by Casey J. Bastian

“The vast majority of people whose deaths we are witnessing at the hands of law enforcement do in fact have disabilities”—HEARD Volunteer Director and Community Lawyer Talila Lewis

In a nation that prides itself on justice and equality, why are disabled individuals so often met with handcuffs instead of help, violence instead of understanding? The disturbing reality is that up to half of all police violence victims are disabled, many experiencing mental health crises when officers intervene. Law enforcement, trained to prioritize control over care, routinely fails to recognize or accommodate disabilities, turning routine encounters into lethal confrontations. Yet solutions—such as crisis intervention teams, de-escalation training, and systemic shifts away from punitive policing—are within reach. This is not just an indictment of a broken system but a call to action. Because disability should never be a death sentence.

Law enforcement officers (“LEOs”) are ill-equipped to handle these sensitive and delicate encounters. LEOs are too suspicious, often immediately reverting to their use-of-force training. Compliance and control methods are not appropriate when dealing with the disabled. But until we achieve greater collaboration between law enforcement training systems and disability advocates, the responsibility must remain with LEOs to protect some of our most vulnerable citizens. A disability should not be a precursor to a death sentence.

Understanding Our Disabled

The Arc’s National Center on Criminal Justice and Disability (“NCCJD”) is one of America’s most prolific disability advocacy groups. NCCJD notes that “disabled individuals are the largest minority group in the United States.” But what exactly is a “disabled individual”? According to the National Crime Victimization Survey (“NCVS”), disabilities are organized based on six limitations: (1) hearing, (2) vision, (3) cognitive, (4) ambulatory, (5) self-care, and (6) independent living limitations.

The Americans with Disabilities Act of 1990 (“ADA”), 42 U.S.C. 1201 et seq., defines a disability as a “physical or mental impairment that substantially limits one or more major life activities, or a record of such an impairment, or being regarded as having such an impairment.” The ADA does not provide an exhaustive list of qualifying conditions.

The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (“DSM-IV”) defines “mental illness” as a person “having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder [“SUD”].” This includes conditions such as anxiety disorder, bipolar disorder, depressive disorders, personality disorders, post-traumatic stress disorder (“PTSD”), schizophrenia, or an emotional or mental condition diagnosed by a medical or other mental health professional. Each condition may be exacerbated when the person also struggles with SUD.

The NCVS revealed that as of 2017–19, “about 12% of the U.S. population age 12 or older living outside institutions had a disability.” That’s almost 40 million disabled people in the U.S. Of this population, 53 percent are female; 70 percent are White, 13 percent Black, and 12 percent Hispanic; and 48 percent are aged 65 or older.

With population numbers like that, it is inevitable that there will be interactions between LEOs and the disabled. Frequently, LEOs claim to be unaware that the subject they encounter is disabled. Sometimes this may be true. There are obvious physical disabilities, such as paralysis or missing limbs; more nuanced disabilities, like visual or auditory impairments and some developmental and intellectual disorders; and then there are the invisible disabilities, specifically underlying mental illness.

“I don’t think there’s anyone in this nation who doesn’t know someone who is mentally ill,” said Tony Thompson, the sheriff of Black Hawk County, Iowa. Thompson added, “Whether it is anxiety, depression, PTSD, whatever. We can all relate. We can all understand.” We can hope, but is that true?

According to the Treatment Advocacy Center, “an individual with mental illness is 16 times more likely to be killed by police.” Regardless of whether the disability is readily apparent, each presents unique challenges to the individual. These human beings strive each day to live full, productive lives. It is often difficult. More to the point, each disability presents a unique challenge when interacting with LEOs. Beyond the expected daily challenges are the unexpected encounters with police, which the disabled often perceive as hostile and belligerent, and which can present the most difficulties.

The reality is that social infrastructures are not always favorable to the disabled. While we have made great progress with updated designs to improve construction of structures for greater physical and program accessibility under the ADA and the Rehabilitation Act of 1973, 29 U.S.C. 701 et seq., the psychological impediments seem to remain.

Plus, the most influential social structures are our criminal justice systems. Within these systems, among those in the most dire need of assistance and understanding are the disabled. Instead, the vulnerability of these persons is often overlooked, overwhelmed, and even ignored. From initial contact with LEOs to incarceration and probation, progress seems to be unavailable for those with disabilities.

A Failure to Understand

Robert Ethan Saylor was 26 years old when three off-duty LEOs working security killed him. Saylor was in a movie theater and refused to leave. This young man had Down syndrome. He did not understand that he had to pay if he wanted to watch the movie a second time. His lack of understanding was treated as a crime. Instead of assisting Saylor and his aide, the officers wrestled him to the ground and placed him in handcuffs.

The aide explained to the three LEOs that Saylor did not react well to being touched. The officers failed to consider the heart issues endemic to those with Down syndrome. Nor did it matter to the officers that Saylor’s IQ was only 40. Brutality was their only response to his lack of understanding.

The three LEOs obviously mishandled the entire situation. Saylor was not hurting anyone or anything. Yet although Saylor’s death was ruled a homicide by asphyxia, no one was held accountable for his senseless killing.

Are we to believe that not one of the three LEOs realized that what they were doing was not merely potentially unlawful but also morally repugnant? An untimely death is an extreme penalty for Saylor’s crime, but Saylor is just one example. Any reasonably observant person can instantly notice that an individual may have Down syndrome. And LEOs, on- or off-duty, cannot be that inattentive. So, is there a benign explain Saylor’s death?

Consider 32-year-old Brian Sterner. Sterner is confined to his wheelchair. A Hillsborough County, Florida, sheriff’s deputy assumed Sterner was faking his quadriplegia. The deputy’s response was to drop Sterner on his face. Nicholas Kincade was charged with battery of a police officer when he was 25 years old. The paraplegic man accidentally rolled his wheelchair over the LEO’s foot. When Kincade tried to explain it was an accident and not intentional, Kincade was brutally shoved out of his wheelchair and charged with felonies. Although the charges were ultimately dropped, the LEO was neither prosecuted nor faced any meaningful discipline.

