The family of a troubled New York man may never know what happened when multiple police officers encountered him in their living room behind a window shade. But his mysterious death is just the latest violent encounter between America’s new first responders and its most vulnerable

Three Thursdays ago, Denis Reyes told his mother he did not feel well. He had been dealing with depression, a symptom of his bipolar disorder. He had recently been diagnosed with schizophrenia, according to his family, and he was very anxious about his health. His mother, Blanca Sierra, suggested he go see a doctor.

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That evening, a crash in the bathroom jolted her and her other adult son, who also lives in their cramped three-bedroom apartment, decorated with crosses and pendants of the Virgin Mary, in the predominantly Puerto Rican section of the Bronx.

Reyes, 40, had pulled down the shower curtain and flung a bucket. In the kitchen, he threw a pot and tried to tear off the oven door. He stormed into the family living room, grabbed a lamp and threw it.

“He lost his mind,” Sierra told the Guardian in an interview at her home. “A person like this doesn’t know what they are doing.”

Sierra had grown used to her son’s tantrums – even violence – but this was different. Reaching for her phone, she called 911.

Frantic, Sierra explained to the receiver that she needed an ambulance. Her son was having an episode and needed medical attention, she recalled telling the operator, who spoke in English. Sierra, who can not speak English, said she was transferred to someone who spoke Spanish, but this operator still struggled to understand her. She hung up the phone, praying help would come quickly.

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An ambulance did come, eventually. But officers from the New York police department came first. An hour later, Reyes was pronounced dead at nearby St Barnabas hospital.

Sierra may never know exactly what transpired during the nearly 20 minutes that, by her count, eight officers spent in the living room with her son.

Sierra said the officers sent her out of the apartment. At some point, she said, the officers pulled down the shade, blocking the view of a small group of neighbors and passersby that had gathered by the living room window to see.

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While police now maintain Reyes died from a cardiac arrest inside the ambulance on his way to hospital, Reyes’s mother said she kissed her son’s forehead before he left. He was, she argued, already dead.

This mother remains certain of one thing, however: if help had arrived in a different order, her son might still be alive.

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A review of police killings by the Guardian found that 27% of people killed during encounters with police so far in 2015, or 122 people, were identified by family members, friends or police as having a mental health disorder. In at least 31 cases, the person killed was described as suicidal.

Mental health advocates and law enforcement experts said that what happened to Reyes in the Bronx on 14 May was emblematic of the dire straits in which the entire US mental health care system is struggling.

Like many police departments slowly responding to a wave of protests following high-profile deaths, the NYPD is in the process of adopting new protocols and techniques for handling situations involving mentally ill people, which mental health care advocates welcomed as a step in the right direction.

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At the same time, service calls from mentally ill residents and their families – from overwhelmed mothers like Blanca Sierra in the Bronx – are inundating the nation’s law enforcement agencies, as departments across the country report spending increasingly more time and resources responding to such calls.

Denis Reyes was not alone.

Earlier this year, Monique Deckard, a black woman with a long history of mental illness, was shot and killed by police officers in Anaheim, California , after she was accused of stabbing a woman at a laundromat and allegedly charging at officers.

On the same day, police shot and killed Anthony Hill , a 27-year-old unarmed black man, in Atlanta, after responding to complaints about a naked man knocking on doors in an apartment complex.

Many more people have died this year in so-called “suicides by cop” after arming themselves and approaching police officers who have little official training on being approached by a mentally ill person carrying a weapon.

The story of what happened to Reyes has been marked by a shifting official version from authorities and details that are sharply disputed by his family.

Police initially told the Guardian that Reyes went into cardiac arrest while being escorted into an ambulance by EMS workers. They later said he went into cardiac arrest inside the ambulance, and clarified that he was still in custody and that EMS workers never restrained him.

His family and neighbors, however, said he already appeared dead when he left the apartment, that they were blocked from seeing how he was handled, and that officers did not bother to inquire about his mental health. They said he spent his last moments unarmed in his own living room, blood on his lips and streaks of vomit in his hair.

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Police said Reyes’ mother reported in her 911 call that he had “struck” her. She denied this to the Guardian and said her son had not been violent towards her. Declining to state this on the record, police sources also said Reyes’ mother and brother said in statements that he had been drinking and using synthetic marijuana earlier in the day. But they told the Guardian they did not say this, and said only that he habitually drank and used the drug.

