MENTAL ILLNESS AND THE POTENTIAL FOR VIOLENCE: VETERANS RETURNING FROM WAR are increasing the risks as well as the need for law enforcement training


SWAT teams as well as law enforcement in general, during periods of high crime and frequent activation, come under intense scrutiny. Certain events concerning SWAT interactions with mental health consumers–such as the grand jury indictments for murder of police commanders in the city of Eureka, California–demonstrate that such inter- actions are fraught with significant risk for both officers and consumers. Incidents of “suicide by cop “ will continue to pose a very real threat to patrol officers and SWAT officers alike.

As demonstrated in the Eureka case, some district attorneys and trial lawyers may take exception to SWAT tactics and seek to punish split-second, critical decisions made by on-scene commanders. Tactical decisions are second-guessed by those who have ample time for reviewing every decision in a non threatening, non-critical environment resulting in claims of failure to supervise and failure to adequately train personnel.

The Eureka case, perhaps above all others, demonstrates extreme after-action scrutiny at levels never before imagined. Fortunately, this travesty was appropriately defended and the two command-level officers involved were found not guilty.

What is critically important for front-line law enforcement personnel to remember is that reduced services by mental health agencies may lead to increased encounters with mental health consumers, who have the potential of becoming violent. They may go so far as to create so-called suicide by cop circumstances, which may at times only be resolved by lethal intervention.

A 1998-2006 study, reported in the Journal of Forensic Science and utilizing data from North American law enforcement agencies, recorded 707 officer-involved shooting cases and concluded that 36 percent of the officer-involved shootings were suicide by cop incidents.

Recently, my agency was involved in four such incidents in a six-month time period. Each incident involved a mental health consumer that turned into a suicide by cop event, with an officer-involved shooting and fatal wounds to the precipitator. These numbers may seem minimal to some, but to put the impact of these events into perspective, Los Angeles Police Department would have to be involved in 120 incidents during the same time period. As you might expect, these events took a tremendous toll on our agency and the community.

Training to deal with mental health consumers may seem low in the order of priority; however, with the continued increase in such contacts, along with the large number of returning veterans suffering from post-traumatic stress disorders (PTSD) and traumatic brain injuries (TBI), the priority list may need to be reviewed.

Crisis intervention training (CIT) is one of the most cutting edge forms of training in law enforcement. In California, CIT is offered in two formats. The first consists of a four-day, 40-hour course. The course includes mental health facility visits and interaction with a pre-selected panel of mental health consumers. Curriculum is provided so students leave with a better understanding of major mental illness, mood disorders, personality disorders, PTSD, TBI and developmental disorders. Additional topics include suicide, suicide by cop, and excited delirium.

The second format is a single, eight-hour presentation. The course content remains the same, excluding site visits, but is condensed due to time considerations. The first format is recommended for CIT certified officers. The second format is recommended for all law enforcement officers and has been condensed to accommodate large numbers and to create less impact on staffing levels for a long period of time.

One of the concepts both classes teach is the use of CIT cards. These cards are filled out by officers in the field in the same way as interrogation cards. In this case they document individuals that may have a suspected mental illness or other issue that can be evaluated and referred to the appropriate agency within your jurisdiction. In addition to standard information gathering of name and date of birth, the CIT cards collect data such as medications and illogical thoughts or speech in a check-box format.

CIT cards are referred to the CIT officer or officers within an agency. The CIT officer evaluates the information and completes a preliminary investigation into the individual. The CIT officer can then take the information to a multi-disciplinary team (MDT) meeting for further follow-up. The MDT includes a veteran’s affairs representative and can possibly provide law enforcement with the opportunity to give back to our veterans and make their daily lives better.

The increasing veteran population brings about many challenges, particularly in California, Florida, Texas, New York and Pennsylvania where a combined 37 percent of the veteran population in the United States resides. Our veterans have served our country and given of them-selves to better our daily lives.

The conflicts in the Middle East, as well as other issues, have taken their toll on our soldiers. A documented increase in the suicide rate indicates the need for concern.

Based on information from the International Committee of the Fourth, it is believed there are 10 failed suicide attempts for each actual loss of life. The figures suggest more than 1,600 Army and Marine soldiers attempted to kill themselves. Civilian law enforcement will be tasked with an increasing number of PTSD-, TBI- and other mental health-related incidents that involve veterans. Taking into account the stress of combat and the number of active duty suicides, we must organize and supply services for our returning veterans.

The multi-disciplinary team involves every stake holder within a given jurisdiction that provides a service to the community. The law enforcement representatives that participate in the team should include participants from the district attorney’s office, the public defender, parole, probation and custody. Participants from other facets within the jurisdiction should include mental health, patient’s rights, developmental disability advocates, veteran’s affairs, adult protective services, animal control and the fire department.

The goal of an MDT is to provide the knowledge and services to those members of your community that have not been able to receive them on their own. Many members of the community, for various reasons, don’t receive much-needed assistance and can become a law enforcement issue. Many people, once given the help they need, remain outside the circumstances that require contact with law enforcement. This in itself lowers the call for service volume on a daily basis for the patrol officers. In some instances, this preemptive measure could also save your agency from being involved in a violent encounter or a suicide by cop event.

The MDT meets on a monthly or bi-monthly basis to discuss cases that have been brought by any of the participating agencies. The focus and goal of the MDT should not be criminal prosecution. Realizing that the criminal justice system is not always the best alternative and finding means to serve members of the community should remain the focus.

MDTs are specifically covered in 15663, 15610.55 and 10850 of the California Welfare and Institutions code. Each of these codes specifically describe an MDT as well as its specific function. In addition to the Welfare and Institutions code, HIPAA also specifically covers liability and the exceptions for law enforcement. HIPAA sections 164.512 (f) and (j) address the issue of private health information. These codes are necessary and training should accompany the formation of an MDT. In addition to training, the use of an MOU or sign-in sheet should be instituted to ensure that all participating agencies understand the goals of the MDT. Consult your local county counsel or city attorney to ensure they are aware and support your efforts for the betterment of the community.

Lt. Gen. Eric Shoomaker, Sugeon General of the U.S. Army, spoke on this topic in May.

“I think we can say as a nation that our mental health facilities and access to mental health providers is not adequate to the need right now. So part of the problem that we as a military are suffering is a shared national problem,” he said.

Often times an unconventional solution will bring about the best results for all involved parties. Ensuring that your officers are safe and enabling them to serve the community needs to be considered in all respects of law enforcement, not excluding the mental health community. Make the effort now and establish the relationships, this will pay dividends in the future.


is a 15-year veteran with the El Dorado County, California, Sheriff’s Department. He was a SWAT team leader for 11 years, a canine officer and a range master. He currently leads the department’s training division. He can be reached at


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