent behavior? https://www.psychologytoday.com/au/blog/fighting-fear/201212/is-it-possible-predict-violent-behavior?collection=113345

The Agony of Releasing a Murderer

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

Violence in the Workplace: Do people just “snap”?

WESTBOROUGH, MA June 2, 2018  Violence in the workplace is commonplace but has taken a back seat in the setting of recent school shootings. Research on the “lethal employee” is becoming more reliable in the aftermath of of workplace violence. Nevertheless people commit murder in their workplace more than ever.  What should people do if they are worried about a co-worker becoming violent.  There are signs that someone is loosing control and may be thinking of violence.  A list of potential factors is taken below from the U.S. Department of Homeland Security publication from 2008. The term “going postal” refers to a workplace shooter or act of violence.  It evolved from workplace violence in the U.S. Postal service in the 1980’s according to a report published in 2008.

“One theory was that the post office was such a high-pressure work environment that it drove people insane. In the years to come, other cases of murderous rages by mailmen cemented the idea in the public mind. “Going postal” became a synonym for flipping out under pressure.”

RECOGNIZING POTENTIAL WORKPLACE VIOLENCE
“An active shooter in your workplace may be a current or former employee, or an acquaintance of a current or former employee. Intuitive managers and coworkers may notice characteristics of potentially violent behavior in an employee. Alert your Human Resources Department if you believe an employee or coworker exhibits potentially violent behavior” (2008)

Indicators of Potential Violence by an Employee Employees typically do not just “snap,” but display indicators of potentially violent behavior over time. If these behaviors are recognized, they can often be managed and treated. Potentially violent behaviors by an employee may include one or more of the following (this list of behaviors is not comprehensive, nor is it intended as a mechanism for diagnosing violent tendencies):
• Increased use of alcohol and/or illegal drugs
• Unexplained increase in absenteeism; vague physical complaints
• Noticeable decrease in attention to appearance and hygiene
• Depression / withdrawal
• Resistance and overreaction to changes in policy and procedures
• Repeated violations of company policies
• Increased severe mood swings
• Noticeably unstable, emotional responses
• Explosive outbursts of anger or rage without provocation
• Suicidal; comments about “putting things in order”
• Behavior which is suspect of paranoia, (“everybody is against me”)
• Increasingly talks of problems at home
• Escalation of domestic problems into the workplace; talk of severe financial problems
• Talk of previous incidents of violence
• Empathy with individuals committing violence
• Increase in unsolicited comments about firearms, other dangerous weapons and violent crimes

U.S. Department of Homeland Security. (2008). Active Shooter – How to Respond
Bovsum, M. (2010) NY Daily News. Mailman massacre: 14 die after Patrick Sherrill ‘goes postal’ in 1986 shootings. http://www.nydailynews.com/news/crime/mailman-massacre-14-die-patrick-sherrill-postal-1986-shootings-article-1.204101 Taken May 19, 2018

The myths and risks to individuals with mental illness

WESTBOROUGH, MA April 8, 2018 The myths attributed to persons afflicted with mental illness need to be directly addressed and corrective programs must evolve provide enhanced understanding and awareness of mental health.  Police officers encounter citizens with mental illness daily and often are called upon to calm a volatile situation often with very little formal training. This fact is changing as more police officers are trained in Psychological First Aid and Crisis Intervention Training – 2 programs that afford front line officers with the behavioral observation skill and communication necessary to reduce risk to police and the public from highly charged persons exhibiting signs of mental health crisis.
Psychological experts believe mentally ill persons lack the higher order planning to execute the complex steps necessary for anything more than petty crime – more often associated with co-morbid substance abuse.  This is where the problem lies. “The myth is you have to be “crazy” to do something like this (active shooter). So retrospectively, you look at people and you say, wow, this obviously – that guy should have been branded – but alcohol accounts for a great deal more violence than mental illness does.” according to Joel Dvoskin in an APA interview dispelling myths about the mentally ill.
Remember it is a fact that those with mental illness are rarely violent and those who commit violence are rarely mentally ill.
Until recently,  here in Massachusetts many smaller police agencies are forced to pay overtime for police officers to sit in hospitals or outside of jail cells watching a mentally ill person who has been arrested. This policy grew from the fear of litigation if someone dies in police custody who is known to be a mentally ill person.  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. If this occurs on a week end night that often means that someone must have eyes on the person in custody until the next available court date.
But is this truth or is this part of the myth associated with those taken into custody for crimes committed while suffering from a substantive mental illness? Or is the problem really associated with substance abuse?
“Pre-arrest diversion also has been shown to be successful when law enforcement and mental health professionals respond together to behavioral health emergencies. Individuals are more often referred to the services and treatment that they need, rather than enter the criminal justice system as an offender. This co-responder model has delivered great results in Massachusetts to date. Programs run by Advocates, a human services agency, in partnership with several police departments in Middlesex County and funded in part by the Department of Mental Health have generated over 4,000 diversions and $11 million in savings since 2003.” Diane Gould Worcester Telegram February 2018

