Health

'We need more light': the fight to change how police deal with mental illness


The first 10 minutes of Ernie and Joe: Crisis Cops, a new documentary on mental health and policing from HBO, offers two different visions of law enforcement. In the first – the opening scene of the movie – two officers in Dallas respond to a call from the mother of a man with schizophrenia. Bodycam footage shows how, in a matter of seconds, the officers tell him to drop a screwdriver he’s holding, then draw their guns, then shoot Jason Harrison, a black man, to death in his driveway (the officers claimed he lunged at them, and neither were indicted).

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The film then shifts to a different part of Texas, San Antonio, where two cops, Ernie Stevens and Joe Smarro, lead a police department specifically trained with the opposite approach: to de-escalate encounters between law enforcement and people with a mental illness rather than kneejerking to force. Minutes after the footage of the Harrison shooting, film-maker Jenifer McShane’s cameras follow Stevens and Smarro on a similar call: a man, also of color, is agitated and decompensating, hearing visions and pacing. Smarro and Stevens approach slowly, casually. They wind the man’s agitation down with open-ended questions. How are you doing today? What kind of drugs do you use? (The man says he likes everything, and Smarro laughs. “I appreciate you being honest, man,” he says, giving him a fist bump). “Since you’re going to be honest with me, I’m going to be honest with you,” he continues, sitting down to assume a less threatening position. The officers explain to the man that he is frightening others in the courthouse, and they’re worried about him. They talk him down enough to sit, put down the pen in his hand, and walk to the cruiser to go to a mental health facility.

This method – de-escalating as a first priority, talking to people in the throes of a mental health crisis on their plane of reality – is at the core of an approach to policing specifically informed by knowledge and training on how to respond to a person in crisis or psychosis, the vast majority of whom are not a danger to others. The shift has massive life-saving potential; Harrison was one of 994 people killed by law enforcement in 2015, over a quarter of whom showed signs of mental illness. Four years later, the statistics remain numbingly similar. As community-based mental health resources remain underfunded or underdeveloped across the country, and with limited access based on means or location, law enforcement officers “have become the de facto first responders”, director Jenifer McShane told the Guardian, making training for mental health crises more critical than ever.

McShane follows Stevens and Smarro from late 2016 through 2019 as they lead the mental health unit of the San Antonio police department, one of several units across the country dedicated to a more communicative and empathy-based approach to distress calls. Through calm questioning, vulnerability (the officers will openly admit they’re scared), and affirmations that they can and will find help, the officers defuse crisis situations ranging from a self-harming marine veteran, a man expressing suicidal thoughts with a recently acquired gun, and a drug-addicted woman with one leg over an interstate bridge.

Stevens, Smarro and their unit also train other law enforcement officers on how to better and more calmly respond to mental health calls through a method called Crisis Intervention Training (CIT), a 40-hour program with first-person testimony from community members with mental illness, education on relationship building with local mental health organizations, and role-play of de-escalation techniques. Though the program is not new – it was established in Memphis in 1987 after law enforcement killed a mentally ill man in the midst of a crisis – and trainings have spread to 45 states, adoption of its techniques has been slow. There are currently 2,700 CIT programs in the US, representing about 15 to 17% of the total number of police agencies (though the number of officers interacting with the program and officers using it is probably higher).

“There’s a huge gap nationally with law enforcement understanding how to deal with the mentally ill population,” Stevens told the Guardian. Decades of underinvestment of intensive community mental health resources following deinstitutionalization, the process begun in the 1960s of closing permanent mental health residencies and turning patients to resources in their own communities, have left police officers as often the first line of response in a mental health crisis.

Ernie Stevens and Joe Smarro



Ernie Stevens and Joe Smarro. Photograph: HBO

Yet academy training has not kept up with this reality. For example, Stevens said, most academies and in-service trainings require yearly qualifications on guns, even though the majority of officers never fire theirs over the course of their career. “But there’s no qualifier on, hey, can you talk to someone? Do you have empathy inside of your heart? Do you have any ability to reason and have perspective for other people?” said Stevens. “That should be a measure. That should be something that we’re looking for.”

Instead, officers are taught to bottle emotions and project toughness. “I’m taught to say, ‘I’m hard. I don’t get scared,’” Smarro tells an audience of officers in Crisis Cops. Traditional training encourages officers to fixate on the gun, not the person. “We need to shift that.”

Both officers freely admit, both in the film and in person, that they didn’t always think this way. Before Stevens took his first CIT course in 2003, he had spent a dozen years as “your stereotypical cop – I wanted to catch bad guys, chase, kick down doors … I wanted to change the world,” he told the Guardian. “But what I realized was that I had to change myself. And for me, for the law enforcement personnel who watch this, I hope that they can see that.”

Joe Smarro and Ernie Stevens



Joe Smarro and Ernie Stevens. Photograph: HBO

“Officers need to understand that this isn’t the future; it is the present of policing,” Stevens said. “We transitioned from revolvers to semi-automatic guns. We transitioned from one type of car to an SUV. So why aren’t we transforming abilities within the police academy to apply those to mental health crises and become better communicators and de-escalators?”

Both said that part of that shift is embracing vulnerability and expressing emotions within law enforcement agencies. Smarro is particularly transparent about his own mental health in Crisis Cops, as he recounts his trajectory from emotionally closed kid from a difficult background to marine to police officer. His time in Operation Iraqi Freedom left scars of PTSD; he’s a survivor of sexual abuse as a child. Smarro – now able to say, sincerely, “I love feelings” on camera – credits his ability to talk about these wounds now to years of therapy. “I think people in general struggle with being their most honest self,” he told the Guardian. “And so for me, I don’t want to be a hypocrite. If I’m going to expect somebody or tell somebody, ‘hey, it’s OK man, tell me how you’re feeling,’ how am I then going to be like, no, I never talk that way, I am always squared away?”

That’s just not true, Smarro said. “I am a mess sometimes and I am incredibly depressed sometimes and I am really, really sad and scared sometimes. But sharing that is where the power is. We all have it, but so many people keep it in.”

Over an hour and a half, Crisis Cops illustrates a progressive vision of policing, one predicated on vulnerability, inter-connectedness, listening, the importance of community investment and prizing empathy over fear. “I want people to feel inspired to say: what’s happening in my community?’” said McShane. “Maybe reach out to law enforcement, reach out to Nami [National Alliance on Mental Illness].” And for those living with a mental illness, “maybe to feel some comfort that they’re not alone and we need to be talking about this. We need a lot more light and oxygen in this conversation.”



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