Then there is the case of Steven Stairs, who is legally blind and uses a folding cane to safely walk in public. Using canes for mobility assistance is nearly ubiquitous in the sight-impaired community. LEOs seem to be unaware of this fact. Stairs was using a payphone. The LEOs approached his wife and friend to ask why Stairs had the cane. The LEOs assumed it was a dangerous weapon, even after being told it was a mobility device. Stairs was then tackled from behind; he later said that he thought he was being kidnapped.

It is likely that Stairs never heard any verbal commands, if the LEOs had even made them. When LEOs fail to ensure that they have properly identified themselves, a blind person has no other way of recognizing that they are dealing with an LEO. And when LEOs rely on physical commands or gestures, blind persons are unable to comply, leading to devastating and preventable incidents.

Those with auditory impairments have an inverse problem. These individuals can appear noncompliant because they cannot hear commands. If the LEO does not take the time to differentiate between intentional and incidental noncompliance, the LEO will assume that they must exert control. The consequence can be a violent death for the disabled person. The Center for Disability Rights notes that members of the hearing-impaired community have “expressed grave concerns about police confrontations.” These outcomes were highly aggravated by the wanton infliction of police violence upon Darnell Wicker, Daniel Harris, and Pearl Pearson Jr.

Wicker was helping his girlfriend move out of her apartment. As LEOs approached, Wicker had no idea that the LEOs were issuing verbal commands. The LEOs fatally shot Wicker, resulting in his death for a wholly innocent transgression.

Harris was lawfully operating his motor vehicle when police stopped him for an alleged driving infraction. As the LEO neared Harris’ vehicle, Harris attempted to communicate via American Sign Language. In response, Harris was shot by the LEO. One can assume Harris was not signing a request to be shot for a minor traffic violation.

Pearson was also a victim of a traffic stop gone wrong. During the stop, Pearson reached for his disability placard. Reports indicate that the reason he was pulled over was unclear to Pearson. When approaching LEOs saw him reach for something, they assumed it was a weapon. Each immediately drew their weapon. Pearson was dragged from his car, placed in a chokehold, and beaten mercilessly. His arm was severely injured. The LEOs pummeled Pearson’s face, resulting in serious eye and brain damage. Apparently, Pearson’s mistake was that he did not exit the vehicle as commanded; reaching for the placard triggered the LEOs.

These LEOs assumed only the worst, never considering an auditory disability. Is it any consolation that at least Harris and Pearson were not killed like Wicker? In a way. But these LEOs again asserted a plausible defense that allowed them to escape responsibility for their actions.

Even when the disability is the consequence of a serious medical condition, LEOs still find no alternative to being aggressive and discourteous. Lisa Edwards was 60 years old when she died of a secondary stroke in police custody. She previously had a stroke and experienced abdominal pain while on a flight from Rhode Island to her native state of Tennessee. After being discharged from the Blount Memorial Hospital, she sought care at the FSRMC.

The LEOs involved were called to the FSRMC because Edwards refused to leave after she was purportedly discharged without further care she desired. When the LEOs arrived, they found Edwards in a wheelchair. She informed the LEOs that she had suffered a stroke and could not walk. Instead of compassion, according to body camera evidence and witnesses, the LEOs “mocked and bullied” the elderly disabled woman. August Boylan, a registered nurse and Edwards’ daughter-in-law, said, “It was very clear she could not use her left side. Her speech got slurred as things progressed; that’s one of the first things you see with a stroke.”

The LEOs threatened Edwards with trespassing and spent 30 minutes struggling to get her into a jail transport van—all while calling Edwards “dead weight,” demanding her cooperation, and telling her to “stop playing games.” Edwards kept telling the LEOs that she could not breathe or stand. The LEOs handed Edwards her inhaler, but she could not use it correctly. Then one LEO sardonically offered her a cigarette instead. The LEOs even told her she was “fine” and eventually placed Edwards in a cruiser because it was easier than the jail van.

Edwards collapsed out of sight in the back seat. When one of the LEOs discovered her unconscious a few minutes later, he suggested Edwards was “faking.” She was not. And it was too late to save her.

Knoxville Police Chief Paul Noel said he was “disturbed and embarrassed” by this incident. Although the LEOs went on paid administrative leave, the internal investigation resulted in no reprimands. It seems that Noel did not demand accountability from his officers. No criminal charges were brought against the LEOs either.

It’s evident that LEOs are not understanding toward a broad range of people with disabilities. When the disability is a mental illness, it gets even worse—both in frequency and negative criminal justice outcomes.

Street-Corner Psychiatrists

Haben Grima is a lawyer and disability rights advocate. Grima believes that the danger faced by those with disabilities, especially those with mental illness, is a predictable consequence of law enforcement’s “compliance culture.” And the convergence of these two realities appears to be a recipe for disaster. “Anyone who immediately doesn’t comply, the police move on to force,” says Grima. This becomes an unreasonable approach when LEOs encounter someone who doesn’t—or simply can’t—react in the manner that they demand.

This idea is personal for Grima, who is deaf, blind, and Black. For her, the potential danger is real. “Someone might be yelling for me to do something and I don’t hear. And then they assume that I’m a threat,” she notes.

Ali Thompson agrees. Thompson is a former deputy with the Boulder County Sheriff’s Office. As a deputy, she explained that it was “scary” when someone didn’t follow direct commands. Thompson said this is a result of the unknowns. “So, your adrenaline starts pumping and you think … ‘they’re not listening to my commands because they have a warrant or because they have a gun on them,’ or you come up with all of these scenarios to explain it,” added Thompson.

These imagined scenarios never seem to include possible disabilities. As a young deputy, she admits that she would have never attributed noncompliance to a disability. Thompson’s current work with the Colorado Developmental Disabilities Council hopes to change that. “We need to start bringing these possibilities into those ‘what if’ scenarios,” Thompson asserted.