According to a statement issued by police in response to a detailed list of questions for this article, police “observed Mr Reyes in the living room and while attempting to place him in custody, he started to kick the officers, who called for assistance”.

New York fire department spokesman Jim Long said Sierra’s emergency call, which was received at 6.05pm, was initially treated as a low-priority “sick call”. At some point during the police encounter, Long said, the urgency of that emergency call was escalated – he said he did not know by whom – and the paramedics were directed to the home immediately.

‘We’re not supposed to be scared of the people that are supposed to protect us’

Sierra was standing outside her home while police restrained her son.

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Maritza Monzon, her upstairs neighbor, said she came downstairs when she heard Reyes was having an episode. When the police arrived, she said, they told her: “Grab the mom and take her outside, because she can’t see what we are doing to him.” Monzon implied this was a procedural request so that Sierra, who was very distressed, would not have to witness her son being physically restrained.

Sierra’s other son, 45-year-old Wilfredo Bracero, was at home during the encounter. Bracero said that from the hallway he saw the officers – he, too, counted eight – push his brother face-down into the couch before placing handcuffs on his wrists and ankles.

“They were holding him down,” Bracero said. “He couldn’t, I think, breathe.”

Bracero said his brother called for help. “He was calling my name. He said: ‘Wilfredo, come here.’” He tried, he said, but the officers ordered him to stay put.

He said Reyes vomited at least once, possibly several times. At some point, his eyes closed. “That’s when I think he passed away,” Bracero said.

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Twenty-one minutes after his mother’s first call for help – after a second call, and after more police arrived – paramedics finally carried Reyes out of their apartment in a wheelchair.

Sierra said she just wanted to touch him.

“I told them: ‘I want to kiss my son. I want to kiss my son,’” she told the Guardian in the first of several interviews over the past week. “They kind of pushed me – because I saw death on the face of my son. White. He was white, completely white, his eyes closed. And when I gave a kiss to my son, he was cold, like death.”

Monzon, the neighbor, who watched as EMS workers transferred Reyes from the wheelchair to a stretcher, also said he looked “pale” and had “purple lips”.

According to Reyes’ step-daughter, Leina Jimenez, the doctor at St Barnabas hospital told her and her mother – Reyes’ former partner, with whom he has two children – that her step-father had choked on his own vomit as well as gone into cardiac arrest. He assured them that EMS responders had tried to save his life, but that Reyes had no pulse by the time he arrived at the hospital.

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Her mother, Magdalia Camacho, who grew up in the same building as Reyes and was with him for 10 years, told the Guardian that he was never violent with her or their children.

“He wasn’t violent. He got agitated, and he got loud, but never violent,” Camacho said. “Whatever he did that night, he didn’t deserve to die.”

Jimenez and Camacho were shown Reyes’ body. There were streaks of blood around his mouth and strands of vomit in his wavy black hair, according to photos taken by the family and reviewed by the Guardian. Jimenez said his lip looked “busted”, his right ear was bruised and his eye was bloodshot.

Staring at her step-father’s bruised and swollen face, Jimenez said she “understood” at that moment why protests had erupted in Baltimore, where another man, Freddie Gray, was fatally injured while in police custody, and in Ferguson, where a disputed encounter left yet another family in mourning.

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Last year the NYPD came under renewed scrutiny following the chokehold death of Eric Garner, on the other end of New York City, in Staten Island. His last words recorded on a cellphone camera, “I can’t breathe”, became an international rallying cry for protesters.

The cause of Reyes’ death remains under investigation by the medical examiner’s office. A spokeswoman for the office refused to disclose any information about the autopsy report because the investigation was active.

“They took a man’s life away,” said Jimenez. “Something has to be done, because even kids are losing their fathers to police officers – we’re not supposed to be scared of the people that are supposed to protect us.”

‘It’s like sending a race-car driver to perform brain surgery’

Related: America’s mental health care crisis: families left to fill the void of a broken system

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Over the past few decades, a significant burden of mental health care in the US has shifted from healthcare professionals and hospitals to police officers and prisons. As the global recession set in, cash-strapped states slashed funding for mental health services by more than $4.5bn between between 2009 and 2012.

