Committee Hearing, December 13, 2000

COUNCIL OF THE CITY OF PHILADELPHIA PUBLIC HEARING BEFORE JOINT COUNCIL COMMITTEES ON PUBLIC SAFETY AND PUBLIC HEALTH & HUMAN SERVICES - - - Room 400, City Hall Philadelphia, Pennsylvania Wednesday, 12/13/00 10:05 a.m. - - - RESOLUTION 000684 - Calling for a public hearing before the joint committees of Public Safety and Public Health and Human Services to investigate the untimely death of Mr. Robert Brown, a paranoid schizophrenic patient of the City of Philadelphia's Department of Public Health Behavioral Health System. PRESENT: COUNCILMAN ANGEL L. ORTIZ, Chair COUNCILMAN DARRELL L. CLARKE COUNCILMAN DAVID COHEN COUNCILMAN JAMES F. KENNEY COUNCILWOMAN BLONDELL REYNOLDS-BROWN COUNCILMAN FRANK RIZZO - - - VINCENT VARALLO ASSOCIATES, INC. Registered Professional Reporters Eleven Penn Center, Suite 600 Philadelphia, PA 19103 (215) 561-2220 2 12/13/00 PUB. SAFETY, HEALTH, HUMAN SVCS. I N D E X Elizabeth Brown, Sister of Robert Brown. . . . 5 Estelle Richman, Director of Social Services 25 6 H. Axelrod, Exec. Dir., Greentree School . . . 39 7 Carolyn Ulmer, Acute Services Manager. . . . . 51 Behavioral Health System 8 Captain Michael Whelan . . . . . . . . . . . . 75 9 Philadelphia Police SWAT Team 10 Lieutenant James Gould, Philadelphia Police. . 75 Department Strategic Training Development Unit 11 Darren White, Special Advisor to the Police. . 76 12 Commissioner 13 Sherry Archer, Executive Director. . . . . . . 107 Community Council for Mental Health and Mental Retardation, Incorporated Joe Rogers, President and CEO. . . . . . . . . 110 Mental Health Assoc. of Southwestern PA Sister Mary Scullion, Project HOME . . . . . . 122 Hector Soto, Police Advisory Commission. . . . 139 Investigator William Johnson . . . . . . . . . 152 Chief Investigator, Police Advisory Commission Brenda Cooper-Cutts, Horizon House . . . . . . 162 Lloyd M. Carpenter, Family Member. . . . . . . 164 of Mental Health Patient Otha Brown (for Reverend Wells). . . . . . . . 182 One Day at a Time 3 12/13/00 PUBLIC SAFETY - RES. 000684 P R O C E E D I N G S

Good morning. AUDIENCE MEMBERS: Good morning.

Welcome to the hearing of the Public Safety Committee and the Health and Human Services Committee. Councilwoman Marian Tasco is the Chair of the Health and Human Services Committee and cannot be here. She is ill, called me up this morning, and she sounded as if she was in the throes of deep pain. I told her to take some tea or Puerto Rican rum and that she would be okay. We are here for a resolution, and would the clerk please read the title of the resolution.

Calling for a public hearing before the joint -- Resolution 684, calling for a public hearing before the joint committees of Public Safety and Public Health and Human Services to investigate the untimely death of Mr. Robert Brown, a paranoid schizophrenic patient of the City of Philadelphia's Department of Public Health Behavioral Health System.

Thank you. How many times -- I mean, I know that 4 12/13/00 PUBLIC SAFETY - RES. 000684 Jannie and I have witnessed over the years so many tragedies here in the City of Philadelphia, tragedies that really shouldn't happen and that happen because people are not prepared, people misunderstand, people really are not fully aware of what is happening, even right before their very eyes. We have had in this Council, over the years, more discussion about homelessness and more debate about those individuals and families who are homeless in the City of Philadelphia and the reasons why they're homeless. And we all know that homelessness is not something that you choose as a style of life; it is something that society and other circumstances really bring upon you, and that many of our people and our families who are homeless suffer from certain mental health problems. And we seem to have become hardened at times as a society, we have become afraid, and we try to legislate them out of vision, if not out of existence. But we can't and we refuse to deal with the problems that they have in a realistic manner. 5 12/13/00 PUBLIC SAFETY - RES. 000684 Tragically enough, Mr. Harold Greenwald and Mr. Robert Brown suffered the ultimate casualty: they're dead, and they don't deserve to be. And they are dead because we as a society have not cared enough and we as a government have not cared enough to institute the policies, the programs that are necessary. After all, why waste money on trying to understand people who society believes don't contribute anything that leads to profit. Why waste money on individuals that don't produce anything that we consider a benefit to the overall society. And we walk over them as we walk down the street. It was -- it was -- it was interesting the other day in City Council, last Thursday. We had a hearing about multimillionaires and their castles and their cathedrals, the stadiums. And we had seven families here in City Council. Now, they could have been seven families, they could have been a hundred families; we have hundreds of families, hundreds of individuals on the list, on the waiting list. And these seven families decided to make a political point, the point to really draw 6 12/13/00 PUBLIC SAFETY - RES. 000684 our attention to the incongruity of us discussing giving millions of dollars to people who don't need it, and we don't have the priority to build housing for those who do, and give care, mental health and otherwise, for those who do. The juxtaposition of that situation was to me ironic and sad, and we're here in a hearing that is brought about because of us not understanding the situation of people that are in a very bad situation and that need understanding, and understanding from us more than anyone else. Jannie, do you have anything to say?

Thank you. Thank you Mr. Chairman. And good morning. We certainly thank all of you for coming out this morning and we thank Councilman Ortiz, as Chair of the Public Safety Committee, and Councilwoman Tasco, as Chair of the public Health and Human Services Committee, for agreeing to convene this hearing. We also thank all of you for being patient with us due to all of the changes that have happened with regard to this hearing with dates and times since we've been dealing with other important issues of the hour as 7 12/13/00 PUBLIC SAFETY - RES. 000684 well. We called for this investigative hearing in response to the tragic shooting of Mr. Robert Brown, a severely mentally ill African-American resident of my district. Mr. Brown was approximately 45 years of age and had been battling with schizophrenia since the late '70. He had been in and out of treatment facilities that provided varying degrees of services, and at this stage of his life, he was attempting to live on his own as a productive member of society. Mr. Brown received his treatment from one of the behavioral system's community-based mental health centers, where he allegedly received individual and group therapy, had an intensive- case manager, and received psychotropic medication. Mr. Brown spent his days at 30th Street and was known to many of the local merchants -- this is 30th Street train station -- as well as to the Amtrak Police officers who are there daily. Prior to this incident, he never showed signs of violence. On July 18, 2000, reportedly, Mr. Brown 8 12/13/00 PUBLIC SAFETY - RES. 000684 arrived at 30th Street Station, as he usually did, acting slightly stranger than normal, however. The day before, several retailers also noticed a difference in his behavior. It is not known if his intensive-case manager or therapist was aware of the reported shift in his mood. At some point, from mid-morning to early afternoon, Mr. Brown allegedly stole some tongs from a local pizza shop and taunted the customers with them. Amtrak Police were called for assistance, and Mr. Brown returned the tongs without incident. Shortly thereafter, reportedly, tensions escalated between Mr. Brown and Officers Kelly and Waller of the Amtrak Police. Reportedly, Mr. Brown was asked to leave. Apparently, he attempted to leave twice but something brought him back to the station again. At this point, mild chase ensued between Mr. Brown and the officers. When the chase came to a halt, Mr. Brown apparently felt threatened. Reportedly, there was a cattle prod -- this is what was being said in the station that day, that the officers were trying to hit him with the cattle prod and so he picked up a chair in the 9 12/13/00 PUBLIC SAFETY - RES. 000684 area to defend himself against the cattle prod. Amtrak says that wasn't what happened, that there was no cattle prod, but those were the rumors that were being circulated that day. We will never know for sure because he was then shot in the abdomen and died shortly afterwards on the floor of the 30th Street Station, in front of children, visitors and patrons, and people whom he knew and saw every day. Let me also let you know that this happened in front of McDonald's, and all of us know that is a family restaurant. He was shot at in front of a family restaurant and died there. This incident has been unsettling to me for many, many reasons; the greatest being a fair that low-income mentally ill or homeless people are vulnerable to abuse by figures of authority, and let me know that Mr. Brown's family reports that he was not homeless, that he always had a place with them. But certainly, the situation is the same whether it be for mentally ill homeless people or for mentally people who have residences. We're also concerned about the threat to the public safety when Mr. Brown was shot in 10 12/13/00 PUBLIC SAFETY - RES.

000684 front of a McDonald's at 30th Street Station, with people coming to and from various trips and to and from the station, as they do every day. When laws or procedures are vague or not enforced, some people with power will have the ability to take advantage of those least empowered. Others improperly trained or lacking experience can strive to manage chaotic situations through the use of force. Due to their illness and social isolation, the homeless and/or mentally ill are often invisible and voiceless until they cross a path with mainstream society who does not tolerate the difference. Because mentally ill and/or homeless persons often exhibit strange behaviors, may dress funny, have poor hygiene habits -- none of these applied to this gentleman -- and rather sleep in the streets than at home, we tend to dehumanize them and want them locked away from public view because they do not fit the, quote/unquote, American Dream. Unlike the Brown family, many family members of mentally ill persons get overwhelmed and abandon their loved ones, leaving them to the 11 12/13/00 PUBLIC SAFETY - RES. 000684 care of institutions by way of case managers, psychotropic drugs, and treatment plans. With the deinstitutionalization of mental facilities, the challenges of integrating mentally ill people now rests on several shoulders and not just the practitioners of the mental health field. Employers, educators, clergy, landlords, retailers, and primary health physicians are having to learn more and more about mental illness as their constituent base with mental illness is growing. This phenomenon is no different for the police, who are increasingly being called into situations that used to only occur in mental institutions and would be resolved by staff. The deaths of Mr. Brown, Mr. Greenwald, Mr. McCleary, and Mr. ) represent human faces to this transitional process. I believe that we can better facilitate this process by integrating departments from both the Office of Mental Health and the Police in doing so. I believe that Philadelphia, given that we have a nationally recognized Behavioral Health System, thanks to the Secretary of Human Services, Estelle Richman, and an equally recognizable Police 12 12/13/00 PUBLIC SAFETY - RES. 000684 Department, can create its own unique model so that response calls to mentally ill persons in crisis can be consistent and non-lethal. To this end, Councilman Ortiz, we would like to say thank you for you and Councilwoman Tasco for hosting this hearing today. We would like to thank all of the community groups, City people, staff people who helped prepare and research for this hearing so that we can have a better understanding of the issues. It is our goal to submit recommendations that City Council can adopt so that all City departments and law enforcement agencies will have one singular response to deal with people in crisis who are mentally ill and/or homeless. Having said that, I would like to turn the hearing back over and certainly again thank you and request that the Brown family speak first, and then we will proceed with the City officials.

Miss Elizabeth Brown and family, please come up. (Witnesses come forward.)

Councilman Ortiz was just talking about how we deal with 13 12/13/00 PUBLIC SAFETY - RES. 000684 victims. And certainly we see Phyllis Gibson -- thank you -- who is Director of Victim Witness Services for West and Southwest Philadelphia. Thank you for coming.

Miss Brown, please identify yourself for the record and bring the microphone closer to you.

My name is Elizabeth Brown. I'm the sister of the late Robert George Brown. I have a statement that I would like to make, if possible.

Please proceed.

