POLICE NEED GREATER UNDERSTANDING OF THE MENTALLY ILL, ADVOCATES SAY

The same complaint has been heard for a decade: San Francisco police
have needlessly harmed mentally ill people in crisis.

In a city that prides itself for its progressiveness and humane
treatment of the disadvantaged, mental health experts say officers
are too quick to fire, turning run-ins with people behaving
irrationally into deadly shootings.

While other cities with far fewer mentally disturbed people were
instituting special training, San Francisco moved slowly, even though
a quarter of all calls to police involve the mentally ill.

In June 2001, when Idriss Stelley, a mentally ill man, was shot to
death in the Metreon theater complex, only 30 officers had completed
a training program that had been endorsed by the Police Commission
almost half a decade earlier but begun just the month before.

In 2002, three more men in mental breakdowns, all armed with knives
like Stelley was, were shot to death by police after confrontations.
Today, more than five years after the department instituted a
specialized 40-hour training program, about 39 percent of the patrol
force has taken it. Nearly three-fourths of the patrol force has
taken a short eight-hour version.

"The fact that it's taken since 1996 and fewer than half of the
officers have been trained is indicative of willfully negligent
practice," said Marykate Connor, executive director of Caduceus
Outreach Services, which works with the mentally ill.

"Police are not mental health professionals," she said. "However,
they are required to have the knowledge and training to respond
effectively with people who have altered mental status and not to
respond to them as if they are criminals."

San Francisco police and others involved in the training say they use
numerous strategies that fall short of gunfire to resolve volatile
encounters with the mentally ill.

"I think the SFPD is very restrained en masse in their use of lethal
force," said Pablo Stewart, a psychiatrist who is former director of
forensic mental health services for San Francisco.

Stewart, who trains police in crisis intervention, said he finds San
Francisco officers "surprisingly sophisticated" in understanding
mental illness.

"These are not trigger-happy cops," he said. "People with mental
illness, especially psychotic illness with substance abuse, are at a
much higher risk of violence than other people.

"When there's a weapon, it becomes a public safety issue, not a
mental health issue."

Training on Mentally Ill

In 1996, the Office of Citizen Complaints found that the June 1995
shooting of a mentally ill man, David Boss, in a Mission District
residential hotel was justified, but it said the incident might have
ended nonviolently if police had received help from psychiatric experts.

The watchdog agency and a consortium of community and mental health
groups proposed in 1997 that the department create a "psychiatric
illness response squad" in which volunteer officers trained as
experts would be dispatched to handle potentially violent situations.
One officer would be on duty per shift per station.

The Police Commission approved the proposal in April 1997.

Some within the department initially resisted, contending that police
were not social workers. They also said the police academy's four
hours of instruction on dealing with the mentally ill was sufficient.

Eventually, police officials agreed about the need to expand
training. But funding issues and disputes between the department and
community groups -- which wanted mental health experts, not police,
to do most of the instruction -- dragged on.

A compromise was eventually reached: The training would rely
primarily on mental health experts. All patrol officers would undergo
40 hours of instruction on mental illness, drug and alcohol abuse,
and the phenomenon of "suicide by cop."

In finally starting the training program in May 2001, San Francisco
lagged 13 years behind the Memphis Police Department, which pioneered
a crisis intervention program that became a national model emulated
by more than 50 cities.

Inability to Grasp Orders

San Francisco police operate under a rulebook of "general orders"
that permit officers "to use whatever force is reasonable and
necessary to protect others or themselves, but no more." The orders
call for a scale of options starting with verbal persuasion and
ending with batons and firearms.

But, according to the Office of Citizen Complaints proposal on the
psychiatric crisis squad, there's an important shortcoming in that continuum:

"If a person disobeys orders, officers assume that they are resisting
arrest. In these situations, officers are authorized to escalate to a
higher degree of force to successfully take custody of a person," the
proposal stated. "The problem is that some people are unable to obey
orders due to their psychiatric illness. These people lack criminal
intent and should not be treated as criminals."

Stelley's death brought a huge outcry from mental health advocates.

"He was one person with a small knife," said Leroy Moore of the
Harambee Educational Council, a statewide organization that advocates
for disabled African American youth and young adults. "Police don't
know how to talk the language of mental illness. They shout out too
many orders. A person in psychiatric crisis doesn't understand a
barrage of orders."

In the span of seven months in 2002, three men in mental health
breakdowns were fatally shot by officers.

In the first shooting, on March 12, 2002, Richard Tims, 35, had
gotten into an argument with a young man on a Muni bus, according to
police reports. Tims followed the man off the bus, then reportedly
stabbed him once in the lower left back.

Officers repeatedly ordered Tims to drop the knife and tried to
pepper-spray him. When Tims lunged at one officer standing about 10
feet away, according to police reports, others opened fire.

