Legal action from families comes amid renewed calls for more thorough police training for encounters with the mentally ill

The last words Elsa Cruz heard her husband say, in response to police officers banging on his locked front door, were: “Don’t knock on my door, it’s against my will.”

She’ll never forget what came next.

“I heard, bluh, bluh, bluh, the sound of the tool as they broke the door down. There was silence, then a loud bang.”

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The shot hit her husband Samuel, a Puerto Rican artist living in New Rochelle, New York, in the chest and left him dying in a pool of blood in their home.

The encounter that led to the shooting, which happened in May of this year, began when Cruz, 55, called 911 to try to get medical help for her husband, who had become agitated. When police arrived, she told them that he had schizophrenia and bipolar disorder, but did not have a weapon. She begged them to allow her to talk to him, but they refused and told her to stay away. She sought refuge in a neighbour’s apartment below the one she shared with her husband, within earshot of the unfolding tragedy.

“My husband was a very loving person, very respectful,” Cruz said. He had come to the US to obtain the medication and treatment he needed for his mental health disorders, she said. She described him as a “model patient”, who listened to health professionals and even volunteered as a counsellor for the mentally ill for 16 years.

On her return in May from a trip to the Philippines, however, she recalls her husband was acting strangely. He did not seem to recognise that she was his wife, and she believed he may have stopped taking his medication.

“I called for help, I thought it would be an ambulance, but it was the police and they killed him,” Cruz said. “I want to die with my husband. They didn’t give him a chance to say anything. Why did they force open the door? They opened it and then, bang, they killed him. Why? It’s so hard to accept.”

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Cruz’s account of events is at odds with that of the New Rochelle police department, which says that Samuel Cruz had brandished a knife, leading officers to tase him twice, and that they shot him when he came at them with his weapon. Patrick Carroll, the New Rochelle police commissioner, has defended his officers, and said the shooting was justified.

But Cruz’s widow said she heard no scuffle, no fight. She wants to know why they left him without medical help for almost an hour. Cruz has sought police information on the incident, including the name of all the officers involved, through a Freedom of Information Act request, but it has gone unanswered.

On Tuesday, Cruz and her husband’s daughter, Frances, filed a federal civil rights lawsuit in which they accuse the city of New Rochelle of failing to adequately train police in procedures to safeguard emotionally or mentally disturbed people. They claim that instead of calming things down, police escalated the situation by forcing open the door, leading to Cruz’s death. They are also seeking $21m in damages and an injunction requiring the police to adopt and implement new protocols for dealing with the emotionally disturbed.

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The Cruzes are being represented by Randolph McLaughlin, of Newman Ferrara LLP, who is also the attorney for the plaintiffs in a suit filed against New York City last month over a strikingly similar case. Mohamed Bah, 28, a student in finance at Bronx Community College, was shot and killed by NYPD officers in Harlem on 25 September 2012. Bah’s mother had called 911 for medical assistance, expecting an ambulance. After the police arrived, she asked them if she could talk to her son to try to calm him down, but was refused. The Bah family’s lawsuit against the city accuses the NYPD of “policies and practice” of “deliberate indifference” to the safety of its residents and cites a number of fatal police shootings of emotionally disturbed persons stretching back to the landmark case of Eleanor Bumpurs, in 1984. The outcry after the death of Bumpurs, a mentally ill woman who was killed by police trying to evict her from public housing, resulted in new NYPD protocols for handing such situations, but they do not include the involvement of mental health professionals.

A more recent case, that of Kenneth Chamberlain, an ex-marine, is currently the subject of a civil rights investigation by the office of the US attorney for the southern district of New York, and a $21m lawsuit filed by his family, which is also represented by McLaughlin, is pending. Chamberlain, of White Plains, New York, was shot by police on 19 November 2011, after a medical device triggered a false medical emergency call.

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The lawsuits come at a time of renewed debate over police protocols for their encounters with the emotionally disturbed.

Last month, advocates for the mentally ill held a rally in which they called on New York City mayor Michael Bloomberg to bring “crisis intervention teams” to the NYPD. The rally followed an incident in which two bystanders were shot in Times Square by officers who were aiming at a man on foot who was weaving erratically in and out of traffic. The man, described by police as “emotionally disturbed”, was eventually tasered and taken into custody.

In New York and across the rest of the state, advocacy groups have echoed concerns expressed by the families of Cruz, Bah and Chamberlain that police lack the training that officers in other areas have for dealing with mental health crises.

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Ron Honberg, the legal director of the National Alliance on Mental Illness (NAMI), said that cases like those of Cruz, Bah and Chamberlain are a tragic result of the way police are traditionally trained.

“These are sadly not uncommon patterns,” said Honberg. “The standard way law enforcement officers respond to people that they perceive to be behaving erratically is by aggression. They are trained to shout at the person and intimidate them into surrendering.”

But such tactics can be counter-productive when dealing with someone in psychiatric crisis, he said: “If large individuals in uniform show up and start yelling it can feed into paranoia, like gasoline on a fire.”

Honberg cites a training programme known as the “Memphis model” – for the city of Memphis, Tennessee, which introduced it in the 1980s – as the gold standard of police policies for dealing with emotionally disturbed persons and “de-escalating” crisis. The Memphis model relies on crisis intervention teams comprised of officers who have undergone between 40 and 80 hours of extra training to respond to EDP calls, rather than a Swat team or similar unit. It has now been adopted by forces in 45 states and 2,800 cities, including Los Angeles and Chicago, and has resulted in significant reductions in violence and better community relations, according to the Memphis crisis intervention team’s website. It also results in a drop in injuries to police officers in their encounters with EDP, which can be highly volatile and dangerous for both parties.

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Memphis police would not provide the Guardian with up to date figures on their programme’s success because of the ongoing legal proceedings regarding the Cruz, Bah and Chamberlain killings. However, lawyers for Cruz said they have found the results to be dramatic. In the three years before CIT was implemented in Memphis, there were 35 injuries for every 100,000 mental-health related calls to police, they say. In the three years after CIT was in place, the rate dropped to seven injuries out of 100,000 calls.

But neither New York City nor the state of New York have adopted it. A spokesman for the NYPD said that all officers receive training on how to recognise and respond to EDPs, but that there were “logistic concerns” with implementing the Memphis model in New York City due to the volume of EDP calls police here receive, more than 100,000 per year. And in a statement emailed to the Guardian, the spokesman noted: “The NYPD is on pace to have the most restrained year in history when it comes to police-involved shootings.” The total number of shootings by NYPD officers has fallen by 33% this year, going from 83 in 2012 to 56 in 2013, as of September 15, according to the statement. (A spokesman for the city of New Rochelle declined to comment for this story, saying only: “The city does not comment on pending litigation.”)

McLaughlin believes that New York police have a long way to go in convincing the public they are adequately trained for situations involving the mentally ill.

“In New York, if someone has a family member in crisis, the question is, what do they do?” he said. “They have to worry, if they make a call, does that put their loved one at risk? People are afraid of making that call.”

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A year after his death, Bah’s grieving mother, Hawa, is still struggling to understand why her youngest son was killed. He had no history of mental illness, no criminal record. He was, she said, a hard-working, loving person, studying so that he could join her in her import-export business in Guinea. A single call for an ambulance that she believed would help him has taken the most precious person in her life from her and turned it upside-down. She won’t rest, she said, until she has justice for him.

“He would have opened the door if they let me talk to him,” she said. He didn’t pose any danger to anyone. He was a sick person. I want justice for my son. I don’t want anyone else to feel how I feel. I can’t work, I have to stay at home. I don’t know what to do. My son, my son.”

© Guardian News and Media 2013