In 1970, our brother, Robert Brown, was diagnosed with paranoid schizophrenia. Our mother passed away in 1982, and a few months later, my brother had to be put on medication. He received injections one day a week in order to cope with his illness and was able to lead a completely normal life while taking his injections. After a period of time, Robert was taken off the injections and given a pill to control his illness. Since then, our brother has battled with his illness, trying to maintain his sanity. 14 12/13/00 PUBLIC SAFETY - RES. 000684 Through the years, Robert has had many counselors, different programs, and has been placed in many institutions. We have always questioned why Robert was taken off the injections when they worked so well and allowed him to function as a normal person. The schedule of injections also assured the family that he was getting his medications on a timely basis. Through the years, Robert tried to maintain his own apartments, some of which the health mental system had helped him obtain. Robert had lost all the apartments until two months before his untimely death. We believe he was unable to cope because of a change in his medication and care. We, the family of Robert Brown, tried to get the proper help for our brother over and over again. We had Robert hospitalized for two weeks in March of 2000, and then he was released by the system. Robert was attending some meetings with his counselors, and they were well aware that he was not taking his medications and that his behavior was worsening as a result of his illness. At some point, the counselors at the 15 12/13/00 PUBLIC SAFETY - RES. 000684 mental Consortium threatened to stop giving him his medication if he continued to miss some of the meetings. Robert's behavior and the missed meetings were not the actions of a healthy, stable person. The mental health system and the Police Department truly failed him. We, the family of Robert, pray that the mental health system be changed such that other mental patients will not be treated in the manner in which our brother has suffered. It is our hope that patients will receive the help they need and they won't be a statistic like our brother for actions they cannot control due to their illness. We, the family of Robert, pray that the families are allowed to help their loved ones and hope that the mental health system respects the family by listening and responding to their concerns. We hope that the family can play a part in a loved one's mental restoration and health without always being told by the mental staff that the patients have rights and that nothing can be done when the patient is unable to control his illness. We have watched the mental system, and 16 12/13/00 PUBLIC SAFETY - RES. 000684 the Police Department as well, fail Robert over the years, and there was nothing that we were able we able to do about it because the mental health workers have always informed us that mental patients have rights too. We fear that the mental health system and its workers hide behind the rights of mental health patients by failing to take action to protect a patient. We have always participated in our brother's mental recoveries. We have visited him on numerous occasions at the different institutions. We have communicated with doctors, trying to find the best method of recovery for Robert. We have explained our great concern to all of his doctors. Close to Robert's untimely death, we felt that the mental health facilities preceding Robert's behavior had gotten worse and that they should institutionalize him for his own safety, but we were wrong. The system again refused to take action, claiming to be protecting the rights of the mentally ill. We were always told by the mental health staff that Robert could only be institutionalized if he caused bodily harm to 17 12/13/00 PUBLIC SAFETY - RES. 000684 himself or another person.

We saw the outcome of that policy as our brother lost his life, because he didn't cause bodily harm to himself or others. Being a part of Robert's life, we have been truly blessed. It's a blessing, because he was a wonderful man despite his illness. Robert was truly loved and loved his family as well. We -- Robert was the baby of the family, and we had all suffered with him throughout his illness. He was truly a great man that pleaded for help from the only people that could help him -- those in the mental health system. We lost our baby brother through no fault of his own, and that is what truly hurts us. We had watched Robert get better, get worse, go up and down with his illness. We knew him better than any counselor because Robert lived with us. He grew from a baby to a -- from a baby to a man among us. We knew when he suffered great depressions, we knew when he was taking his medications, we knew when things in his life were getting to be too much for him to deal with. We watched the hurt and confusion when Robert stood by the grave sites of his siblings that were 18 12/13/00 PUBLIC SAFETY - RES. 000684 passing away before him. On several occasions, we watched him stay strong, and at the same time suffer because he wouldn't be home with his family to grieve. We would know right away when it was time to get professional help for him, and every time that he would try to get him institutionalized or get help for him, we were told that he had to hurt someone first. As a result, our family has had to bury another sibling. Our baby brother Robert is gone now and we wonder if only the mental health institutions had seen past the patient rights excuse and taken action to protect our brother. He would be alive today. It was clear to see that Robert was not able to take care of himself and live in a society where he was not taking his medications. The behavior changed is our brother and our brother was obvious. There is something wrong with a system that forces a mentally ill patients to make decisions for himself, including taking medications when he is incapable of doing so. 19 12/13/00 PUBLIC SAFETY - RES. 000684 There is something wrong, there is something wrong with the system that concerns of the loving family around the mentally ill patient, the guise of patient's rights. There is something wrong with a system that under the guise of patient rights allows a person to be killed when his only crime is that he suffered a mental illness. We hope that no other family has to endure the pain we have been forced to deal with. I thank you very much.

Thank you. I have to make a point that the Amtrak Police will not be testifying today because they say that there's an ongoing D.A. investigation.

I would like, if possible, to say the mental system and the Police Department certainly needs to be retrained as to how they're dealing with mental ill persons. Our brother was a -- he was a meek person, he was in and out of, as I said, institutions. He lived in boarding homes. One of the boarding homes he lived in, worked -- and lived there, but one of the nuns by the name of Sister Angelo, she named my brother "Gentle 20 12/13/00 PUBLIC SAFETY - RES. 000684 George," so he was not a person that would harm anyone. The police, I believe, forced him into a corner, so to speak. I believe that they truly need to be trained, they need to -- the mental system and the Police Department truly needs to be trained as to how they deal with persons that has any such mental condition at all.

Was he -- was your brother under treatment?

Yes, he was. My brother has always been under treatment. He would go to his meetings, he would miss his meetings. My brother lived a completely normal life, a completely normal life when he was on his medications. And he had beautiful apartments, he paid own bills, he took care of himself.

Had he been off his medications when --

He had not been completely off his medications. As I stated in this statement here, he went to some of his meetings, but he did not go to all of them. His counselors knew he was taking some of his medication, but 21 12/13/00 PUBLIC SAFETY - RES. 000684 they did not -- he did not take it on a proper basis that he should take it.

At the time when he was shot by the police, was he living on the street or --

No, he was not. He has never lived on the street. My brother had lost his apartment about two months before he died. And one of the -- two of the first employees from the mental place where he went to programs had brought him to one of my nieces' homes in South Philadelphia, and that's where Robert lived at the time of his death.

Did he go around 30th Street often?

I believe that this was a place where he had just started going within the last week or two. This is not a place where he frequently went because I have -- I never heard of him frequenting 30th Street Station, so this was someplace where he recently started going. I believe he met friends around there and this is where he would go, but I don't believe that this was a place where he has been going for a long 22 12/13/00 PUBLIC SAFETY - RES. 000684 period of time.

Prior to this incident, had he had other incidents in which he had to be restrained by police or --

No. 7

Or he acted out in some way in which --

He was always --

-- in which the police had to be called?

He was always afraid of the police. He respected the police, he respected the police. He was always afraid of the police. If you said, "I'll call the police," he would humble himself. He respected the police.

So he had -- before this, he had no other incidents of this nature in which he had -- 'cause the police said that he had gone off and started throwing chairs or --

I believe --

-- and that he was acting in a violent manner and that -- had he had any, to your knowledge, any incident of that nature prior to this one? 23 12/13/00 PUBLIC SAFETY - RES. 000684

Well, not recently, no, no. 3

Had he ever been confronted, like I said, by the police or --

Yes, when the police would confront him, he would go right along with them, he would be humbled, he wouldn't give them a problem at all. He would never give the police a problem at all.

What do you think happened?

Excuse me?

What do you think happened that day?

I don't know whether -- I -- I truly don't know what happened. I believe that Robert was -- I don't know where his frame of mind was at the time, but I believe that he was antagonized in some way because Robert was -- and I don't say this just because I'm his sister. Robert was a humble person.

All of his life, had he ever harmed anyone?

Yes, yes. But he was a person that was humble, he was a person that was 24 12/13/00 PUBLIC SAFETY - RES. 000684 humble.

Jannie?

Thank you. Mrs. Brown, would you like to introduce the family members and others who are with you today?

Yes. This is my sister, my oldest sister, Marie Dorsey.

How do you do?

Certainly, we do want to welcome you. You're welcome to stay for the entire hearing, if you would like to, but we appreciate you coming out today. We certainly mourn with you, and certainly all of this is in West Philadelphia, certainly the train station and certainly your residence and -- but it's symptomatic of what can happen anyplace.

Yes, yes.

And we certainly want to do our part to make sure that we have a system that certainly serves people so that those who are ill certainly do not have to feel that they have to become victims of violence themselves and lose their lives. 25 12/13/00 PUBLIC SAFETY - RES. 000684 We do thank you very, very much and are always available for you.

I thank you very much.

Thank you.

Secretary Estelle Richman, please, and Carolyn Ulmer. (Witnesses come forward.)

Is there someone here from the Philadelphia Police, someone representing the Police Department? UNIDENTIFIED MAN: Yes.

Please come forward. Dr. Herman Axelrod, please come forward. (Witnesses come forward.)

Pull a chair up. Miss Richman, I believe you know the process here? SECRETARY RICHMAN: Yes.

So identify yourself for the record. COMMISSIONER RICHMAN: Thank you. I am Estelle Richman, Director of Social Services of the Managing Director's Office 12/13/00 PUBLIC SAFETY - RES. 000684 for the City of Philadelphia. I'm also President of the Board of Community Behavioral Health, a part of the behavioral system. I am joined today by Carolyn Ulmer, Acute Services Manager for the Behavioral Health System. First of all, I'd like to thank Mrs. Brown for her testimony. Indeed, in an untimely, tragic death, the system did not work. The system will continue to struggle between the dual rights of consumers and individuals, the love and rights of the family, and forced treatment. It is also my hope that no other family will also have to suffer in the way that this family has suffered and that we can all work towards that as a goal. Also, thank you, Councilwoman Blackwell and Councilman Ortiz, for the opportunity to testify regarding the Behavioral Health System, its crisis intervention service, and our ongoing efforts to work together with the Philadelphia Police Department. The City of Philadelphia has a 30-year history of providing mental health and substance abuse services under the auspices of the Office of 27 12/13/00 PUBLIC SAFETY - RES. 000684 Mental Health, the Coordinating Office of Drug and Alcohol Abuse Programs, the establishment of Community Behavioral Health, working with OMH, and CODAAP completes the array and strives for a seamless system of care for Philadelphians with mental health problems, serious mental illness, and substance additions. The Commonwealth Health Choices initiative outlines two categories of service. In-plan services are those required to be made available to medical assistance recipients and are authorized and monitored by the Behavioral Health System. Beginning July 1, 1997, in-plan services included inpatient, outpatient, partial hospitalization, targeted case management, and crisis services. Supplemental services are services not currently required by Health Choices but provided to people as a part of a comprehensive behavioral health care system. These include emergency services, residential, vocational, clubhouses, peer support, and family support services. The Adult Behavioral Health System has been designed with special focus on those who 28 12/13/00 PUBLIC SAFETY - RES. 000684 require frequent, intensive, and specialized services. Access to those service can be obtained through a comprehensive and high-quality provider network, with more than 300 provider agencies. Consumers can access service directly to any one of over 150 outpatients clinics that provide assessment referral and treatment. Member Services provides consumers with the location of clinics, their hours and specializations. A member service representative is available 12 hours a day. 13 Consumers can also receive services at 14 one of 80 psychiatric partial hospitalization 15 programs located in every geographic section of 16 the City. In addition, the Behavioral Health 17 System works with case management provider 18 agencies, residential providers, and homeless 19 outreach workers, with over 30 psychiatric 20 inpatient providers and 5 Crisis Response 21 Centers. 22 In our efforts to bring services to 23 people who are homeless, five two-person teams 24 compromise the Homeless Outreach service. The teams are mobile and provide a vital array of 29 12/13/00 PUBLIC SAFETY - RES. 000684 social services to frail and chronically homeless persons who are living on the streets of Center City and in some sections of West Philadelphia. The Behavioral Health System works closely with a number of agencies to address the needs of people served by multiple systems.

