I don't know about NYC's new program, but Portland has been doing something like this for a couple years. They send out teams of a medic from the fire department and a counselor/social worker with specific training in deescalating acute mental health crisis.

There have been no incidents of these teams being attacked or injured.

This "under siege" mentality that the police have adopted as central dogma, which clearly has spread to you as well, is the problem.

I'd suggest reading the various interviews and comments from Patrick Skinner. He's been on a solo crusade for a more compassionate approach to beat policing for a few years now. He gets a lot more clout with police with it though, as he's ex CIA, so no one questions his machoness. The very core of his approach is "how would you solve this without a badge and gun?"

It's simple. It works. It's moral. It doesn't mean we abandon society to anarchy, it just means we stop seeing citizens and police as enemies of each other, where the default assumption is that a restraint and a gun are necessary to even have a conversation.

https://www.inquirer.com/news/west-philadelphia-police-shoot...

In the UK for example, the normal beat police do not have guns. If they approach a situation where they feel in danger, they're trained to back off and call for either more backup or an armed response. Turns out most of the time whatever the issue is will still be there when backup arrives. On the other hand, if it's a simple issue, they can just deal with it and there's a much smaller chance someone gets shot.

I can see that helping in some situations, but how does that help when the situation really is urgent?

Say you have someone who is violent and irrational due to drug intoxication and they need medical aid or they'll die, yet it's not safe to provide that. What is the answer in that case?

I'm only half joking.

In all of the recent cases that have blown up in the US though, this was never the issue. The issue was the situation escalated way beyond where it should have. George Floyd was being arrested for using a supposedly counterfeit $20 bill. Maybe they could have just let him run. I'm sure the US economy won't be ruined by there being an extra $20 in circulation.

In the EMT case, I think we have to think about the alternative outcomes. If the EMTs can't help because the person is irrationally violent due to drugs, and the EMTs can't restrain them, I don't really see why calling the cops would make the situation any better. All they're doing is providing more hands, which could be done by simply having more EMTs. If they have a gun, then call the police. If they don't, they're unrestrainable, and you can clear out members of the the public, just let them be. The only other options simply make the situation worse for the person. Even using a taser in that situation can cause a heart attack.

In aggregate it would be.

It's like thinking you'll win the war on drugs by arresting weed smokers, except even less effective

We know from plenty of examples that in the scenario you describe there’s a high chance that the individual will end up shot by the police, and probably dead. We know police don’t have the training or the tools to handle this scenario well.

I don’t see how brining in people with better training could be a detriment. Worse case you ended up back where you started, the “violent and irrational” person ends up dead. Best case they successfully deescalate and render appropriate treatment, saving their life.

Not sure where the downside is.

The data simply do not comport with the position you are advocating. Here's some old (2005) data: https://www.bjs.gov/index.cfm?ty=pbdetail&iid=653

- 20% of people in US had contact with police in the year. - 9/10 people reported police acted properly - 44 million people with interactions, only 1% of those had violent conflict involved with the interaction, that's 440 thousand incidents

Hell, even the left-leaning WaPo tried to use data to buttress their/your argument and it's just plain embarrassing: https://www.washingtonpost.com/graphics/investigations/polic...

- 1000 people shot by police in 2019 - they actually removed the numbers for unarmed, because it was so dismal for their message - less than 50 "unarmed" black people killed by police in 2019

Take an honest look at these numbers and then please try again to justify your position about how there's a "high chance that the individual will end up shot by the police" because by the light of the data you're living in a fantasy land.

But then my next question is, what does a police officer bring to the table other than a gun? What unique skill and tools does a police officer have that could help resolve such a scenario peacefully, that wouldn't also be available to someone specially trained in dealing with mental health issues?

The UK has ~5 guns (legal and illegal) per 100 civilians.

The US has 120 per 100 civilians.

https://en.wikipedia.org/wiki/Estimated_number_of_civilian_g...

I think it goes down with many more factors applying at the same time, not just „guns“.

Domestic abuse/violence, threatening behavior towards third parties or behavior that's so unpredictably out of line that you can't confidently sit back and not deal with it because you'd be wondering if others would be placed in danger by your non-action.