The solution to this problem begins with understanding the treatment of those with mental illness (whether diagnosed or not) and the role of law enforcement in responding to incidents involving such persons. America currently has a dearth of available diagnostic, treatment, and care systems for those suffering from mental health conditions. Approximately 60 years ago, our society deemed psychiatric institutions used to house mentally ill individuals as inhumane—and they were. Human beings were locked away, out of sight, and left to suffer through their plight.

We as a society began to insist it would be a more appropriate to deinstitutionalize such persons, and that significantly reduced the populations residing in psychiatric hospitals. But it also put them on the streets, left to their own devices. There were not enough community-based resources, such as support housing, offered before they were released onto the streets. The consequences were inevitable.

Since that time, the numbers have increased, and their behavior has again begun to be viewed not as a medical issue but rather a criminal issue. Those with severe mental illnesses have been left to end up in criminal justice systems because their disruptive behaviors are viewed as anti-social and dangerous. Rather than provide necessary treatment, they receive punishment. In fact, mentally ill individuals routinely encounter police and spend time in jail or prison.

LEOs have become frontline professionals expected to manage persons in crisis. Dr. Philip Yanos’, a professor of psychiatry at John Jay College, research found that LEOs are more likely to negatively stereotype those with mental illnesses. “Police training is such that officers are not the best respondents. Once an officer intervenes, stigma comes into play, and it can lead to tragic outcomes,” observed Yanos. Despite this reality, law enforcement has been placed in the default role of “street-corner psychiatrist.” They are then forced to render what has been colloquially referred to as “psychiatric first aid,” which they are not trained to provide. Plus, some even resent this implicit obligation.

LEOs have a serious problem fulfilling this role because they receive almost no training to perform such triage. Many police chiefs insist LEOs shouldn’t even be the mental health response agency of first resort and argue that LEOs are placed in untenable situations. This diverts limited resources from core law enforcement priorities while placing additional strain on resources and time. But LEOs are under a legal obligation to respond to every request for assistance 24/7. They have no choice.

In many cases, LEOs report that when they do act as street-corner psychiatrists, making the decision to take a person to the hospital can result in hours of waiting in the emergency room. And on many occasions, the person isn’t even admitted for care. It is understandable that LEOs don’t want the responsibility of managing these situations. If the next level of care is not provided by medical professionals, what is the LEO supposed to do at the next event? The LEOs instead treat the incident as a crime. That is where we get “mercy bookings.” Obvious deficiencies in health and social systems place restraints on options for LEOs, with arrests further divesting the ill of timely, necessary care.

These realities support the position of so many LEOs, who don’t want the responsibility placed on them. “Officers say that they’re not here to diagnose and they don’t want to be told how to diagnose,” says Abigail Love, Director of Police Community Autism Training. Sergeant Brandon Johnson of the Loveland Police Department in Colorado emphasized the limitations of LEOs as first responders. Johnson notes, “We have to be the first responder. We have to have a good foundational understanding of all of it. But we’re also not … we’re also not experts.”

So why does our society insist on resorting to street-corner psychiatric first aid? LEOs are given this responsibility as a result of two common-law principles. First, it is the direct outcome deriving from the power and authority invested in law enforcement to protect the welfare of our communities as a whole and the safety of the individual; the obligation recognized as one to “protect and serve.”

The second is a “parens patriae” obligation to protect individuals who cannot protect themselves, such as the disabled. Parens patriae is a Latin term that means “parent of the country.” It is legally defined as the state acting in its capacity as the provider of protection to those unable to care for themselves. Which is ironic. As we’ve noted, too often this obligation to protect becomes a mechanism for the wanton infliction of harm on our most vulnerable. Or worse, because so many of these circumstances seem deliberate.

To be objective, it is necessary to acknowledge that many of the people LEOs encounter, especially when the disability concerned is a mental illness, can appear to be a danger to both themselves and the community. “A police response is not the type of response you want when people are in a mental-health crisis,” according to Carla Rabinowitz, the coordinator and project leader for the mental health nonprofit Community Access.

LEOs are vested with the legal discretion to choose how to respond to most circumstances. The first responder LEO must recognize whether a person is in crisis and needs treatment for their mental illness. They may also decide that certain conduct constitutes illegal activity and should result in a criminal arrest. Of course, any discretion has limits. Whether a person is mentally ill or not, the commission of a serious crime will result in an arrest and commitment to jail.

However, there is a frequent reality wherein the LEO may believe that alcohol or drug intoxication is causing behavior that is criminal per se, while a mental health professional would likely recognize certain behavior as arising from an illness that does not need criminal justice interventions. Yet even when the LEO recognizes a mental health crisis, jail is frequently the first alternative. This practice is known as “mercy booking.” The LEO charges at least a misdemeanor, books the person in jail, and allows the system to run its course.

The LEO may reasonably believe that once the person is in custody, they will be seen by a mental health professional attached to the jail or court and eventually receive a psychiatric evaluation and medical care. If not, our criminal justice system is the one system that “can’t say no.” The act of utilizing “mercy booking” is viewed as unconstitutional by many legal experts, but most states do not have legal prohibitions against detaining the mentally ill when they are clearly not engaged in illegal conduct.

From a law enforcement perspective, if needed treatment is provided, then good. And if it results in a criminal disposition, so be it.

The Criminalization
of Mental Illness

It is concerning that LEOs are often relied upon to use arrest powers against disabled people due to a lack of options for them. When it is children with mental health and developmental disabilities, that is even more shameful and possibly illegal.

The Four Rivers Special Education District (“FRSED”) operates the Garrison School in the tiny Illinois town of Jacksonville. FRSED has on average fewer than 65 students enrolled per year. It functions as a therapeutic day school for students with significant emotional and behavioral disabilities, which includes disabilities like autism and ADHD.

Students at FRSED are also arrested at an alarming frequency. Some of these children were arrested at the age of nine. FRSED has more students arrested than any school district in the U.S.