These efforts have resulted in letters of agreement between the Police Department and Crisis Response Centers, the behavioral system and police procedures to implement the sidewalk ordinance, and letters of agreement between the Behavioral Health System and the Office of Emergency of Specialized Services, the Department of Human Services, and the Philadelphia Corporation for Aging. A number of cross-system committees are working to further improve collaboration among these agencies. We are also working to develop additional performance and outcome measures for the behavioral health programs. The Consumer Satisfaction Team, a nationally recognized initiative, serves as a voice for consumers and families in identifying programs that meet consumer needs and those in need of improvement. 30 12/13/00 PUBLIC SAFETY - RES. 000684 Their efforts are being supplemented by monitoring teams that measure compliance with performance standards and review provider-initiated quality improvement plans. These plans analyze data relative to performance, and include steps that will result in specific and immeasurable improvement. These initiatives or part of an ongoing effort to improve accountability of all contracted agencies. Each year, more than 20,000 individuals present to the Behavioral Health System in crisis. Many of these individuals have been unwilling to participate in outpatient treatment. Others are enrolled in various behavioral health services and continue to experience acute episodes. I would like to describe the services that form the core of behavioral health crisis intervention in Philadelphia. The first is the Crisis Response Centers, or CRCs. Three years ago, these programs replaced the psychiatric emergency services. An in-depth analysis revealed that an emergency service must be a behavioral health service, not only a psychiatric service. We needed to respond 31 12/13/00 PUBLIC SAFETY - RES. 000684 to the varying needs of persons with mental illness, substance abuse problems, and persons with co-occurring disorders. We also concluded that the new service must provide a range of individualized services and rapid linkages to follow-up care based on the acuity of the crisis and precipitating factors. The Behavioral Health System includes five Behavioral Health Crisis Response Centers. The programs are designed to meet the needs of persons in crisis with severe mental illness, drug and alcohol issues, and those that are dually diagnosed with mental health and addictions, as well as other special populations. While located in several areas of the City to be geographically accessible, Crisis Response Centers are expected to provide services to all Philadelphia residents, regardless of place of residence or insurance coverage. All providers are hospital-based organizations with immediate access to medical services capable of screening for medical clearance and responding to medical emergencies. All CRCs also have the ability to link consumers 32 12/13/00 PUBLIC SAFETY - RES. 000684 with an array of mental health, drug and alcohol services, and specialized service. The crisis response service is not a single service but a range of services organized and provided based on the individual needs of the consumer. Within this range of services, there are four major functions. All four functions are immediately available to all persons in crisis 10 hours a day, 7 days a week. 11 The first is triage and assessment, the 12 second is acute psychiatric drug and alcohol 13 evaluation and intervention, and the third is 14 crisis counseling and support, and the fourth is 15 referral and linkage. 16 This first function is the capacity to 17 officially provide a face-to-face assessment that 18 will determine what level of crisis the individual 19 is experiencing and triage each person to the 20 appropriate intervention.

21 The second function is psychiatric drug 22 and alcohol and medical evaluation and 23 intervention to alleviate acute symptomatology. 24 In addition to a psychiatric evaluation, it may include intensive crisis stabilization through 33 12/13/00 PUBLIC SAFETY - RES. 000684 medication management, intensive crisis counseling, an observation bed, seclusion, and restraint. The third function is crisis counseling. It involves working with the consumer to resolve clinical and social issues related to substance abuse or environmental stresses such as tension through family, employers, or landlords. The fourth function is service procurement, or linking the consumer with ongoing services and supports. Crisis services must be formally linked to other community services. These service include mental health and substance abuse, outpatient services for the consumer that the consumer needs in the aftermath of the presenting crisis. Transportation to inpatient, subacute and outpatient programs is the responsibility of the Crisis Response Center. The Mental Health Delegates retain administrative responsibility for obtaining access to emergency, psychiatric, or drug and alcohol evaluation. However, our Crisis Response Centers are required to assist all petitioners in the completion of a 302 Petition, which is involuntary 34 12/13/00 PUBLIC SAFETY - RES. 000684 commitment, regardless of the place of residence of the petitioner or the consumer. Assistance includes filling out all involuntary petitions completely, including all information about how to reach the petitioner and all information regarding the consumer's behavior before calling the Delegate for approval. The Crisis Response Center psychiatrist is required to see and evaluate all persons brought in with an approved petition, regardless of place of residence, within two hours of their arrival. If the consumer is discharged after the psychiatric evaluation, the 302 Petition is to be completed by the doctor, the Delegates are to be informed, and the original petition to be sent to the Office of Mental Health Delegates. Crisis Response Centers must also inform the Delegates of the psychiatrist's recommendation of hospitalization and the facility where the consumer will be hospitalized. CRCs must fully comply with a comprehensive set of performance standards. Each CRC is also expected to submit a quarterly Quality Improvement Plan that assesses performance in eight programmatic areas. A CRC Monitoring Team 35 12/13/00 PUBLIC SAFETY - RES. 000684 composed of representatives from all parts of the behavioral system reviews the CRC Quality Improvement Plan and makes monthly visits to monitor performance. The Monitoring Team also provides technology assistance to improve performance in areas identified by either CRC or members of the Monitoring Team. There are three other behavioral health crisis intervention programs within the City: the Crisis Specialist Program, the Crisis Residence, and the Mobile Emergency Team. The Crisis Specialist Program is a citywide crisis prevention and intervention service. It is designed to meet the needs of the acute, chronically mentally disabled adults, children, and family. The service provides mental health assessments and evaluations in unusual settings, often in consumer homes. The Crisis Specialist may act as a mediator and provide extended support to families or individuals in crisis. A crisis residence program serves the needs of adults with severe mental illness in crisis situations. The program provides up to 36 12/13/00 PUBLIC SAFETY - RES. 000684 five days of crisis intervention and stabilization for up to eight people who need to be away from a stressful environment but do not require inpatient care. The crisis residence serves two populations simultaneously, persons with severe mental illness with a residence and those who are homeless, providing crisis stabilization and crisis evaluation services.

The Mobile Emergency Team provides citywide psychiatric crisis prevention and intervention in non-traditional settings. The Mobile Emergency Team is available hours a day, 14 7 days a week, and can be dispatched only by the 15 Office of Mental Health Delegates. Intervention 16 is provided in consumers' homes when necessary, 17 with the Mobile Emergency Team often becoming a 18 mediator and support system for families in the 19 times of crisis. When the intervention is 20 provided in a community residence, the team is 21 often able to make recommendations for medications 22 and treatment planning. Additionally, the Mobile 23 Emergency Team works with the Police Department 24 and mental health emergencies, providing clinical assessments, psychiatric consults, and involuntary 37 12/13/00 PUBLIC SAFETY - RES. 000684 commitment applications or acts as petitioner in 302 commitments when appropriate. People have been quick to indict the Police Department and the Behavioral Health System for the untimely death of Mr. Brown. Indeed, both systems may have some responsibility for this unfortunate and unnecessary death. The police are routinely called upon to deal with a very large number of people with behavioral issues in a crisis. These include serious suicide attempts, the initiation of an involuntary petition for involuntary treatment, and involuntary transport for psychiatric evaluations. Police officers are often called to family members' homes to remove a consumer experiencing a psychiatric or other type of behavioral crisis. Sometimes a crime has been committed, and the police officer must determine if psychiatric treatment is required before criminal processing. A new hybrid personnel is needed that has law enforcement authority, coupled with social work training. There are such positions, and for these positions, there is additional training 38 12/13/00 PUBLIC SAFETY - RES. 000684 needed that requires motivation as well as a disposition in temperament that can work well both in a crisis and interpersonally with a wide variety of troubled, frightened, and at times volatile individuals. We believe that specially trained officers who can provide immediate response to a person with mental illness in a state of crisis can prevent, reduce, and eliminate injury to both police officers and consumers. Such models of highly trained personnel do exist in several cities in this country, for example: Memphis, Tennessee; Portland, Oregon; and Houston, Texas. In summary, the police are called frequently to deal with extremely complicated behavioral crisis situations. Many of these cases are handled very well by our police officers. The Police Department and the Behavioral Health System have worked together to develop letters of agreement and revised behavioral health and police procedures to better address the needs of people with behavioral health needs. We are appreciative of the efforts the Police Department has made in this area; nonetheless, more needs to be done, 39 12/13/00 PUBLIC SAFETY - RES. 000684 more work needs to be collaborated on, and new models need to be sought out. Thank you very much for allowing me to testify, and Carolyn and I will be glad to answer question.

Thank you. Dr. Axelrod, can you give your testimony, and then we'll ask questions.

Okay, thank you. Thank you for inviting me today. I'm Herman Axelrod, the Executive Director of the Greentree School in the Germantown section of Philadelphia. We are a State-approved, private school, educating students aged 6 to 21 who are identified as seriously, emotionally disturbed autistic, PDD, neurologically impaired, and learning-disabled. The majority of our students come from Philadelphia, and the rest from several districts in contiguous counties. We also have classes for Philadelphia children ages to who exhibit developmental delays. There are two campuses: one for the lower and middle school and one for our high school. The symptoms are students present 40 12/13/00 PUBLIC SAFETY - RES. 000684 necessitate a concerted clinical approach. Many are on some type of pharmacological therapy. Dr. Dewitt Montgomery, a child psychiatrist, is our clinic director, and Mr. ) Is the assistant director in charge of everyday activities. In addition to a teacher and teacher assistant in every classroom, we have specialty teachers, a behavior management staff, and counselors and therapists in both of our schools. Even with all of these supports, we at times need police intervention for a variety of problems. I am relatively new at my job and have only been at Greentree for six months. Early in this role, there was a problem at the high school on a Friday afternoon, which was resolved at the time, but with the word around school that it will be continued on Monday. To preempt any repercussions from the Friday incident, I visited with Captain Joseph Lynch of the 14th Police District. He was gracious and gave me as much time as I needed to describe the population and the situation at hand. We decided that the police officer assigned to the schools in the 14th District, Officer Raymond 41 12/13/00 PUBLIC SAFETY - RES. 000684 Thompson, would be at the school from 8:30 to 9:30 to ensure the safety of the students and prevent a recurrence of Friday's problems. The strategy worked. His presence warded off any other incident that day. The next day, Officer Thompson again came to Greentree early in the morning, and I took him to all of our classrooms and introduced him to the students, where he explained his role and answered the students' questions. We did the same thing at the lower school, and he met all of the staff as well. The students now understand that if their behaviors or actions warrant police intervention, Officer Thompson or someone else will be there immediately to investigate and deal with the incident. Officer Thompson also sat in on a clinical interview I conducted with a student that potentially could have resulted in a police action. We have seen him interact with students too; thus, he was able to learn from us and us from him. Recently, Captain Samuel Lynch, no 25 relation to Captain Joseph Lynch, the Philadelphia 42 12/13/00 PUBLIC SAFETY - RES. 000684 Police School Safety Coordinator working out of the 35th District, came to our weekly executive staff meeting. He explained the concerted police initiative to keep our schools safe and the kinds of supports they have available for us. He gave us his phone and pager number and said we could call him or Officer Thompson at any time. We arranged for Officer Thompson to visit both of our campuses for five minutes each day to further familiarize himself with our students and to let them know that the police are our friends and are there to help. This arrangement has been working, and it's comforting for us to know that when we need help, it is readily available. Due to the myriad of behavior symptoms our students exhibit, it is not always feasible for our clinic staff to resolve some of the acute mental health problems that may render them out of control. Sometimes a child presents a clear danger to himself, others and/or property. This at times becomes a scary situation for the child, staff, and other students.

