US’s highest court will consider whether police must take special precautions when arresting a person who is mentally ill, after shooting of Teresa Sheehan

This article is more than 5 years old

This article is more than 5 years old

In August 2008, Teresa Sheehan, a mentally ill 56-year-old woman, was shot multiple times by San Francisco police officers. The police had been called to take her for an emergency psychiatric evaluation when she threatened a case worker, but the situation quickly escalated.

After Sheehan threatened the officers with a knife, they shot her five or six times, including in the hip and head. She survived but needed two hip replacement surgeries.

Sheehan sued the officers and the city for failing to take her mental health status into account during arrest. Her lawyers argue that Title II of the Americans with Disabilities Act (ADA) requires officers to “reasonably” modify arrest procedures when confronting people who have mental illness; San Francisco says the ADA does not apply to arrests, especially with public safety at stake.

On Monday, the US supreme court will hear oral arguments in the Sheehan case, to decide whether and how disabilities regulations apply to police policies and procedures during arrests.

The case has reached the nation’s highest court at a time when US police use of force is under sharp scrutiny. In the eight months since the killing of unarmed teenager Michael Brown brought increased focus on police violence, more and more officer-involved shootings that also involve mental illness have come to light.

Just last week, video footage went viral of Dallas police shooting dead a mentally ill man whose mother had called 911 for help; a month earlier, international attention focused on a 17-year-old shot dead on a visit to a Texas police station that her family described as a cry for help.

Though national data on police shootings is unreliable, a 2013 study estimated that at least half of all people shot and killed by US police have mental health problems. Despite multiple conclusions by the US Justice Department that police forces systematically use force against the mentally ill, there remains no national standard for crisis intervention.

The problem with training police

Confrontations like Sheehan’s are “a pretty typical situation that happens across the country these days”, said Ron Honberg, director of policy and legal affairs at the National Alliance for Mental Illness (Nami), which filed a brief supporting her suit.

Law enforcement officers “have become first responders to people in psychiatric crisis”, he said, but “oftentimes, their traditional academy training doesn’t really teach police how to respond to such crisis”.

It’s difficult to gauge how much training police officers receive on mental health issues. Each state has a police training and standards board that sets minimum requirements for academy curricula, but those requirements vary from state to state.

Some state boards, like the Alaska Police Standards Council, do not require any mental health crisis training at all, while others either require a few hours of coursework or include mental health issues in broader disability training.

After police academy graduation, such trainings become a department-level affair.

‘A triable issue’

In 2008, Sheehan, who suffers from schizoaffective disorder, stopped taking her medication. She refused to change clothes, eat or attend meetings at the co-op for people with mental illness where she lived. When a case worker attempted to intervene, Sheehan told him to leave her alone and threatened to kill him. So he dialed 911.



When officers arrived, Sheehan refused to cooperate with their involuntary commitment order and threatened them too. She wanted to be left alone.

The officers left Sheehan’s room and called for backup, but soon after decided to re-enter, with mace and guns drawn. Aggravated, Sheehan came toward the officers wielding a knife. After mace failed to stop her, they opened fire.

In court documents, Sheehan argues that the officers’ second entry unnecessarily escalated a volatile situation and that officers should have waited for backup instead of forcing their way back into her room. She did not pose a threat to anyone while alone behind closed doors, she argues.

Police contend that Sheehan could have climbed out of a back window or found more weapons if they had waited any longer.

A district court judge initially threw out Sheehan’s case, but the 9th circuit court of appeals reversed the decision, ruling that there is “a triable issue whether the officers failed to reasonably accommodate plaintiff’s disability when they forced their way back into her room without taking her mental illness into account or employing generally accepted police practices for peaceably resolving a confrontation with a person with mental illness”.

The city of San Francisco appealed that decision and is expected to argue before the supreme court that the ADA should not apply to officers’ actions while making arrests, among other issues.

Mental health advocates, including the American Civil Liberties Union and Nami, insist that de-escalation procedures could be practiced well before situations get to the point of arrest and that officers need to be better trained to handle psychiatric crises.

‘Let people know they’re there to help’

The most widespread model for improving how police “peaceably resolve” such situations is Crisis Intervention Training (CIT), a framework developed in Memphis in 1988 in response to a fatal police shooting involving a man with a history of mental illness.

CIT has been adopted by approximately 3,000 police departments – roughly 16% of the more than 18,000 independent state and local law enforcement agencies across the US.



The program combines two key elements. The first is a 40-hour training course which covers various mental health issues and teaches de-escalation techniques for both low- and high-risk situations.

The training involves teaching police officers “to calm people down, to let people know they’re there to help them and not hurt them”, Nami’s Honberg said. His organization partnered with CIT to help develop best practices.

Officers “learn to keep their distance, to have backup on the scene”, he added.

CIT’s second key element is a strategy to forge relationships with mental health advocates, like Nami, as well as service providers in the community. The goal is to have officers bring people in the midst of crisis somewhere they can get treatment, instead of an emergency room or jail.

But finding such partners in the community can be hard. As the Guardian reported last year, more than 77% of US counties have a severe shortage of mental health professionals.

The city of San Francisco runs its own CIT program, but it has not been confirmed whether either officer involved in Sheehan’s case had been trained to its specifications.

Even within police departments that participate in CIT or similar programs, not all officers receive the training.

“CIT is a specialist program,” said Sam Cochran, who served as the coordinator of the Memphis police department’s crisis intervention team between 1988 and 2008. “Think of it as specializing in any field.” (During his tenure in Memphis, about 20-25% of the police force were trained through CIT, he said.)

Cochran said that, ideally, there would be a CIT officer available to respond to every call that suggests a person may be experiencing a mental health crisis. If such an officer is unavailable, he said, other officers on the scene should know to call and wait for backup.