It isn’t just that the students are arrested but also that the teachers and administrators actively pursue charges. Between 2017–18, nearly half of all students were arrested. In the last five years, nearly 100 students have been placed in police custody. Each child arrested is taken to the local police station, fingerprinted, photographed, and placed in a holding cell.

Media attention eventually prompted the U.S. Department of Education (“ED”) to launch a civil rights investigation. The ED investigation seeks to determine if children were deprived of a suitable education due to the “practice of referring students to law enforcement for misbehaviors.” After the investigation was launched, records requests made by the Chicago Tribune and ProPublica revealed that nearly 415 students have had police incident reports filed against them. Some of the behaviors were potentially serious, like when a student spit on a teacher. But most arrests stemmed from behavioral issues, such as “running the halls” or a child leaving class to use the restroom after they were told they couldn’t leave.

Catherine Lhamon, a former assistant secretary for civil rights at the ED, made a statement after the investigation was launched. “I emphasize that at this time [the Office of Civil Rights] has reached no conclusion as to whether the District has violated any law OCR enforces,” said Lhamon.

Criminalizing mental illness is a phenomenon that has occurred throughout American history. In the 18th and 19th centuries, the so-called “moral” movement led by reformers like Dorothea Dix advocated for the creation of state-run asylums to house the mentally ill. Citizens were led to believe that these people would be cared for while they recovered. In reality, it was simply a means to get them off the streets and out of sight. Laws, like “ugly laws,” created a lawful way to prohibit and restrain the undesirable from appearing in public. These laws and the “moral” movement began the era of mass arrests, confinement, and even forced sterilization. Even though the last ugly law was technically repealed in 1974 by the city of Chicago, eerily similar policies are still on the books elsewhere.

As late as 2022, New York City Mayor Eric Adams issued a directive to law enforcement to identify those persons experiencing a mental health crisis and unable to meet “basic living needs” on their own. Persons identified as having such diminished functioning could be removed by force and subjected to involuntary commitment in institutions that do still operate. But these facilities are very limited.

After the U.S. decided to shut down institutions in the 1960s, available community-based resources became severely overburdened. As time went on, the country faced both workforce and funding shortages. Community health providers struggled most during the period between 1980 and 2000. These providers and remaining systems could not meet the rising demand for services.

President Ronald Reagan’s administration slashed federal funding of mental health services by 25 percent. Between 2009–12, states collectively cut $4.5 billion in expenditures for mental health resources. Funding was not increased until President Donald Trump’s administration used the CARES Act to do so in 2020. The total budget was increased by $425 million, and the Substance Abuse and Mental Health Services Administration (“SAMHSA”) received most of the funding. Of this, $250 million was provided to certified community behavioral health clinics.

A 2022 National Council for Mental Wellbeing survey found that 33 percent of respondents still reported lack of available care. President Joe Biden’s administration then allocated $15 billion in the 2023 fiscal year spending bill—$707 million more than the previous year. The survey also found that serious deficiencies remained, including a lack of providers and prohibitive costs. Many people reported a lack of culturally and linguistically appropriate services as well. These deficiencies cause many people to self-report to emergency rooms because they can find no reasonable alternative when in crisis.

Often bystanders, family, and friends call 911 for assistance, which is how police become involved. That leads to arrests, imprisonment, or worse, people maimed or killed by aggressive LEOs. Also, far too often, the first time a person begins to get any mental health care is when the judicial process mandates it. Such care is then provided in jails and prisons.

Dr. Lior Gideon is a professor of Criminal Justice in the Department of Law, Police Science, and Criminal Justice Administration at John Jay College and the editor in chief of the Health & Justice journal. Gideon said, “What we see with the criminalization of mental illness is that society has no other way to deal with people with mental illness,” and added, “It basically forces them into the criminal justice and correctional systems.”

Sheriff Tony Thompson wrote a book titled Anyplace but Here: The Uncomfortable Convergence Between Mental Illness and the Criminal Justice System. Thompson said that 60 percent of incarcerated individuals housed in his jail had a history of mental health disorders. “We’re the greatest country in the world, but we leave people behind and then we pretend like they don’t exist,” Thompson decried. “And we cannot simply arrest our way out of this problem.”

At least two million people suffering from serious mental illness are jailed every year. A 2011–12 national inmate survey conducted by the U.S. Department of Justice (“DOJ”) found that 1 in 4 jail detainees, and 1 in 7 prisoners, at the state and federal level show signs of “serious psychological distress.” The DOJ survey also found that 33 percent of those incarcerated had a clinically diagnosed mental health disorder, compared to only 20 percent of the non-incarcerated population.

Chan Noether is director of SAMHSA’s Gather, Assess, Integrate, Network, and Stimulate (“GAINS”) Center. The GAINS Center is one organization that provides mental health services for those enmeshed in the criminal justice systems. Noether notes that the nature of these systems is not conducive to effective treatment. “It’s focused more on the punitive nature of the process of incarceration than on the rehabilitative nature,” observes Noether. Even those on probation are often left without meaningful care.

The University of North Carolina at Chapel Hill (“UNCCH”) conducted a survey of probation departments and identified some clear deficiencies. Adults with mental illness are found in the probation populations across America at a rate of more than double the general population. If the person has a co-occurring substance use disorder, the rate is five times. When it comes to gender, women are twice as likely to be arrested and go to prison for a new offense or probation violation than those without such diagnoses.

Statistics demonstrate that even when shown “leniency” through the imposition of a probationary sentence, the underlying contributing factor of disability is left untreated. And to be clear, a mental illness and SUD together are devastating to the people left to suffer them untreated. The UNCCH survey found that less than half of the probation departments that responded evaluated whether a mental health-centered approach produced improved probation outcomes. For example: would such an approach reduce technical violations? This means that nearly 54 percent of all departments never even consider such questions.

Agencies usually fail to even consider specialized mental health probation, despite the fact that specialized probation is shown to produce significant benefits for those suffering from co-occurring mental health and SUD. This positive outcome is facilitated through additional training for probation officers, more personalized attention, and smaller caseloads.