Emotional first aid on the spot is not always enough, and we may determine that a child has to go to a mental 43 12/13/00 PUBLIC SAFETY - RES. 000684 health hospital for an evaluation. Sometimes a child indicates to us that he or she is going out of control and wants to go to a mental health facility, but at other times, it is a staff decision. Our first step is to call the Mobile Team from the Basis Service Unit, Northwest Center, which is affiliated with the Office of Mental Health. They assess the child to determine whether he or she is in need of emergency hospital care and an evaluation from a psychiatrist. If so, they will help us fill out the paperwork and ask the child to go with them to the hospital. The child agrees, the parents are contacted and agree, they are told to come to the school or where to meet their child. In all cases, the parents are immediately notified that the Mobile Unit was contacted, and the parents are usually with their child at school through this initial process. When all parties are in agreement, the Mobile Unit may take the child to the hospital. There are times that the child does not agree to go to the mental health facility with the Mobile Team. At other times, we cannot contact 44 12/13/00 PUBLIC SAFETY - RES. 000684 the parents that an evaluation is indicated. The Mobile Unit must then contact the Office of Mental Health and get clearance to proceed with an Act 302, involuntary commitment. After the approval from OMH, we then need a staff person to sign a petition to send the child to the hospital and contact the police under Act 302, involuntary commitment. Under these circumstances, the police are required, for the child's and officer's safety, to take the child in handcuffs in a police car to the hospital. Before the police transport the child, one of our counselors speaks with them about our school, if they are not familiar with it, and the nature of the child's symptoms and disability. I have observed this happen twice, and it is heart-wrenching to see a troubled child in these circumstances. Both times, the police were caring, sensitive, and did their job well. They had the degree of understanding necessary to try to reassure the child that he or she will be helped by a doctor in a hospital. After the evaluation, several options 45 12/13/00 PUBLIC SAFETY - RES. 000684 are available. The psychiatrist in the hospital may decide that the situation was transitory and the child can return home and back to school. Second, medications may be prescribed and/or changed. Third, the psychiatrist may decide to hold the child in the hospital for 72 hours to a couple of weeks' observation. And fourth, the child may be referred to a residential treatment center for an indefinite period of time until the symptoms are alleviated and the child can return home and to school. In summary, the police are valuable assets and working partners in our school's program. By establishing a relationship with the captains at two precincts and having continuing dialogue and communication with the officers assigned to Greentree, we have accessed the help when necessary. It has also been very helpful to have the officers just visit. This has established a positive relationship with the students and helped them to understand that the police are our friends and want to make sure that everyone is safe and secure when attending school. Thank you for the opportunity to 46 12/13/00 PUBLIC SAFETY - RES. 000684 testify.

Thank you. You're the witness from the Police Department. (Witnesses come forward.) UNIDENTIFIED MAN: From the Police Department, we have three representative to give testimony here today. We have Sergeant Taylor, Captain Whelan from the SWAT Team, and Lieutenant Wolf from advanced training.

Let me ask some questions of Estelle. Can you wait? Estelle, Miss Richman? COMMISSIONER RICHMAN: Yes, that's fine.

What went wrong on that -- in that incident at 30th Station and the Greenwald incident, in your perspective? And -- because we know we have services. SECRETARY RICHMAN: Right.

But obviously, unless you have enough time to be able to maneuver and call in those services, incidents will happen and you lose control, as we saw on -- when 47 12/13/00 PUBLIC SAFETY - RES. 000684 Mr. Brown reacted or acted out in 30th Street and he got shot. We didn't have time to get a crisis intervention team down there to be able to come between the police officer. And what went wrong?

Actually, if I may piggyback on that. SECRETARY RICHMAN: Yeah.

And the Chairman indicates the Crisis Intervention Team. Let me thank Brenda Cooper-Cutts (ph.), from Horizon House, who is here, and Secretary Richman knows her as well. And as you know, they're a half a block from the station and they do emergency crisis outreach. SECRETARY RICHMAN: This is Estelle Richman, Director of Social Services. There are several things that I think could be identified that either went wrong or could have been done better. If this was an individual, as Mr. Brown was, who had been frequenting 30th Street Station with enough regularity that they recognized him and they realized that the behavior on that day was different, that's the time to call -- not wait for 48 12/13/00 PUBLIC SAFETY - RES. 000684 the crisis. The emergency -- the crisis emergency -- the Mobile Emergency Team can usually be dispensed downtown very, very quickly. And they're the equivalent of two teams on duty during the day.

Yes. SECRETARY RICHMAN: So to be able to call at that point and say, We have an individual here who we believe has a behavioral health problem, we need help, get someone their quickly. From the description that the Councilwoman read early on, there was -- there seemed to be several points where a phone call of that nature would have been promote.

What gets to me is -- I've seen it happen so many times in Philadelphia and New York and other places -- the use of deadly force. SECRETARY RICHMAN: Right.

I mean, that's really an extreme measure to use when someone is not acting out of criminal intent but acting out of an illness. And what gets to me is that we 49 12/13/00 PUBLIC SAFETY - RES. 000684 have two cases -- Greenwald and Mr. Brown -- in which deadly force was used in both cases. They were both mentally ill individuals. And a failure, a breakdown occurred in which the use of deadly force, the use of a gun, and in order to protect themselves -- I've been at 30th Street Station, I've been through the place where the event occurred. You can retreat in 30th Street Station, you can move back if the individual is throwing a chair or something. You can move away from that, and -- but to use that -- that to me is what gets to me, the -- that there was no other recourse except to draw a gun and shoot. SECRETARY RICHMAN: Right. I think that in the testimony you hear today by any number of people, I think what we're going to come back to in lots of different formats is the necessity of training and understanding. How do we train people to -- when you see a crisis, when you see a crisis that you believe is based in some level of behavioral problem. In other words, this person has an active psychosis, this person is mentally ill, this person has addictions that is driving their behavior. 50 12/13/00 PUBLIC SAFETY - RES. 000684 The key is, are the people who are going to be interacting with that person trained to understand what to do to keep it calm, to de-escalate, and to be able to figure out how to get professionals who are trained to deal with that kind of individual on site. The thing to remember at the same time is, how do we make sure everybody who is in that facility remains safe, including the individual who has the problem. And it really comes back to -- and I think, again, the way we look at it is that there is a training issue. Did we have all of the staff who needed to interact with that individual either at that point in time or before that point in time adequately trained to make the decisions that they were being asked to make at that critical point. If the client had not been taking his medication and people were aware of that, what should have been done.

The first person that comes in contact usually in an incident such as this, in a public place or the street, is probably a police person. SECRETARY RICHMAN: It seems that a 51 12/13/00 PUBLIC SAFETY - RES. 000684 police person -- it may be just a bystander, actually, or somebody who says this person isn't acting right, and they call the police.

Or someone that was there at 30th Street Station, at the scene. SECRETARY RICHMAN: That's right.

Let me follow up on that, if I may. Do you provide educational outreach to non-City departments who may also interact with the homeless and/or mentally ill persons, such as Center City Retailers, Special Servicing Ambassadors, Center City Office Building, or 30th Street Office Building, people who are security guards? And do they get a list of who to call and where to call? SECRETARY RICHMAN: Let me have Carolyn Ulmer answer that question.

Hello, Carolyn Ulmer, Manager of the Acute Services Unit. We provide training to anyone that makes the request. Currently -- in fact, yesterday -- I met with the Police Department, the Hostage Negotiation Department, to begin to set up 52 12/13/00 PUBLIC SAFETY - RES. 000684 training with that department, to help them to understand symptoms related to mental illness, symptoms related to drug and alcohol abuse, and symptoms related to dual-diagnosed problems, people that are both drug- and alcohol-addicted, as well as being mentally ill. So we started with that department. But I think, as Estelle said, there needs to be a hybrid in terms of training within the Police Department, so that key officers have skill when they intervene with someone that is mentally ill or drug- and alcohol-addicted.

Yeah, it's too bad that we don't have someone from Amtrak here to testify because 30th Street Station historically, historically, just like other office buildings across the City and the library and public places such as those, have been places where homeless folks congregate, especially when it's cold or when it's bad outside.

Mm-hmm.

And I was wondering whether any sort of -- they had contact -- if Amtrak had been in touch with your agency or any 53 12/13/00 PUBLIC SAFETY - RES. 000684 other agency to ask what Jannie just asked: Had there been some sort of training at 30th Street Station? Because that's where a lot of the homeless congregate.

In terms of formally training the Amtrak Police Department, we have nod had that opportunity, but they are certainly aware of the various outreach teams, from the Horizon House Outreach Team to the Mobile Emergency Team that we have dispatched to that particular -- to that site to deal with homeless individuals that appear to have mental health problems as well as drug and alcohol problems. But I think we also need to develop formal training with them so that they have skills that will allow them to respond to people.

But it goes beyond the police, doesn't it? Because you have a lot of folks, I think, as Estelle Richman just said, that the issue here in the incident with Mr. Brown might have been resolved before he was acting out totally because people had been observing him over weeks or days or -- and thought he was a frequent visitor. 54 12/13/00 PUBLIC SAFETY - RES. 000684

Mm-hmm.

So any change in behavior -- I mean, there are people at the information desk there, there are a lot of people that do a lot of stuff. I mean, they are constantly in contact with the people that hang out at 30th Street Station. And I was wondering if anything at all -- well, the company is not here, Amtrak is not here.

And let me follow up on that question as well, because I understand, Madam Secretary, that the retailers at 30th Street were complaining about his behavior the day before. And in conjunction with that, maybe the Chairman would be willing to have a two-page statement from Amtrak read into the record at our hearing. Do you currently have a reporting format for incidents that occur between Behavioral Health System and any of the police departments in the City, whether it be the Philadelphia Police or Amtrak? Or is this information shared with various entities? And also, is it available to the public? 55 12/13/00 PUBLIC SAFETY - RES. 000684 SECRETARY RICHMAN: I'm sorry, would you ask that again.

Do we have any reporting format, and does it go to all policing agencies? SECRETARY RICHMAN: A reporting format for them to report to us?

Right, or for you to report to them, or either way, so that the incidents are known and information is shared about clients, and is that information available? SECRETARY RICHMAN: If there's any change in the procedure in terms of how they need to reach us, yes, they are told that. In other words, if they need to -- whatever procedure they would need to know to reach the Delegates office, to be able to get the Mobile Emergency Team activated, we would make sure they would have that information. Do we report to them? Any time there is a --

If you have a mentally ill person who's acting out. It seems to me -- I know when we were feeding in the subway, I 56 12/13/00 PUBLIC SAFETY - RES. 000684 have a relationship with -- in fact, one of the officers had a wife who worked at Jefferson, so we would talk about everybody. If they carried Pop out sick, knew he was at Jefferson. If somebody was acting out -- we talked every day so we could communicate about clients and kept down problems. And since each of us had a respective role, it kept problems down because we could talk to one another. SECRETARY RICHMAN: There is not a procedure or a reporting format on clients on a routine basis who are acting out. In other words, if there is a client who someone is aware has a problem, there would be no -- there would be no 16 routine contacting of police to say, This person is a mental health client and will be in a certain location. If there is a need for police backup because the Mobile Emergency Team has gone into a situation where they believe now it's dangerous, yes, they would contact the police. But if they are normally going on, say, a home visit because there's been a call that says, We believe that there is an -- we need a mental health crisis worker in a location, there 57 12/13/00 PUBLIC SAFETY - RES. 000684 would not normally be a routine call to the police asking for backup if the situation wasn't deemed dangerous. It would just be a mental health crisis call. When the police go in and go into a crisis situation, they have been trained to call us if they believe it's a mental health emergency. But that -- but that doesn't always apply to either the Amtrak Police or the SEPTA police.

Or the PHA police? SECRETARY RICHMAN: Or PHA police. What I think needs to happen in part as a result of this is there needs to be an aggressive outreach of training to police and to police structures in Philadelphia. So when I say "police," I'm using a generic police term, not just the Philadelphia Police, but the other police departments within the City to make sure they are aware of the resources and supports that are available when they are in contact with a person who's within a mental health crisis, or who they believe could be within a mental health crisis 58 12/13/00 PUBLIC SAFETY - RES. 000684 state.

Well, the thing that concerns me is the use of deadly force to deal with these issues. And reading in terms of the 30th Street and Mr. Greenwald's events, it -- it really is difficult to go to the point in which you can even begin to conceive how at what point you just draw a gun and shoot. I mean, I -- and maybe the police can clarify this and maybe you can come up and -- because, really, what we're talking about right now is how do we deal at that point. Miss Richman spoke that we have a -- we have a system in place, we have a system that has outreach teams, that has individuals that are trained. We have training that goes on, but we have a system that breaks down and people die. And maybe the police can come up -- can you come up and --

May I follow up with one or two questions for the Secretary?

Yes, go ahead.

How is confidentiality treated when the person is in care 59 12/13/00 PUBLIC SAFETY - RES. 000684 of the family or in direct communication with the family? Certainly, the Brown family was quite involved in his care. Would they be notified, for example, of changes in his medication or frequency or therapy? How is family also integrated into that family care? SECRETARY RICHMAN: It's probably one of the most frequent issues that comes to my attention, is that there -- the confidentiality is used as a reason not to give families information. Exactly what Mrs. Brown said I have heard numerous, numerous times. It is what I call "a very slippery slope." In other words, trying to find the balance between making sure the family has the necessary information they need to support the person. Because frequently, the family is the support system, they are the people who are providing the day-to-day support for that individual, they are the group that knows that individual better than anyone else. There are also situations where a person who uses services very definitely wants to have the right to make their own decisions sometimes when they may not be fully capable of 60 12/13/00 PUBLIC SAFETY - RES. 000684 doing that, but they don't want, to an extent, have the family involved at the same level. The key for most professionals is to be able to tell the difference and to be able to understand when you share information with families and when you need to work more carefully in that area. I think many -- if you question all of the individuals probably even in this room, there would be a variation of how far someone would go down that path. As an individual, my personal feeling is that we need to do whatever it takes to make sure someone doesn't get themselves in a situation that would lead to their death or injury, which may at times appear to be violating some confidentiality rules. At other times, where a person has been very capable of being able to make those decisions and they have given very explicit instructions over how they want situations taken care of, we need to listen to that. But it is -- there should be no routine answer that there -- that we only do things one way and that people's confidentiality should be protected, regardless of their need, regardless of 61 12/13/00 PUBLIC SAFETY - RES. 000684 their ability to make their own decisions that would indeed at that point put their life in jeopardy. And why I said that we often will come back in many formats to training, it is an issue of making sure that professionals who are dealing in the case understand the needs of families who are the primary caretaker, understand the need the need and the depth of need of a client who's in a crisis, and try to make sure those things come together, rather than saying I can't give you information because of confidentiality. That is a non-answer and it's unacceptable.

And also the involvement of family members in a patient's care is very important. SECRETARY RICHMAN: It's very important. The system, as good as we would like to believe it is, doesn't provide 100 percent care hours a day. Most of that care in many, many 23 cases is provided by family members, and there has 24 to be a respect of the family members, for the care they're providing, for the support they're 62 12/13/00 PUBLIC SAFETY - RES. 000684 providing, and for the crisis that they live through on a day-to-day basis.

And a knowledge of where their family members -- SECRETARY RICHMAN: That's right. Their knowledge is invaluable. At the same time, we need to be aware of the client, what they want, where they are in their illness, and their ability to guide that. It is a very difficult slippery slope many times, but people need to treat it as that and understand the obligations on both sides and not disfranchise that family. More times than not, the family provides a support to that client, more often than the system.

What happens for a mentally ill person or even a person suspected, for example, of substance abuse? If they're disturbing the peace, how is a decision made whether they go through the criminal justice system or the Behavioral Health System, especially in public places?

Boy, that's a very good question. If the person is acting in a manner -- if the person that is mentally ill acts in a 63 12/13/00 PUBLIC SAFETY - RES. 000684 manner that indicates he is a danger to himself or others, is unable to care for himself, is suicidal or is self-mutilating, then more than likely, an involuntary commitment, which should be (unintelligible) in that individual so that he can receive a psychiatric evaluation. If I am angry at you and I am not mentally ill and I decide to take a gun and shoot you, I go into the criminal justice system. So the determination is generally made by my mental state, whether or not my actions were clearly related to my mental state or whether they were just related to the fact that I am a bad person and I have poor judgment and I decided to do something dangerous. And that is a determination the police make.

That's why communication is so very, very, very important because somebody knows -- most people really aren't in the world alone, somebody knows who that person is and what's going on, if people are certainly communicating. I assume -- Secretary Richman, some 64 12/13/00 PUBLIC SAFETY - RES. 000684 demographics, the people who you usually treat in your system, is there some general age, ethnic background, income background, and income level, or generally -- or someplace in the City that there seems to be a general pattern for those accessing your system? SECRETARY RICHMAN: The -- in general, let me see if I can start with a couple of easy ones. Many people with a severe mental illness tend to be on SSI. And by definition, that classifies them as poor. SSI does not pay a huge amount, and by the time you try to pay living expenses, there's actually very little dollars left. That is why the support of the family becomes so important. You otherwise find that mental illness in general strikes all parts of a population. There -- It's not that people are minority or people are wealthy or people are poor; it is a biological illness that begins to be identified now earlier and earlier. While we once said it was 18 to 25, we now can find that a biological -- a neurobiological illness can be identified at a fairly young age. But as the illness progresses, 65 12/13/00 PUBLIC SAFETY - RES. 000684 people often end up on SSI and, therefore, their income is very low and they have not as many other resources as we would like them to have. And I think that more and more literature is coming up to tell us that misdiagnosis of folks happens frequently. We are finding there are a disproportionate number of African-American males that are diagnosed with schizophrenia, for a variety of different diagnosis reasons, and if you would like any of those studies, I can make sure our office provides those. We are also aware that areas of the City, because of low income, people are going to tend to live in areas of the City that -- where rents are inexpensive, where they can afford. So you're going to indeed find more of people with mental illness, particularly those that are living without residential supports probably are living within the Center City area or other areas close to Center City, as in West Philadelphia or North Philadelphia. Otherwise, you will find that the largest group of clients probably lie between the 66 12/13/00 PUBLIC SAFETY - RES. 000684 ages of and probably 40. 3

Councilman Kenney? 4

Councilmember 5 Blackwell, were you finished? 6

Fine. I'm 7 glad to defer. 8

Secretary or 9 Commissioner, I'm not a mental health 10 professional, obviously, and I'm not a police 11 professional. And one would hope that in 12 situations like Mr. Brown and like Mr. Greenwald 13 that there would be some other way other than 14 short of taking someone's life, whether it's a 15 macing or whether it's a baton or whether it's a 16 tackle or whether it's some diversion, to actually 17 get the person and to bring them into custody and 18 to bring them under control. And I'm not talking about these particular instances. But in many ways, hasn't, over the years, the courts and the system itself created obstacles for families, for social service agencies, for governments, for police departments to be able to deal with people who are exhibiting mental health and substance abuse problems that 67 12/13/00 PUBLIC SAFETY - RES. 000684 are obviously in detriment to their health and their life? And that issues of the confidentiality, issues of civil rights, issues of making your own decisions, even when you're not, as you said, not capable of making own decisions, hasn't all of those rules, which have really been a good-faith effort to protect the individual right of a person kept us all from helping them in some way? I just -- I hear of all the families that have tried and reached out for mental health help for their children or for their relatives, and have been, because of court requirements, because of the rules that you need to follow, have been unable to reach them or help them. And when I see someone lying on the sidewalk by choice, because of mental illness or because of substance abuse, it would seem to me that that person would need intervention whether they wanted it or whether they didn't. And in some ways over the last decade or more, probably the last 15 years, the system that's in place now is more concerned about the individual rights of those that are mentally ill 68 12/13/00 PUBLIC SAFETY - RES. 000684 or substance abusers than they are as to all of our goodwill to help them recover and to have a safe place to be. And I guess the frustration here is just that we all know, and I'm sure the families of mentally ill and substance abuse people who are plugged in and really want to help, know what it is they need and know what it is sometimes that they have to almost be forced, forced to get what they need in the way of help. And some of the systems that we have in place now require a decision made by the person who is in desperate need of help who can't make that decision or refuses that decision. SECRETARY RICHMAN: Right.

And I guess the frustration that I dealt with when we went through the sidewalk behavior issue, and Councilmember Blackwell's deeply involved in that, and Council President -- the Mayor now, the former Council President Street, I mean, we went and we did all of these kinds of discussions. And in the end, I think sometimes it comes down to the fact that that person who's 69 12/13/00 PUBLIC SAFETY - RES. 000684 lying on the sidewalk or that person who's wandering aimlessly through the City, or through whatever city they happen to be in, we need to have the ability take them somewhere in a kind, caring way and make them get the help they need, as opposed to asking them whether or not they want it or whether they'll accept it. And I think that's where we've kind of gone off in two different areas. SECRETARY RICHMAN: I hear your frustration. I have probably heard that same frustration from countless numbers of families over the years. It's a -- it is a constant struggle, I think, even for folks that report to Carolyn, who listen to sometimes these petitions, listen to family members, constantly trying to figure out how do we make sure someone gets help when they don't say they don't want it and when they actively fight against it but it is incredibly true that they need it. And how do we do that at the same time we're trying to listen to what it is that they want, that they may be willing to receive? 70 12/13/00 PUBLIC SAFETY - RES. 000684 My concern always is do, the workers we have in the system struggle with that as an active issue, or do they really just say, I can't do anything because the rules don't let me. There are a lot of things within rules that don't let us do things, if we only read the rules.

Right. SECRETARY RICHMAN: The key for working in this area is understanding both people and rules, and make decisions that you believe will never hurt someone.

The example I guess I give is an individual who we find lying on the sidewalk, who fell and split open their head or are unconscious. We don't wait to wake them up to ask them whether or not we want to take them to the hospital to have them treated medically. And when I look at someone who is in the throes of substance abuse or in the depths of mental illness who say that I don't want to get off the street, I want to be here, lying on the corner, I want to be on the steam grate, I don't care whether the outreach worker's here, I don't care whether the police officer's here, I want nothing to do with 71 12/13/00 PUBLIC SAFETY - RES. 000684 this. We have a dichotomy between that person who needs physical medical help immediately in an emergency ward and a person who needs, obviously needs, for their own protection and for their owning well-being, mental help, but we allow that person to stay there because of this perceived right of theirs to refuse that help. And I guess that's where the -- I don't have to explain to you the frustration 'cause I know you deal with it every day. But from a government standpoint, it really is frustrating when people -- you know what the need is and you know that maybe some people you can talk in, and maybe you can talk them in for a period of time, and that frustrating process we should deal with because we always want to give them the opportunity to be helped and to get better. But when the person obviously mentally ill or obviously a combination of both, and we say, Okay, that's your right to tell me or to tell us that we're not going to -- you don't want me to help you but I'll let you lay on the street and die, or I'll let you become the victim of an 72 12/13/00 PUBLIC SAFETY - RES. 000684 incident at 30th Street Station, or I'll let you become, you know, the victim of another incident somewhere along in your life that's going to affect not only your life but the life of your family, the life of the people involved in the incident much. I mean, I'm sure that the officers who were involved in that incident, I hope and I'm sure that they struggle with what happened every day. And if we had the ability to physically take that person and to get them the help they need, they also -- they would be alive and everybody else's lives, the families, the officers involved, the City as a whole wouldn't be going through this. And that's where I guess it's -- I mean you're not a federal judge, so I'm sure you can't change it with the -- SECRETARY RICHMAN: No, but what we do continue to have the ability to do and need to continue to forget that it is our responsibility is to make sure that people who are interacting with clients never forget that when a person can't make the decision on whether they need help and their life becomes endangered, that's not to say 73 12/13/00 PUBLIC SAFETY - RES. 000684 that they have to get to that point. We're supposed to have people well enough trained and understanding that they know enough about signs, symptoms, and behavior to catch it before and get that help to you beforehand so don't end up in life-and-death situations. Obviously, the system has not figured out how to do that well enough.

Well, I'm sure there are people who, because of the system and all the interventions prior to crises, I'm sure have directed people to wellness and to places where they're safe before they get to the crisis, but the cohort of people who are in immediate crisis or right on the verge of immediate crisis that we seem to be paralyzed to help them because of rules that we've imposed on ourselves by the courts and by the legislature and by our procedures that keep us from being able to scoop them up in a nice way, in a gentle way and take them somewhere for help. And I know you hear me. SECRETARY RICHMAN: I hear you.

And those are the individuals that generally may at one point or 74 12/13/00 PUBLIC SAFETY - RES. 000684 another react and then something like Mr. Brown and so on. Miss Richman, could you just stay a second please, if you don't mind? Or do you have to leave? SECRETARY RICHMAN: I have a -- I'm running the press conference downstairs.

Okay. SECRETARY RICHMAN: But Carolyn will be here.

Okay. SECRETARY RICHMAN: And that press conference shouldn't last too long, and I'll check back up.

Okay, very good. Could we have -- because I really want to go into -- Mr. Frank Rizzo is here and he has joined the panel. Could I have the police? UNIDENTIFIED MAN: Yes.