I'd say that most of the comments in this thread are very out of touch with reality and firmly in the realm of wishful thinking.

But to answer your question directly, there are tons of simple things you can do, from body language to tone. They aren't really a mystery to figure out either. Start with empathy and asking how you can help.

Like I mentioned above, Patrick Skinner distills this succinctly with "how would I solve this problem without my badge and my gun?" and in particular, using the example of if your next door neighbor asked you for help with some minor crisis.

Treat your neighbor that lives rough the same way and it's amazing the difference in reaction you get.

Assuming violence is necessary from the start becomes a self fulfilling thing.

I listened to the local dispatch until recently when the cops switched to encrypted channels. Fire/EMS is still available though.

How do you know this?

We have already made this transition once. Police are no more able to handle someone experiencing an emergency mental issue as they are able to handle someone having a heart attack. Why not change the system to get the proper people on site as fast as possible?

99 Percent Invisible recently did a great podcast on the early history of EMT services and ambulances.

https://99percentinvisible.org/episode/freedom-house-ambulan...

> Presumably there would be some up front report and assessment of whether the person is exhibiting violent behavior.

That's a very presumptuous thing to presume, when the person who actually has personal experience with the matter says that dispatch is notorious for misevaluating situations (surely through no fault of their own much of the time, since dispatch is not on the scene and can only relay what they've been told.)

Deep structural problems.

I was implying that the call centre worker is probably less credentialed than the EMT.

Yours in a strong point though: dispatch can only pass on what they know, so their misevaluation may not actually be the result of mistakes or a pack of training, and I probably shouldn't have read that meaning in to OPs words.

Thank you.

I don't think doing an action to have the policed called on you is the best approach, considering it can be weaponized by dishonest actors.

Purple call the police on someone yelling. A mentally ill person yelling isn't a danger. They might be in crisis or pain, or they might be unable to effectively communicate.

A gun didn't help in any of those, the vast, vast majority of cases.

So to reiterate, nobody in this thread has presumed as bluntfang claims.

As I see it, that's just common sense. If you get a call from a woman telling you she's fallen down and is hurt, how likely is it that EMTs are met at the door by a drunk man who claims nothing is wrong? What first appeared to be a simple medical situation may actually be a case of domestic violence. Neither the dispatcher nor the EMT can know this before anybody arrives on the scene, so whoever gets there first needs to be cognizant of all possibilities. Recognizing the possibility that somebody might be violent is not the same as believing they will be.

> As I see it, that's just common sense. If you get a call from a woman telling you she's fallen down and is hurt, how likely is it that EMTs are met at the door by a drunk man who claims nothing is wrong

This is

1. Exceedingly unlikely

2. A situation where escalating might be warranted, but the person who knocks on the door isn't in imminent danger.

3. You wouldn't bring a police officer to this call, but as you've so clearly pointed out, there's a chance it could turn violent. The logical conclusion here would be that police should respond to all medical emergencies, but they don't for reasons that become clear if you look into the history of how separate medical emergency response came to be.

There is always risk.

Suicide rates are a separate issue.

The first is mental health issues are a very wide umbrella. This includes anxiety, depression, and things like eating disorders which all parties can agree are probably not associated with increased rates of violence.

But if we limit it to diagnoses like bipolar or schizophrenia I'm sure there are increased risks of violence.

My mother (who had schizophrenia) for instance was fine 364 days a year. But on the 365th she'd try to claw my grandmother's eyes out because she thought she was the devil. And EMTs and other people who aren't being called out to deal with my mother on the 364 days a year she's fine.

The other issue with those studies is they control for a host of other factors to get the conclusion it's not correlated with violent crime.

If you just look at a bland, we separate people into two buckets, mentally ill and non mentally ill. Which bucket commits more violent acts per capita, the mentally ill do. You have to do a lot of statistical correction before you found that mental illness isn't correlated with violence.

But what about the rate of violence among mental ill people who are committing some action that warrants a 9-11 call? What exactly leads to someone calling 9-11? It isn’t that someone is sitting in their house mentally ill — they are doing some action that is concerning enough to warrant a callout. So among that group of mentally ill, what’s the violence rate compared to the “general population.” It’s going to necessarily be higher.

I honestly think most people opining on the subject have never worked as a front line first responder before. It’s like news pundits talking about battlefield tactics when they have never been in combat. Lethal force should obviously be a last option, but when some literally insane person starts lunging at you with a knife all that theory of “the best way” goes out the window. There are thousands of mental health “dangerous” 9-11 calls happening every day and the vast majority end peacefully. Police on-duty firearms discharges are very rare but people act like it’s an epidemic because these incidents get magnified and broadcast to make people think it’s a frequent occurrence. How many mental health 9-11 calls end violently? 1 out of 10,000? 1 out of 100,000? Without knowing that number, any implication that this is a systemic problem is grounded in emotion rather than data. There are also unintended consequences. Saving that 1 out of 10,000, could result in an increase in risk that would offset any gains from such policies.

If NYC wants to experiment, good for them. I am not opposed to a better way. I am concerned about unintended consequences of policies — consequences that are often ignored.

This doesn't follow. People don't call the police for mentally bill people being violent, they call for them being disruptive, or in the best case, perceiving the mentally ill person as a threat.

Neither of those implies any violent action on the part of the mentally ill person. People are primed to assume that any sort of abnormal behavior is dangerous or implies potential for violence. That doesn't really follow.

Not do we even touch on second order effects like how escalating aggression with mentally ill person will lead to more aggression in response.

What we do have, already, is fairly conclusive data that these policies do work, in other nations and our own.

I mean, what’s does this guy know? It’s just his day to day job.

I don't get that - a mental health emergency is a health emergency (the clue is in the name)... which is what EMTs are for aren't they?

Would you have higher hopes for this pilot succeeding if these mental health professional made as much as cops? I think that is supposed to be the logic of defund the police. But yeah 12/hr is a crime.

I personally like EMS because even though it's not exactly _safe_, if someone is acting out the cops deal with them, and if something is on fire or spewing ethyl-bethyl-bad-stuff into the air, fire/HAZMAT deals with it. We're the smart people in the wee-woo box that primarily focus on patient care with our friends in law enforcement and fire close by.

My issue with it is that EMS and a "mental health professional" could easily get stuck in a situation with a violent, armed person and be at the mercy of police coming from a separate location to help in an emergency. Sure, the vast majority of patients are not like that, but it doesn't make sense to me to take the risk. In my experience, having police on scene but keeping their distance is fine and patients usually understand when we say they're not in trouble and anything they say to us is confidential. Some other services probably don't do it as well, especially since police get there faster most of the time.

https://www.police1.com/columnists/charles-remsberg/page-12/

Most of the abuse I've seen is by officers who either were never given the training Remsburg presents in his books or ignored it.

It sounds like this is one of the major issues, if not the most important issue. Nobody is going to attempt to repeal the Second Amendment, and trying to do so would cause way too much upset in a country where gun culture has been ingrained in the populace since its founding.

I personally believe that so long as guns are so widely available, and mentally ill people who are predisposed not to seek or have no treatment available exist (which given human nature pretty much always will), gun violence will continue to occur, and so the police and other responders will assume that they could be killed from guns in risky encounters. All it takes is one mistake in determining that someone does not have a gun to have someone killed and make headlines and potentially be remembered for years.

I wonder how I would feel about the gun laws in the U.S. if I were born and raised in a country that prohibits firearms. I would prefer to live in such a country but very few people directly affected by the violence have the option of leaving. I also wonder how many people would be accepting of guns today if we didn't have the Second Amendment from the beginning, and people didn't end up receiving the impression that the founders of the country affirmed gun ownership. Trying to cut back on the violence with the gun culture continuing sounds very complicated to me.

This is not to underrate your personal experiences, just that situations can be different in different places. Guns in NYC are fairly rare, but your comment holds true with any weapon.

NYC has an extreamly low violent crime rate, and a murder rate that is nearly non-existent. And that crime rate is dropping lower and lower: https://www1.nyc.gov/assets/nypd/downloads/pdf/crime_statist...

It is possible that our crime rate is reaching a low enough valley that this might be successful here.

What, are you kidding? This is a crazy statement to make. Guns are everywhere here in NYC and everyone who lives in an actual NYC neighborhood knows this.

I've lived in NYC my whole life. I always knew kids that had handguns, I knew people that sold them, I knew people that would buy them every chance one came on their radar.

I was at my local deli today and heard a 45 year old gentleman telling another older person about the new Smith & Wesson they had for sale.

> that crime rate is dropping lower and lower

That's not really the "crime rate" that is dropping lower, but rather the number of crimes booked by police officers. Police spent months not responding to, nor intervening in, basically any crimes committed in NYC in 2020. The incidence of crimes committed against innocent citizens in NYC - as well as the gun crimes - all are rising dramatically, as anyone who lives here would be quick to tell you.

I am impressed with the amount of disinformation in this post, given how few words you actually wrote.

When I was a when I was maybe 15 I was on the roof of a building when someone reported a visible gun. With 15 minutes my friends and I were surrounded by police and questioned as they looked for the gun. They did find the person about 10 minutes later.

I also had a kid in my school shoot himself in the leg by accident because he thought he'd be cool and tuck it in his pants. The closest I ever come to an active shooting.

I stick by my statement that guns are extremely rare in NYC. They are not non-existent, but they aren't at all common place.

The nypd downplaying crimes is a significant real issue, that is true. But that only fuels the the thesis that what is proposed may work here.

I grew up right outside of NYC, spent A LOT of time there. I then lived in NYC for about 8 years. I never saw, heard of or experienced what you described. Nor have I ever communicated with anyone that shared a similar experience.

Can you be more specific about what 'neighborhoods' you refer to?

There are police openly carrying guns on every street corner in NYC. There must be like a hundred thousand guns in the city minimum. Your idea of ‘rare’ is delusional even if we just consider the police let alone everyone else.

- they get tased, pepper sprayed, and thrown around by law enforcement officers

- they get a less safe drug like midazolam, lorazepam, or haloperidol

- they get restrained and fight against the restraints which puts them at risk of sudden death and rhabdomyolysis

In some of these cases, it seems like the officers could have tried to de-escalate the situation while keeping these options in reserve in case that failed. The choices don’t have to be either immediate compliance or overwhelming force.

Even with animals—-where the use of drugs is a lot less ethically fraught—-ketamine isn’t necessarily the first option.

https://en.wikipedia.org/wiki/Death_of_Elijah_McClain

"normal" dose would be something like 10-30mg

Also, this scenario does jive with what I'm saying. Ketamine is generally safe. Would you rather have a shot of ketamine, mechanical disablement (multiple broken bones), or a shot of 9mm? These officers could have moved higher up the force continuum without the ketamine, even killing him in other ways (intentionally or accidentally). Are you saying tasers should never be used also?

I believe the vascular restriction (that they shouldn't have used) is the reason he was brain dead.

Forcible injection is up there with taser and pepper spray. I don't think anyone wants to be forcibly injected with an unknown substance.

When Elijah said he's different, perhaps they could have asked how he's different? Is he autistic, does he suffer from anxiety and panic attacks? Instead you suggest the only plausible alternatives to forced Ketamine injection is him getting his bones broken or 9mm bullet in his body. That mindset is exactly the problem.

Pretty sure the ketamine was before cardiac arrest and brain death. Isn't that the claim - the ketamine caused those issues...

"Instead you suggest the only plausible alternatives to forced Ketamine injection is him getting his bones broken or 9mm bullet in his body. That mindset is exactly the problem."

What mindset is that? What are you suggesting as an alternative once someone has started fighting, (reportedly) grabbing for a weapon, and continuing to struggle once restrained?

It would be great if we had video to confirm that the injection was justified in this specific case. I would have also liked to see what the actions were leading up to the encounter.

If he was actually killed by the chokehold, then no way should someone be injecting Ketamine into someone unconscious or without pulse, especially under the guise of them resisting or being a threat.

If he lost his pulse shortly after being administered too high a dose of Ketamine, then that kinda indicates Ketamine could have been a cause or contributed.