A stray bullet seriously wounded bystander Vilda Curry, now 44, who
required hospitalization for six months and is unable to work. She
sued the city, and a $625,000 settlement is on its way to final
approval by the Board of Supervisors.

Mentally Ill Die in Standoffs

Three months later, on June 14, police fatally wounded Robert Ruffin,
57, who had been walking nude around his residence, the Drake Hotel
in the Tenderloin, armed with a knife. A family member said he had
been unable to work for years because of mental problems. That day,
according to witnesses and police reports, officers ordered Ruffin,
to drop the knife he was brandishing in a stairway.

Officers hit him with their batons, doused him with pepper spray,
then fired when Ruffin stabbed at one of the officers, cutting his forearm.

Four months later, officers shot and killed another mentally ill man,
Jihad Akbar, 28.

A former football standout at UC Berkeley who worked in juvenile
justice and AIDS prevention, Akbar battled depression and an
addiction to methamphetamines. He had been arrested three times, once
in Santa Cruz for drug possession, once in San Francisco for
resisting arrest, and once in Berkeley for assault on a police
officer and resisting arrest -- the assault charge was later dropped.

He was eager to enter a residential treatment program but was
rejected because his mental illness "was considered not severe
enough," said his domestic partner, Tim Silard, a San Francisco
assistant district attorney.

On Oct. 8, 2002, at the Bagdad Cafe on Market Street, Akbar took two
10-inch knives from the kitchen, then walked up and down the sidewalk
in front, "dancing around with the knives with a big smile on his
face, and making racial and homophobic statements," according to
police reports. Officers repeatedly ordered him to drop the knives.

Akbar reportedly leaped at Officer Michael Celis, who fired twice.
One bullet hit Akbar in the chest; the other went through two
apartment windows across the street, hitting no one.

After the shooting, as Akbar lay face-up on the pavement, more than
20 witnesses gathered and argued heatedly over the necessity of the
shooting, said one witness, Robert Little, 34, a chiropractor in El Cerrito.

"It was hard to see him die," he said. "The problem was he was so
close to other people. The police officers came between us and him,
which put them really close to him. You had to err on the side of safety."

Silard, the dead man's partner, said in an interview that the
shooting was "grossly excessive and avoidable." Instead of trying to
de-escalate the crisis, officers shouted at Akbar and trained their
weapons at him, "someone clearly in a mental health crisis."

"Could nothing have been done to stabilize the situation while
protecting Jihad, police and the public?" he asked.

Police Adopt Safer Weapon

The next spring, two years after Idriss Stelley's death, the city
settled a civil rights lawsuit by Stelley's mother for $500,000.

Though San Francisco denied wrongdoing, as part of the settlement,
the Police Department promised reforms.

One of the most significant changes involved increasing the
availability of "beanbag" shotguns, specially constructed weapons
that fire projectiles made of pellets covered by a synthetic cloth.

Since September 2002, when the department started using the
less-than-lethal weapon, it has been brought to the scene of an
incident 86 times and fired 25 times, according to department statistics.

"The Metreon case made the need for beanbag guns more acute," said
former Deputy Chief Greg Suhr, who is now chief of security with the
San Francisco Public Utilities Commission. "If all those rounds that
were fired had been beanbag rounds, maybe we wouldn't have had all
the acrimony we've had over this incident."

In 2004, the state Commission on Peace Officer Standards and Training
evaluated San Francisco's crisis intervention training program and
made a favorable report to the Legislature, concluding the training
was effective.

In February 2005, the department instituted an abbreviated,
eight-hour version of the 40-hour training program. So far, 1,040
patrol officers -- nearly 74 percent of the total patrol force --
have taken the shorter class, said Officer Kelly Dunn, who helps
conduct the sessions.

"The chief wanted to make sure everyone had the opportunity to get
this information sooner," Dunn said.

San Francisco's courses do not include training in disarming mentally
ill suspects. Maj. Sam Cochran, a crisis intervention expert who
pioneered the program in Memphis, said that such instruction is
standard in his program and that knives are usually the weapon that
must be taken away in mental health encounters by police.

Carmen Lee, who helps train officers in the San Francisco program,
said she respects the work of police but bemoans their handling of
some cases involving the mentally ill. Lee, 71, who has spent much of
her life battling her own mental illness, founded Stamp Out Stigma, a
Peninsula organization designed to foster understanding of the mentally ill.

"Police don't see us as being scared, but rather as a potentially
dangerous person," Lee said. "Isn't it an irony? Police are trying to
protect themselves and the suspect who is trying to protect himself,
too. Sometimes people in a mental health crisis pick up a weapon
because they are scared. They can't conceptualize that police are
there to help them."