Mental illness in suspects poses challenge for police — (Pittsburgh Post-Gazette)

After John Rush was arrested two years ago for assaulting his then-girlfriend, a worker at the Allegheny County Jail’s behavior clinic recommended that he receive outpatient treatment for an unspecified mental illness.

That detail, and further information about the 21-year-old’s diagnosis, was not available to Allegheny County sheriff’s deputy John Herb last week when he spotted the fugitive who was wanted on two bench warrants and a fresh assault warrant. Rush, police said, punched the deputy and later killed a Pittsburgh police dog and injured several officers who were trying to arrest him.

A history of mental illness, law enforcement officials say, is one of several factors they consider when executing an arrest. But strong federal and state privacy laws often prohibit officers from receiving even the most basic information about someone’s mental health status.

It’s an information gap local authorities said they hope to bridge.

“We believe that such information is critical to the safety of both law enforcement personnel and the person being sought for questioning,” said Mike Manko, spokesman for the Allegheny County district attorney’s office.

Mr. Manko said the DA’s office is working with other prosecutors and legislators to amend the state Health Information Act to “provide law enforcement with basic information about whether or not a person being sought on an arrest warrant has had any mental health diagnosis.”

Several tools available

Police officers have several tools they can use to check a person’s history.

In Rush’s case, they could have used the National Crime Information Center database and discovered that he had been convicted of statutory sex assault, simple assault and other crimes.

They could have run a firearms check to see whether he was licensed to carry a weapon in Pennsylvania or whether any number of factors barred him from legally having a gun. Involuntary mental health commitments and felony convictions are among the factors that strip someone of the right to legally carry a firearm, but the check will not always indicate why someone was barred from owning a weapon.

Occasionally, officers get lucky and find family members who can tell them about a defendant’s mental state, psychiatric medications and triggers.

In some cases, the name of a judge issuing a warrant can signal to Allegheny County sheriff’s deputies that someone might have a history of mental illness.

For example, Common Pleas Judge Beth A. Lazzara has presided the last three years over mental health court.

Most days, she presides over general criminal court cases. On Mondays, she hears cases assigned to the mental health court docket. By the end of the session, she must issue bench warrants for the defendants in the program who failed to appear for court.

When that happens, she said, sheriff’s deputies serving the warrants probably already know the defendants in question have some form of mental illness because Judge Lazzara is the one issuing the paperwork.

But in cases outside of mental health court, the notification isn’t there.

“As far as how do we know the stability of the individual we’re going to get, usually, we don’t know that,” Sheriff William P. Mullen said. “We like to have as much information as possible when you’re dealing with people we’re picking up that are wanted, but we do understand that there are certain laws that we must abide by.”

Sheriff Mullen said he believes the federal Health Insurance Portability and Accountability Act, which protects the privacy of someone’s medical records, restricts what information court workers can put on bench warrants. Those warrants are part of the public record, and thus, the general public can often access them.

Judge Lazzara questioned whether the reach of HIPAA has become overbroad, and whether it would be possible to simply note on the warrant “history of mental illness” without giving a specific diagnosis.

She believes the notification to officers should exist.

“It’s a no-brainer. How do we not provide them with the information that they need?” she said.

“To me that’s a safety thing for the officers. I would think they’d want to know. They need to have sufficient information to ensure everyone’s safety involved.”

Training is available

Exactly what impact mental health history has on a person’s arrest depends upon the way the department views mental illness and the circumstances surrounding the arrest.

Sheriff Mullen sent some deputies for specialized training to teach them how to interact with people with mental illness. Four of his deputies attended Crisis Intervention Team training organized by the Allegheny County Office of Behavioral Health and hosted by Pittsburgh Mercy Behavioral Health. Pittsburgh police have been training officers in the program for the past several years.

The training runs over the course of five eight-hour days. In one class, officers wear a headset that plays a recording of voices shouting while instructors ask them to do routine tasks.

“Officers get some even vague hint of what it’s like to live life hearing voices all the time in your head,” said Sue Martone, deputy director of the county Office of Behavioral Health.

Another session focuses on “tactical communication,” or how officers should interact with mentally ill people. Some illnesses might make people more sensitive to loud noises and yelling, while others might signal that the person doesn’t typically like to be touched, Ms. Martone said.

A separate class teaches officers about medications and the illnesses with which they are associated so they know that if someone takes Prozac, for example, the person might be depressed.

But there are differing schools of thought on what officers should do with that information.

Some believe it could help them prepare for whatever situation they’re about to enter. Others, Ms. Martone said, ask: “What if that person’s mental health history has nothing to do with the incident that is taking place right now? They’re stable. They’re taking their meds.”

Judge Lazzara said it’s sometimes smart to take the opposite approach.

“The thing with the warrants is, if they’re on the run, you have to assume they’re off their meds,” she said.

Sheriff Mullen said the presence or lack of violent offenses in a person’s past is often more indicative of how they will interact with deputies than their mental health diagnosis. He said deputies scuffle with people every week but added, “I can’t remember the last time we’ve had a major problem with someone who had mental problems outside of John Rush.”

Information that someone might be violent or might be unstable “all comes into play when you arrest somebody,” and could prompt a department to send extra deputies, he said. But often deputies are working solo when they encounter a fugitive and have to make an arrest or risk losing the person.

“You’d like to prepare for the worst, but in this line of work, you frequently just can’t do it,” he said.