Mr. Axelrod, thank you very much.

Thank you.

And I want to ask 75 12/13/00 PUBLIC SAFETY - RES. 000684 some questions. (Witnesses come forward.)

Identify yourself for the record and. . . CAPTAIN WHELAN: My name is Captain Michael Whelan. I'm commanding officer of the Philadelphia Police SWAT Team. LT. GOULD: My name is Lieutenant James Gould, Philadelphia Police Department Strategic Training Development Unit, formerly called the Advanced Training Unit.

As you know why we're here. We're here in terms of trying to see why some things have happened. We had the death of Mr. Greenwald shot by the Philadelphia Police; the death of Mr. Brown, shot by an officer of the Amtrak Police Department. And I'd like to know -- I'd like to begin finding out, after the death of Mr. Greenwald, was there an evaluation within the Police Department of the policies of dealing with the mentally ill and the use of deadly force in any confrontation with individuals who are mentally ill. We have seen from the testimony of 76 12/13/00 PUBLIC SAFETY - RES. 000684 Secretary Richman that we have systems in place that we can have access to. We have individuals that we can refer to in moments of crisis, but sometimes, as we have seen, the crisis overtakes and those schemes never get there. Have you had any -- after the death of Mr. Greenwald, what was the policy before and have the policies changed in terms of how we deal with mentally ill in the Police Department? And can you state those policies?

My name is Darren White. I'm Special Advisor to the Police Commissioner. We have no facts or information here today regarding the Greenwald incident, but we did come prepared to speak on the policies of the Police Department with regard to dealing with the mentally ill in crisis and mentally ill.

Well, tell me what -- tell me first what the policies are.

Okay.

And if you can, I'd like to find out, did they fail in the case of Mr. Greenwald?

Okay. We could state the 77 12/13/00 PUBLIC SAFETY - RES. 000684 policies, but we don't have the factual scenario with regard to the Greenwald incident. UNIDENTIFIED AUDIENCE MEMBER: It's been six months.

I know, all right? Let me -- go ahead, tell me what the policies are and tell me how the Police Department deals with someone who is mentally ill and who is acting out.

Okay.

Obviously, you know, sometimes -- you must have known that we were going to ask about it because there was an incident that led to the use of deadly force with someone that was mentally ill, and you must have known that I was going to ask some of those questions.

I'm sorry, we're here pursuant to communication --

We're here pursuant to policies dealing with the Police Department and the police forces both of Amtrak and the Police Department in terms of the mentally ill and how they deal with those individuals that are in crisis that sometimes lead to the use of deadly 78 12/13/00 PUBLIC SAFETY - RES. 000684 force. And to me, it's -- the hearings are -- were done because two individuals got shot, and it wasn't just coming out of because we wanted to sit here and talk about policies in a vacuum. It was because we wanted to find out what events led to two individuals, two human beings who were sick, getting shot by two different arms of the police and safety departments of the City -- one in Amtrak one in the Police Department. And we wanted to see what policies are in place, what happened during Greenwald and what did you do to change, if anything, those policies, and what type of training you went through and what type of situational -- situational functioning or training that would lead to the prevention and the nonuse of deadly force in future events. LT. GOULD: Councilman Ortiz, I could go over the police policy now, but what I would like to do is talk about the training and then I'll get into the policy.

Give me the training, all right, and I want you at one point 79 12/13/00 PUBLIC SAFETY - RES. 000684 to tell me why and when the use of deadly force is used, and I'd like to find out the circumstances around which you used deadly force in the case of Mr. Harold Greenwald. I mean, that's why we're here. We're not here to discuss policies in a vacuum; we're here to discuss policies because two individuals are dead. And to me, that signifies a failure, a failure of policy. That to me signifies that something went wrong. And you could state to me everything, everything, but unless we know and are able to detect and ascertain what went wrong in these two incidents, and that's why I'm not very happy that Amtrak is not here, because I wanted to go into these details; I didn't want to go into the criminal investigation or whatever it is. But something went wrong twice in the space of a year and two people are dead.

As a follow-up, my question with regard to that is a follow-up, stating the same question in another way. Are you able to comment on how other police departments as well as yourself within the City respond to crisis calls involving the mentally 80 12/13/00 PUBLIC SAFETY - RES. 000684 ill? Is there a memorandum of understanding between the Philadelphia Police and other police departments and stating who takes precedence on the scene; for example, PHA or Amtrak?

Why don't you begin with your training and then refer to Councilwoman Blackwell's question as you go along. LT. GOULD: Okay.

Okay? LT. GOULD: In 1987, the Philadelphia Police College started working with the Office of Mental Health and Mental Retardation. We have a liaison person, Corporal Harriett Farr (ph.), from the Police College, formerly called the Police Academy, who has had extensive training in the development of criteria for instructing recruits in the handling of responding to mentally ill persons in crisis. The Police College teaches class consisting of custody of the mentally disturbed persons, antisocial behavior, the Mental Health Act, handling the mentally ill, behavioral management and crisis intervention, dispute intervention, hostage situations, barricaded 81 12/13/00 PUBLIC SAFETY - RES. 000684 and/or suicidal persons. Mental health issues also are discussed, psychological emergencies, and also role-playing in which the recruits are given a variety of scenarios and then instructed to work out an appropriate response. These recruits are given -- are taught how to handle the mentally ill who are in custody, provide techniques on how to respond to the mentally ill and are provided techniques on how to respond to the mentally ill. Currently, in Act 120 dealing with police recruits, the recruits receive 31 hours of this type of training. Corporal Harriett Farr is also working in conjunction with Carolyn Ulmer, from the Office of Mental Health and Mental Retardation; Carolyn Skipworth from the Emergency Medical Mobile Emergency Team; also Carol Wiener from the Behavioral Health Training and Education Network; and also David Divish (ph.), President of the Family Training and Advocacy Center for Serious Mental Illness. They are working in conjunction to improve on the training that the recruits are receiving.

You keep on talking of training. What is the training? I don't -- 82 12/13/00 PUBLIC SAFETY - RES. 000684 you know, don't give me -- what is the training besides Directive 136 in terms of -- what is the training? What does it consist of? LT. GOULD: Okay. The -- I deal with the in-service training, which is something similar. In 1994, a lesson plan was developed in dealing with the mentally ill, called "Mental Illness Awareness." This course developed by myself and Corporal Farr in conjunction with Southeastern Mental Health, who gave their approval on the lesson plan. At the time, we had Robert Lerner (ph.), who was the Executive Director, and also at the time, Joseph Rogers was the Deputy Executive Director. In 1995, this course was given to police supervisors in the Philadelphia Police Department. In 1996, it was given to every police officer in Philadelphia.

What does the course consist of? LT. GOULD: The course consists --

Don't tell me they get a course; tell me what it is. Do they actually meet people? Do they actually recreate 83 12/13/00 PUBLIC SAFETY - RES. 000684 some scenario in which a mentally ill person acts out? Do they go through a process to identify what -- how to identify illnesses and so on? LT. GOULD: With regard to the in-service training, the course that was given was relating to the history of mental illness in the United States, Patient's Bill of Rights, what is mental illness, identifying and understanding mental illness, assessing the behaviors, ways to diffuse and peacefully resolve encounters with the emotionally disturbed, and also related to the Philadelphia Police Department directives and procedures and officers. Also in conjunction with that course were videos that were supplied to the officers with individuals who were suffering from mental illness. In 1996, we had a group called the Forensic Advocacy Coalition. This group consisted of persons with mental illness in the criminal justice system. They were consumers, family members, and advocates from across the Commonwealth, including Philadelphia. We had three seminars -- I'm sorry, we had five seminars back in 1996, we had three 84 12/13/00 PUBLIC SAFETY - RES. 000684 seminars back in 1998. What they talked about was basic facts about mental illness involving Pennsylvania community statutes, public attitudes about mental illness, substance abuse users versus individuals with mental illnesses, approaching individuals in severe mental distress, dealing with children with behavioral and emotional disorders. And some of the guest speakers were Ruth Seegrist, who's mentally ill daughter was arrested for shooting at the Springfield Mall. Mr. Jay Centefanti (ph.) was also involved with this training. And it gave you a hands-on how people would act out.

Say an individual's at the Clothes Pin and he's acting out and he's jumping up and down and he is talking to people that are not there, for example, and he is -- he may be going off and acting very strangely, takes off his shirt, walks up and tries to climb the Clothes Pin and comes down, and a policeman comes before him, what is he trained to do? LT. GOULD: We tell the officers this: never try to handle it alone. No matter how comfortable they feel with a particular 85 12/13/00 PUBLIC SAFETY - RES. 000684 individual, going at it alone can have bad results. We do have a force continuum. We have a assist officer directive, which specifically gives the officer tips for dealing with mentally disturbed individuals.

I'm asking, what is he going to do? Don't tell me that you have -- tell me -- the policeman, he comes in front of an individual and he is going off and he's acting crazy, or what we believe is crazy. What are the things we're going to do? And the guy lunges, he goes towards him right there, at 15th and Market? SERGEANT TAYLOR: I'm Sergeant Taylor. I've been a policeman for 33 years.

Right. SERGEANT TAYLOR: I'm assigned to Center City. I've been down here working with the homeless population for the last seven years. I've been on the scene or supervised over a hundred 302 commitments. There's a narrow parameter here of when a person can be -- we can stop their free movement and take them away because of their mental 86 12/13/00 PUBLIC SAFETY - RES. 000684 problems. We have to convince a psychiatrist that this person is a danger to themselves or a danger to others. Now, in the situation you just described, where this person's trying to climb the Clothes Pin, if they're pulling their clothes off, running in traffic, this person needs help. Would a policeman just walk up and say, It's not my business here, you don't meet that criteria, and leave? The answer is no. We would take action there.

What action? SERGEANT TAYLOR: What you just described, the person is a danger to themselves, they're trying to climb the clothes pin, a public building.

I understand, I -- tell me what -- SERGEANT TAYLOR: We have a Crisis Response Center.

I am "Joe Policeman," I come in and I see this guy going crazy. I -- what do I do? Do I call you? Do I call -- 87 12/13/00 PUBLIC SAFETY - RES. 000684 CAPTAIN WHELAN: If we have a situation where an individual indicates by his actions or implications that he intends to harms himself, then that should be handled in accordance with 136 -- and I'm talking about mental health patients, in accordance with Directive 111, as a barricaded individual. And a proper, sterile area should be created, with the assistance of the SWAT Team so the specialist can come into this area and hopefully talk this individual into seeking some type of help.

Let's say I'm the policeman. CAPTAIN WHELAN: Right.

I grab my communications device and I call -- CAPTAIN WHELAN: A supervisor.

-- a supervisor, and I say to the supervisor, Supervisor, I got somebody here who's acting out. You know, implement Directive 136. CAPTAIN WHELAN: Correct.

Who comes? CAPTAIN WHELAN: Well, police radio -- 88 12/13/00 PUBLIC SAFETY - RES. 000684 if it's if declared to be a barricade at that point, then the SWAT Team is going to come out, as well as a higher-ranking supervisor. If it's for an evaluation, then the sergeant will come in and make that decision.

Say the guy doesn't want to be helped, the guy doesn't want to go anywhere, what happens? CAPTAIN WHELAN: Then we're going to come in there and we're going to handle it just like we would a barricaded scenario.

And when you say "We are going to come in there," how do you come in? CAPTAIN WHELAN: We come in --

Do you come in with a billy club? CAPTAIN WHELAN: No. 19

Do you come in with something? Do you -- you know, do you come in with arms, with guns out? CAPTAIN WHELAN: We do not come into a scenario with arms and gun out, unless there is a threat of serious bodily injury towards us or others. However, we do lean towards -- 89 12/13/00 PUBLIC SAFETY - RES. 000684

When do you assess that there's a threat to bodily injury to take out your gun and so on? CAPTAIN WHELAN: Are you talking about the initial officer arriving at the scene? Or are you talking about people that are coming five to ten minutes later?