Regarding mindset, while Elijah did resist, the transcript suggests he was eventually compliant and pleading with officers.

> I can't breathe. I have my ID right here. My name is Elijah McClain. That's my house. I was just going home. I'm an introvert. I'm just different. That's all. I'm so sorry. I have no gun. I don't do that stuff. I don't do any fighting. Why are you attacking me? I don't even kill flies! I don't eat meat! But I don't judge people, I don't judge people who do eat meat. Forgive me. All I was trying to do was become better. I will do it. I will do anything. Sacrifice my identity, I'll do it. You all are phenomenal. You are beautiful and I love you. Try to forgive me. I'm a mood Gemini. I'm sorry. I'm so sorry. Ow, that really hurt! You are all very strong. Teamwork makes the dream work. Oh, I'm sorry, I wasn't trying to do that. I just can't breathe correctly.

He was on the ground for an extended period of time and threatened with dogs. An officer determined his "need" for Ketamine before emergency medical personnel arrived, not the medical personnel themselves. The medical personnel then gave him overdose based on his actual body weight.

The police tunnel visioned into the guy being whacked out on drugs, completely ignoring his pleas and explanations, and the medical personnel were complicit in unquestionably following orders of the officers and then administered an incorrect dosage of Ketamine.

Police should consider they might be dealing with someone neurodivergent, that someone "acting suspiciously" might just be anxious or panicking, and may not actually be a criminal or on drugs. Fight or flight and adrenaline are a hell of a combo on their own.

Did he have any diagnosed conditions? If not, then the part about being neurodivergent wouldn't be applicable (but yes, more training on that would be good). It's possible the random language and topics in his pleas were seen as a sign of intoxication, especially with the officer's comment about strength in the struggle. Also, the incoherence could indicate the beginning of a stroke from that hold.

I also think people should look at the Karen involved in this story. You have no reason to report any crime or threat, but you call the police anyways?

Did they ask if he had any conditions before grabbing him and instigating the struggle? Did they ignore his explanations while on the ground, and his breathing complaints? It certainly is applicable, the entire point is to find ways for people to survive interactions with the police, not excuse away deaths caused by police intervention.

There are plenty of instances where 911 calls are outright lies or incomplete information is provided. It is up to the responding officers to take the reports with a grain of salt. Again, your focus seems to be to find ways to redirect blame away from the officers who directly contributed to Elijah's death.

https://en.wikipedia.org/wiki/Shooting_of_John_Crawford_III

https://en.wikipedia.org/wiki/Shooting_of_Tamir_Rice

https://en.wikipedia.org/wiki/2017_Wichita_swatting

I'm not making up excuses. As I've said in my previous comments, I believe the vascular constriction killed him, via a stroke or stroke-like event. What I am saying, is that you seem to be living in a fantasy land where you have some aversion to drugs being part of the force continuum and don't understand reasonable suspicion standards as well as the obligations and rights of citizens during an investigation.

It seems a lot of police have trouble spotting the "fakers". Literally they did a chokehold on him, how much training do you need to understand that causes harm? More excuses from you.

You seem to live in a land where just because it's written on paper and police can legally kill people, that it makes it okay. Maybe policies need to change in light of so many of these tragedies, and the willy nilly use of Ketamine and chokeholds should actually be reconsidered. Hopefully this pilot program is a success, and we can avoid the amateur hour antics that lead to Elijah's death.

On one hand, you have cops trying to pull the man's head off, starving his brain of oxygen. On the other hand, you have a sedative that is renowned for being safe, administered in a quantity that should be safe a few times over. How in the world people look at this situation and blame ketamine instead of the cops is completely beyond me.

Also the recorded audio sounds like he was pleading with the officers and compliant, not that he needed further restraint or sedation.

My point is that even the best training probably won't make the tradeoff of not having law enforcement on scene worth it. Patients with the kinds of issues I listed above - they tend not to respond to being talked down. No amount of babying is going to make the person who's been high on meth and awake for 4 days straight stop seeing the shadow people.

How have you people not realised that a country full of guns will generate constant escalating violence?