In 2023, The Pew Charitable Trusts conducted a survey of probation professionals. A document entitled National Survey of Probation and Mental Health Report published the findings. Most probation officers (“PO”) reported that they don’t feel adequately trained to deal with those suffering from mental illness. One PO said, “I would say that one of the big ones would be that the majority of officers, especially new officers, aren’t trained in mental illness and mental health.”

In the Pew report, the same PO observed that even when they are told, for example, that the person has bipolar disorder, the POs don’t know what that means or what that looks like. “I think that’s the biggest challenge,” said the PO. Another PO said that oftentimes the case file transferred in from the courts doesn’t even contain information about the person’s disability. “Sometimes, we don’t know that they have a mental illness until they come in and tell us,” stated the second PO. He argued that there should be mandated procedures in place to ensure this doesn’t happen.

According to the Pew report, the PO also stated that oftentimes the person shouldn’t even be on probation. The PO said, “Some people, they shouldn’t even be on supervision if they have a mental health issue.” It is incredibly difficult to properly supervise a person if the disability isn’t even acknowledged until after the violations are occurring.

Diversionary programs, modeled on drug court programs, aim to keep people arrest-free and out of incarceration. The goal is to instead provide treatment and guidance. Gideon noted, “They’re trying to divert that segment of the population away from the criminal justice system.” This starts with collaboration and awareness. The law enforcement perspective is that LEOs want and need immediate on-site assistance from professionals trained to handle mental health events. LEOs are often faced with those acting acutely psychotic, behaving bizarrely, or exhibiting violent behavior. Sometimes that behavior is directed at themselves. LEOs are then forced to deal with a suicidal person.

It has become increasingly apparent that LEOs, especially when the person is indicating self-harm or suicidal ideations, must work with specially trained teams to prevent harm to everyone involved in the incident. The two systems must work together. But even when they are in place, the programs are not always utilized. Instead of helping the person through a suicide crisis, the police act as agents of compliance and control.

Attempted Suicide by Cop:
A Crime?

A situation that strongly emphasizes the need for collaboration between LEOs, mental health professionals, and treatment systems is the “suicide by cop” phenomenon. LEOs admit that this can be the most difficult situation they face. Suicide by cop, or “police-assisted suicide,” accounts for nearly 11 percent of all metropolitan law enforcement officer-involved shootings. That is according to one of the most rigorous studies on the subject. Other studies report that the number is actually between 16–46 percent. Either way, it is far too many.

LEOs faced with a person engaging in dangerous or life-threatening behavior with a lethal weapon, or what appears to be such a weapon, discharge their firearm as per their training. However, LEOs must be aware that the escalation is behavior typically intended to provoke such a lethal response. Without crisis team collaboration, LEOs revert to their use-of-force training instinctively. Avoiding unnecessary deaths is obviously optimal, and it seems that more could be done.

Joshua Wesley is a biracial man and resident of Washington County, Oregon. On October 24, 2022, Wesley was 27 years old and a soon-to-be father. Yet that morning, he was experiencing suicidal ideation for the second time in a three-month period, and apparently, he “desperately wanted help from a qualified mental health professional.”

After initiating a three-way call between his former intimate partner and a veteran’s crisis line, the call was forwarded to the local emergency response number. At that time, deputies with the Washington County Sheriff’s Office (“WCSO”) were dispatched to Wesley’s apartment. Wesley had “explicitly requested non-police responders be sent to assist him.” Wesley recognized the importance of receiving emergency care from appropriately trained professionals. Despite having reason to know of Wesley’s condition and current mental health crisis, five WCSO deputies were dispatched. An ambulance was placed on standby at a location near the apartment.

While en route to Wesley’s apartment, WCSO deputies were advised that the call was upgraded from a Priority 2 call to a Priority 1 call. Priority 1 calls are meant for “an emergency where there appears to be an imminent threat to life.” When the deputies arrived at Wesley’s apartment, he was asked to come outside. Although hesitant, and admittedly intimidated by the large police presence, Wesley agreed. He was compliant with commands, was not aggressive, and threatened no other person. Wesley said that he had no weapons on him or in the immediate vicinity.

WCSO Deputy #1 told Wesley that he would be subject to a “Police Officer Hold” because there was evidence that Wesley was suicidal and had recently cut himself. The deputies were aware that Wesley was suffering from a mental health crisis as a result of his mental health disability, but no one attempted to provide the service of a qualified mental health professional—the one thing that Wesley specifically asked for.

WCSO Deputy #1 advised Wesley that he was going to be handcuffed, placed in the back of the squad car, and transported to the local emergency room. Wesley strongly disagreed. He did not want to be handcuffed nor placed in the cruiser. Eventually, Wesley was placed on a stretcher and transported by ambulance to the emergency room. At no time did qualified mental health professionals work to assess, stabilize, or treat Wesley prior to being taken to the hospital.

During transport, Wesley continued to experience suicidal ideation. Upon arrival, Wesley was not placed in the hospital’s secure room, which is an area specifically designated for the purpose of protecting those in the hospital and those suffering from a mental health crisis. While continuing to remain in an unstable mental condition, Wesley was having his vitals taken when he walked out of the unsecured area.

As Wesley approached Deputy #1, Wesley attempted to take hold of the deputy’s firearm, repeatedly saying, “Let me kill myself.” A struggle commenced. Deputy #1 stabbed Wesley several times with his knife in an effort to purportedly keep Wesley from obtaining the firearm. Wesley suffered life-threatening injuries after he was stabbed in the chest, stomach, and head. Wesley remained in the hospital for three weeks. At that point, he was transferred to the Washington County Jail and charged with multiple criminal offenses resulting from the altercation.

After being arraigned in the Mental Health Court of Washington County, Wesley pleaded guilty and received a five-year probation sentence. Wesley suffered serious bodily injury, emotional trauma, incarceration, and was subject to criminal prosecution all because he was feeling suicidal.