I'm talking about -- I am there, I'm confronted with an individual. CAPTAIN WHELAN: That's a matter of discretion, Councilman. I think you're asking for a definitive answer when you approach what you believe to be a threat with your weapon. I can't answer that question; only you have to be able to judge within your mental framework of you feel there's a threat towards you. I mean, if you're standing there all by yourself and you're confronted with a situation --

If you're standing there by yourself and you have -- you're on Market Street. CAPTAIN WHELAN: I understand.

You could go to the middle of the street. 90 12/13/00 PUBLIC SAFETY - RES. 000684 CAPTAIN WHELAN: Right.

And the guy could be against the wall and you could be talking to him or you could be close to him. I mean, when is it -- and we're talking about two people who died. CAPTAIN WHELAN: I understand.

And obviously, excessive or deadly force was used, whether excessive, you know, that's to be seen. But -- but deadly force was used with two individuals who were mentally ill, and that people, as I've been told, these individuals were presenting no deadly harm or harm to the individuals. Mr. Brown was not going to hurt the police officer who shot him and Mr. Greenwald, the same thing. I mean, Mr. Greenwald was shot in his backyard. When -- you know, what we're trying to see is what is the training and what needs to be done? If more training needs to be done, we'd like to find out. If more instruments need to be done, if you have -- if you can subdue an individual without using bullets, or without using -- I mean, Mary (unintelligible) was telling me about these police who have shotguns with beanbags 91 12/13/00 PUBLIC SAFETY - RES. 000684 or whatever that -- you know, in different police departments. CAPTAIN WHELAN: All officers are issued OC pepper spray, number one. All officers do maintain that on their body, as well as the department -- as soon as the policy is initiated, air Tazers will be initiated to all supervisors (unintelligible) districts. Basically what it is a hand-held gun that shoots two darts that will immobilize the individual through current. In addition to that my, unit the SWAT Unit, does maintain, as you referred to, a beanbag weapon as well as cylindrical rubber projectiles in our inventory as well.

What is THE definition you give the police officer of "an immediate threat"? In your training? CAPTAIN WHELAN: Well, I guess we -- well, if you're referring to --

What is an immediate threat? CAPTAIN WHELAN: Where there's a belief there's some type of harm being directed towards you or others. 92 12/13/00 PUBLIC SAFETY - RES. 000684

Excuse me? You got to come closer to the microphone 'cause -- CAPTAIN WHELAN: Where there's some type of perceived harm being directed to you or to another person.

Could that harm -- you know, I may be cursing you out. I may be, you know -- CAPTAIN WHELAN: It depends on what the information is you're receiving. You know, are you getting any intelligence prior to getting there, did somebody stand by tell you that this person that passes you has a weapon?

Does an individual need a weapon of some sort in his hand and in close proximity to the police person to be in a situation of immediate threat? CAPTAIN WHELAN: If you're asking me if the person has to brandish a weapon for me to believe that I'm in an immediate threat, the answer is no. Again, I have to gather the intelligence that I have at hand at that time.

Can I follow up on that question? 93 12/13/00 PUBLIC SAFETY - RES. 000684

Go ahead.

How are officers trained to tell the difference between, for example, a substance abuser and a person who's mentally ill and they're acting out? Are both given the same opportunity for treatment, or is one taken to a crisis center and one taken to prison? LT. GOULD: If we can determine that the person is dealing with a psychosis because of a substance, that person would be taken to the hospital, because the Crisis Response Center will not treat that person because it's a substance abuse and not a mental illness. However, sometimes when you're dealing with someone who is violent and is mentally ill, we do have guidelines we have to follow; it's a force continuum, and deadly force is the last resort, and that's only to protect yourself or others from harm. We have with the force continuum, we have -- it would be mere presence where you show up on the scene. Councilman Ortiz talked about the individual at the Clothes Pin. If I was the 94 12/13/00 PUBLIC SAFETY - RES. 000684 officer on the scene or the supervisor called to the scene, I would try to talk that person down. Maybe it is a psychosis dealing with chemical abuse, maybe it is a mental illness, I don't know. But I would try to get that person, take them to the hospital or to the Crisis Response Center. If the person's up on the Clothes Pin and I can't get him down, I'm going to contact the SWAT Unit because that's considered to be a barricaded individual. A lot of times we can talk to these people and bring them to the Crisis Response Center. It's better if we can talk to them and get them to voluntarily commitment themselves rather than committing themselves. We try to tell our officers to have human compassion, act professional, and have some empathy for this person, and use good judgment. I mean, when we're dealing with the mentally ill, there are situations that you cannot predict. You could have an individual who you talk with on your sector, that you know has a problem, and the one time they're acting out, we tell officers, Do not -- don't be alone. I mean, don't feel so assured 95 12/13/00 PUBLIC SAFETY - RES. 000684 that nothing's going to happen, because people can just snap. So we give officers guidelines on how to deal with these individuals. If there's a problem, we tell 'em. Our directive says to call for backup, have a supervisor en route. In fact, our police directive says a supervisor will be called to the scene. We tell the officers that treatment's the way to go for the individual. We talk about judicious use of force, and sometimes you have to use force to take that person into protective custody. I have done that in the past, i have used the pepper spray, and then that person was taken to the hospital.

How many mental health crisis calls do you receive on an average in a given year? Are suicide calls included in this number, and how many 302 calls might you get in a year? SERGEANT TAYLOR: In the last 12 months the Philadelphia Police --

Could you identify yourself for the record, please? SERGEANT TAYLOR: Yeah, I'm Sergeant 96 12/13/00 PUBLIC SAFETY - RES. 000684 Taylor.

Thank you, Sergeant. SERGEANT TAYLOR: The Philadelphia Police committed on their own 650 people, Involuntary 302. I think the City as a whole had about 8500. Now, they're not sure how many of these cases the police transported for family and friends who signed the 302. So the 650 wouldn't be the only ones we were involved in. It's probably thousands that police took to Crisis Response Centers.

What's the difference between the two numbers, the 605 and the -- SERGEANT TAYLOR: In the 650, the police were the petitioners. We described the circumstances that led us to take them into custody. And in the other ones that takes it up into the thousands, the police were just called to a scene of a home where it was family members or friends that described the situation that allowed a Mental Health Delegate to approve the 302, and we would just transport them. 97 12/13/00 PUBLIC SAFETY - RES. 000684

I see. And I assume if it's mentally ill children, then you call the Department of Human Services; is that correct? SERGEANT TAYLOR: Oh, if it's mentally ill children, they go to one hospital, one Crisis Response Center, it's Einstein. Now, the vast majority of them are pre-approved by the Department of Mental health. They're the ones that understand and dictate the circumstances that would lead the police to transport them to Einstein Hospital.

I understand there are a large number of mental health and mental retardation facilities in the Northeast -- it's not my area, so I don't know it at all, really. Do they have -- do you have a special relationship, the police in that area, or any area where there are high concentrations reportedly of mentally ill people? SERGEANT TAYLOR: Certainty. The CRS that covers the Northeast is Friends, it's an arm in Friends Hospital. And I've been there to several meetings with Mental Health Delegates, 98 12/13/00 PUBLIC SAFETY - RES. 000684 Estelle Richman's group, to discuss ongoing problems, the direction they'd like to see the police take their training. We're involved in meetings at least one a month with Estelle Richman, Carol Ulmer, and any of these interested groups on problems that come up, shortcomings they see in our directives and training, and things they want us to adjust. And this is disseminated by the Police Department to all interested groups. The Police Academy works on these. You know, other agencies have a real say on how we conduct our training.

Do you have any special programs in west or Southwest Philadelphia? SERGEANT TAYLOR: I don't know that. I know Southwest Philadelphia has Horizon House.

Right. SERGEANT TAYLOR: And they help the Police Department quite a bit. They're out there, they call for our assistance, and we call for theirs, also.

In this instance, at 30th Street -- where Horizon House 99 12/13/00 PUBLIC SAFETY - RES. 000684 wasn't called, and they're also on 30th Street, you know, like a number of feet away -- do you have any idea -- I know that it was the Amtrak Police and not Philadelphia Police, and they said they couldn't testify today because they don't know if they will be charged by the District Attorney, so they couldn't be here, although they issued a statement, as we requested. Do you know why the Horizon House outreach team would not have been called in, given that this was a daily haunt of a mentally ill person, and they're there, they're a matter of a few steps away, a half a block maximum? Wouldn't that be a normal response, to call in a crisis team that does that? Is that not what you would do in the same situation? LT. GOULD: What I would do -- and I'm not talking about in that situation -- in any situation dealing with someone who is mentally ill, that has -- is exhibiting violent propensities, is, of course call, for the supervisor and make sure I have proper backup, possibly call the Crisis Response Center and see if they can help, and also try to convince that 100 12/13/00 PUBLIC SAFETY - RES. 000684 person to come with us for some treatment. And like I said before, if there's -- time is of no essence, we don't have to do something right away. We have the -- I talked about that in-service training course program we've put together. Part of that dealt with tips for dealing with the mentally disturbed individuals. And we go over it step by step with the officers: do not try to handle it alone, take time to look over the situation, keep a safe distance, don't be judgemental, don't abuse or threaten, convey an image of quiet self-assurance, encourage ventilation, don't take anger personally, try to label emotions, try to make contact with that person, do not deceive. We talk about if force becomes necessary. We're guided by the law, have a force continuum. But we can take in protective custody -- I have done that over the years -- for their own safety.

Do you have a review mechanism such that if something happens, there's a board or a group that discusses it to 101 12/13/00 PUBLIC SAFETY - RES. 000684 see what could have happened or what could have been done differently? LT. GOULD: In the case with someone who's injured, we have our Internal Affairs Bureau who gets involved with the investigation.

Do you review any national models for interacting with the mentally ill population? SERGEANT TAYLOR: On your last question, I know the Department of Social Services has a panel that they call "The Significant Incident Review Panel," and anything that comes up that's a significant incident, you know, involving the police, the mental health workers and any client, they review. If there's a death, if there's an injury, if anything goes wrong, they review this with the Police Department and Estelle Richman's department to find out what went wrong, how we can adjust it, and to keep it from going wrong in the future.

Do you have any suggestions for us as a panel trying to come up with recommendations in this area that you think would be helpful or that we as legislators 102 12/13/00 PUBLIC SAFETY - RES. 000684 should look at? LT. GOULD: You talked about the -- what other training or departments we're looking at. We just sent a supervisor down to Memphis, Tennessee, to look at their program. For January 2001, we have in-service mandatory training, Act 180. One of the courses that is mandated is, of course, dealing with special needs. In that, we'll be dealing with individuals with mental illness, mental retardation, and other situations where we might encounter someone. They'll talk about Tourette's Syndrome, even diabetic emergencies where someone might be acting out bizarre and you think maybe they have a mental illness, but it's a physical problem.

In fact, Amtrak, in their statement to us, referred to inspector John O'Connor and the Memphis, Tennessee, study. They also said they formed an internal committee to examine and review all of their training policies as they relate to the mentally ill, and they also mention training videos about interacting with mentally ill individuals for use in roll call. Do you have 103 12/13/00 PUBLIC SAFETY - RES. 000684 such a video as well? LT. GOULD: We have the videos that I discussed in the lesson plan that officers see, dealing with people that are in crisis. We also have the seminars I talked about, that they interact with the officers and the training.

I just have one or two questions more. One, I assume you have a relationship with the SEPTA officers as well, SEPTA and Amtrak. And do you generally just -- do you have different duties within the respective location, or do you defer to one another, depending on where it is or where an incident occurs? Or do they -- do they have your authority in certain areas? SERGEANT TAYLOR: Well, yes. They have powers of arrest, if that's your question.

Okay, so it just depends on who's where and what area is defined as under whose responsibility; is that correct? SERGEANT TAYLOR: That's correct.

I have one final question about the crisis intervention team. 104 12/13/00 PUBLIC SAFETY - RES. 000684 Mental health advocates would like to see some kind of crisis intervention team. What would be the possibility of implementing a crisis team? Apparently, they have seen it in other places.