Dvoskin, J. (2018) Speaking of Psychology: Dispelling the myth of violence and mental illness Episode 27 American Psychological Association

Gun-violence Restraining Orders

firearm-revolver-bullet-gun-53219.jpegWESTBOROUGH, MA APRIL 8, 2018 Restraining orders in cases of domestic violence have been around for decades or longer. At times people require formal court orders of protection from those who might bring forth violence to loved ones.  I have personally written over 50 requests for protection of a victim of domestic violence.  Most of these are temporary order issued by an on-call judge who listens to police officer statements over the telephone.  They are usually granted and valid through the next court day – generally within 48 hours.  The problem is that after the 48 hours is up the conflict between intimate partners has been long forgotten resulting in a waste of police resources and an irritated district court judge. Obviously this is not always the outcome.
In Massachusetts, the MGL 209-A covers orders of protection and its legal underpinning. Section 3B in MGL 209-A requires the removal of firearms from those with active RO’s taken out against them.  As many as 50 percent of restraining orders (RO’s) also called protection from abuse orders (PFO’s) are continued because the victim showed up at court and testified as to the protection she believes is needed and fear she feels living with her intimate partner.  These are not new and the complaints and dysfunction among intimate partners is a continuous drain on LEO resources.
Calls for service because of domestic violence are frequent.  Police officers are often asked to keep the peace at times when violence has occurred.  Arrests are mandatory when physical injury has occurred.  At this point police are required to remove the violent spouse and offer protection from further abuse to the victim and her family.  When RO’s are granted there is a growing belief that guns should be taken from subjects against whom RO’s are granted.  Experts say these GVRO laws are modeled after domestic-violence restraining orders that also authorize police to take away guns from people who pose threats to their partners, but with safeguards.
“Ensuring the mental wellness and health of first responders has long been an under appreciated task for the heads of police agencies. U.S. law enforcement has learned from tragic events over the years and now trains to respond to threats with the best equipment and practices known today. However, many chiefs are not prepared to deal effectively with the intense scope and unanticipated duration of the aftermath of these events, and many chiefs are unaware of the impact such events will have on their communities and the officers in their agencies.”
“These red-flag laws are a possible solution because they’re an intermediate step between doing nothing and trying to involuntarily hospitalize an individual,” said Christopher Slobogin, a law professor at Vanderbilt University.
“While LEO’s may be more resilient, law enforcement officers also quietly deal with an outsized share of our society’s violence and death. As a result, too many officers struggle with alcoholism, post-traumatic stress disorder, and depression.”
“You can’t just call up law enforcement and say this person that I’m mad at is a danger to me, it is not possible without judicial oversight,” said April Zeoli, a professor who studies domestic violence at Michigan State University. Her research shows these restraining orders reduced intimate partner violence by 13%.
“Research data provide strong evidence supporting the effectiveness of emotional fitness training to enhance resilience, positive emotions, cognitive flexibility, and emotional well-being, and more importantly, they strengthen professional pride and organizational commitment” according to Tung Au, et.al. in the Journal of Police and Criminal Psychology in 2018.
Felons, the dangerously mentally ill, perpetrators of domestic violence – these people have demonstrated their unfitness to own a firearm” David French, 2018
Supporters say the “red flag” measure—also known as a gun-violence or extreme-risk protection order—offers a way to address a legal conundrum: how to take action against people perceived as an imminent threat to themselves or others, but who haven’t done anything illegal.

Au, W.T., Wong, Y.Y., Leung, K.M. et al. J Police Crim Psych (2018). https://doi.org/10.1007/s11896-018-9252-6
French, D. A (2018) Gun Control Measure Conservatives Should Consider. National Review, February 2018
Kamp, J. and Mahtani, S. (2018) States Consider Laws Allowing Courts to Take Guns From Dangerous People  ‘Red flag’ measures are gaining ground after Florida high school shooting. Wall Street Journal
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Profiling a package bomber

OKC bombing
 

Alfred P. Murrah Federal Building in downtown Oklahoma City

 

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

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

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

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

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

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

Michael Sefton, Ph.D.