If only the WCSO deputies had not been the primary responders to Wesley’s mental health crisis, all of this additional damage could have been avoided. Instead, Wesley was denied the opportunity to be assessed and provided stabilizing treatment at his home. The WCSO deputies exacerbated Wesley’s crisis and failed to provide him with appropriate care. His mental health crisis effectively became a crime.

Mobile Crisis Teams

A lawsuit was filed by Wesley in the District of Oregon that alleged violations of federal civil rights law by Washington County, et al. Disability Rights Oregon (“DRO”) filed the lawsuit on behalf of Wesley and other similarly situated persons harmed by deficiencies in the emergency response systems. The suit was filed in early 2024, and as of publication, it has yet to be resolved.

DRO is the Protection and Advocacy System in Oregon that is required by federal law and meant to “ensure that rights of individuals with mental illness are protected.” This mandate is pursuant to the Protection and Advocacy for Individuals with Mental Illness Act (“PAIMI”), 42 U.S.C. § 10801, which was enacted in 1986. The suit also alleged that these acts or omissions constituted violations of the Americans with Disabilities Act and the Rehabilitation Act.

PAIMI requires that states establish and fund systems within each state to protect and advocate for the rights of the disabled, as well as investigate incidents of neglect and abuse of these persons. The suit alleged that Washington County has failed to provide proper medical care to those suffering a mental health crisis under PAIMI. Washington County specifically has failed to provide those with mental health disabilities equal access to, and benefit from, emergency response services and programs.

The suit alleged that when a person suffers from a heart attack or stroke, the county dispatches qualified medical personnel trained to perform triage and provide necessary medical care. But when dealing with a mental health crisis, a person who calls for emergency help is treated as a criminal or public safety threat. Instead of paramedics or a crisis response team, “tactically-trained and armed law enforcement officers who are more likely to exacerbate, rather than resolve, the mental health crisis” are deployed.

DRO asserted this was evidence of systemic discrimination. The suit cited multiple examples of persons harmed in Washington County. When you consider that the U.S. Department of Health & Human Services finds that most “people with mental illness are not violent” and less than five percent of “violent acts can be attributed to individuals living with a serious mental illness,” the conduct of Washington County officials appears more egregious. It is further recognized that those with a severe mental illness are “over 10 times more likely to be victims of violent crime than the general population.” Despite these facts, the defendants operated a mental health crisis response system that “prioritizes the reduction of perceived risk of public harm over the actual need for medical aid and treatment.”

Washington County previously acknowledged this deficiency by creating a Mobile Crisis Team (“MCT”). It also had LEOs that received advanced training as part of the WCSO Mental Health Response Team (“MHRT”). The WCSO MHRT was intended to provide LEOs who had received “Crisis Intervention Training,” or CIT, which is designed to reduce serious injury or death when there are interactions between LEOs and those in crisis. Yet according to an article published by Michael S. Rogers et al., titled “Effectiveness of Police Crisis and Intervention Training Programs,” there is scant evidence in peer-reviewed literature “that shows CIT’s benefits on objective measures of arrests, officer injury, citizen injury, or use of force.” Still, the County was mandated to provide any CIT-trained personnel that it had available.

The County’s MCT is the sole provider of non-police response for situations involving mentally ill individuals. The MCT is operated by LifeWorks NW. Pursuant to a contract between Washington County and LifeWorks NW titled “Washington County Community Human Services Program Contract Agency Agreement,” a crisis response team is supposed to be available 24/7. However, according to the lawsuit, Washington County has failed to “sufficiently fund and adequately staff the [MCT].” It often does not deploy the WCSO MHRT under appropriate circumstances. These systemic failures have resulted in unnecessary discrimination and harm to several individuals.

The DRO suit is direct evidence that we have a long way to go. As discussed, LEOs claim to want rapid on-site assistance from MCTs mandated by federal law. Yet the CIT that LEOs and MCTs receive is clearly underutilized. And despite evidence that CIT isn’t as effective as it might otherwise be, it is at least a step in the right direction. It surely couldn’t have caused Wesley any greater trauma than he experienced in its absence.

Feedback from many communities indicates that the proper use of the CIT model for MCTs has been used to effectively, and safely, deal with psychiatric emergencies. The purpose of these models is to continue to decrease hospitalization or incarceration by facilitating the resolution of a mental health crisis where it’s occurring. And if such a resolution isn’t possible on-site, MCTs can act as a liaison between the individual and appropriate mental health care systems with the ultimate goal of potentially eliminating arrests and criminalization. When hospitalization is necessary, the MCT can gain access to emergency care faster than they would through referrals by LEOs.

An MCT can be primarily composed of LEOs, mental health professionals, or both. This separate strategy involves the use of MCTs that use mental health consultants who work for the law enforcement agency but are not LEOs. Then there are those that use psychiatric emergency teams composed of mental health professionals that act in concert with law enforcement agencies to provide on-site responses. In this example, they are not directly connected to the agency at all—they are independent professionals.

No matter how an MCT is constituted, the most important elements are training and information. It is an imperative goal for responders to ascertain all available information about the person in crisis and any past interactions with law enforcement. This includes information about suicide attempts, possible or actual violence, and how previous crises were resolved. It has become productive to include photographs of the individual taken by the MCTs. These photographs are loaded into the law enforcement databases and made available to the LEO through their computer systems. This allows the responder to see how the person may have changed over time.

MCTs that incorporate mental health professionals allow for this database information to include a complete mental health history. LEOs don’t necessarily have access to confidential medical records, nor should they. But qualified health professionals are legally entitled to such medical information. A complete description of the person’s condition(s), prior history, and how prior crises were resolved facilitates safe and effective resolutions for everyone involved. Having as much relevant medical history information available will also allow appropriate and effective treatment by the clinicians at the emergency department to be initiated in an expeditious manner.

A final piece of the MCT model is consistent collaboration and feedback. This is crucial. The successful development and maintenance of specialized MCTs requires continuous program evaluation. No evaluation is complete without all the available, necessary data. Response times, arrest rates, selected mental health alternatives, and similar data provide feedback about the MCT’s effectiveness. It also allows for needed improvements by identifying deficiencies in the MCT models.