Darren White, for the record. As stated before, Memphis, Tennessee, has come up to the Philadelphia Police Department a few years ago and did presentations with regard to their crisis intervention team. We evaluated that and we looked at it as recently as December 4th and 5th. We sent a commander down to Memphis, Tennessee, to relook at the Memphis, Tennessee, plan. We are getting information from that visit right now and we're making evaluations with regard to that model itself. And that should be out shortly.

Thank you very much, thank you very much. That's the end of my questions, Mr. Chair.

Councilman Rizzo.

Thank you. 105 12/13/00 PUBLIC SAFETY - RES. 000684 Gentlemen, thanks. The reason I was late getting here this morning is I was out at the graduation ceremony for Class 331 from the College, and I heard something there that I want publicly to be heard, that in Philadelphia -- and I understand the reasons for these hearings, just to look and see how we do business and just to make sure that an incident that occurred at 30th Street won't occur involving Philadelphia Police Department, at least going forward. But I learned something there today about the way our officers -- and I'm not talking about in-service training; I'm talking about the way they're educated at the Police Academy, college credits, nine months, nine months of training; where in other cities, in other police departments, it's limited in some cases to four or five months of training. But in Philadelphia, nine months of training, where this issue, from what I understand, dealing with the mentally ill, is a real concern and a significant part of the training at the -- at the Police College. With saying that, again, I just wanted to make sure that everyone in the audience and 106 12/13/00 PUBLIC SAFETY - RES. 000684 also listening to this hearing understands how highly trained the graduates from the Police Academy and the in-service training, how thorough directives are reviewed and new processes are reviewed, and this is a very serious situation raised by a police officer, knowing that -- hearing the phone ring at 3 o'clock in the morning, when a person -- when a police officer was seriously injured or, worse yet, killed. It's very difficult when you have that split-second decision to determine exactly the situation, especially when you feel your life's in jeopardy. And, again, I understand the relevance of these hearings today, but I do want to again go on record of repeating what I've just learned a little more than an hour ago, about the quality of the education that our officers get that work here in the City of Philadelphia. Thank you.

Thank you. Thank you very much. LT. GOULD: Thank you very much. CAPTAIN WHELAN: Thank you. SERGEANT TAYLOR: Thank you very much. 107 12/13/00 PUBLIC SAFETY - RES. 000684

Sherry Archer, Joe Rogers, and "the Great Lady of Philadelphia," Sister Mary Scullion. (Witnesses come forward.)

Good morning, or good afternoon. Miss Archer, could you identify yourself for the record.

Certainly. My name is Sherry Archer, I'm the Executive Director of Community Council for Mental Health and Mental Retardation, Incorporated.

Do you have a statement?

I do. I apologize I did not know I was supposed to give you a written statement in advance. I was advised that what you would be looking from me was the experience that I've had to date with the Police Department in relationship to the agency because of the services that we provide. And so I'm able to do that for you very briefly.

Could you briefly explain that to us, please. 108 12/13/00 PUBLIC SAFETY - RES. 000684

Certainly.

And bring the microphone closer to you, please.

I'm sorry. It's the cold season, I'm afraid. As I indicated, I am the Executive Director of Community Council and have been since 1984. Community Council is a mental health center in West Philadelphia, which has been providing services since 1967. We provide mental health, mental retardation, and some substance abuse services. Currently, I'm also the President of the of the Philadelphia Coalition of Mental Centers, Mental Retardation Centers, and we are a part of the public system. As you have heard earlier, we are partially supported by the Community Behavioral Health System. The relationship that the agency has had over the past years with the Police Department has been one that has been very positive. We have to call them frequently, they respond quickly, frequently transporting our clients to the emergency room or helping just to quell a 109 12/13/00 PUBLIC SAFETY - RES. 000684 situation that exits. I believe that the relationship is good because they know when they come to the organization we've been there such a long time that the population we're serving will require intervention on their behalf. They're walking into a situation where they understand the circumstances of the client. They are also dealing with other professionals who assist in getting the kind of help that they need. It would be difficult for me to respond about how they would react if indeed they did know the circumstances of the client. I can only spook from the persons experience of Community Council and our residential sites where they are frequently called. I reiterate that we call them at a minimum once a day and sometimes two and three and four times, and they've always responded and gotten our clients to the kind of assistance that we've needed from them.

Thank you. Sister Mary or Joe? Joe -- excuse me, Mr. Rogers. We have known each other so long, 110 12/13/00 PUBLIC SAFETY - RES. 000684 but, Mr. Rogers, you said you had some details as to the Greenwald thing and how it occurred.

Well, I was fascinated to -- I was happy you asked the question. I'm sorry you didn't get an answer because we've been asking that question for several months, a good number of months. We want to know what happened and why did Mr. Greenwald, who was in the backyard, his own backyard, who had some sort of incident. It looks like it was an incident of -- related to a mental illness, and a police officer was called, I believe, by the neighbors, and we don't know what happened. We know the results; the results was, he was shot dead by the police officer. Our agency, the Mental Health Association of Southeastern Pennsylvania -- my name is Joseph Rogers, by the way, for the record, and I'm the President and CEO of this agency -- has been demanding and asking that the police give us, you know, give us some details of what happened, what actions were taking place.

Did he have a weapon in his hands?

I understand there was a 111 12/13/00 PUBLIC SAFETY - RES. 000684 knife, there was a knife involved, the reports of the neighbors and stuff -- again, we've gotten no 4 official transcripts of what the police officer said took place, and nothing -- there's been no 6 report from anyone, and I think it was unfortunate that they weren't prepared for this hearing to give that report. But what we've heard from the neighbors was that he was not threatening anyone at that point. The officer -- he was contained in his backyard, a fenced backyard. The officer could have backed off, the neighbors thought he could have backed off. As the police talked about, one of their procedures is that if you can, you back off, and you call for assistance and you contain the situation so that a person doesn't get hurt. We'd like the police to look into this. What we are asking for, Councilwoman Blackwell, Tasco, and Ortiz, is that we're -- on behalf of the Mental Health Association of Southeastern Pennsylvania -- this is not the first (unintelligible) asked for. For example, a similar tragedy occurred last January when Howard 112 12/13/00 PUBLIC SAFETY - RES. 000684 Greenwald, who also had a mental illness, was shot and killed in his own backyard by Philadelphia Police officers. These occurrences are tragedies, not only for individuals whose lives are cut short and for their families, but for police officers involved, and for the entire Police Department. Since people may develop mental illness -- and this is an important issue -- at any time, you know, I mean, if you look at the situation, people can get into crises. Most crises that the police are called out on are not necessarily people that are known to the mental health system. You can have a family dispute, tempers get out of control, people get angry, maybe a little bit of substance abuse, but not necessarily some big history of substance abuse, and you have an out-of-control situation, and the police officer is confronting a situation with an individual who's out of control. What we're asking for at the Mental Health Association is that we take this very seriously, that the fact that we've had deaths in our community, the potential for future deaths, 113 12/13/00 PUBLIC SAFETY - RES. 000684 and even in some ways -- well, not even more important, but another important issue is that we've had injuries of police officers. One of the questions that we hope in your reports to the -- in your questions to the police as you continue your study is how many officers get hurt in these situations where they're responding to a domestic dispute or where they're responding to a 302 petition, and the police officer gets hurt. We've looked around the country and what we find is that this is one of the most -- for police, this is one of the most threatening situations, that more officers get killed and get hurt in these kinds of disputes than in bank robberies, than, you know, in holdups. You know, people coming to a house where there's been a problem, somebody in crisis, and the situation gets out of control, many times it's not the individual that gets hurts, it's the police officer that gets hurt. As a result of the fact that in many of the police departments -- Houston, for example, Memphis, the fact that police are getting hurt, 114 12/13/00 PUBLIC SAFETY - RES. 000684 civilians are getting hurt, they wanted to do something about it. And one of the things that they've done in these cities is create a model of crisis intervention teams that are specialized teams. These teams are made up of police officer who are trained. In Memphis, the CIT currently consists of nearly a fifth of the uniformed patrol division, about 190 officers out of a division of approximately 1,000, and they handle approximately 7,000 calls involving people with mental disabilities annually. The CIT officers maintain citywide coverage, hours a day, 7 days a week.

14 And they're not limited to geographical boundary; 15 they respond to calls. 16 The interesting thing as you look at 17 these programs is that the CIT team, a lot of what 18 we've heard today -- and, Councilman Rizzo, I 19 think you brought up an excellent thing, that the 20 police are pretty well trained, they're not -- you 21 know, they're not unfamiliar with the issues. I 22 am -- you know, nine months of college training, 23 with a large amount of psychology and those 24 courses is excellent. And -- but what we find is that the 115 12/13/00 PUBLIC SAFETY - RES. 000684 police officer, when they're out in the field -- you heard Commissioner Estelle Richman testify about the system. I don't know if you were here, but when she testified about the system, she talked about the 302, she talked about the Crisis Intervention Team, she talked about the Crisis Intervention Center, she talked about -- she -- you know, the 302, the 303s, 304s. It's a complex system that you probably need nine months of education just on the system. And you're asking a police officer who may be very well equipped and trained to make an intervention that needs to bring together those elements. In other words, their police training, their ability to control and contain a situation, keep the person from getting hurt, keep themselves from getting hurt, keep others from getting hurt, and also understand the need to mobilize resources for that individual that are the appropriate resources. And what we're saying is with this model of a crisis intervention team, where the police, these well-trained, well-knowledged police, who are -- you know, and I've had the experience of a young police officer responding to 116 12/13/00 PUBLIC SAFETY - RES. 000684 my own mental health crisis. And, you know, it was the best mental health counseling I ever got. I mean, the person was, you know, just absolutely delightful. They came and assured me that it was going to be -- the situation -- they were getting me help, the situation was going to be dealt with, just gave me great confidence, moved me from where I was in his despair, and just the human touch that they gave me, this police officer gave me, gave me hope. So we have those kinds of officers. What these teams do is work with those officers on a volunteer basis, ask them as volunteers to join in, meet with mental health professionals, meet with people like Sister Mary, and get to really know each other and work together to work on these kind of crisis interventions. So I -- I -- it was hopeful to hear about your experience. I think with a combination of this kind of model, we could really build a kind of response to these things or we wouldn't see these incidents happen.

I think that your points are well made, and I appreciate you 117 12/13/00 PUBLIC SAFETY - RES. 000684 recognizing the points that I made. What I think was interesting also was, Councilwoman Blackwell mentioned about the volume, and I think just yesterday in the paper, another incident where a police officer was responsible for resolving a situation that could have been -- could have been a bad situation. I think the statistics really need to be looked at and how many cases Philadelphia Police officers -- and I'm not talking about the Amtrak Police, the SEPTA Police, but I guess really all police organizations that have responsibility here in Philadelphia. I think it would be interesting -- to me personally it would be to look at how many situations we've dealt with, and I think we've heard some numbers, but the hundreds and hundreds and hundreds of situations that are successful, and we would hope that we could be perfect at this task in dealing with these types of issues. And I think what we're accomplishing here today and the recommendations that you are making will get us to the point where we can be as perfect as humanly possible in dealing with these situations. 118 12/13/00 PUBLIC SAFETY - RES. 000684

I think because we have an educated, well-informed police department, we're starting many steps ahead because of your experience and much of the experience and it's a real experience of these officers are young, bright, well-educated people coming -- we're not talking about something that's going to be foreign to them, something that's going to be alienating to them. This is something that's going to be natural to them, the idea of coming together, working with people like Sister Mary, and finding a way to collectively deal with these situations that are terribly threatening situations for the officers, for the community, for the people. I want to ask that my -- if my written record could be entered because I don't need to read it all, and maybe we could get other people in here to talk.

Thank you.

Thank you.

Good morning. Mr. Rogers, do you have a way of tracking complaints that your clients make by way of the Police Department or how many or instances where 119 12/13/00 PUBLIC SAFETY - RES. 000684 you all -- where you reach out or your agency reaches out to them for help with this client base?

No, we don't specifically have that. You do? Mary does.

Okay, thank you. Miss Archer -- before you begin, Sister Mary, welcome, and we thank all of you for your patience -- do you know about how many people you service generally in a year?