Calif. police, clinicians look to shift mental-health response burden away from LEOs
Police and county officials have begun looking for new solutions
By Robert Salonga
The Mercury News
SAN JOSE, Calif. — Jim Tourino watched helplessly as his 280-pound son, holding a knife above his head, charged at a San Jose police officer.
Staring at the 28-year-old mentally ill man coming toward him, the officer made a split-second decision: He fired his weapon, fatally wounding Tourino’s son.
Time after time, Joseph, in the throes of a violent mental breakdown, had been brought to psychiatric emergency rooms, but he always calmed down enough to avoid being admitted. On May 2, his breakdown unfolded not at a hospital, but in front of police outside the Tourino home on Mt. Frazier Drive.
“From (ages) 18 to 28, I tried to protect him,” Jim Tourino said. “I tried to protect society.”
With increasing frequency, police across the country are the first and last resort for situations involving mentally ill people. Those volatile encounters can quickly turn deadly: One in four officer-involved fatal shootings nationwide involve the mentally ill, according to one analysis. In San Jose, nearly a third of the officer-involved shootings over the past decade involved this group.
As the deadly encounters continue, police and county officials have begun looking for new solutions. San Jose’s officers already get crisis-intervention training to help them handle situations involving the mentally ill, but training can go only so far, they say. This year alone, six of the city’s eight police shootings have involved people with mental illness.
“The onus to deal with mental illness right now comes down to a police officer, and that is unfair,” San Jose police Chief Eddie Garcia said. “In a perfect world, a clinician responds rather than a police officer with 40 hours of (mental health) training.”
Answering that call is the primary aim of new programs from Santa Clara County, including on-call response teams featuring mental health clinicians who can answer resident and police calls. Two teams, based in East San Jose and South County, are expected to go live by November.
“When a local law enforcement officer gets a 911 call and it appears that person has behavioral health issues, we want that officer to contact our mobile-crisis team,” said Toni Tullys, director of the county behavioral health department.
For more serious calls, the Psychiatric Emergency Response Team, set for a spring launch, will pair a licensed behavioral-health clinician and a crisis-trained law-enforcement officer. These ideas have garnered the support of police unions across the country.
According to a recent SJPD review of interactions with known mentally ill people, between mid-2012 and the end of 2016, city officers had repeat contacts with 5,800 people with known mental illness. Lt. Paul Spagnoli added that in 2016 alone, San Jose police referred 3,000 cases to the county’s psychiatric emergency room at Valley Medical Center.
San Jose police encounters with people with known mental illnesses or experiencing mental-health crises accounted for at least 31 percent of the 54 officer-involved shootings since 2009, according to department figures analyzed by this news organization.
That’s slightly less than the 40 percent estimated by the state and far less than San Francisco, which reported that during a recent nine-year period, 58 percent of the city’s police shootings involved mentally ill people.
“We see de-escalation as a silver bullet, but that is based on the understanding that you’re dealing with a rational person who will stop and listen to commands,” said Jim Dudley, a retired San Francisco police deputy chief and lecturer at San Francisco State University.
Vicki Showman welcomes the idea of having a clinician available in these tense encounters. Her daughter Diana was fatally shot by San Jose police in 2014, after approaching officers with a cordless drill painted black to resemble an Uzi, which she told 911 dispatchers she had.
“One of the frustrations we faced was we wanted our daughter in inpatient treatment,” Vicki Showman said. “We were told that when a crisis occurred, call 911. I would never call 911 again for any situation dealing with a mentally ill situation.”
She added: “Having someone less threatening who can offer creative solutions to whatever problem is occurring at the time could only help.”
Tullys said in October her department will open two new voluntary crisis residential programs — 15 beds apiece in San Jose and South County — that offer assessment, counseling, medication and therapy, and where the average stay would range from two to four weeks instead of the industry-standard 72-hour hold.
The agency is also unveiling an eight-bed crisis-stabilization facility in San Jose to provide immediate medical and psychiatric evaluation, treatment and monitoring for up to 24 hours to help the county’s emergency facilities.
“We’re trying to do things in the community to catch people before they need EPS,” Tullys said, referring to emergency psychiatric services, “and get people at a much earlier state.”
A couple of weeks before he was shot by police, Joseph Tourino tried to hang himself from a tree in his father’s front yard. Police had a history of responding to calls involving the son. But his father recalled just one instance when someone recommended long-term psychiatric care, and it was ultimately rejected.
Jim Showman said his daughter Diana was admitted twice to EPS at Valley Medical Center, but that each time she was released within 24 hours after calming down.
“It was understandable that they would let her be released,” Vicki Showman said, “but the underlying issues needed to be observed over time.”
“This is where a lot of tragedies happen,” said Kathy Forward, executive director of the Santa Clara County chapter of the National Alliance on Mental Illness. “The flaw in the system is we wait for people to get so ill.”
The national police union push for more clinician help includes a legislative component to ease medical privacy restrictions so police and mental-health professionals can more readily share information and address one of Jim Tourino’s biggest frustrations: different agencies had scattered pieces of his son’s profile.
“The biggest failure, in my thinking, was that we could not put a picture together to say, ‘This is going to happen if we don’t commit him,'” he said.
Jim Tourino is still looking for answers. He sympathizes with everyone who tried to help his son, every clinician, judge and police officer, including the one who shot Joseph.
“It’s not systemic to one piece,” he said. “The system itself is overworked too, to the point where things fall through. When (Joseph) finally got to the point where he hanged himself, he should have never been back on the street.”
He added: “It should have been automatic. He has a history, we have time, let’s put him in a safe, highly managed environment while we do a real good evaluation and figure out what to do.”
Garcia said his officers need to go back to being a last resort in these situations.
“This is about what services are offered to an individual when they are 5150’d, and who tracks this individual,” he said, referring to when someone is put on a psychiatric hold. “And what services are there before they get to these moments of crisis.”
It’s what Jim Tourino has been thinking for a while. But he knows it hinges not only on freeing up resources but a broad public commitment.
If not for his son, then someone else’s.
“I’ve got to believe that people like my son have a record,” he said. “Joseph is not a one-off.”
©2017 the San Jose Mercury News (San Jose, Calif.)