Protection from abuse: the role of social media in the reduction of safety

WESTBOROUGH, MA March 20, 2018  Greater protection of victims of domestic violence is needed.  When provisions for a plan of safety are executed victims are expected be afforded greater safety but not always. Domestic violence victims are at greatest risk when they make the decision to leave a violent partnership.  This often means having a safety plan – especially when specific threats have been made. Safety plans are often drawn up by women in conjunction with counselors who specialize in helping families stay off the grid and hidden from violent spouses.  In one case of familial homicide and suicide it was clear that the commonalities needed to be exposed among cases of familial homicide.
In particular, when I teach law enforcement officers about DVH,  I encourage detailed witness statements much as possible especially if the victim described the fear and belief that she will one day be murdered by her partner. These documented statements, if spontaneously uttered, are often the greatest predictor of potential harm to victims and her children. If written into a police report the decision about dangerousness and bail may be influenced.
In the 2011 homicide from Maine, Steven Lake used social media to track his wife and 2 children from whom he was mandated to stay away.  Yet, if his wife posted a photograph of his children he went to great lengths to undermine their safety by identifying anyone who “liked” the photo or commented on it. He used these posts to triangulate her whereabouts and living arrangements.  This was a large part of what marginalized Stephen Lake and in turn Lake posted his own propaganda espousing his loneliness and love for his children. Lake garnered significant support from those social media “friends” who knew nothing about what he had done to require the protection from abuse order. Many, in fact, encouraged him to fight for his children which may have been a catalyst in his festering resentment and ultimately terminal rage. He was provided information and access to his wife’s social media platforms by a family member.  For her part, Lake’s wife wanted to remain close to her in-laws in an effort to normalize her children’s life as much as possible. For example  Lake’s parents were invited to the family’s thanksgiving celebration but declined because Steven Lake could not attend.
Similarities in domestic violence
Cases of domestic violence have similarities across socioeconomic status, ethnic and cultural background, and the cycle of abuse. The growth of social media platforms affords those inclined to control and isolate intimate partners from persons who might provide them security. Cases of domestic violence share the common theme of intimidation, coercion and control.  Social media are a fun and useful medium to keep in touch with friends and family.  But it is also lends itself to sometimes nefarious trolling to gain a perceived advantage in undermining the safety plan. Social media trolling contributes to the control they seek especially when victims seek protection.  In order to limit the impact of social  media stalking victims need to shut down all social media accounts and activity. Greater protection of victims and family members requires a comprehensive plan with provisions for times when they are violated – including mandatory arrest, risk assessment and no bail containment if deemed necessary.
“That is one conclusion of four former and current police officers in a recently released report. The men, who were volunteers and had no connection to the shootings, spent the last several months interviewing 69 people about the triple homicide and suicide in Dexter in June, to suggest ways to prevent future tragedies.” Portland Press Herald, November 11, 2011
The Psychological Autopsy report suggests improvements that may prevent future domestic violence homicides:
 Use of social media platforms by people involved in conflicts should be minimized, to prevent intimidation and stalking.
 Protection-from-abuse orders and bail conditions should mandate disclosure of all firearms that are accessible to the domestic-violence offender.
 An offender who seeks, hides, uses or attempts to acquire a gun or ammunition when a protection-from-abuse order is in place should be charged with a felony and not allowed bail.
 Bail amounts should be high enough to deter abusers from violating a protection orders.
 When a protection order violation involves a deadly threat, a judge should set bail, not a bail commissioner.
 Global positioning systems should track abusers during periods of protection orders in any incidents that involve deadly threats or evidence of weapons.
 At least two officers should be sent to all domestic-violence calls when officers suspect violence is likely.
 At-risk spouses should be advised to live in as secure an environment as possible, with deadbolts on doors, secured windows, motion sensor lights and a land telephone line.
 People charged with domestic violence crimes should not wait more than a year to go to trial.
The safety of potential victims including children is the penultimate goal of protection orders but too often they are ignored via stalking efforts that include using social media to track the activities of an estranged spouse.  This overt defiance requires careful analysis and requires the arrest of the violator.  Once this takes place a dangerousness hearing must take place before he or she is released but this rarely takes place.