Many LEOs recognize that current training systems are deficient. “On the whole, we’re doing terrible,” said Jim Burch, the president of the non-profit National Police Foundation (“NPF”). The NPF is an organization that focuses on police training and research. Burch added, “We have to do much, much better at being able to recognize these types of issues and being more sensitive to them.” And Burch isn’t wrong. It has to improve.

Cooperation at all levels will lead to more success and less harm to the vulnerable. It is vital to acknowledge that the rates of damaging contact between the mentally ill and LEOs reveal more about our society than they do about the perceived criminality of those with mental illnesses.

Training Priorities and Reformation Objectives

Current training generally leaves LEOs unable to identify and correctly respond to persons in a mental health crisis. LEOs have identified multiple areas of concern. Some areas needing improved training methodology and information include: identifying the mental illness exhibited, responding to specific psychotic behavior, handling actual or potential violence displayed; responding to threats of self-harm or suicide; and recognizing when an MCT should be notified and utilized. LEOs should also be made aware of what community resources are available and how to access them.

Whether it is autism or mental health, disabilities leave members of our society in a vulnerable position when situations require the intervention of law enforcement. The most effective training process is evidently that which incorporates collaboration between mental health professionals and law enforcement. Its success requires greater levels of active participation by trainees. “Just training in and of itself is not going to create that long-term change that we are hoping for,” observes Lee Ann Davis, director of criminal justice initiatives for The Arc’s NCCJD.

Sam Crane is the legal director of the Autistic Self Advocacy Network and makes a pertinent observation. Crane argues, “If you have 50 hours of training on how to make sure you’re in control at all times and tackle people, and then four hours of training on how to deal with autistic people, you’re not going to be acting on those four hours of training in a crisis.” The minimal training would require LEOs to acquire familiarity with the common classification of mental disorders, just as mental health professionals are required to do.

LEOs must learn and demonstrate crisis intervention skills, like how to place those suffering a crisis in touch with meaningful resources that are less restrictive than just direct hospitalization. They should also become familiar with laws that affect the mentally disabled. This is specifically true in regard to laws that allow involuntary psychiatric evaluation and treatment.

The training must place significant emphasis on situational de-escalation techniques and minimizing the use of deadly force on those with mental illness. If LEOs are unable to complete such training, they should not be allowed to be psychiatric first responders. Not every LEO is cut out to be a street-corner psychiatrist, and the implementation of expanded training protocols should not end with psychiatric disabilities. It must extend to all disabilities. Experts suggest that this training should be mandated to begin at the academy. It is also suggested that training should involve the highest-ranking LEOs in an agency.

This top-down approach allows for executive decisions to direct the conduct of LEOs at the street level. If the administrators for the law enforcement agency have also received the necessary training, that knowledge can be utilized to facilitate the greatest systemic changes. And that can’t happen without meaningful CIT for working in conjunction with MCTs. If the heads of these agencies don’t understand what is going wrong and why, then how can we ever expect the LEOs to act accordingly?

Another important piece of this overall puzzle is developing national uniform standards for law enforcement training. “Training is all over the place. From nonexistent to proficient,” said Allen Copenhaver, an assistant professor of Criminal Justice at Lindsey Wilson College.

Even without further training, there are already laws like the ADA and the RA that mandate certain protections for the disabled. Law enforcement agencies at the state level are covered by the RA mandates if they receive federal funding; the ADA mandates cover these agencies whether they receive federal funding or not. The ADA governs almost every action the LEO might take. This includes: taking complaints; the interrogation of witnesses; the arrest and booking process; the operation of 911 call centers; providing emergency response medical services; and the enforcement of laws.

The ADA covers anyone who is legally “disabled.” Generally, if the person has a physical or psychological impairment “that substantially limits one or more major life activities,” they are covered by the protections of the ADA or RA. A “major life activity” can be things such as “caring for one’s self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working.”

A substantial limitation is when activities are “restricted in the manner, condition, or duration in which they are performed in comparison to most people.” People with disabled loved ones should really educate themselves on the implications these laws have on their local law enforcement agencies. The information is comprehensive, technical, and too immense to be fully included in this report, but it could save a loved one’s life.

Across the country, citizens are making changes at the grassroots level, and that is how change will come. When citizens and advocacy groups place pressure on law enforcement agencies and state and federal legislators, notable programs can be created and implemented. This has already happened in several states.

For example, in Eugene, Oregon, the White Bird Clinic runs Crisis Assistance Helping Out on the Streets, or CAHOOTS, a program that reroutes 911 and non-emergency calls to mental health and substance abuse professionals. CAHOOTS was created in the 1980s. This organization allows professionals to respond instead of the police. CAHOOTS receives roughly 24,000 calls per year. “There’s really a constructive relationship that we have with law enforcement because they see us as experts,” said CAHOOTS operations coordinator Tim Black. CAHOOTS organizations also exist in Denver, Colo., Olympia, Wash., and Oakland, Calif. In New York City, a similar pilot program serves the same purpose.

Legislators have been making some efforts as well. In 2004, Congress passed the Mentally Ill Offender Treatment and Crime Reduction Act (“MIOTRA”). MIOTRA provided funding for the creation of mental health courts that focus on rehabilitating juveniles and adults with disabilities. The emphasis is on first-time offenders and finding alternatives to immersion and entanglement with the criminal justice systems.

In 2020, the bipartisan National Suicide Hotline Designation Act was passed by Congress (“NSHDA”). NSHDA created the direct-dial 988 number. Calling 988 reroutes mental health emergency calls directly to those professionals trained to provide mental health care. This helps avoid putting LEOs in the position of giving psychiatric first aid; it also saves resources where they can be utilized. It should also save people like Wesley from being seriously harmed during police responses.

There are also some organizations that operate at the international level. One such group is Dignitem Foundation. This foundation published a treatise called “For Inclusive Quality Police Services for Persons with Disabilities: 10 AREAS OF ACTION.” The Dignitem suggestions are modeled on the “United Nations Convention on the Rights of Persons with Disabilities.” The convention’s goal is to “promote, protect, and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity.”

Some of the largest law enforcement agencies in the U.S. are also creating permanent programs to reduce the victimization of the disabled. Of the nation’s 50 largest police agencies, 62 percent have already begun establishing programs since 2020.

Bexar County Sheriff’s Office (“BCSO”), Bexar County, Texas: The BCSO serves around 2 million people. The BCSO has created the Specialized Multidisciplinary Alternative Response Team (“SMART”). SMART consists of two teams. One team is staffed by civilians, the other by LEOs. However, SMART is only deployed to calls determined to be “nonviolent mental health calls”; and we already know that is very subjective.

Denver Police Department (“DPD”): The DPD serves about 780,000 people. The DPD has created, or works in conjunction with, a Crisis Intervention Response Unit, an Outreach Case Coordinator, an Assessment, Intake & Diversion Center, and a Support Team Assisted Response.

Harris County Sheriff (“HCS”), Harris County, Texas: The HCS serves nearly 2.1 million people. The HCS oversees the county’s jail that has extensive mental health programs, including the Competency and Sanity Evaluation Unit, the Jail-Based Competency Restoration Unit, and the Community Assistance Resource Program. The HCS also provides CIT to LEOs and runs the Clinician and Officer Remote Evaluation program.

Houston Police Department (“HPD”):c
The HPD serves about 2.3 million people. The HPD uses CIT training, Crisis Intervention Response Teams, a Crisis Call Diversion program, and a Chronic Consumer Stabilization Initiative, among many others. Some of what the HPD also requires of its LEOs are 40-hour CIT training for all cadets; 8-hour annual Advanced CIT classes; 8-hour refresher courses; and mandated 8-hour de-escalation classes for all cadets.

Los Angeles Police Department (“LAPD”): The LAPD serves almost 4 million people. The LAPD uses a multi-layer approach that includes trained dispatchers, 24-hour triage lines for LEOs, embedded mental health professionals, and a robust 40-hour Mental Health Intervention Training course.

Miami-Dade Police Department (“MDPD”): The MDPD serves around 2.75 million people. The MDPD operates a mobile crisis unit and a co-responder unit. It also operates the Data Access and Collaboration on Treatment Alternatives program that collects data about interactions between LEOs and the mentally ill.

Tucson Police Department (“TPD”): The TPD serves nearly 600,000 people. The TPD has created a Mental Health Support Team (“MHST”) that pairs MHST LEOs with mental health clinicians to provide proactive and compassionate services to those in crisis; a Crisis Intervention Team training program, and works with MCTs.

Wichita Police Department (“WPD”), Wichita, Kansas: The WPD serves around 389,000 people. The WPD has created a co-responder unit called the “Integrated Care Team,” which works with COMCARE, the largest community mental health center in Kansas.

These are just some examples of the programs being created and implemented by agencies across America. But they do need oversight and evaluation. We can’t just trust that the law enforcement agencies will reform themselves. We need to know what does, and doesn’t, work. “We need to appropriately respond to people’s needs and reduce the likelihood that something damaging will happen in a crisis,” said Dr. Philip Yanos. “And we need to be systematically studying these programs as we roll them out.”

Conclusion

The stories of Robert Ethan Saylor, Brian Sterner, Steven Stairs, Lisa Edwards, and countless others are not isolated tragedies—they are symptoms of a deeply broken system that criminalizes disability and prioritizes force over compassion. The alarming frequency with which disabled individuals are brutalized, incarcerated, or killed by law enforcement reveals a fundamental failure in policing, training, and societal priorities. These encounters should never escalate to violence, yet time and again, LEOs default to aggression rather than understanding, compliance rather than care. The consequences are devastating: lives cut short, families shattered, and trust eroded in the very institutions meant to protect the most vulnerable.

But this is not inevitable. Change is possible—if we demand it. The solutions exist: robust crisis intervention training, widespread deployment of mobile crisis teams, meaningful accountability for officers who harm disabled individuals, and systemic divestment from punitive policing toward community-based mental health care. Programs like CAHOOTS, SMART, and CIT demonstrate that alternatives work when given proper funding and support. Yet too many departments still resist reform, clinging to outdated tactics that prioritize control over de-escalation. The Americans with Disabilities Act and Rehabilitation Act are clear: law enforcement must accommodate disabilities, yet officers routinely violate these protections with impunity. True reform requires dismantling the culture of compliance that views non-normative behavior as a threat. It means shifting resources away from militarized policing and toward mental health services, housing, and disability advocacy. It means holding officers—and the departments that enable them—accountable when they fail to uphold their duty to protect.

The fight for justice is not just about preventing the next tragedy—it’s about affirming the dignity of disabled lives. No one should fear that an encounter with police could turn deadly simply because they move, speak, or react differently. No parent should worry that their autistic child’s meltdown could end in handcuffs or a bullet. No deaf individual should die because an officer mistook their inability to hear for defiance. We must reject the notion that disability is a crime. Instead, we must build a system where law enforcement serves rather than terrorizes, where crisis response prioritizes care over coercion.

The disabled community has long advocated for these changes. It’s time for the rest of society to listen—and act. The stakes are not abstract; they are measured in lives lost and families destroyed. The question is not whether we can afford to reform policing—it’s whether we can afford not to. The answer, for the sake of justice and humanity, must be a resounding no. Enough is enough. The time for change is now.  

Sources:abcnews.com; aclu.org; ada.gov; americanprogress.org; bjs.ojp.gov; cssjusticecenter.org; chicagotribune.com; dhhsc.org; enablingdevices.com; illinoisttaonrygeneral.gov; innocenceproject.org; johnjayimpact.org; knoxnews.com; kffhealthnews.org; nih.gov; pewtrusts.org; policebrutalitycenter.org; providencejournal.com; spectrumnews.org; sportskeela.com; time.wm; un.org; usatoday.com; voanews.com; wthr.com

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