In the absence of an adequate national system, mental-health experts say, police have become the first line of defense for thousands of innocent people in crisis, sometimes with fatal consequences.

“Our system lets people get worse and worse until they’re in a crisis situation,” said Laura Usher of the National Alliance on Mental Illness (NAMI). “When they call 911, there’s nobody to respond but the police.”

“We’ve become reliant on those without the proper training to provide that first-tier support and that’s a fundamental flaw in our system,” said Jonathan Thompson, the executive director of the National Sheriffs’ Association. “It’s like sending a race-car driver to perform brain surgery. You wouldn’t do that.”

Law enforcement agents, he said, are trained to regain control of a potentially dangerous situation, not to handle mental health problems. For example, he said, in instances when an officer may only have a few seconds to act in a potentially dangerous situation, an erratic response or the failure to follow police orders can be easily misinterpreted.

A 2012 report by the National Sheriffs’ Association and Treatment Advocacy Center found the number of police killings resulting from an attack on law enforcement had jumped by 67% between 1980 and 2008.

Last month, the US supreme court sided with police in a limited ruling on the case of a San Francisco woman who survived a police shooting after threatening officers with a knife. The justices offered partial immunity to the police in such encounters and declined to settle whether such victims were protected by national disabilities protections.

‘His problems were never out-of-this-world’

Despite multiple conclusions by the US Department of Justice that police departments systematically use force against the mentally ill, there remains no national standard for crisis intervention. Nearly three decades since the traditional model for crisis intervention training (CIT) was first introduced, experts now say support for increased training has grown amid national attention on deadly police killings and calls to to redress perceived police misconduct.

Departments that were once resistant to reforms – such as the NYPD – are suddenly more open, say local community activists.

“Right now there is a total sea change in the police,” said Carla Rabinowitz, an organizer with Community Access , which provides housing and support to New Yorkers with psychiatric disabilities. “They’re very receptive to the mental health community.”

Until recently, the NYPD was the only force among the largest cities in the US without a specialized response program. But starting this month, 5,500 NYPD officers in Harlem and other areas will undergo pilot training in crisis intervention, Rabinowitz said.

For Denis Reyes’ family, that will be one month too late.

Born only a year apart, Wilnelia Reyes and her brother shared everything. She admired her big brother, who everyone called Puro, Spanish for “pure”. He made friends easily, with his big grin and boundless energy. She said he loved school, and always qualified for the accelerated classes, but he also struggled to concentrate.

Denis started hanging with the wrong crowd, his sister said, and eventually he dropped out.

“I don’t understand why he chose the path he chose,” Reyes said. “We grew up together under the same roof. We shared everything. We did everything together. I don’t understand why. He was always the bright one.”

Reyes said she believes her brother was diagnosed with bipolar disorder sometime in his late 20s. He wasn’t diagnosed with schizophrenia until recently. He also struggled with substance abuse, and sought treatment for alcoholism.

“He had his good and bad days, like all of us,” Reyes said. “He was never aggressive towards people, or to us. Really, it was nothing major. His problems were never out-of-this-world.”

To the best of her knowledge, Reyes said her brother took his medications as directed and visited a psychiatrist regularly. Sierra, the mother, said a police officer with the domestic violence unit would visit her house twice per month to check that there had been no disturbances; she adamantly denies that her son ever hit her.

Denis Reyes spent time in prison, including for theft and drug-related offenses, according to his sister and prison records. He most recently served time for a parole violation, according to court officials. The last time she saw her brother, Reyes’ sister realized the toll his time behind bars had taken.

It was March in New York City. It was freezing, but he was sitting on the bed with the window wide open. She asked him why he had the window open, and he said he didn’t like “the feeling of being locked up”.

He had become severely claustrophobic and had panic attacks when was surrounded by too many people. Despite the anxiety and depression, Reyes said she thought she detected some of that old spark of ambition in her brother.

He told her he had visited a technical school to inquire about training to become a mechanic, like their father.

“The last conversation we had … I told him: ‘You need to focus on yourself. Don’t worry about anybody else. Just make sure you seek medical attention. Make sure you see your doctors,’” Reyes said. “He promised me he would do that.”

guardian.co.uk © Guardian News and Media 2015

Watch video of Denis’ mother discuss the incident below: